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PubMed1999

Neuroanatomy of comorbid schizophrenia and learning disability: a controlled study.

BACKGROUND: Reasons for the higher frequency of schizophrenia in learning-disabled populations are uncertain. We investigated the neuroanatomical basis for this phenomenon by structural magnetic resonance imaging (MRI) in patients with learning disability and schizophrenia, learning-disabled patients, and patients with schizophrenia. METHODS: Age-matched and sex-matched patients with learning disability (20 cases), schizophrenia (25), and both disorders (23) underwent MRI scans of the brain. Whole brain areas and specific regions of interest were examined. 29 normal controls were also scanned. FINDINGS: The scans of the group with both disorders were closely similar to those of the schizophrenic group, in terms of both general structures and the structure of the amygdala-hippocampus. However, the amygdala-hippocampus was significantly smaller on both sides than that of normal controls (left 4.1 vs 4.5 cm3, p=0.011; right 4.2 vs 4.99 cm3, p<0.0001). The brains of learning-disabled patients were generally smaller than those of the other three groups, but the amygdalohippocampal complexes were larger. INTERPRETATION: In terms of brain structure, patients with comorbid learning disability and schizophrenia resemble patients with schizophrenia and not those with learning disability. We suggest that the higher frequency of schizophrenia in learning-disabled patients is due to a greater tendency of schizophrenic patients to develop cognitive deficits, and that within the learning-disabled population there may be individuals whose deficits result from undiagnosed schizophrenia.

Adolescent↗
PubMed2001

Effect of innate direction bias on T-maze learning in rats: implications for research.

Adult, male Wistar rats showed substantial left (22.2%) or right (52.8%) bias in spontaneous arm preference in the T-maze; this bias was consistent over 2 days of testing separated by a 30 day interval. Left and right biased rats learnt very rapidly when trained to enter the arm ipsilateral to the bias; learning was significantly poorer or did not occur in the contralateral arm. This contralateral learning difficulty was particularly evident when transfer of learning was assessed. Right-biased rats were more impaired in contralateral learning than left-biased rats. Unbiased rats (25%) also showed learning difficulties. This study has important implications for spatial tasks of learning and memory; with specific reference to the T maze, it is concluded that animals should be preselected for capacity to learn in both arms, randomization into experimental and control groups should be stratified for spontaneous arm bias, and original learning should be directed towards the contralateral arm while transfer of learning, if required, can be directed into the ipsilateral arm.

Animals↗
PubMed2001

Reconsideration of the role of the hippocampus in learned inhibition.

The purpose of this article is to reconsider the role of the hippocampus in learning tasks that require suppression or prevention of memories or responses. This type of learning has generally been referred to as inhibitory learning. Although early theories proposed that the hippocampus was important for inhibitory learning, these ideas have generally fallen out of favor. However, new developments in the conceptual understanding of inhibition along with recent experimental evidence require that we review these conceptual changes with regard to hippocampal function. We review three general categories of 'inhibition' that have been used with reference to hippocampal function: neural inhibition, inhibition of attention and associative or learned inhibition. We then consider recent developments in the field of animal learning that call for changes in the early conceptualizations of learned inhibition. Specifically, current findings suggest that different types of learning paradigms can yield conditioned inhibitors that are embedded in different associative structures, at least some of which can co-exist with conditioned excitation. Next we proceed to review a number of recent experiments from our laboratory as well as others that encouraged renewed interest in the role for the hippocampus in inhibitory learning. We then conclude by considering some of the implications of the idea that the hippocampus is involved with performance of conditioned responses based on cues that are concurrently embedded in inhibitory and excitatory associations.

Animals↗
PubMed1997

Reinforcement learning by Hebbian synapses with adaptive thresholds.

A central problem in learning theory is how the vertebrate brain processes reinforcing stimuli in order to master complex sensorimotor tasks. This problem belongs to the domain of supervised learning, in which errors in the response of a neural network serve as the basis for modification of synaptic connectivity in the network and thereby train it on a computational task. The model presented here shows how a reinforcing feedback can modify synapses in a neuronal network according to the principles of Hebbian learning. The reinforcing feedback steers synapses towards long-term potentiation or depression by critically influencing the rise in postsynaptic calcium, in accordance with findings on synaptic plasticity in mammalian brain. An important feature of the model is the dependence of modification thresholds on the previous history of reinforcing feedback processed by the network. The learning algorithm trained networks successfully on a task in which a population vector in the motor output was required to match a sensory stimulus vector presented shortly before. In another task, networks were trained to compute coordinate transformations by combining different visual inputs. The model continued to behave well when simplified units were replaced by single-compartment neurons equipped with several conductances and operating in continuous time. This novel form of reinforcement learning incorporates essential properties of Hebbian synaptic plasticity and thereby shows that supervised learning can be accomplished by a learning rule similar to those used in physiologically plausible models of unsupervised learning. The model can be crudely correlated to the anatomy and electrophysiology of the amygdala, prefrontal and cingulate cortex and has predictive implications for further experiments on synaptic plasticity and learning processes mediated by these areas.

Adaptation, Physiological↗
PubMed2001

Impaired associative learning in chronic schizophrenics and their first-degree relatives: a study of latent inhibition and the Kamin blocking effect.

The performance of chronic schizophrenic probands (n=21), their first-degree schizotypal (22) and non-schizotypal (19) relatives, and normal controls (24), was measured in two associative learning paradigms, latent inhibition and the Kamin blocking effect. These paradigms assess the effects on learning of initial exposure to other learning contingencies. The normal subjects showed latent inhibition (retarded learning of an association between a burst of white noise and a visually displayed counter increment, if the subject had first been pre-exposed to the white noise without any other consequence) and Kamin blocking (retarded learning of an association between two visual stimuli, if the conditioned stimulus was presented simultaneously with a second, already conditioned stimulus). The schizophrenic probands and both the schizotypal and non-schizotypal relatives were severely impaired in basic associative learning, performing much worse than the normal subjects in the control conditions (i.e. those lacking stimulus pre-exposure of any kind) of both the latent inhibition and the Kamin paradigms and also showed a loss of the normal latent inhibition and Kamin blocking effects. The performance of the three clinically defined groups was statistically indistinguishable. These findings contrast with previous reports of the performance of normal subjects classified as schizotypal by questionnaire, who are not impaired in basic associative learning, and are particularly fast to learn after stimulus pre-exposure. The results question the assumption that high schizotypy, as assessed by questionnaire, is like schizotypy in schizophrenic kin. The severe impairment in basic associative learning in schizophrenic patients and their kin warrants further investigation.

Aged↗
PubMed2002

Functional MRI of motor sequence acquisition: effects of learning stage and performance.

Neural networks of motor control are well understood and the motor domain therefore lends itself to the study of learning. Neuroimaging of motor learning has demonstrated fronto-parietal, subcortical, and cerebellar involvement. However, there is conflicting evidence on the specific functional contributions of individual regions and their relative importance for early and advanced stages of learning. Using functional MRI (fMRI), we examined hemodynamic effects in seven right-handed men during brief episodes of explicit learning of novel six-digit sequences (experiments 1 and 2) and during prolonged learning of an eight-digit sequence (experiment 3), all performed with the dominant hand. Brief episodes of new learning were predominantly associated with bilateral activations in premotor and supplementary motor areas, superior and inferior parietal cortices, and anterior cerebellum. In experiment 2, which included a control condition matched for complexity of motor execution, we also found unexpectedly strong activation in the bilateral inferior frontal lobes. In experiment 3, analysis of task by learning stage interactions showed greater involvement of the bilateral superior parietal lobes, the right middle frontal gyrus, and the left caudate nucleus during early stages, whereas left occipito-temporal and superior frontal cortex as well as the bilateral parahippocampal region were more activated during late learning stages. Analysis of task by performance interactions (based on each subject's response times and accuracy during each scan) showed effects in bilateral fronto-polar, right hippocampal, and anterior cerebellar regions associated with high levels of performance, as well as inverse effects in bilateral occipito-parietal regions. We conclude that superior parietal and occipital regions are most intensely involved in visually driven explicit digit sequence learning during early stages and low performance, whereas later stages of acquisition and higher levels of performance are characterized by stronger recruitment of prefrontal and mediotemporal regions.

Adult↗
PubMed2001

Précis of How children learn the meanings of words.

Normal children learn tens of thousands of words, and do so quickly and efficiently, often in highly impoverished environments. In How Children Learn the Meanings of Words, I argue that word learning is the product of certain cognitive and linguistic abilities that include the ability to acquire concepts, an appreciation of syntactic cues to meaning, and a rich understanding of the mental states of other people. These capacities are powerful, early emerging, and to some extent uniquely human, but they are not special to word learning. This proposal is an alternative to the view that word learning is the result of simple associative learning mechanisms, and it rejects as well the notion that children possess constraints, either innate or learned, that are specifically earmarked for word learning. This theory is extended to account for how children learn names for objects, substances, and abstract entities, pronouns and proper names, verbs, determiners, prepositions, and number words. Several related topics are also discussed, including naïve essentialism, children's understanding of representational art, the nature of numerical and spatial reasoning, and the role of words in the shaping of mental life.

Child Language↗
PubMed2002

The impact of response mode on implicit and explicit sequence learning.

Evidence regarding the influence of response mode on sequence learning in serial reaction time (SRT) tasks has been mixed so far. In the present study, sequence learning was investigated under two different response conditions: manual (button presses) versus verbal (pronunciation of digits). Additionally, participants were divided post hoc into subgroups differing in their degree of explicit knowledge about the sequence. Results showed an interaction between response mode and type of learning (implicit vs. explicit), with explicit learning functioning more effectively under verbal than under manual conditions, whereas implicit learning was unaffected by the variation of the response mode. Implications concerning different underlying learning mechanisms (R-R learning vs. R-S learning) are discussed. Specifically, we suggest that the high response-effect distinctiveness of the verbal responses facilitated R-R learning.

Adult↗
PubMed1984

Building spatial representations through primary and secondary learning.

The current study examined the conditions under which cognitive representations of spatial information are stored in orientation-specific ways (like pictures) versus orientation-free ways. College students learned simple paths by viewing a map of them (map condition), by walking them while blindfolded (walk condition), or by directly viewing the route from a single vantage point (look condition). Blindfolded subjects then stood on the route in various orientations and made directional judgments to other locations on the route. When subjects learned the route by indirect, symbolic means (map), judgments were quite easy when aligned with the learned map orientation and were difficult if the judgment was not aligned with the learned map orientation. However, when subjects learned the route by more direct, primary spatial learning (walk or look), there were no alignment effects. Thus, subjects treat information from primary (direct) and secondary (symbolic) spatial learning in distinct ways. Learning from a map results in a figural representation that has great precision but a specific orientation. Learning the route more directly results in a representation that is less precise but one that can be used in more flexible ways.

Cognition↗
PubMed2007

Psychometric intelligence dissociates implicit and explicit learning.

The hypothesis that performance on implicit learning tasks is unrelated to psychometric intelligence was examined in a sample of 605 German pupils. Performance in artificial grammar learning, process control, and serial learning did not correlate with various measures of intelligence when participants were given standard implicit instructions. Under an explicit rule discovery instruction, however, a significant relationship between performance on the learning tasks and intelligence appeared. This finding provides support for Reber's hypothesis that implicit learning, in contrast to explicit learning, is independent of intelligence, and confirms thereby the distinction between the 2 modes of learning. However, because there were virtually no correlations among the 3 learning tasks, the assumption of a unitary ability of implicit learning was not supported.

Adolescent↗
PubMed1997

Modular decomposition in visuomotor learning.

The principle of 'divide-and-conquer' the decomposition of a complex task into simpler subtasks each learned by a separate module, has been proposed as a computational strategy during learning. We explore the possibility that the human motor system uses such a modular decomposition strategy to learn the visuomotor map, the relationship between visual inputs and motor outputs. Using a virtual reality system, subjects were exposed to opposite prism-like visuomotor remappings-discrepancies between actual and visually perceived hand locations- for movements starting from two distinct locations. Despite this conflicting pairing between visual and motor space, subjects learned the two starting-point-dependent visuomotor mappings and the generalization of this learning to intermediate starting locations demonstrated an interpolation of the two learned maps. This interpolation was a weighted average of the two learned visuomotor mappings, with the weighting sigmoidally dependent on starting location, a prediction made by a computational model of modular learning known as the "mixture of experts". These results provide evidence that the brain may employ a modular decomposition strategy during learning.

Feedback↗
PubMed2000

Implementing contract learning in a clinical context: report on a study.

This paper reports on a study of the implementation and evaluation of learning contracts in a clinical context for a group of students who were in their third year of study in a pre-registration bachelor of nursing degree programme in Hong Kong. A learning contract was implemented as a learning tool in the students' clinical placement in mental health nursing. An action research approach was used in this study. Data were collected from questionnaires and interviews with students and clinical instructors. Results showed that students and clinical instructors generally agreed that there was an increase in students' autonomy and motivation in learning with the use of a learning contract. It also increased the sharing between students and clinical instructors. The findings of the questionnaire and interviews supported each other. However, the lack of experience in using contract learning and the limited time in the clinical areas created difficulties for both students and clinical instructors. Despite the limitations, contract learning is considered beneficial to students' learning and has the potential to be used in clinical learning.

Attitude of Health Personnel↗
PubMed2003

Primary health care provision for adults with a learning disability.

BACKGROUND: During the last decade, primary care has been designated as the main provider of health care to people with learning disabilities. Practice nurses based in primary care teams are increasingly the first points of contact with health services. They make an important contribution to promoting good health, with health screening and illness prevention work being a significant part of their role. However, little is known about their views or involvement regarding the provision of primary care for people with learning disabilities. There is therefore a need to explore the nursing perspective, from within primary care, on the current provision of care for people with a learning disability. RESEARCH AIM: To inform the learning disability service of the role of primary care in current service provision for people with learning disabilities. RESEARCH METHOD: A survey of all practice nurses currently employed by Grampian Health Board in Aberdeen was conducted in June 2001. An initial pilot study was conducted in primary care and learning disability services. Data collection took place during June and July 2001. All practice nurses working in the geographical region of Grampian were invited to participate. RESULTS: Communication barriers exist, preventing access to health screening and treatment for some people with learning disabilities. Independent living skills, for example dietary management and budgeting, require additional community support. These conditions pose complex problems for practice nurses and other members of the primary care team. CONCLUSION: This study indicates a need for closer support and partnership with the learning disability service. The factors necessary for providing health care to people with learning disabilities extend beyond the domain of primary care teams. The findings of this survey have important implications for education and support to enable carers and professionals to provide a high standard of care.

Adult↗
PubMed2000

Learning in primary care--a report.

A symposium on Learning in Primary Care was held in Cape Town, South Africa, as a pre-conference workshop to the 9th International Ottawa Conference on Medical Education. The aim of this report is to inform medical educationalists of important issues in learning in primary care and to stimulate further debate. Four international speakers gave presentations on their experiences in teaching and learning in primary care. Objective positive outcome measures include acquiring clinical skills equally well in general practice as in hospital, and improved history taking, physical examination and communication skills learning. Students regard the course as an essential requirement for learning and are appreciative of the wider aspect to learning provided by the community, giving a more holistic view of health. A SWOT analysis (strengths, weaknesses, opportunities and threats) of teaching and learning in primary care identified that learning in primary care is of a generalist nature and reality based, but is hampered by a lack of resources. The increased professionalization of teaching in primary care results in better training, cost containment, and improved quality of health care at community level. It is important to focus on turning threats into opportunities. Academic credibility needs to be established by conducting research on learning in primary care and developing the conceptual basis of primary care.

Clinical Competence↗
PubMed2002

Students' evaluation of problem-based learning.

This paper examines students' evaluations of the use of problem-based learning over a 4-week period in a 'traditional' discipline-structured nursing degree. A total of 130 Year 2 students experienced the period of problem-based learning and 100 responses to an evaluative questionnaire were received and analyzed. The paper outlines the ways in which students found their learning different -- how they perceived themselves differently as students and the relationship of the learning process to their clinical practice. The analysis of the responses found that the problem-based learning approach promoted critical thinking and problem solving; active participation in the learning process including self-direction, identification of own learning needs, teamwork, creative discussion and learning from peers; and the integration and synthesis of a variety of knowledge. The paper also concludes that this type of learning was realistic, fun and interesting for students. These findings are important for nurse educators, particularly those involved in curriculum or subject design and implementation.

Attitude of Health Personnel↗
PubMed2004

[Evaluation of a case-based computerized learning program (CASUS) for medical students during their clinical years].

BACKGROUND: Clinical undergraduate medical education at the Ludwig-Maximilians University in Munich (LMU) is supplemented by computerized case presentations. This educational strategy teaches problem-solving abilities and differential diagnostic reasoning, thus preparing the students for the management of actual clinical situations with real patients. This study describes the use of a case-based learning system and its acceptance in internal medicine from the students' perspective. Effects of age and gender were taken into account. The results are used for continually improving the system and the offered contents (cases). METHODS: By means of qualitative and quantitative methods data on the integrated concept of the students' perceived learning success, their motivation and acceptance were assessed during 1999 to 2002. Connections between the different factors were evaluated and the reasons for not using the learning program were given particular attention. Data were obtained from on-line and printed questionnaires as well as electronic protocols. Results were obtained from 380 fourth year medical students, aged between 20 and 34 years. 47% of all registered students during the academic year 2001/2 were female, but they were 58% of those completing the written questionnaire part of the study. RESULTS: The study showed a good acceptance rate and broad utilization of cases by the students. Case-based learning improved study motivation. Voluntary use of cases increased from 11% in 1999 to 31% in 2002. Male and older students were more motivated than female and younger students. In free comments the students pointed out the close link between this new learning method and real life and the chance of a useful learning experience. CONCLUSION: Case-based computerized learning programs adapted to concurrent lectures assists in the self-assisted learning. Thus the integration concept contributes to the learning process.

Adult↗
PubMed2006

[E-Learning in radiology; the practical use of the content management system ILIAS].

PURPOSE: Due to the possibility of using different kinds of visualization, e-learning has the advantage of allowing individualized learning. A check should be performed to determine whether the use of the web-based content management system ILIAS simplifies the writing and production of electronic learning modules in radiology. MATERIALS AND METHODS: Internet-based e-learning provides access to existing learning modules regardless of time and location, since fast Internet connections are readily available. RESULTS: Web Content Management Systems (WCMS) are suitable platforms for imparting radiology-related information (visual abilities like the recognition of patterns as well as interdisciplinary specialized knowledge). The open source product ILIAS is a free WCMS. It is used by many universities and is accepted by both students and lecturers. Its modular and object-oriented software architecture makes it easy to adapt and enlarge the platform. The employment of e-learning standards such as LOM and SCORM within ILIAS makes it possible to reuse contents, even if the platform has to be changed. CONCLUSION: ILIAS renders it possible to provide students with texts, images, or files of any other kind within a learning context which is defined by the lecturer. Students can check their acquired knowledge via online testing and receive direct performance feedback. The significant interest that students have shown in ILIAS proves that e-learning can be a useful addition to conventional learning methods.

Computer-Assisted Instruction↗
PubMed2006

Attitudes to concept maps as a teaching/learning activity in undergraduate health professional education: influence of preferred approach to learning.

Pre-prepared concept maps that organise knowledge in a non-linear fashion appeal to a variety of cognitive learning styles and may thus represent an educational tool that supports 'teaching to all types'. However, another central cognitive factor, learning approach, may have a bearing on student take-up of this learning resource. Student attitudes to pre-prepared concept maps introduced in Stage 2 MPharm and BSc Pharmacology lectures were therefore examined in relation to the principal learning orientations according to Duff's 30-item revised approaches to study inventory (RASI). Approximately one half of students (49.6 +/- 4.5%) reported pre-prepared concept maps to be useful to their learning (n = 121). When preferred learning approach was examined, derived from the highest RASI score per individual and excluding ties, 31.9 +/- 4.3%, 29.3 +/- 4.2% and 38.8 +/- 4.5% of students demonstrated a preference for the deep approach (DA), strategic approach (STA) and surface approach (SUA), respectively (P > 0.05, chi2 goodness-of-fit test, n = 116). There was a weak but statistically significant association between preferred learning approach identified by Duff's 30-item RASI and the self-reported usefulness of concept maps (P < 0.05, chi2 test of independence; Cramer's V = 0.235; lambda = 0.193). In contrast, gender was not significantly associated with attitude to concept maps in this student cohort. A preliminary analysis of standardised residuals based on observed and expected frequencies revealed that the greatest contributions to this significant association were: a positive influence of DA and a negative influence of STA, respectively, on attitude to concept maps. These data now indicate a contribution of the principal learning orientations vis-à-vis student attitudes to pre-prepared concept maps when employed alongside more traditional teaching/learning activities in medical and biomedical science education, and may further suggest a role for concept maps in the support of deep learning.

Attitude↗