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The self-management of skills by persons with mental retardation.

The transition of persons with mental retardation to less restrictive environments is often hindered by difficulties in managing their own behavior in the absence of external controls. This observation has led to an upsurge of interest in the advantages of teaching self-management skills to persons with mental retardation. This article reviews evidence about the effects of self-management training on the acquisition, maintenance, and generalization of skills. The analyses show that self-management training has been useful in promoting the maintenance of behavior change first effected by external control procedures, but that a dearth of evidence and a number of methodological problems preclude convincing conclusions about its value in promoting generalization. The empirical evidence also suggests that the effectiveness of these procedures may depend upon the cognitive and linguistic abilities of the persons receiving self-management training. Finally, the design of much of the empirical research does not enable the disentanglement of the specific effects of self-management training from those arising from the concurrent application of external control procedures. Carefully controlled componential studies of the effects of self-management training and external control procedures are sorely needed.

Activities of Daily Living↗

Reducing the risk of cancers. A distance learning resource for cancer prevention throughout the EC.

This paper describes an initiative in distance learning for cancer prevention for health care professionals throughout the EC. 'Reducing the Risk of Cancers' is a multi-media integrated study pack of learning materials prepared by the Open University (U.K.) with funding from the Europe Against Cancer programme of the European Commission. The teaching materials aim to enhance cancer prevention and health promotion skills and competencies amongst health care professionals at local level. In the paper the background to the pack is considered, the production process is described and the aims and philosophy of the teaching materials are outlined. The content of the pack is described and usage, dissemination and evaluation for health professionals throughout Europe are discussed.

European Union↗

How do residents manage personal finances?

BACKGROUND: We examined three research questions: How do residents' debts and savings compare to the general public? How do surgical residents' financial choices compare to other residents? How may institutions help residents' personal financial decisions? METHODS: The Survey of Consumer Finances was modified and piloted tested to elicit financial information. The instrument was completed by 612 residents at 8 programs. RESULTS: Only 60% of residents budgeted expenses, and 25% and 10% maintained cash balances <611 dollars and unpaid credit card balances >10,000 dollars, respectively. Compared with controls, residents held greater median ratios of debt to household income (2.46 vs. 1.06, P <0.0001), fewer assets to income (0.64 vs. 2.28, P <0.0001), less net wealth to income -1.43 vs. 0.90, P <0.0001), and lower retirement savings balance to household income (0.01 vs. 0.12, P <0.0001). Surgery residents were the least financially conservative group. Mean annual resident contributions to retirement accounts were $1532 higher at institutions with versus without retirement plans (P <0.01). CONCLUSIONS: Resident debts are higher and savings lower than the general public. This behavior is most common among surgery residents. Residents save more for retirement when they are eligible for tax-deferred retirement plans. Graduate medical programs should instruct residents on financial management.

Adult↗

Teaching evidence-based public health to public health practitioners.

PURPOSE: The purpose of the Evidence Based Public Health (EBPH) course is to train public health practitioners to utilize a comprehensive approach for program development and evaluation from a scientific perspective, including principles of scientific reasoning and systematic uses of data and information systems. The increasing technical sophistication of public health problems and approaches emphasizes the importance for an evidence-based approach to developing policy and interventions. METHODS: The training methods used highlight the linkages between data systems and program/policy initiatives. Participants learn to access and interpret existing data systems and methods of using data to impact specific policies or decision-makers. From 1992 through mid-2004 the EBPH course was offered a total of 20 times, in Missouri, nationally and internationally. In March 2002, the workshop was taped and pressed into a 16-CD set that public health workers can use as a self-teaching program in their own homes and offices. The group exercises from the classroom workshop have been adapted into individual self-guided applications, and background readings are included in the set. RESULTS: Compiled results of course evaluations indicate average ratings for course satisfaction ranging from 8.50 to 10.00 on a scale from 1 to 10. Satisfaction with course instructors ranged between 8.00 and 10.00 on the same scale. Ninety-four to ninety-six per cent of participants reported that they would use the course in their day-to-day work. Qualitative comments from participants at the time of and after the course show that the material is applied in a variety of ways. CONCLUSIONS: The EBPH course is making a valuable contribution in strengthening the application of scientific methods to public health practice. To expand the offerings of this training, a train-the-trainer component for the EBPH course is being developed, to be made available in 2005.

Curriculum↗

Teaching diagnostic decision making: student evaluation of a diagnosis unit.

OBJECTIVE: The aim of the study was to report on chiropractic students' response to a changed learning format and on how the students fared in their final examination. METHODS: A 13-week year-4 diagnosis unit that used a structured self-study guide, a prescribed text, classroom clinical simulations, WebCT-based learning, and self-assessment tasks is described. After 4 weeks of study, a questionnaire was used to assess the chiropractic students' interim evaluation of the various learning experiences. The ability of students to meet unit objectives was assessed in a summative examination. RESULTS: Most students found the learning experiences acceptable and believed the learning options provided would enable them to meet the unit aims. This belief was confirmed both on formative and summative student assessment. CONCLUSION: Diverse classroom teaching/learning opportunities combined with self-learning guides provide a viable alternative to more traditional teaching formats for introducing chiropractic students to differential diagnosis.

Chiropractic↗

Self direction in a problem based learning program.

Baccalaureate nursing graduates must enter their professional careers with the understanding and ability to engage in continuing learning in order to ensure competence in professional practice. The graduate's ability to be self directed in learning is an important indication of the ability to pursue continuing learning as a practitioner. It has been surmised that Problem Based Learning nursing programs facilitate the development of abilities to become self directed in learning. A quasi-experimental design using the self directed learning readiness scale (SDLRS) was used to examine the self directed learning (SDL) of students at the beginning and end of one year in a problem based learning (PBL) program. In order to complement the quantitative data, year end focus group interviews were held with students to explore their experiences with SDL. Students demonstrated average self directed learning readiness scores at the beginning and end of the first year in the PBL program. Although students did not demonstrate any increase in SDLRS at the end of one year in a PBL program, they were able to describe themselves as having developed many of the documented characteristics associated with self directed learners.

Adolescent↗

Modularisation - flexible or restrictive professional education.

In response to the Dearing Report [Higher education in the learning society. Report of the National Committee of Inquiry into Higher Education. HMSO, London, 1997] modularising courses has been a major activity in schools of nursing and midwifery. This should make it easier for students to transfer between courses, university to university with credit for academic achievement. In respect of mental health nursing students the effect upon opportunities for personal and professional development is considered. The paper questions whether a modular framework of learning experiences meaningfully prepares students for their future as mental health nurses. The continued use of an adapted [A. Beattie, in: P. Allan, M. Jolley (Eds.), The Curriculum in Nurse Education, Croom Helm, London, 1997] fourfold curriculum model in working with students is contrasted with the process of modularisation. Challenges that have arisen for mental health nursing lecturers to continue with this are discussed.

Curriculum↗

Nursing students' and tutors' perceptions of learning and teaching in a clinical skills centre.

BACKGROUND: Clinical Skills Centres (CSCs) can ease pressure on clinical skills development and assessment in clinical areas; and provide added value through experiential learning and self-directed learning. Published accounts of innovation in CSCs tell part of this story but little is known about perceptions of students and tutors engaged in day-to-day learning and teaching in CSCs. METHODS: This paper reports one strand of a mixed methods study in a busy multidisciplinary CSC: a questionnaire survey of nursing students' and tutors' perceptions of learning and teaching. Questionnaires focused on items representing commonly espoused views regarding the use and usefulness of CSCs. RESULTS: Students and tutors enjoyed learning and teaching within the CSC, although senior students were slightly muted in their views. All groups valued the supported practice of clinical and communication skills. The CSC was seen as a learning environment that supports the linking of theory and practice. There was some ambivalence, particularly among tutors, about the relationship between performance in the CSC and in clinical areas. DISCUSSION: The favoured pedagogic approach of expert demonstration by tutors followed by supported practice necessitates attention to tutors' training. The muted responses of senior students may signal a need to review the CSC learning experiences offered to them.

Attitude of Health Personnel↗

Self-directed learning: implications and limitations for undergraduate nursing education.

Self-directed learning (SDL) is an educational concept that has received increasing attention in recent years, particularly in the context of higher education. Whilst the benefits of SDL have been espoused by a number of adult education theorists (Brookfield, S., 1986. Understanding and Facilitating Adult Learning. Jossey-Bass, San Francisco; Houle, C., 1984. Patterns of Learning: New Perspectives on Life-Span Education. Jossey-Bass, San Francisco; Knowles, M., 1998. The Adult Leaner: A Neglected Species, fifth ed., Gulf, Houston; Tough, A., 1979. The Adults Learning Project: A Fresh Approach to Theory and Practice in Adult Learning. Ontario Institute for Studies in Education, Toronto), its introduction into curricula has not always been successful (Nolan, J., Nolan, M., 1997a. Self-directed and student-centred learning in nurse education: 1. British Journal of Nursing 6 (1), 51-55; Nolan, J., Nolan, M., 1997b. Self-directed and student-centred learning in nurse education: 2. British Journal of Nursing 6 (2), 103-107; Slevin, O., Lavery, M., 1991. Self-directed learning and student supervision. Nurse Education Today 11, 368-377). The indiscriminate application of SDL principles and poorly prepared teachers and/or students has at times meant that the introduction of SDL has been resented rather than welcomed (Iwasiw, C., 1987. The role of the teacher in self-directed learning. Nurse Education Today 7, 222-227; Turunen, H., Taskinen, H., Voutilainen, U., Tossavainen, K., Sinkkonen, S., 1997. Nursing and social work students' initial orientation towards their studies. Nurse Education Today 17, 67-71). This paper clarifies and explores these issues by: (a) examining the origins of SDL; (b) discussing the relevance of self-directed learning to Knowles' theory of adult learning and contemporary educational practices such as enquiry based learning and problem based learning; and (c) highlighting the implications and limitations of SDL with regard to adult education in general, and undergraduate nursing education in particular.

Education, Nursing↗

The effect of two types of memory training on subjective and objective memory performance in healthy individuals aged 55 years and older: a randomized controlled trial.

The objective of the study was to examine the effectiveness of two types of memory training (collective and individual), compared to control (waiting list), on memory performance. Participants were 139 community-dwelling older individuals recruited through media advertisements asking for people with subjective memory complaints to participate in a study. Data were collected at baseline, and at 1 week and 4 months after the intervention. Training efficacy was assessed using measures of subjective and objective memory performance. After the intervention, participants in the collective training group reported more stability in memory functioning and had fewer feelings of anxiety and stress about memory functioning. In addition, positive effects were found on objective memory functioning. Compared with the other two groups, the collective training group participants had an improved recall of a previously learned word list. Compared to controls, participants in the individual training group reported fewer feelings of anxiety and stress in relation to memory functioning.

Affect↗

[Electronic learning: interactive learning in medicine or Socrates in electronic guise].

E-learning has been widely used for training in different fields. More recently, it was introduced during medical studies or for continuous medical education. The Canadian Universities are pioneers in e-learning creating special departments dedicated to pedagogy. Developing countries like Brazil or Central Europe have made some pilot experiments, which were successful. Several electronic companies have given a free access to the programmes and sites. The use of electronic media leads to an adaptation of teaching methods making them more interactive.

CD-I↗

Cost effectiveness of changing health professionals' behavior: training dental hygienists in brief interventions for smokeless tobacco cessation.

OBJECTIVE: Disseminating effective interventions to health care professionals is a critical step in ensuring that patients receive needed advice and materials. This cost effectiveness analysis compared two methods of disseminating an effective protocol for smokeless tobacco cessation intervention. METHOD: Interested dental hygienists (N = 1051) were recruited in 20 Western and Midwestern U.S. communities and randomized by community to receive workshop training, self-study with mailed materials, and delayed self-study training, in 1996-98. Hygienists were surveyed about their smokeless tobacco-related activities with patients at baseline and post-intervention. Data on intervention costs were collected, and incremental costs per unit of behavior change were calculated. RESULTS: Self-study was more cost effective than workshop training under a wide range of assumptions: change in group versus individual behavior, hygienists' time and travel costs included or excluded, and hygienist wage rates at the national median or substantially lower. However, workshops may be as cost effective in producing behavior change among hygienists earning wages substantially higher than the national median. CONCLUSION: Self-study may be a more cost effective method than workshops to achieve behavior change among motivated health professionals.

Cost-Benefit Analysis↗

Perioperative education--perspective from the think tank.

The AORN Foundation and the National League for Nursing (NLN) cosponsored a think tank to address concerns about the shortage of perioperative nurses and the lack of perioperative experiences in many nursing programs. Think tank participants identified traditional and existing paradigms in nursing education and envisioned a new self-directed learning model for nursing school curricula, in which students would be held accountable for their own learning and faculty members would serve as learning facilitators. AORN and NLN members agreed to collaborate to spread the message that the perioperative arena is an excellent place for nursing students to develop the knowledge, skills, and values they will need to practice effectively in today's complex health care institutions.

Curriculum↗

A didactic and experiential approach to nursing education.

Postanesthesia care unit PACU nursing practice requires in-depth understanding of sedation, analgesia, and anesthetic agents and techniques; physiological and psychological responses to anesthesia; and the vulnerability of patients subjected to anesthesia. This article reviews a pilot program designed to broaden the knowledge base of PACU RNs. Twenty-three RNs completed a self-paced module on anesthetic agents before participating in an anesthesia and surgical observation phase. The nurses then completed evaluations. Results of the evaluations indicated that this approach to learning was rewarding for the participants.

Adult↗

Using adult learning principles for perioperative orientation programs.

New graduates and experienced nurses who choose perioperative nursing need comprehensive training because of the specialized nature of the OR. A comprehensive orientation program results in quality care for patients. This article presents four adult learning principles and strategies for orienting new nurses to the OR. The strategies suggest a framework for developing, organizing, or revising a perioperative nursing orientation program. The program gives nurses who are interested in perioperative nursing the opportunity to enter this specialty.

Adult↗

Take charge. Getting the technical information you need.

Remember that manufacturers want your business. Manufacturers want to provide what you need to use a product correctly. They believe they are meeting that need. It is up to you to decide your future. Your frustration and anxiety with new technology will never change unless you take charge and communicate your needs to manufacturers. Tell them what you like about a product and, just as important, how to make it better. Tell them what resources are needed to minimize the anxiety and frustration associated with using their products.

Disposable Equipment↗