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PubMed1988

Beyond career choice: the role of learning style analysis in residency training.

A recent article in this journal took an important step toward rethinking the utility of behavioural instruments designated as learning style tests (Jewett et al. 1987). The authors of that paper made much of a distinction between the terms 'learning style' and 'learning preference'. However, the results of their study do not seem to substantiate a marked difference between the function of the Rezler Learning Preference Inventory (LPI) and Kolb's Learning Style Inventory (LSI) with which it was contrasted. The most important aspect of their paper was that it rescued the concept of learning style analysis from the arena of career choice prediction at the undergraduate level and applied these ideas to doctors who had already made their specialty selections and were actively engaged in residency training. Clinical instructors in teaching institutions have, for the most part, little or no formal background in educational principles. For these individuals, an easily comprehensible model of resident-instructor psychology can be very useful on a daily basis. This article reviews the authors' experience with the LSI and describes their utilization of Kolb's Experimental Learning Model in the areas of resident counselling and residency curriculum design. The results of two recent studies are also presented in which learning style was examined as a predictor of success in residency, and teacher-resident learning style distributions were shown to exhibit parallel relationships at four different anaesthesiology residency training programmes.

Anesthesiology↗
PubMed2006

Students' views of reflective learning techniques: an efficacy study at a UK medical school.

OBJECTIVE: To describe the effects of a voluntary intervention using reflective learning techniques on students' learning. DESIGN: An interventional study with reflective learning techniques offered to medical students. SETTING: Year 3 of undergraduate medicine at Cardiff University where the curriculum is integrated with early clinical contact. PARTICIPANTS: All 232 Year 3 students were invited to participate. A total of 65 attended an introductory lecture. After the lecture 35 students agreed to take part; 15 of these subsequently dropped out (some before attending tutorial groups, others after taking part for some weeks). INTERVENTIONS: Participants kept learning journals for 2 terms and attended fortnightly, facilitated tutorial groups where they discussed their reflective journal entries. Main outcome measures were qualitative interviews and examination results. RESULTS: Interviews were carried out with 19 full participants, 4 initial participants and 7 non-participants. Participants perceived that they gained a greater ability to identify learning objectives and to integrate learning. The tutorial groups encouraged students to compare progress with their peers. Some students did not take part because they thought that the large factual content of the curriculum would make reflective learning less useful. There were no differences between the groups in examination results. CONCLUSIONS: Students among the small, self-selected group of participants were better able to identify what they needed to learn although there was no improvement in examination results. Students appear unlikely to take up voluntary reflective learning if they do not think it relates to the curriculum and assessments. Student culture exerts a potent effect on willingness to attend extra tutorial groups.

Attitude of Health Personnel↗
PubMed2006

Clinical clerkships: students can structure their own learning.

In clinical clerkships, student learning is often unstructured and diverse. Even when curriculum objectives are explicit, they are seldom used by students to guide their learning. Student-determined learning objectives may help students to structure their learning. This study aimed to assess whether students can use this method to meet widely differing learning needs within the general practice clerkship and considered the relationship of student objectives to overall curriculum objectives. Students allocated a 5-week clerkship in general practice from April 2000 to April 2001 were required to set and meet personal learning objectives within a supportive learning environment. They recorded the strategies they used, how well objectives were met and which curriculum objectives they met. Objectives were categorised using a hierarchical system. A total of 143 (85%) students recorded 1549 objectives. Four categories accounted for 1092 (70%) of objectives: Consultation Skills; Study of Diseases; Practical Procedures, and Therapeutics. Otherwise the range of objectives set was wide, encompassing all curriculum objectives. A total of 1043 objectives were rated as satisfactorily or highly satisfactorily met and 185 (12%) were not met at all. Strategies that students used to meet objectives included clinical experience with doctors but also with practice-based nurses. Students were able to use student-determined learning objectives to meet a diverse range of learning needs within the general practice clerkship. The objectives set reflected the breadth of curriculum objectives. This method allows students to address gaps in their knowledge in a clerkship where teaching is largely based on opportunistic contact.

Clinical Clerkship↗
PubMed2006

Different signal transduction cascades are activated simultaneously in the rat insular cortex and hippocampus following novel taste learning.

Novel taste learning is a robust one-trial incidental learning process, dependent on functional activity of the insular (taste) cortex. In contrast to that of the cortex, the role of the hippocampus in taste learning is controversial. We set out to identify the time courses of the activation of mitogen-associated protein kinase (MAPK), transcription factor cAMP-response element-binding protein (CREB) and Akt/PKB (protein kinase B) in the insular cortex and hippocampus of rats subsequent to novel taste learning. Following taste learning, an early response (20 min) occurred at the same time in the insular cortex and the hippocampus. However, whereas MAPK was activated specifically in the insular cortex, CREB and Akt were phosphorylated in the hippocampus but not in the cortex. In addition, the immediate early gene, CCAAT/enhancer binding protein (C/EBPbeta) was induced in both the hippocampus and the insular cortex 18 h following taste learning. The results demonstrate, for the first time, correlative activation and gene expression in the hippocampus following novel taste learning. Moreover, the results suggest that different signal transduction cascades necessary for taste learning are activated in concert in different brain structures, to enable taste learning and consolidation.

Animals↗
PubMed2006

Coordination of presynaptic and postsynaptic maturation in a zebra finch forebrain motor control nucleus during song learning.

While some species of birds retain the ability to learn new songs as adults, many species can only learn during a restricted period when young. Previous studies have suggested that one potential mechanism of such a limited learning period, an alteration in the composition of postsynaptic NMDA receptors, does not competely block further song learning. Here, we examined whether presynaptic function could play a role in the regulation of learning capacity. We first showed that the participation of NMDA receptor NR2B subunits in synaptic currents in the robust nucleus of the arcopallium (RA), a critical location for integration of signals during song learning by young birds, decreases from young birds to adults. Using release-dependent block of postsynaptic NMDA receptors by an open-channel antagonist to assay presynaptic function, we showed that transmitter release at RA synapses from both HVC and the lateral magnocellular nucleus of the anterior nidopallium systematically decreases during the period of song learning, and in adults is about half that of juveniles. Further, activation of postsynaptic NMDA receptors could induce an acute depression of transmitter release, while lack of exposure to a normal learning environment could delay the developmental reduction in transmitter release. These results suggest that regulation of learning capacity may occur in part by coordination of presynaptic and postsynaptic function.

Age Factors↗
PubMed2006

Achieving change through mutual development: supported online learning and the evolving roles of health and information professionals.

INTRODUCTION: Major changes in health care, within an information- and technology-rich age, are impacting significantly on health professionals and upon their education and training. Health information professionals-in both the National Health Service (NHS) and higher education (HE) contexts-are consequently developing their roles, skills and partnerships to meet the needs of flexible education and training. This article explores one facet of this-supported online learning and its impact on role development. METHODOLOGY: A case study approach was taken, aiming to explore how academics, health information professionals and learning technologists are developing supported online learning to explicitly address the e-literacy and information needs of health students within the context of NHS frameworks for education. This was contextualized by a literature review. RESULTS: The case study explores and discusses three dynamics--(i) The use of supported online learning tools by future health-care professionals throughout their professional training to ensure they have the appropriate e-literacy skills; (ii) the use of supported online learning by current health professionals to enable them to adapt to the changing environment; (iii) the development of the health information professional, and particularly their role within multi-disciplinary teams working with learning technologists and health professionals, to enable them to design and deliver supported online learning. CONCLUSIONS: The authors argue that, in this specific case study, health information professionals are key to the development of supported online learning. They are working successfully in collaboration and their roles are evolving to encompass learning and teaching activities in a wider context. There are consequently several lessons to be drawn in relation to professional education and role development.

Health Education↗
PubMed2006

Visuoperceptual learning in alcoholic Korsakoff syndrome.

Relative to the characteristically profound deficits of explicit memory, components of implicit memory remain largely intact in patients with alcohol-induced Korsakoff syndrome (KS). Perceptual priming occurs in KS and transfer of learning has been consistently observed on mirror reading, a perceptual reversal task. Although priming also occurs with fragmented pictures, a perceptual closure task, it is unclear whether transfer of learning can occur. This study examined visuoperceptual learning in 4 men with alcoholic KS, 9 recently detoxified alcoholic men (ALC), 21 healthy age-matched normal control men (NC), and 6 young normal control men (YNC). Subjects were tested with the Gollin Incomplete Pictures Test at initial and 1-hour and 1-day retest sessions. Both alcoholic groups (KS, ALC) were impaired in visuoperceptual ability. All subject groups showed visuoperceptual learning. The KS group showed additional learning after continued exposure to the stimuli, despite their nonmnemonic visuospatial deficits and profound explicit memory impairment for the test stimuli. Transfer of learning to similar but new stimuli was not evident in either the KS or young healthy control subjects; learning occurred only for the specific items presented. The persistence of learning beyond the life of the percept, which was independent of declarative features (such as item recall), suggests that perceptual learning and memory reflects an intact cognitive memory process in KS. This process is likely mediated by posterior cortical networks relatively unaffected in KS and that are independent of the hippocampal-diencephalic declarative memory system.

Aged↗
PubMed2004

Dental students, social policy students and learning disability: do differing attitudes exist?

OBJECTIVES: To examine the attitudes of dental students and social policy students towards learning disabilities in order to identify whether attitudinal differences exist and to suggest recommendations in the dental undergraduate curriculum commensurate with Government legislation in the United Kingdom. DESIGN: A cross-sectional survey of all undergraduate dental students at Queen's University, Belfast and all undergraduate social policy students at University of Ulster. METHOD: A convenience sample of all undergraduate dental and social policy students was obtained. The students completed a questionnaire to assess attitude towards learning disability. The data were analysed using Cronbach's alpha, Student's t-test and analysis of variance (one-way fixed effect model). The level of statistical significance was set at 5%. RESULTS: The response rate was 83% for dental students and 97% for social policy students. Dental students had significantly lower mean scores and hence less favourable attitudes to learning disability compared with social policy students. Female dental students had significantly higher mean scores and hence more favourable attitudes to learning disability compared with male students. CONCLUSIONS: The findings show that dental undergraduates compared with social policy students had less favourable attitudes towards those with learning disability. Dental students should receive training in learning disability and undergraduate programmes should be conceptualised as a spiral curriculum. It is proposed that social policy theory should be introduced into undergraduate dental curricula, that early exposure to learning disability in a community setting should be incorporated into the first undergraduate years and in later undergraduate clinical years students should treat patients with learning disability in order to promote experiential learning and reflective practice.

Analysis of Variance↗
PubMed1996

Uncoupling learning from initial recall: the relationship between speed and memory deficits in old age.

Nettelbeck & Rabbitt (1992) found that measures of speed of performance with low knowledge requirements (four-choice reaction time, inspection time and coding-substitution) accounted substantially for age-related changes among 104 persons aged from 54 to 85 years in a number of more complex cognitive measures reflecting general fluid ability. However, the numbers of words recalled from a list after either a single brief viewing of each word, or following a cumulative learning procedure across four trials, provided an exception to this general trend, leading to the conclusion that some aspects of memory may be independent of mental speed. A follow-up of 82 of the same people 18-20 months later was designed to partition performance in a similar cumulative learning procedure into an initial first recall component and a subsequent learning component. This was accomplished by fitting individual cumulative learning data with a hyperbolic power function which met the theoretical requirement of defining separate initial recall and learning parameters. These parameters were found to be independent and it was concluded that learning involved rehearsal, whereas first recall did not. The hyperbolic power function provided a good account for 92 per cent of individual cases. Analyses which combined Nettelbeck & Rabbitt's (1992) data with new measures confirmed the reliability of these authors' results. Furthermore, it was found that first recall, but not learning, was mediated by processing speed. Learning was relatively unaffected by age-related slowing in mental speed, suggesting that Nettelbeck & Rabbitt's results were the consequence of a strong rehearsal component in their memory tasks. Thus, while mental slowing is clearly one important aspect of cognitive decline during old age, it does not constitute a sufficient explanation for changes in all areas of cognitive functioning. Specifically, age-decline in rate of learning with rehearsal appeared to be independent of slowing in speed of information processing.

Aged↗
PubMed2002

Research report: learning styles of biomedical engineering students.

Examining students' learning styles can yield information useful to the design of learning activities, courses, and curricula. A variety of measures have been used to characterize learning styles, but the literature contains little information specific to biomedical engineering (BMEN) students. We, therefore, utilized Felder's Index of Learning Styles to investigate the learning style preferences of BMEN students at Tulane University. Tulane BMEN students preferred to receive information visually (preferred by 88% of the student sample) rather than verbally, focus on sensory information (55%) instead of intuitive information, process information actively (66%) instead of reflectively, and understand information globally (59%) rather than sequentially. These preferences varied between cohorts (freshman, sophomore, etc.) and a significantly higher percentage of female students preferred active and sensing learning styles. Compared to other engineering student populations, our sample of Tulane BMEN students contained the highest percentage of students preferring the global learning style. Whether this is a general trend for all BMEN students or a trait specific to Tulane engineers requires further investigation. Regardless, this study confirms the existence of a range of learning styles within biomedical engineering students, and provides motivation for instructors to consider how well their teaching style engages multiple learning styles.

Adolescent↗
PubMed2005

Do children with developmental dyslexia have an implicit learning deficit?

OBJECTIVE: The purpose of this study was to investigate the effects of specific types of tasks on the efficiency of implicit procedural learning in the presence of developmental dyslexia (DD). METHODS: Sixteen children with DD (mean (SD) age 11.6 (1.4) years) and 16 matched normal reader controls (mean age 11.4 (1.9) years) were administered two tests (the Serial Reaction Time test and the Mirror Drawing test) in which implicit knowledge was gradually acquired across multiple trials. Although both tests analyse implicit learning abilities, they tap different competencies. The Serial Reaction Time test requires the development of sequential learning and little (if any) procedural learning, whereas the Mirror Drawing test involves fast and repetitive processing of visuospatial stimuli but no acquisition of sequences. RESULTS: The children with DD were impaired on both implicit learning tasks, suggesting that the learning deficit observed in dyslexia does not depend on the material to be learned (with or without motor sequence of response action) but on the implicit nature of the learning that characterises the tasks. CONCLUSION: Individuals with DD have impaired implicit procedural learning.

Child↗
PubMed1997

The acceptability of personal learning plans in vocational training.

Personal learning plans have been advocated as a means of introducing the principles of adult learning into general practice vocational training. The aim of this study was to investigate attitudes amongst general practice trainers and registrars to the introduction and use of personal learning plans. A questionnaire was sent to general practice trainers and registrars in one vocational training scheme prior to the introduction of personal learning plans. Overall, doctors in the training scheme were positive to the idea of personal learning plans. Trainers were significantly more positive towards introducing learning plans than their registrars. Registrars in their final general practice posts were significantly more positive towards the idea of learning plans than their hospital counterparts. Doctors who had completed membership of the Royal College of General Practitioners, usually trainers or final year registrars, were also more positive in their attitude. This pilot study suggests that most trainers and registrars were positive in their attitude towards personal learning plans prior to their introduction in the Lincoln vocational training scheme. The study cautiously suggests a wider use and evaluation of personal learning plans in vocational training.

Adult↗
PubMed2006

Hand-preference training in the mouse reveals key elements of its learning and memory process and resolves the phenotypic complexity in the behaviour.

Handedness in the mouse comprises 2 different behaviours. Some strains have a conditional behaviour, in that the mice learn a direction of hand preference in response to reaching for food, whereas other strains have an innate or constitutive behaviour, and prior experience has no measurable effect on their hand preference. However, hybrids from different strains have revealed both recessive and dominant forms of constitutive hand preference. We proposed that kinetic parameters of the learning process would resolve this genetic heterogeneity as well as the phenotypic complexity in the behaviour. We conducted and report here a detailed kinetic analysis of hand-preference training in the C57BL/6J strain. It revealed elements of the fundamental process of learning and long-term memory that underlies the behaviour by documenting consolidation of memory, blocking of this consolidation by an inhibitor of protein synthesis, retention of memory, and speed of learning in response to training reaches. Furthermore, speed of learning is clearly described by 2 parameters that we call "capacity" (or maximum amount of learned preference) and "ability" (or number of training reaches to achieve half the capacity). These 2 kinetic parameters can vary independently among genetically different strains that learn a preference, and we used them to demonstrate that the respective recessive and dominant forms of constitutive hand-preference may be the consequence of a true null or loss of function and a gain of function, possibly a memory regulator, in the learning process. The quantitative measures provide a sensitive and selective method to establish the fundamental learning process underlying mouse hand preference and to demonstrate empirically how genes and contextual environment shape its phenotypic complexity.

Animals↗
PubMed1992

Purkinje cell complex and simple spike changes during a voluntary arm movement learning task in the monkey.

1. To evaluate the role of the cerebellum during improvement of voluntary motor performance over time, the discharge of 88 Purkinje cells in the intermediate and lateral cerebellum of two primates (Macaca mulatta) was investigated during a motor learning task involving visually guided arm movements. The animals were trained to move a draftsman's style manipulandum over a horizontally placed video screen. The animals were required to move a cursor from the start box to one of four target boxes by movement of the manipulandum. Errors were introduced into the movement by altering the visual feedback loop, changing the gain between the cursor movement and the hand movement. When a novel gain was presented over 100-200 movement trials, the animals adapted the movements to the new gain. The animals used a strategy of scaling the amplitude and velocity of the initial phase of the movement while keeping the time to peak velocity constant. 2. The learning paradigm consisted of an initial control phase with 35-100 trials at the gain of 1.0. The next 100-200 trials, the learning phase, were presented at one of four gains (0.6, 0.75, 1.5, 2.0). Lastly, a testing phase involved 80% of 100 trials at the learned gain and 20% of the trials randomly interspersed at the control gain of 1.0. An additional "distance control" was used in most experiments to control for the movement scaling associated with learning. In this series of movements using a gain of 1.0, the target box was placed at the distance and direction the hand would have to move in the adapted state. Two aspects of the kinematics were the same for the distance control and the movement at the learned gain: movement amplitude and time to peak velocity. There were, however, slight differences in the peak velocity attained. For gains < 1.0, the peak velocity of the learned task was 14-20% lower than the distance controls, and for gains > 1.0, it was 10-18% higher. 3. After implantation of chronic unit recording hardware, Purkinje cell simple and complex spike discharge was recorded extracellularly during the learning task. The cells were located primarily in the ipsilateral intermediate zone or nearby hemisphere of lobules V and VI. Simple and complex spike histograms, as well as averages of the hand displacement and velocity profiles, were calculated for each phase of the paradigm. To determine the time course of any changes, the learning trials were subdivided into three equal phases.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗
PubMed1998

Effects of cerebellar nuclear inactivation on the learning of a complex forelimb movement in cats.

The purpose of this study was to determine the effects of inactivating concurrently the cerebellar interposed and dentate nuclei on the capacity of cats to acquire and retain a complex, goal-directed forelimb movement. To assess the effects on acquisition, cats were required to learn to move a vertical manipulandum bar through a two-segment template with a shape approximating an inverted "L" after the injection of muscimol (saline for the control group) in the interposed and dentate cerebellar nuclei. During training periods, they were exposed progressively to more difficult templates, which were created by decreasing the angle between the two segments of the template. After determining the most difficult template the injected animals could learn within the specified time and performance constraints, the retraining phase of the experiment was initiated in which the cats were required to execute the same sequence of templates in the absence of any injection. This stage of the experiment assessed retention and determined the extent of any relearning required to execute the task at criterion levels. Next, the animals were overtrained without any injection on the most difficult template they could perform. Finally, to determine the effects of nuclear inactivation on retention after extensive retraining, their capacity to perform the same template was determined after muscimol injection in the interposed and dentate nuclei. The findings show that during the inactivation of the dentate and interposed nuclei the animals could learn to execute the more difficult templates. However, when required to execute the most difficult template learned under muscimol on the day after injections were discontinued, the cats had to "relearn" (reacquire) the movement. Finally, when the cerebellar nuclei were inactivated after the animals learned the task in the absence of any injections during the retraining phase, retention was not blocked. The data indicate that the intermediate and lateral cerebellum are not required either for learning this type of complex voluntary movement or for retaining the capacity to perform the task once it is learned. Nevertheless, when the cerebellum becomes available for executing a task learned in the absence of this structure, reacquisition of the behavior usually is necessary. It is hypothesized that the relearning observed after acquisition during muscimol inactivation reflects the tendency of the system to incorporate the cerebellum into the interactions responsible for the learning and performance of a motor sequence that is optimal for executing the task.

Animals↗
PubMed2004

Norepinephrine and dopamine as learning signals.

The present review focuses on the hypothesis that norepinephrine (NE) and dopamine (DA) act as learning signals. Both NE and DA are broadly distributed in areas concerned with the representation of the world and with the conjunction of sensory inputs and motor outputs. Both are released at times of novelty and uncertainty, providing plausible signal events for updating representations and associations. These catecholamines activate intracellular machinery postulated to serve as a memory-formation cascade. Yet, despite the plausibility of an NE and DA role in vertebrate learning and memory, most evidence that they provide a learning signal is circumstantial. The major weakness of the data available is the lack of a specific description of how the neural circuit modulated by NE or DA participates in the learning being analyzed. Identifying a conditioned stimuli (CS) representation would facilitate the identification of a learning signal role for NE or DA. Describing how the CS representation comes to relate to learned behavior, either through sensory-sensory associations, in which the CS acquires the motivational significance of reward or punishment, thus driving appropriate behavior, or through direct sensory-motor associations is necessary to identify how NE and DA participate in memory creation. As described here, evidence consistent with a direct learning signal role for NE and DA is seen in the changing of sensory circuits in odor preference learning (NE), defensive conditioning (NE), and auditory cortex remodeling in adult rats (DA). Evidence that NE and DA contribute to normal learning through unspecified mechanisms is extensive, but the details of that support role are lacking.

Animals↗
PubMed2003

Dissociating hippocampal versus basal ganglia contributions to learning and transfer.

Based on prior animal and computational models, we propose a double dissociation between the associative learning deficits observed in patients with medial temporal (hippocampal) damage versus patients with Parkinson's disease (basal ganglia dysfunction). Specifically, we expect that basal ganglia dysfunction may result in slowed learning, while individuals with hippocampal damage may learn at normal speed. However, when challenged with a transfer task where previously learned information is presented in novel recombinations, we expect that hippocampal damage will impair generalization but basal ganglia dysfunction will not. We tested this prediction in a group of healthy elderly with mild-to-moderate hippocampal atrophy, a group of patients with mild Parkinson's disease, and healthy controls, using an "acquired equivalence" associative learning task. As predicted, Parkinson's patients were slower on the initial learning but then transferred well, while the hippocampal atrophy group showed the opposite pattern: good initial learning with impaired transfer. To our knowledge, this is the first time that a single task has been used to demonstrate a double dissociation between the associative learning impairments caused by hippocampal versus basal ganglia damage/dysfunction. This finding has implications for understanding the distinct contributions of the medial temporal lobe and basal ganglia to learning and memory.

Aged↗
PubMed2001

Intrinsic stabilization of output rates by spike-based Hebbian learning.

We study analytically a model of long-term synaptic plasticity where synaptic changes are triggered by presynaptic spikes, postsynaptic spikes, and the time differences between presynaptic and postsynaptic spikes. The changes due to correlated input and output spikes are quantified by means of a learning window. We show that plasticity can lead to an intrinsic stabilization of the mean firing rate of the postsynaptic neuron. Subtractive normalization of the synaptic weights (summed over all presynaptic inputs converging on a postsynaptic neuron) follows if, in addition, the mean input rates and the mean input correlations are identical at all synapses. If the integral over the learning window is positive, firing-rate stabilization requires a non-Hebbian component, whereas such a component is not needed if the integral of the learning window is negative. A negative integral corresponds to anti-Hebbian learning in a model with slowly varying firing rates. For spike-based learning, a strict distinction between Hebbian and anti-Hebbian rules is questionable since learning is driven by correlations on the timescale of the learning window. The correlations between presynaptic and postsynaptic firing are evaluated for a piecewise-linear Poisson model and for a noisy spiking neuron model with refractoriness. While a negative integral over the learning window leads to intrinsic rate stabilization, the positive part of the learning window picks up spatial and temporal correlations in the input.

Action Potentials↗