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PubMed1999

Improved cognitive knowledge of midwives practising in the eastern Cape Province of the Republic of South Africa through the study of a self-education manual.

OBJECTIVES: To determine whether the Maternal Care manual of the Perinatal Education Programme (PEP) is effective in improving the cognitive knowledge of midwives. DESIGN: A prospective controlled trial in a region where PEP was not previously used. The midwifery knowledge of all midwives caring for pregnant women in the three towns was tested before the commencement of the study. The Maternal Care manual was then introduced to the midwives in he study town and they worked through the programme. Following the completion of the manual, all midwives were tested again with the same test. The time interval between the pre and post testing was 12 months. SETTING: Three towns on the Eastern Cape Province of South Africa. PARTICIPANTS: All Midwives caring for pregnant women in three towns. INTERVENTIONS: The Maternal Care manual of PEP was studied by the midwives in the study town. MEASUREMENTS AND FINDINGS: Changes in cognitive knowledge were tested with multiple choice questions. A significant improvement (p < 0.0001) was achieved in the study town. The mean score (maximum 70) improved by 22.4 (32%) marks, from 35.9 (51%) to 58.3 (83%). KEY CONCLUSIONS: The cognitive knowledge of midwives who completed the Maternal Care manual improved significantly. IMPLICATIONS FOR PRACTICE: These findings are to particular importance as the method by which the Maternal Care manual of PEP was applied conforms to the method suggested for the its national use.

Adult↗
PubMed1977

Programmed texts: success or failure? An analysis of medical students' opinions.

It is shown that German medical textbooks have sold about nine times better than programmed texts, even if they were written by the same author and on the same subject. To explore some of the reasons why programmed texts are being used so little in comparison with conventional textbooks, 4th and 5th year medical students of the University of Berne were asked to work through a short programmed text in clinical neurology and to answer questions related to several aspects of using programmed texts and other materials. The analysis of the 212 questionnaires returned (58%) indicates that almost all students considered such a learning experience as highly useful and stimulating, but only about 25 per cent had no reservations. It is concluded that programmed medical texts may be used so little because they require students to learn in a highly standardized way, and because students need additional learning resources which provide them with conceptual framework of and sufficient information about a given area.

Adult↗
PubMed2001

Increasing asthma knowledge and changing home environments for Latino families with asthmatic children.

We tested an asthma education program in 204 underserved Latino families with an asthmatic child. The education program consisted of one or two sessions delivered in each family's home in the targeted participant's preferred language by a bilingual, bicultural educator. We encouraged, but did not require, attendance by the child. The curriculum was culturally-tailored, and all participants received education on understanding asthma, preventing asthma attacks, and managing asthma. Outcomes included change in asthma knowledge and change in home environment asthma management procedures. Asthma knowledge increased significantly (39 to 50% correct from pre- to post-test, P < 0.001) and participants made significant changes to the child's bedroom environment (mean number of triggers decreased from 2.4 to 1.8, P < 0.001; mean number of controllers increased from 0.7 to 0.9, P < 0.001). The results support the value of asthma education and its importance in the national agenda to reduce health disparities among minorities.

Adolescent↗
PubMed2003

Incorporating patients' views and experiences of life with IBS in the development of an evidence based self-help guidebook.

To become active partners in chronic illness management, patients need relevant information which clearly explains treatment choices. This paper describes a method of producing information to feed into production of a guidebook for people with irritable bowel syndrome (IBS). Users were involved throughout the development process. Five focus groups were held involving 23 people with IBS out of 147 who responded to a newspaper article asking for help with a study of self-care in IBS. Qualitative analysis of transcripts from these meetings formed the basis of guidebook development. Patients described their experiences, coping strategies, experiences of the healthcare system, treatments and social consequences of the condition. Medical literature searches were made to find answers to identified areas of information need. The book includes direct quotes from patients describing their own experiences. Guided and practical ways of support are required for people with IBS who want to self-manage their condition.

Adaptation, Psychological↗
PubMedDate not supplied

Evaluation of a self-teaching program.

A self-teaching booklet on hypertension was evaluated in two populations: clients attending public health screening clinics and inpatients at a Veterans Administration hospital. Participants were randomized into an education or a control group. Evaluation consisted of measuring knowledge gained from the booklet immediately after reading it and retention of key concepts two weeks later. Men did better than women, and VA education participants did better than VA controls. No differences were detected between the public health education and control groups or the combined VA and public health) education and control groups. The self-teaching booklet alone did not appear to yield a measurable amount of new knowledge. Health professionals, when educating patients and evaluating programs, should consider combinations of educational methods when using self-teaching programs.

Adult↗
PubMedDate not supplied

The role of self-directed in vivo exposure in combination with cognitive therapy, relaxation training, or therapist-assisted exposure in the treatment of panic disorder with agoraphobia.

The effects of self-directed in vivo exposure in the treatment of panic disorder with agoraphobia were examined. Seventy-four chronic and severe agoraphobic subjects were randomly assigned to Cognitive Therapy plus graded exposure. Relaxation Training plus graded exposure, or therapist-assisted graded exposure alone. Treatment consisted of 16 weekly 2.5-hour sessions. All subjects received programmed practice instructions for engaging in self-directed exposure as a concomitant strategy to their primary treatment. All subjects were instructed to keep systematic behavioral diary recordings of all self-directed exposure practice. The diary data were analyzed across and within treatments and assessment phases. Statistically significant findings were obtained across all diary measure domains with powerful repeated measures effects observed across all treatments. Significant between group effects and treatment x repeated measures interactions were obtained across the diary measure domains. Multiple linear regressions of in vivo anxiety levels and, to a lesser extent, frequency of self-directed exposure practice were found to be significantly associated with global assessment of severity at posttreatment and 3-month follow-up assessments. Furthermore, depression and marital satisfaction were significantly associated with in vivo anxiety. These and other findings are discussed with regard to their conceptual and clinical implications.

Adult↗
PubMedDate not supplied

Teaching students to self-regulate their behavior: the differential effects of student-vs. teacher-delivered reinforcement.

The effects of selected student-directed learning strategies on the classroom behavior of six students with varying disabilities in general education were examined using a multiple baseline design across groups. Target behaviors included academic, study, and social skills. Results indicated increases in student target performance for all participants, however, differential effects were observed across groups and reinforcement conditions (student-vs. teacher-delivered). Additionally, anecdotal reports obtained from the cooperating teacher and students supported the study's findings. The implications of these findings are discussed.

Adolescent↗
PubMedDate not supplied

Re-evaluation of a programmed method to teach generalized identity matching to sample.

Programmed training in identity matching to sample was given to six participants who had severe mental retardation, mental age-equivalent scores of 3.0 years or less, and histories of failures in prior assessments and training attempts with standard procedures. An intermediate goal of the training program was to establish one-trial discrimination learning (OTDL), where new discriminations are acquired after a single training trial, OTDL was included because an analysis of the task requirements for identity matching suggested that it could be a prerequisite skill. One participant was eliminated from the experiment when stimulus control by prompting procedures broke down relatively early in training. Only one of the remaining participants achieved OTDL. When the program was modified to eliminate OTDL as an intermediate goal, for participants completed it and passed tests for generalized identity matching with high accuracy scores. The program was partially successful with the sixth participant in that it established highly accurate and reliable identity matching when different stimuli were displayed on every trial (nonconditional-function matching), but not when the same set of comparison stimuli was displayed on every trial (conditional-function matching). The results showed that (a) one-trial discrimination learning appears to be sufficient but not necessary for identify matching, and (b) the program successfully established identity matching in a majority of difficult-to-teach students who had well-documented failures to learn by standard teaching methods.

Adolescent↗
PubMed2000

[Personal sports training in the management of obese boys aged 12 to 16 years].

OBJECTIVE: Estimation of both physical and psychological effects of an adapted physical training on children undergoing an obesity treatment. MATERIAL AND METHODS: The survey was carried out on 36 obese boys (ages = 12-16 years) who stayed in the medical center for at least four months. Eighteen of them were trained with the SELF method (the SELF-training is global, progressive, adapted to each boy, controlled and takes place within a ten-week period with five sessions a fortnight, each session lasting 30 to 40 minutes). The parameters that were studied concerned auxology, breathing function exploration, aerobic and anaerobic capacities, muscle strength and psychomotor qualities; the subjective effects of the training were estimated with a questionnaire about life quality, and the hand test. At inclusion the results were reported to a standard kind of population. At the end of the training the results of the 18 boys that were trained were compared to those of the 18 controls. RESULTS: Compared to a standard population, the obese children' aerobic capacity is diminished for the maximum power but is identical in absolute value for the VO2 max; their anaerobic capacities, muscle strength and psychomotor capacities are lower and their psyche is affected by the disease. After a three-month training period and after comparison with the 'control' group, there can be noticed a significant improvement in the psychomotor capacities, a major tendency for the improvement of the aerobic capacities and very positive effects on the psyche. CONCLUSION: SELF-training in association with dietetics appears to be very useful in the therapeutic care of obese children. For the follow-up at home it would need to be registered within the domain of physiotherapy.

Adolescent↗
PubMed2003

RadioGraphics: a Web-based model for radiology resident self-education.

RATIONALE AND OBJECTIVES: The residency review committee (RRC) for diagnostic radiology of the Accreditation Council for Graduate Medical Education mandates core competencies including computer-aided applications in medicine. The purpose of this review was to evaluate the use of RadioGraphics' on-line CME to satisfy the RRC requirements. MATERIALS AND METHODS: Twenty radiology residents at a university training program read the same four articles in the on-line version of RadioGraphics. Before reading each article, the residents took the associated CME pre-test and, after completing the article, the CME post-test. Each resident completed a survey to evaluate the quality of the resident experience using RadioGraphics' CME on-line program after completing the four articles and tests. RESULTS: The combined mean scores of all four articles pre-test and post-test scores were 5.6 and 9.3. Significant improvement in the test scores was determined by a student t-test (P < .001). Fourteen residents agreed and one resident disagreed with the statement that the modules were time effective. Nineteen of 20 residents agreed with the statement that valuable information for future practice was gained and that they would continue to use RadioGraphics for CME in the future. All of the residents agreed with the statement that the experience satisfied the residency's requirement to teach computer skills appropriate for ongoing learning. CONCLUSION: RadioGraphics' on-line CME an effective method to teach residents skills required by the RRC.

Internship and Residency↗
PubMed2000

Maintaining the Characteristics of Effective Clinical Teachers in Computer Assisted Learning Environments.

There has been a growing trend in medical education to integrate the use of computers into the undergraduate medical curriculum. While it seems intuitively obvious that personal computers and the Internet can be useful learning tools, it is not clear that the perceived advantages of Computer Assisted Instruction (CAI) are warranted. One problem is that computers are too often used in CAI simply as presentation devices for predefined material without ample consideration paid to the pedagogical principles that have informed more conventional teaching practices. The creation of an environment that is conducive to effective learning has often been overlooked in favour of the development and use of increasingly more sophisticated technologies. The current paper represents an attempt to delineate ways in which we might better develop instructional multimedia programs by employing some of the strategies believed to characterise effective clinical teaching. To do so, this paper will briefly review the work of Irby and others in an attempt to draw attention to ways in which the characteristics identified by these researchers might be implemented for the use of CAI.

Journal Article↗
PubMed2004

A comparison of phonological awareness skills in early French immersion and English children.

This 2-year study examined the effects of early second language exposure on phonological awareness skills. Syllable, onset-rime and phoneme awareness skills of 72 anglophone children attending English or French immersion programs in primary and grade 1 were investigated. Three-way mixed ANOVAS revealed the following effects and interactions. In terms of grade effect, grade 1 students performed significantly better than primary students on phoneme and onset-rime tasks. A stimulus language effect was observed for the three levels of phonological awareness. All children performed better on English tasks than on French ones. Interaction effects of stimulus language by program were revealed for phoneme as well as syllable tasks. Posthoc analyses revealed that French students performed better on English phoneme and syllable tasks than on French, while English students performed better than French immersion students on French syllable tasks. Correlational analyses revealed significant relationships between reading and phoneme and onset-rime phonological awareness tasks regardless of program of instruction (English, French immersion) or language of reading test (English, French). Syllable awareness was only significantly correlated with the French non-word reading task for the French immersion students.

Age Factors↗
PubMed2006

[Bibliotherapy as a self-help program for parents of children with externalizing problem behavior].

OBJECTIVES: Externalizing problem behaviour is one of the most frequent and most stable behavioural disorders of childhood and adolescence. The development of applicable alternatives to expensive and restrictedly available treatments becomes increasingly necessary. This pilot study tested bibliotherapy in the form of a manual-assisted self-help programme under minimum contact conditions for parents of children with externalizing problem behaviour. METHOD: A total of 21 children, aged 6 to 15 years and diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) and/or an Oppositional Defiant Disorder, were recruited from an outpatient population. The bibliotherapy lasted 10 weeks and consisted of working through a self-help book for parents (Wackelpeter und Trotzkopf). Initial clinical interviews and pre- and post-treatment evaluations were included, as well as short weekly telephone contacts (approx. 20 min. per contact) with the parents. RESULTS: The children's externalizing behaviour was significantly reduced during the intervention. The parenting skills were strengthened. The satisfaction of the parents with the program was high. Fewer than 20% of the parents indicated a need for an additional intensive behavioural outpatient treatment at the end of the intervention. CONCLUSIONS: Bibliotherapy may be an applicable and effective treatment alternative for children with disruptive behaviour disorders, at least in families with the resources necessary for this kind of intervention. The results have to be replicated within randomized control group trials.

Adolescent↗