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PubMed2006

FITSK: online local learning with generic fuzzy input Takagi-Sugeno-Kang fuzzy framework for nonlinear system estimation.

Existing Takagi-Sugeno-Kang (TSK) fuzzy models proposed in the literature attempt to optimize the global learning accuracy as well as to maintain the interpretability of the local models. Most of the proposed methods suffer from the use of offline learning algorithms to globally optimize this multi-criteria problem. Despite the ability to reach an optimal solution in terms of accuracy and interpretability, these offline methods are not suitably applicable to learning in adaptive or incremental systems. Furthermore, most of the learning methods in TSK-model are susceptible to the limitation of the curse-of-dimensionality. This paper attempts to study the criteria in the design of TSK-models. They are: 1) the interpretability of the local model; 2) the global accuracy; and 3) the system dimensionality issues. A generic framework is proposed to handle the different scenarios in this design problem. The framework is termed the generic fuzzy input Takagi-Sugeno-Kang fuzzy framework (FITSK). The FITSK framework is extensible to both the zero-order and the first-order FITSK models. A zero-order FITSK model is suitable for the learning of adaptive system, and the bias-variance of the system can be easily controlled through the degree of localization. On the other hand, a first-order FITSK model is able to achieve higher learning accuracy for nonlinear system estimation. A localized version of recursive least-squares algorithm is proposed for the parameter tuning of the first-order FITSK model. The local recursive least-squares is able to achieve a balance between interpretability and learning accuracy of a system, and possesses greater immunity to the curse-of-dimensionality. The learning algorithms for the FITSK models are online, and are readily applicable to adaptive system with fast convergence speed. Finally, a proposed guideline is discussed to handle the model selection of different FITSK models to tackle the multi-criteria design problem of applying the TSK-model. Extensive simulations were conducted using the proposed FITSK models and their learning algorithms; their performances are encouraging when benchmarked against other popular fuzzy systems.

Algorithms↗
PubMed2006

Development and testing of a Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students.

Aim. This paper reports the development and testing of the psychometric properties of the Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students. Background. The quality of the clinical learning environment is an essential factor in determining the quality of nursing students' clinical experience. It is also well-recognized that the clinical setting can be a source of stress and anxiety for students. To design an optimal clinical learning environment for students, instruments based on the cognitive and socio-emotional aspects of the learning process are necessary. Method. The hypothetical construct of the clinical learning environment was derived from a comprehensive review of the literature, including experiential learning theory and the epistemology of practice. Developing the instrument involved the collection of items through semi-structured interviews, assessing content validity and determining the scaling. After a pilot study, the instrument was tested with 312 undergraduate students and 157 preceptors between September and December 2004. The factor structure was determined by exploratory factor analysis. Results. Exploratory factor analysis produced a five-factor solution that was similar to the hypothetical model. Cronbach's alpha internal consistency reliability coefficients ranged from 0.65 to 0.77 across the five factors. Three-week test-retest reliability coefficients ranged from 0.59 to 0.74. Criterion-related validity and construct validity were estimated by the correlation between the Clinical Learning Environment Diagnostic Inventory and appropriate other instruments and a set of comparison data obtained from the students and preceptors. Conclusion. The findings yielded acceptable estimates of reliability and validity of the Clinical Learning Environment Diagnostic Inventory. Therefore, this instrument is considered useful for assessing learning environments in clinical settings.

Adult↗
PubMed2005

Effective e-learning for health professionals and students--barriers and their solutions. A systematic review of the literature--findings from the HeXL project.

INTRODUCTION: In 2003/4 the Information Management Research Institute, Northumbria University, conducted a research project to identify the barriers to e-learning for health professionals and students. The project also established possible ways to overcome these barriers. The North of England Workforce Development Confederation funded the project. METHODOLOGY: The project comprised a systematic review of the literature on barriers to and solutions/critical success factors for e-learning in the health field. Fifty-seven references were suitable for analysis. This review was supplemented by a questionnaire survey of learners and an interview study of learning providers to ensure that data identified from the literature were grounded in reality. RESULTS: The main barriers are: requirement for change; costs; poorly designed packages; inadequate technology; lack of skills; need for a component of face-to-face teaching; time intensive nature of e-learning; computer anxiety. A range of solutions can solve these barriers. The main solutions are: standardization; strategies; funding; integration of e-learning into the curriculum; blended teaching; user friendly packages; access to technology; skills training; support; employers paying e-learning costs; dedicated work time for e-learning. CONCLUSIONS: The authors argue that librarians can play an important role in e-learning: providing support and support materials; teaching information skills; managing and providing access to online information resources; producing their own e-learning packages; assisting in the development of other packages.

Communication Barriers↗
PubMed2001

Active learning of respiratory physiology improves performance on respiratory physiology examinations.

Active involvement in the learning process has been suggested to enhance creative thinking, judgement, interpretation, and problem-solving skills. Therefore, educators are encouraged to create an active-learning environment by incorporating active-learning strategies into the class. However, there is very little documentation of the effectiveness of active-learning strategies. Furthermore, faculty are often reluctant to incorporate new strategies without documentation of the effectiveness of these strategies. To address this concern, we compared the performance of two individual classes on an identical respiratory physiology examination. One class was taught respiratory physiology using active-learning strategies. The other class was taught respiratory physiology using the traditional lecture format. The results document that students who learned using active-learning strategies did significantly better (P < 0.05) on the respiratory physiology examination than students who learned by the traditional lecture format (61 +/- 2.2 vs. 86 +/- 1.0). Thus, by actively involving students in the learning process, academic performance is enhanced.

Education, Graduate↗
PubMed2002

Dissociation of habit-learning in Parkinson's and cerebellar disease.

Damage to the medial-temporal region is known to result in declarative (explicit) memory deficits but nondeclarative (implicit) memory is largely unaffected by such lesions. Earlier studies have shown that some forms of implicit learning depend on cerebellar circuits but remain preserved following affections of the basal ganglia circuits. It is unknown which forms of implicit learning persist in patients with cerebellar pathology but are affected after basal ganglia lesions. Therefore, we determined if a test sensitive for habit-learning (probabilistic classification task) resulted in normal values for patients with cerebellar disease but resulted in affected results in patients with Parkinson's disease (PD). To this end, 23 patients with PD, 16 patients with familial or idiopathic cerebellar degeneration (CD), and 20 controls were tested for habit-learning. There was no impairment of patients with CD for the early learning period but there was abnormal learning in the PD group. For a later learning period, the patients with the PD showed improved performance. We conclude that the probabilistic learning task is an implicit, nonmotor learning task which is sensitive for basal ganglia pathology but remains unaffected in the case of cerebellar pathology. Such a test may be of special interest for the detection and possible neurobehavioral treatment of cognitive and motor deficits.

Aged↗
PubMed1998

Constructive incremental learning from only local information

We introduce a constructive, incremental learning system for regression problems that models data by means of spatially localized linear models. In contrast to other approaches, the size and shape of the receptive field of each locally linear model, as well as the parameters of the locally linear model itself, are learned independently, that is, without the need for competition or any other kind of communication. Independent learning is accomplished by incrementally minimizing a weighted local cross-validation error. As a result, we obtain a learning system that can allocate resources as needed while dealing with the bias-variance dilemma in a principled way. The spatial localization of the linear models increases robustness toward negative interference. Our learning system can be interpreted as a nonparametric adaptive bandwidth smoother, as a mixture of experts where the experts are trained in isolation, and as a learning system that profits from combining independent expert knowledge on the same problem. This article illustrates the potential learning capabilities of purely local learning and offers an interesting and powerful approach to learning with receptive fields.

Journal Article↗
PubMed2005

Memory and selective learning in children with spina bifida-myelomeningocele and shunted hydrocephalus: a preliminary study.

BACKGROUND: Selective learning is the ability to select items of relevance from among less important items. Limited evidence exists regarding the efficiency with which children with spina bifida-myelomeningocele and shunted hydrocephalus (SB/SH) are able to learn information. This report describes initial data related to components of learning and metacognitive skills in children with SB/SH. METHODS: Twenty six children with SB/SH and 26 controls (age: 7-16 y) with average intelligence, and monolingual English-speaking backgrounds participated in the study. Exclusion criteria for the SB/SH group were: prior history of shunt infection, history of seizure or shunt malfunction within the previous three months, prior diagnoses of attention disorders and/or clinical depression. Children were presented lists of words with equal exemplars each of two distinct semantic categories (e.g. fruits, animals), and told to make as high a score as possible by learning the words. The value of the words was designated by category membership (e.g. animals = low value; fruits = high value). The total number of words learned across three learning trials was used to determine memory span. Selective learning efficiency (SLE) was computed as the efficiency with which items of greater value were selectively learned across three trials. RESULTS: Children with SB/SH did worse than controls on memory span (P < 0.05). Although SLE was not significantly different between groups, when asked what strategy was used in the selective learning tasks, 65% of the SB/SH children said they tried to remember all words (inefficient strategy). In contrast, 85% of controls said they tried to remember the higher value words--the more efficient strategy. CONCLUSION: Success in school is often dependent on the ability to recall important facts selectively and ignore less important information. Children with SB/SH in our study had a poor memory span and were unable to monitor and report an efficient and workable metacognitive strategy required to remember a list of words. Preliminary findings may begin to explain our previous clinical and research findings wherein children with SB/SH often focus on extraneous details, but demonstrate difficulty remembering the main gist of a story/event.

Journal Article↗
PubMedDate not supplied

Investigating users' requirements: computer-based anatomy learning modules for multiple user test beds.

OBJECTIVE: User data and information about anatomy education were used to guide development of a learning environment that is efficient and effective. The research question focused on how to design instructional software suitable for the educational goals of different groups of users of the Visible Human data set. The ultimate goal of the study was to provide options for students and teachers to use different anatomy learning modules corresponding to key topics, for course work and professional training. DESIGN: The research used both qualitative and quantitative methods. It was driven by the belief that good instructional design must address learning context information and pedagogic content information. The data collection emphasized measurement of users' perspectives, experience, and demands in anatomy learning. MEASUREMENT: Users' requirements elicited from 12 focus groups were combined and rated by 11 researchers. Collective data were sorted and analyzed by use of multidimensional scaling and cluster analysis. RESULTS: A set of functions and features in high demand across all groups of users was suggested by the results. However, several subgroups of users shared distinct demands. The design of the learning modules will encompass both unified core components and user-specific applications. The design templates will allow sufficient flexibility for dynamic insertion of different learning applications for different users. CONCLUSION: This study describes how users' requirements, associated with users' learning experiences, were systematically collected and analyzed and then transformed into guidelines informing the iterative design of multiple learning modules. Information about learning challenges and processes was gathered to define essential anatomy teaching strategies. A prototype instrument to design and polish the Visible Human user interface system is currently being developed using ideas and feedback from users.

Anatomy↗
PubMed1992

Learning contracts in clinical education: evaluation by clinical supervisors.

Learning contracts can be a useful learning and evaluation tool within a clinical setting provided the supervisor shifts their role from one of imparter of knowledge to facilitator of learning. If this role is not assumed then a student's learning experience could be jeopardized. In a survey of 59 student supervisors, 90 percent found the learning contract to be a useful evaluation and teaching tool. Advantages stated suggest that the learning contract promotes negotiation between student and teacher, provides a flexible learning environment and promotes acquisition of self-directed learning skills. These qualities are important in a clinical or practical setting where learning experiences cannot be standardized.

Canada↗
PubMed1998

Learning with technology: use of case-based physical and computer simulations in professional education.

This presentation will clarify contemporary ideas on the role of technology in education and how it can be employed to improve student learning experiences and outcomes. The paper will emphasise RMIT's role in providing quality education that is relevant to today's world and professional practice. It will examine a specific collaborative (RMIT & ACU), interdisciplinary project 'Pregnancy Simulator: Developing and Enhancing Student Learning of Assessment Skills'. This project consist of a physical pregnancy model connected to a multi-media computer-assisted learning package for the purpose of enhancing student learning of abdominal assessment skills. Our paper outlines an innovative technology-based teaching project and includes current educational issues or problems encountered in professional education, steps already taken to address these difficulties and how this project intends to facilitate learning. It identifies expected learning outcomes for midwives, nurses and medical students, and examines pedagogical principles applied to technological applications designed to provide guided discovery for allowing students to build confidence and competence in professional education. The case-based physical and computer simulations contextualise learning to assist transfer of learning to real world situations. This paper will also discuss how technology-based projects can be evaluated and integrated into university curricula to enhance student learning.

Computer Simulation↗
PubMedDate not supplied

Improving patient care through work-based learning.

AIM: To record post-registration community nurses' perceptions of the impact of work-based learning on the quality of patient care. METHOD: Ten nurses were interviewed. Each interviewee, who had successfully completed work-based learning programmes, was asked to describe their impact on the quality of patient care. FINDINGS: The participants valued work-based learning. Four themes emerged where work-based learning contributed to improving the quality of care: increased health promotion, increased access to services, increased patient choice and reduced risk of infection. The relevance of studies and distance learning materials were perceived to be the main aspects that influenced changes in practice. CONCLUSION: The study provides insight into how work-based learning helped staff develop practice. It highlights that time for learning and mentoring are paramount for changes in practice to occur through work-based learning. Further studies are required to establish the best structure and style of distance learning materials needed to meet the needs of post-registration community nurses.

Attitude of Health Personnel↗
PubMedDate not supplied

The effects of Internet-based distance learning in nursing.

Distance learning has been the turning point for accomplishing adult learning in nursing education. This article describes the development and structure of a distance-learning course used to deliver distance learning to the RN-BSN students at Yonsei University, College of Nursing. The distance-learning course was developed cooperatively by content experts, instructional designers, programmers, and graphic designers. The course content, "Growth and Development", was a computerized instructional course delivered using the Internet. The programming system was developed on the Web Server and Oracle DB through the Internet. The characteristics of adult learners--graduates with 3-year RN diplomas and working full-time--were considered during development of the course. For a semester, the students studied the growth and development of a person from infancy to adolescence through interactions with peers and instructors using alternative menus on the Internet. The course was evaluated from feedback of 60 RN-BSN students on their satisfaction with this distance-learning course in regard to instructional design, the arrangement and structure of instruction, and the function and feasibility of the courseware. When the self-reported questionnaire with 25 open questions was evaluated, students' general responses were relatively positive. Insufficient feedback from the professor, excessive time and difficulties experienced when connecting to the Internet, and the lack of information about related websites were primary negative responses. For an effective use of the distance-learning system, improvements to the telecommunications network service are crucial. School authorities should support the professors who are interested in developing distance-learning courses so that the courses can be developed with technical perspectives. More distance-learning courses applying interactive multimedia instructional design through the Internet should be developed with the improved network service in the future.

Computer Systems↗
PubMed2001

Acceptance of rules generated by machine learning among medical experts.

OBJECTIVES: The aim was to evaluate the potential for monotonicity constraints to bias machine learning systems to learn rules that were both accurate and meaningful. METHODS: Two data sets, taken from problems as diverse as screening for dementia and assessing the risk of mental retardation, were collected and a rule learning system, with and without monotonicity constraints, was run on each. The rules were shown to experts, who were asked how willing they would be to use such rules in practice. The accuracy of the rules was also evaluated. RESULTS: Rules learned with monotonicity constraints were at least as accurate as rules learned without such constraints. Experts were, on average, more willing to use the rules learned with the monotonicity constraints. CONCLUSIONS: The analysis of medical databases has the potential of improving patient outcomes and/or lowering the cost of health care delivery. Various techniques, from statistics, pattern recognition, machine learning, and neural networks, have been proposed to "mine" this data by uncovering patterns that may be used to guide decision making. This study suggests cognitive factors make learned models coherent and, therefore, credible to experts. One factor that influences the acceptance of learned models is consistency with existing medical knowledge.

Alzheimer Disease↗
PubMed2002

A Model for Learning Over Time: The Big Picture.

OBJECTIVE: To present a method of describing the concept of "learning over time" with respect to its implementation into an athletic training education program curriculum. BACKGROUND: The formal process of learning over time has recently been introduced as a required way for athletic training educational competencies and clinical proficiencies to be delivered and mastered. Learning over time incorporates the documented cognitive, psychomotor, and affective skills associated with the acquisition, progression, and reflection of information. This method of academic preparation represents a move away from a quantitative-based learning module toward a proficiency-based mastery of learning. Little research or documentation can be found demonstrating either the specificity of this concept or suggestions for its application. DESCRIPTION: We present a model for learning over time that encompasses multiple indicators for assessment in a successive format. Based on a continuum approach, cognitive, psychomotor, and affective characteristics are assessed at different levels in classroom and clinical environments. Clinical proficiencies are a common set of entry-level skills that need to be integrated into the athletic training educational domains. Objective documentation is presented, including the skill breakdown of a task and a matrix to identify a timeline of competency and proficiency delivery. CLINICAL ADVANTAGES: The advantages of learning over time pertain to the integration of cognitive knowledge into clinical skill acquisition. Given the fact that learning over time has been implemented as a required concept for athletic training education programs, this model may serve to assist those program faculty who have not yet developed, or are in the process of developing, a method of administering this approach to learning.

Journal Article↗
PubMed2004

Effects of Clinical Field-Experience Setting on Athletic Training Students' Perceived Percentage of Time Spent on Active Learning.

OBJECTIVE: Our purpose was to examine undergraduate athletic training students' perceptions of how time is utilized during clinical field experiences while enrolled in Commission on Accreditation of Allied Health Education Program (CAAHEP)-accredited athletic training programs and to determine the effects of clinical field-experience length and setting, academic standing, sex, clinical assignment, and National Collegiate Athletic Association level on active learning. DESIGN AND SETTING: Using the Athletic Training-Clinical Education Time Framework (AT-CETF) and Utilizing Time and Active Learning Survey, subjects completed a 1-day, self-reported observation of how their clinical field-experience time was utilized. SUBJECTS: Program directors at 131 CAAHEP-accredited athletic training programs were sent survey packages. Seventy-two (41%) male subjects and 105 (59%) female subjects from 25 institutions completed the survey packages. Eight of the 10 National Athletic Trainers' Association districts were represented in the study. MEASUREMENTS: The AT-CETF is a behavioral time-profiling framework that measures athletic training students' perceptions of utilization of clinical field-experience time based on the performance domains associated with the 1999 National Athletic Trainers' Association Board of Certification Role Delineation Study and literature related to time and learning. RESULTS: Subjects spent 51% of their clinical field-experience time engaged in active learning, 9% in managerial activities, 17% in unengaged activities, and 23% in waiting activities. Multiple 2 x 2 x 3 analyses of variance (length of clinical field experience x academic standing x clinical field-experience setting) revealed a significant difference between the levels of clinical field-experience setting and the dependent variables of perceived percentage of active learning time and waiting time. A 2 x 3 analysis of variance (sex x clinical assignment) revealed a significant difference between the levels of clinical assignment and the dependent variable of perceived percentage of active learning time. CONCLUSIONS: The type of clinical field-experience setting and clinical assignment affects the amount of time spent in active learning. Therefore, profiling students' use of time may allow educators to identify clinical field-experience settings that maximize active learning time, expose students to their own unique learning situations, and offer students access to clinical field-experience settings aligned with their professional goals.

Journal Article↗
PubMed2003

Brain-compatible learning: principles and applications in athletic training.

OBJECTIVE: To discuss the principles of brain-compatible learning research and provide insights into how this research may be applied in athletic training education to benefit the profession. BACKGROUND: In the past decade, new brain-imaging techniques have allowed us to observe the brain while it is learning. The field of neuroscience has produced a body of empirical data that provides a new understanding of how we learn. This body of data has implications in education, although the direct study of these implications is in its infancy. DESCRIPTION: An overview of how the brain learns at a cellular level is provided, followed by a discussion of the principles of brain-compatible learning. Applications of these principles and implications for the field of athletic training education are also offered. APPLICATION: Many educational-reform fads have garnered attention in the past. Brain-compatible learning will not likely be one of those, as its origin is in neuroscience, not education. Brain-compatible learning is not an educational-reform movement. It does not prescribe how to run your classroom or offer specific techniques to use. Rather, it provides empirical data about how the brain learns and suggests guidelines to be considered while preparing lessons for your students. These guidelines may be incorporated into every educational setting, with every type of curriculum and every age group. The field of athletic training lends itself well to many of the basic principles of brain-compatible learning.

Journal Article↗
PubMed2006

e-Learning in nursing education--Challenges and opportunities.

Quick changes on the field of informational communication technologies forces educational and other institutions to think about different ways of teaching and learning in both formal and informal environments. It addition it is well known that due to fast advancement of science and technology the knowledge gained in schools is getting out-of-date rapidly, so life long learning is becoming an essential alternative. As a consequence we are facing a rapid development and use of new educational approaches such as e-learning, simulations, virtual reality, etc. They brought a revolution to learning and instruction. But in general the empirical results of e-learning studies are somewhat disappointing. They cannot prove the superiority of e-learning processes over traditional learning in general, neither in specific areas like nursing. In our international study we proved that e-Learning can have many benefits and that it can enhance learning experience in nursing education, but it has to be provided in correct manner.

Education, Distance↗
PubMed1999

Impaired learning and memory and altered hippocampal neurodevelopment resulting from interleukin-2 gene deletion.

Interleukin-2 (IL-2), the protypical T cell growth factor and immunoregulatory cytokine produced by lymphocytes, has been implicated as a brain neurotrophic factor and neuromodulator. The consequences of the absence of endogenous IL-2 on brain development and function were unknown. Brain IL-2 receptors are enriched in the hippocampal formation, an area critical for the acquisition and consolidation of spatial learning and memory. Thus, we tested the hypothesis that mice lacking IL-2 would exhibit alterations in hippocampal-dependent learning and neurodevelopment. Compared with C57BL/6-IL-2+/+ wild-type mice, we observed that C57BL/6-IL-2-/- gene knockout mice had markedly impaired spatial learning and memory in the Morris water maze. No significant deficits in parameters of learning and memory performance were found in severe combined immunodeficient (SCID) mice (C57BL/6scid), however, suggesting that the impaired spatial learning and memory exhibited by IL-2 knockout mice is not attributable to generalized immunodeficiency resulting from the absence of endogenous IL-2. Examination of other domains of behavioral performance showed that the IL-2 knockout and wildtype mice did not differ in measures of fearfulness or locomotor activity in an elevated plus maze, or in reflexive startle responses to auditory stimuli--although prepulse inhibition of acoustic startle (PPI) was increased significantly in IL-2 knockout mice. The spatial learning and memory impairment in IL-2 knockout mice was accompanied by reductions in hippocampal infrapyramidal mossy neuronal fiber length, a factor shown previously to correlate positively with spatial learning ability. These findings indicate that, in addition to being a pivotal cytokine in immune regulation, IL-2 may play a role in the development and regulation of brain neurons involved in spatial learning and memory.

Acoustic Stimulation↗