The effects of an interactive software application on the self-assessment ability of dental students

A randomised controlled trial was designed to test an Internet-based interactive application as a stand-alone support for the development of self-assessment skills among second-year dental students at the Faculty of Dentistry, University of Malmö, Sweden. Fifty-two students were randomised into an experimental (n = 26) and a control group (n = 26). Both groups went through four identical learning cases in elementary clinical Periodontology during a period of 1 month. The experimental group received the cases with the interactive software, while the control group received them through a static web page. After the end of the learning phase, both groups were assessed blindly by two assessors during the interactive examination methodology. There was a moderate agreement between the two assessors, but both failed to find any significant differences between the two groups with regard to self-assessment skills and overall performance of the students. Students positively received the Internet support, but several attitude differences were observed between the two groups during the study. Time on task and competence with computers were positively correlated to assessment results for both groups. On the basis of these findings, it remains unclear if computer-based applications with automated feedback can constitute an effective remedial support for the improvement of self-assessment skills of students. In addition, for such applications to be successfully accepted, two factors are critical: students must have a clear perception of the benefits deriving from the use of the software and the use of the software should be integrated in the curriculum, replacing some of the existing workload.

Training reading fluency in dysfluent readers with high reading accuracy: word specific effects but low transfer to untrained words

The outcome of a training study attempting to increase German speaking poor readers' reading fluency is reported. The aim of the training was to help children establish orthographic representations for a limited set of training words as well as for high-frequency onset clusters. A sample of 20 dysfluent readers (8-11 years) received a computerized training of repeated reading of a limited set of 32 training words over a period of up to 25 days. Each day training words were presented up to six times with a special emphasis on the onset segment. Post-tests were carried out one and five weeks after the last training day. A considerable decrease in reading times could be achieved for the trained words that remained stable for both post-tests, however, even for the limited set of training words a remarkable amount of repetitions did not lead to age adequate word recognition speed. Generalization to untrained words starting with a trained onset cluster (transfer words) was statistically reliable but small.

Morphological awareness in developmental dyslexia

This study examines morphological awareness in developmental dyslexia. While the poor phonological awareness of dyslexic children has been related to their difficulty in handling the alphabetical principle, less is known about their morphological awareness, which also plays an important part in reading development. The aim of this study was to analyze in more detail the implications of the phonological impairments of dyslexics in dealing with larger units of language such as morphemes. First, the performance of dyslexic children in a series of morphological tasks was compared with the performance of children matched on reading-level and chronological age. In all the tasks, the dyslexic group performed below the chronological age control group, suggesting that morphological awareness cannot be developed entirely independently of reading experience and/or phonological skills. Comparisons with the reading-age control group indicated that, while the dyslexic children were poorer in the morphemic segmentation tasks, they performed normally for their reading level in the sentence completion tasks. Furthermore, they produced more derived words in the production task. This suggests that phonological impairments prevent the explicit segmentation of affixes while allowing the development of productive morphological knowledge. A second study compared dyslexic subgroups defined by their degree of phonological impairment. Our results suggest that dyslexics develop a certain type of morphological knowledge which they use as a compensatory reading strategy.

The stroop color-word interference test as an indicator of ADHD in poor readers

The performance on the Stroop Color-Word Interference Test of 36 boys with Attention Deficit Hyperactivity Disorder (ADHD) was compared with performances of a matched control sample. The control group outperformed their counterparts on the control and interference conditions of the Stroop test, suggesting ADHD-specific executive and reading deficits. When individuals with both ADHD and reading disorders were excluded from the analysis, the authors found a significant difference between the ADHD group and the control group on the color-word test, indicating that poor reading skills may produce false negatives on the Stroop test. However, fast and slow readers with ADHD did not perform differently from each other on the color-word test. The authors postulated the existence of two different causes of reading problems: phonological deficits and attentional deficits.

Treatment of cognitive dysfunction in psychiatric disorders

Most people with severe and persistent psychiatric disorders have significant cognitive deficits. Both schizophrenia and affective disorders with psychosis are associated with problems in attention, memory, and executive functioning. These deficits are predictive of lower work status, impairments in social skills, and poorer response to psychosocial skills training. Cognitive impairment makes it difficult for individuals to benefit from focused skills interventions that they are offered. This article describes behavioral treatments available to address cognitive dysfunction in individuals with psychiatric disorders. The evidence for efficacy is reviewed and recommendations are made for ways to begin addressing cognitive impairment in mainstream psychiatric practice.

Interventions Aimed at Improving Reading Success: An Evidence-Based Approach

There is a consensus among researchers about the critical elements for effective reading instruction. These elements are the integration of explicit instruction in the alphabetic principle, reading for meaning, and opportunity to learn. These critical elements are present in classroom instruction that prevents reading difficulties as well as effective small-group and one-on-one interventions. Research on effective classroom instruction and reading interventions is described, and the case is argued that the most effective intervention is provided early--in kindergarten through 2nd grade--rather than after 3rd grade, and allows for sufficient intensity, duration, and supportiveness that no child is left behind. Policy implications for changes in (a) the way learning disabilities are identified and (b) the content of professional development of teachers are discussed.

The auditory basis of language impairments: temporal processing versus processing efficiency hypotheses

Claims have been made that language-impaired children have deficits processing rapidly presented or brief sensory information. These claims, known as the 'temporal processing hypothesis', are supported by demonstrations that language-impaired children have excess backward masking (BM). One explanation for these results is that BM is developmentally delayed in these children. However, little was known about how BM normally develops. Recently, we assessed BM in normally developing 6- and 8-year-old children and adults. Results showed that BM thresholds continue to improve over a comparatively protracted period (>10 years old). We also analysed reported deficits in BM in language-impaired and younger children, in terms of a model of temporal resolution. This analysis suggests that poor processing efficiency, rather than deficits in temporal resolution, can account for these results. This 'processing efficiency hypothesis' was recently tested in our laboratory. This experiment measured BM as a function of delays between the tone and the noise in children and adults. Results supported the processing efficiency hypothesis, and suggested that reduced processing efficiency alone could account for differences between adults and children. These findings provide a new perspective on the mechanisms underlying communication disorders, and imply that remediation strategies should be directed towards improving processing efficiency, not temporal resolution.

The Development of Argument Skills

This work sought to obtain experimental evidence to corroborate cross-sectional patterns of development in argument skills and to evaluate the effectiveness of an intervention designed to foster development of these skills in academically at-risk 13- to 14-year-olds. Students participated in 16 sessions of a collaborative, goal-based activity providing dense exercise of argumentive thinking. One condition included peer dialogues; another did not. The former was the more effective, although both groups progressed. Participants showed increased frequency of usage of powerful argumentive discourse strategies, such as counterargument, and decreased frequency of less effective strategies. Quality of individual arguments (for or against a claim) also improved, supporting the existence of a close relation between these two kinds of argument skills.

The impact of cognitive remediation on psychiatric symptoms of schizophrenia

OBJECTIVE

The relationship between psychopathology and cognitive functioning in schizophrenia is of interest, both for an understanding of the nature of the disease, and for comprehensive treatment planning. The aim of this study was to investigate how psychiatric symptoms affect, and are affected by, cognitive remediation.

METHOD

Fifty-four psychiatric inpatients received either cognitive remediation exercises (remediation group) or no cognitive intervention (control group). The subjects' scores on tests of cognition and on the Positive and Negative Symptoms Scale (PANSS) were measured before, after the 10 session treatment, and again 4 weeks post treatment.

RESULTS

Only the remediation group showed significant and persistent improvement on all three PANSS Subscales as well as on the Positive Symptoms and Depression Factors. There were no significant between-group differences on any PANSS pre/posttreatment change scores. Baseline measures of psychopathology did not correlate meaningfully with amount of change made on cognitive measures after rehabilitation.

CONCLUSIONS

A brief 10-session course of cognitive remediation is sufficient to benefit cognition and has some positive effects on psychopathology as measured by the PANSS, but does not add significantly to the effects of standard psychiatric treatment on psychopathology. Furthermore, psychiatric symptom profile is not predictive of the degree to which cognitive symptoms respond to cognitive remediation. The differential impact of cognitive remediation on cognition and psychopathology may imply that psychopathology and cognitive functioning follow fairly independent treatment courses.

Predictors of NCLEX-RN Success in a Baccalaureate Nursing Program as a Foundation for Remediation

This study evaluated students' demographic and nursing program variables and standardized test scores to determine whether significant differences existed between students who successfully completed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and those who were unsuccessful. In addition, the predictive accuracy of two standardized examinations, the Mosby AssessTest and the Health Education Systems, Incorporated (HESI) Exit Examination were compared. Two cohorts of graduating senior nursing students were studied (1999 cohort N = 121; 2000 cohort N = 103). Demographic and nursing program variables were obtained from student records. The Undergraduate Studies Committee provided standardized test scores (Mosby AssessTest in 1999; HESI Exit Examination in 2000). Only two program variables were consistently associated with success on the NCLEX-RN--final course grade for a didactic, senior-level medical-surgical nursing course and cumulative program grade point average. Scores on both standardized tests were significantly different in students who were successful on the NCLEX-RN and those who were not. The HESI Exit Examination demonstrated greater sensitivity, specificity, positive and negative predictive value, and test efficiency, compared with the Mosby AssessTest. Use of program variables and students' standardized test scores may allow faculty to identify students at risk for failing the NCLEX-RN and to provide structured remediation so these students may be successful on the licensing examination and begin their nursing careers.

Predictors of NCLEX-RN Success of Associate Degree Nursing Graduates

The authors discuss a study that examined the relationship of prenursing admission variables to success on the National Council Licensure Examination-Registered Nurse (NCLEX-RN). The sample included 325 associate degree graduates from 1997-2001. Statistical analyses revealed that grade point average at admission is the strongest predictor of success. Course grades on psychology and natural sciences are also positively related to success. The results will help nurse educators to select applicants with greatest potential for success and identify "at risk" students early.

Are the effects of cognitive remediation therapy (CRT) durable? Results from an exploratory trial in schizophrenia

BACKGROUND

This paper investigates the durability of the effects of cognitive remediation therapy (CRT). In a randomised control trial, CRT was compared with a control therapy (intensive occupational therapy activities), matched for length of therapist contact. The main three cognitive outcomes, (i) number of categories achieved on the Wisconsin Card Sort Test, (ii) age-scaled score on the Digit Span subtest of the WAIS-R, and (iii) mean number of moves on the Tower of London test, were chosen because they are known to be problematic in schizophrenia. In addition, a wide variety of other outcomes (symptoms, social functioning, self-esteem and cognition) were assessed. At the end of treatment, CRT conferred a benefit to people with schizophrenia in cognition and self-esteem [Schizophr. Bull. 25 (1999) 291]. This study investigates these outcomes 6 months after the therapies were withdrawn.

METHOD

Participants were assessed at baseline, posttreatment and 6-month follow-up (n=17 for the CRT group; n=16 for the control therapy group). In addition to the functioning measures, data on use of services and cost of therapy were collected.

RESULTS

The effects of CRT on cognition were still apparent at follow-up, particularly in the memory domain. When these cognitive improvements reached a criterion threshold, there were also improvements in social behaviour and symptoms. The gains made in self-esteem disappeared following the withdrawal of therapy. The economic analysis showed overall reductions in the care packages of both patient groups but there was a significant increase in day-care costs for patients who have received CRT. This additional use of day care may confer further advantages to the CRT group, such as improved social functioning and quality of life.

CONCLUSIONS

The overall results of this first trial of a novel CRT approach have produced encouraging results which merit further investigation.

The Better Beginnings, Better Futures Project: a universal, comprehensive, community-based prevention approach for primary school children and their families

Evaluated a community-based, universal project designed to prevent emotional and behavioral problems and promote general development in young children, while also attempting to improve family and neighborhood characteristics, to link effectively with existing services, and to involve local residents in project development and implementation. The research involved 554 4-year-old children and their families living in 3 disadvantaged neighborhoods in Ontario, Canada. Longitudinal analyses of changes over the first 5 years of project operation indicated significant improvements in children's and parents' social-emotional functioning and physical health, parenting behaviors, and neighborhood and school characteristics. The findings from the Better Beginnings, Better Futures Project are encouraging and provide unique evidence for the extent to which a universal, comprehensive, community-based prevention strategy can promote the longer term development of young children, their families, and their neighborhoods.

Naming difficulties in children with dyslexia: application of the tip-of-the-tongue paradigm

The present study used the tip-of-the-tongue (TOT) experimental paradigm in a picture naming task to explore the source of the naming deficits of children with dyslexia. Compared with a control group of typically developing readers, the children with dyslexia showed fewer correct responses and spontaneous recalls, more don't know (DK) and TOT responses, and less accurate feeling of knowing (FOK) judgments. When they failed to retrieve a target word, the children with dyslexia did not differ from the control group in the partial semantic information they provided, but they gave less valid and more invalid partial phonological information. The children with dyslexia also benefited less from phonological cues. The phonologically related responses of the children with dyslexia elicited during the administration of the TOT procedure were related to their performance on a phonological awareness test. These findings suggest that the naming problems of children with dyslexia arise because of their difficulty in accessing the phonological word forms after the corresponding abstract lexical representation has been successfully accessed. The results are discussed in relation to the claim that two-stage models of naming can be profitably used in the early identification and treatment of reading disabilities.

[Practice in spelling in remedial groups--results of an evaluation study in secondary education]

OBJECTIVE

This study aims to evaluate in a school-based tutoring setting a training program for spelling (Marburger Rechtschreibtraining) that has proven effective in non-school settings. A spelling training program already in use at the school serves as the control condition.

METHODS

A total of 37 second- and third-graders rated by their teachers as spelling disabled participated in the study. In addition to their regular lessons, the children received two added lessons in small tutoring groups each week.

RESULTS

The skills of the children in the tutoring program had increased significantly two years later regardless of the method used. This effect was confirmed both by tests as well as by teachers' and parental reports. However, the children's emotional attitudes towards school failed to change significantly. The control group that had received no tutoring improved as well.

CONCLUSIONS

Tutoring spelling disabled children in small groups is an effective method for improving their reading and spelling abilities. Nevertheless, the fact that the skills of children in the control group without any tutoring also improved raises a number of questions. The choice of method in our study had no effect on the outcome. Our study was unable to systematically evaluate a number of potential influences (such as sample selection); these should be investigated further.

Improving the ability of elementary school-age children to identify emotion in facial expression

The authors evaluated an intervention program developed to remediate children's deficits in reading emotions in facial expressions. Thirty children from 2 elementary schools in suburban Atlanta participated in 6 30-min sessions over 4 weeks in which they were taught to discriminate, identify, express, and apply facial expression cues. The ability to read emotion in facial expressions significantly improved for the intervention group compared with the control group. Improvement on identifying facial expressions was associated with increased feelings of lower social anxiety and higher self-worth for girls. Boys' self-concept was negatively related to improvement. On the basis of the results, the authors suggested that structured interventions like the present one could be used to improve students' nonverbal processing abilities within public school settings, but with some cautions regarding the impact of new learning for boys.

The New York State postgraduate fifth-year dental residency as a new licensure path: concerns for public protection

The recently enacted law creating an alternative pathway to dental licensure in New York state is benchmark legislation. Along with the positive effects of dental education that may ensue, the author has serious concerns that the strongly emotional and political debate occurring during the bill's consideration obscured important considerations for public safety and the erosion of standards for licensure in New York. In addition, this pathway has potential to negatively affect freedom of movement and licensure by credentials for practice in other jurisdictions.

A novel idea for an organized hospital/school program for children with malignancies: issues in implementation

The aim of this pilot study was to provide children with cancer hospitalized at the Department of Pediatric Hematology-Oncology of the University Hospital of Heraklion, Crete, with an educational program based on the SIOP guidelines. This would help them to follow the school program during the days of absence due to treatment. The realization of the initial idea generated difficulties that had to be overcome to achieve the goals and caused several changes in the program. Children refused to attend a regular class in the appropriately designed playroom of the Department but were very keen on room-to-room teaching that was adjusted to their needs and wills. This method of teaching was very well accepted by the children. A workup was done with parents and health professionals to convince them of the necessity of such a program and persuade them to participate in the procedure by encouraging children to attend it. Several steps have been taken and others have been planned for the teachers to receive education concerning the special needs of these children after dismissal from the hospital as well as that of their siblings to help in the reentry procedure. An adjustment to the personal needs of the hospitalized children with cancer, especially in areas where the psychosocial resources are minor, has proved very helpful and effective for the reentry of these children to regular school and social life.

Dental licensure reaches a crossroads: the rationale and method for reform

Following calls to reform the dental licensure process, New York state has adopted an innovative approach that is responsive to the perceived shortcomings of the existing Part III examination. This solution eliminates the legally, psychometrically, and ethically compromised system, replacing it with a requirement that both ensures the public's protection and gives the new dentist additional experience in contemporary procedures in a supervised setting. The best preparation for the practice of dentistry is the practice of dentistry--something so profound and simple; yet it constitutes the core of New York's revolutionary reform. And the best way to measure that preparation for initial licensure is with the continual evaluation that occurs during the postdoctoral experience. New York is the first state to allow applicants for licensure to substitute the successful completion of a postdoctoral clinical program--a test in itself--for the traditional clinical licensure examination. The primary objective of this reform is to improve the quality of dentistry by elevating the standards for licensure. New York's expanded training protocol parallels that of medicine and reflects developments in the science and practice of the dental profession. The introduction of this new professional training model renders the clinical examination requirement obsolete. The fundamental principle of New York's new system is that a clinical examination is unnecessary to verify that a dentist is competent to enter practice following postdoctoral clinical training consisting of ongoing patient care, continuous oversight, mentoring, and evaluation.

Life in school: narratives of resiliency among Vietnamese-Canadian youths

This qualitative study examined eleven Vietnamese refugees' self-reported experiences of discrimination in urban schools in British Columbia, Canada. The students reported experiencing or witnessing racial conflict, harassment, and unfair treatment. The boys reported experiencing more racism than did the girls. However, most of the students felt confident that racism would not present insurmountable obstacles for them in the future.

A controlled trial of cognitive remediation in schizophrenia

A randomized, controlled trial of a 3-month cognitive remediation program was examined for its efficacy at ameliorating deficits in social and emotion perception in 42 hospitalized patients with schizophrenia. Generalization of training effects to attention, memory, and executive functioning was also examined. The program included an eclectic mix of self-instruction, memory enhancement, inductive reasoning, and compensatory training procedures, while the control condition included participation in a leisure group that was matched to the experimental group for staff involvement time. Patient care management, including type and dose of antipsychotic medication, remained constant throughout the study period. The results indicated that the cognitive training program improved emotion perception, with some evidence of generalization to measures of executive functioning; other areas of neurocognitive functioning were largely unaffected. While cognitive training programs may improve targeted areas of neurocognitive processing, broad generalization effects to domains outside those targeted for intervention are not likely concomitants.

An evaluation of clinical mock boards and their influence on the success rate on qualifying boards

An important responsibility of each dental school to its graduating dental students is exposure to and evaluation on a mock board that simulates one or more of the examinations given by its respective regional testing agencies. An introduction to the procedures and environment that will be encountered on a qualifying examination will hopefully increase a student's chance for success on such a test. The purpose of this study was to test the relationship of the various attributes or variables of mock boards given by dental schools in the United States and Puerto Rico with results obtained on the regional or state qualifying board(s) related to timing, structure, method of evaluation, graduation, and remediation. A twenty-item questionnaire was mailed to key clinical or curricular deans at fifty-four accredited dental schools. Ninety-three percent of schools completed and returned the questionnaire. In the sample of respondents, the percentages of schools participating in the various qualifying exams were: CRDTS = 22 percent; NERB = 42 percent; SRTA = 20 percent; WREB = 28 percent; Independents = 24 percent, with a reported overall passing rate (greater than or equal to 70) of 58 percent. The median time between the mock board and the qualifying board was 7.5 weeks. Results indicated that no single aspect of a mock board had a statistically significant effect on the outcome of qualifying examinations, resulting in a failure to reject the null hypothesis. Such findings may indicate that schools should focus their efforts on reassessing the restrictions and requirements imposed upon their students related to their mock board. A future study could include surveying recent graduates for their opinions of the value of their mock board experiences.