"Studying cognitive reappraisal as an antidote to the effect of negative emotions on medical residents' learning: a randomized experiment"

BACKGROUND

Medical trainees often encounter situations that trigger emotional reactions which may hinder learning. Evidence of this effect on medical trainees is scarce and whether it could be counteracted is unclear. This study investigated the effect of negative emotions on medical residents' learning and whether cognitive reappraisal counteracts it.

METHODS

Ninety-nine medical residents participated in a three-phase experiment consisting of: (1) watching a video, either a neutral or an emotion-induction version, the latter either followed by cognitive reappraisal or not (2) learning: all participants studied the same medical text; study-time and cognitive engagement were measured; (3) test: a recall-test measured learning. Data was analysed using Chi-square test and one-way ANOVA.

RESULTS

Study time significantly varied between conditions (p = 0.002). The two emotional conditions spent similar time, both significantly less than the neutral condition. The difference in test scores failed to reach significance level (p = 0.053). While the emotional conditions performed similarly, their scores tended to be lower than those of the neutral condition.

CONCLUSION

Negative emotions can adversely affect medical residents' learning. The effect of emotions was not counteracted by cognitive reappraisal, which has been successfully employed to regulate emotions in other domains. Further research to examine emotion regulation strategies appropriate for medical education is much needed.

Team-based learning (TBL): Each phase matters! An empirical study to explore the importance of each phase of TBL

CONTEXT

In Team Based Learning (TBL), it is, based on theory, assumed that knowledge development in each phase contributes to the subsequent phase and to learning performance. However, there is no empirical evidence for this assumption.

AIM

In order to find support for the relation between TBL and the underlying theory, we determined to what extent each phase of TBL is associated with the knowledge development in the next phase and with the total learning performance.

METHODS

We measured the scientific concepts recalled by 56 second-year undergraduate medical students before TBL, after each of the three phases and after TBL. We used multivariate regression analysis to determine the statistical association between the phases as well as the total learning performance.

RESULTS

Results showed that in each phase, students produced new concepts in addition to those previously recalled. Regression models showed statistically significant explained variance ranging from 0.19 to 0.26, between the three phases and the total learning performance.

DISCUSSION

Each phase of the TBL is significantly associated with knowledge development in the subsequent phase and with the total learning performance, and therefore matters. This study contributes to the scientific underpinning of TBL and offers leads to more elaborate research and interventions to improve TBL.

Discovering Entrepreneurship Competencies through Problem-Based Learning in Higher Education Students

The increase in student engagement in the learning process has driven educators to use more dynamic pedagogical methodologies. Several studies have shown evidence of increased interest in learning when real-world problems are integrated into the learning environment. This paper presents the competencies developed by higher education students through application of the problem-based learning (PBL) methodology in higher education courses. The research begins with the identification of a set of competencies developed by higher education students in other studies developed and reported in the last five years and includes them in a survey to analyze the level of development of those competencies when problem-based learning is applied in university courses. To identify the competencies developed by applying the problem-based learning methodology, the research employed a document analysis and a survey of the students that participated in the experimental application. The research questions “What are the competencies developed by students in problem-based learning?” and “Are the competencies identified by the students sufficiently learned in universities?” guided the study. The competencies found by the students were identified through a questionnaire given as an online survey to 76 students. The key outcome of the research is the identification in the bachelor courses of the competencies perceived as essential by students participating in the application of PBL in terms of their advancement.

The Science of Workplace Instruction: Learning and Development Applied to Work

Learning is the engagement in mental processes resulting in the acquisition and retention of knowledge, skills, and/or affect over time and applied when needed. Building on this definition, we integrate the science of training and the science of learning to propose a new science of workplace instruction, linking the design of instructional events to instructional outcomes such as transfer and job performance through the mediating effects of learner events and learning outcomes. We propose three foundational elements: the learner, instructional principles, and training delivery (methods and media). Understanding and applying instructional principles are the primary methods for enhancing training effectiveness; thus, we detail 15 empirically supported principles. We then discuss the erroneous pursuit of aptitude-by-treatment interactions under the guise of learner styles and age-specific instruction. Finally, we offer suggestions for future research that draw on the foundation of instructional principles to optimize self-directed learning and learning in synthetic learning environments.

Incisional hernia repair in a high-fidelity silicone model for open retro-muscular mesh implantation with preparation of the fatty triangle: validation and educational impact study

BACKGROUND

Incisional hernia repair requires detailed anatomic knowledge. Regarding median subxiphoidal hernias, the proper preparation of the fatty triangle is challenging. To foster proficiency-based training, a cost-efficient model for open median retromuscular mesh repair resembling the human body was developed, including the main anatomical structures related to the procedure. The aim is to create and validate a high-fidelity model on open retromuscular mesh repair suitable for "training before doing".

MATERIALS AND METHODS

Different types of fabrics for imitation of connective tissue and 2-component silicones were used to construct the incisional hernia model. Sample size for validation of the model was determined by a triangular testing approach. Operations from six beginners and six experts were assessed by three blinded-raters. Reliability and construct-validity were evaluated on a behaviorally anchored rating scale (highest score: 4) for the criteria: "instrument use", "tissue handling", "near misses and errors", and "end-product quality".

RESULTS

The model authentically mimicked an open median retromuscular mesh repair. Participants considered the procedure realistic. Reliability was excellent, ranging from 0.811 to 0.974 for "end-product quality", and "tissue handling" respectively. Construct-validity was confirmed with experts significantly outperforming beginners in the "use of instruments" (M_beg. = 2.33, M_exp. = 3.94, p < 0.001), "tissue handling" (M_beg. = 2.11, M_exp. = 3.72, p < 0.001), "near misses and errors" (M_beg. = 2.67, M_exp. = 3.67, p < 0.001), and "end-product quality" (M_beg. = 2.78, M_exp. = 3.72, p < 0.001). Criterion-validity revealed a paradox effect: beginners performed significantly better than experts (p < 0.05) when preparing the fatty triangle.

CONCLUSIONS

The model covers all relevant aspects involved in median-open retromuscular incisional hernia mesh repair. Performance differences between beginners and experts confirm construct-validity and thereby realism of the model. It enables to efficiently improve and practice technical skills of the demanding surgery.

Efficacy of Stress Exposure Training on Target Acquisition in Combat Simulations

Transfer of training from simulators to real-world environments has recently come under investigation, as the generalizability of task-specific training has come into question. New hypotheses recommend that, to ensure effective performance under stress in real-world environments, one should supplement skill-based training with Stress Exposure Training (SET). Stress Exposure Training has further benefits in that it may serve as a more generalizable form of training and transfer across tasks and stressors. The impact of improving performance and reducing perceived stress and workload is of vital importance to many military operations, especially in high technology and high workload situations such as Landwarrior or Unmanned Arial Vehicles (UAVs; Mouloua, Hancock, & Gilson, 2003), in which mistakes are costly in terms of economics as well as life. In this paper the limits of SET transfer between laboratory training and field performance are investigated in regards to simulated combat target identification tasks.

The Relationship between Expertise and Self-Regulation in Movement Performance: Some Theoretical Issues

Although self-regulation has been advanced as a construct in sport psychology, little attention has been paid to the relationship between motor expertise and the actual self-regulation of a motor task. The present text examines the theoretical notions of self-regulation (on-line supervision and control), expertise, and performance, in the light of certain particularities implicated in motor skills, such as the nature of practical and conceptual knowledge and the relationship between them.

PASS: An Alternative Approach to Intelligence

As a by-product of the cognitive revolution, a coherent theory of cognitive processing has challenged traditional methods of studying and measuring intelligence. The PASS (Planning, Attention, Simultaneous and Successive cognitive processing) theory of intelligence identifies three operational units that are important to understand mental functioning: attention, simultaneous and successive processing, and planning. The PASS theory of intelligence is based on the neuropsychological work of A.R.Luria. The PASS model is an alternative approach to measuring and studying intelligence. A remediation programme based on the PASS model is presented and its utility in improving the specific cognitive processes that underlie academic skills is discussed.

A Typology of Training Design and Work Environment Factors Affecting Workplace Learning and Transfer

The purpose of this article is to develop a typology of elements involved in the design of training as well as in the work environment that affect work-place learning and transfer. This typology focuses on elements that can be manipulated by the human resource development (HRD) researcher and practitioner as part of the HRD implementation rather than on dispositional and personality characteristics of individuals participating in the intervention. It identifies elements within the work environment, as well as elements before, during, and after training. By presenting a typology, this article provides a first step in theory building or a “theory of the middle range. ” Furthermore, it leads to implications for future theoretical development, research, and practice.

To what extent do tutor-related behaviours influence student learning in PBL?

The purpose of this study was to investigate how tutor behaviours influence learning in problem-based learning (PBL). A previous study had indicated a significant influence of the tutor's social congruent behaviour on the PBL process and this study further investigates this finding by examining two groups of tutors displaying differences in social congruence. The participants were 77 students under the tutelage of four tutors and a self-report questionnaire ranked two tutors to be more socially congruent as compared to the other two. Student learning was measured by a concept recall test and the results from the analysis of covariance indicated a significant impact of the tutor's social congruent behaviour on learning after the problem analysis phase but not on the self-directed learning and reporting phases. It was concluded that the academic abilities of students and the small number of tutors involved may have affected the results, which led to the second part of this study. A group of 11 tutors were selected and the impact of their behaviours on student achievement measured by the module grade was examined. Results indicated that the tutor behaviours had a greater influence on average students as compared to the academically stronger and weaker students. This finding suggests that students who are academically stronger are not as reliant on the tutor while average students may depend more on the tutor to guide and motivate them in order to achieve the learning goals.

Transforming Our Models of Learning and Development: Web-Based Instruction as Enabler of Third-Generation Instruction

In this paper, I suggest that our methods for how to train are based historically on what we understand learning to be. I briefly trace the history of instructional design models, which embody both first-generation objectivist and second-generation cognitive constructivist views of learning. I then suggest we are on the cusp of a third-generation instructional model, one that places greater emphasis on the learner forming understanding largely through a process of social negotiation, either in training or on the job. I argue that Web-based instruction offers a technology ideally suited to the social constructivist approach at the core of this third-generation model. I discuss the importance of interaction in learning and suggest why Web-based networked learning may result in more, not less, interaction during training. Finally, I discuss other applications of third-generation learning such as peer mentoring and professional forums.

The development of managerial skills in MBA programs

Purpose

Business schools have been under fire for their alleged inefficacy in developing students’ managerial skills in MBA programs. On the basis of extant learning theories, the purpose of this paper is to propose a reconsideration of learning goals and assessment procedures for managerial skill development within MBA education.

Design/methodology/approach

The authors review the literatures on stage, experiential, social, and action learning theories to identify pedagogical suggestions for optimal skill development and to highlight the constraints program administrators and teachers face in efforts to advance students’ acquisition of complex managerial skills in MBA classrooms.

Findings

Conceptually, the authors argue that an emphasis on mastering complex managerial skills – as an expected learning outcome – might be an overly ambitious goal that can lead to neglecting early attainments in skill acquisition and create false impressions of MBA program failure. Furthermore, the authors discuss how MBA programs could consider the use of newer evaluation procedures for evaluating skill development.

Originality/value

The paper calls for greater attention to intermediate stages of managerial skill development for establishing learning goals, the consideration of knowledge structures for assessing the degree of skill development, and a focus on managerial skill development as a life‐long process.

Is learning in problem-based learning cumulative?

Problem-based learning (PBL) is generally organized in three phases, involving collaborative and self-directed learning processes. The hypothesis tested here is whether learning in the different phases of PBL is cumulative, with learning in each phase depending on that of the previous phase. The scientific concepts recalled by 218 students at the end of each PBL phase were used to estimate the extent of students' learning. The data were then analyzed using structural equation modeling. Results show that our hypothesized model fits the data well. Alternative hypotheses according to which achievement is predicted either by collaborative learning alone or by self-directed learning alone did not fit the data. We conclude that the learning in each PBL phase is cumulative, and strongly influenced by the earlier phase, thus providing support for the PBL cycle of problem analysis, self-directed learning, and a subsequent reporting phase. We also demonstrate an efficient method to capture and quantify students' learning during the PBL process.

Effect of worksheet scaffolds on student learning in problem-based learning

The purpose of this study was to investigate the effect of worksheets as a scaffolding tool on students' learning achievement in a problem-based learning (PBL) environment. Seventeen PBL classes (N = 241) were randomly assigned to two experimental groups-one with a worksheet provided and the other without. Students' learning of the topic at hand was evaluated by comparing results from pre- and post-lesson concept recall tests. We also obtained information about students' perceptions of factors impacting their learning using a Learning Impact Questionnaire. The data was analyzed by means of analyses of variance. Results of the study indicated that there was no statistically significant difference between the levels of understanding for both groups of students. In addition, survey results revealed that the strongest factor perceived by students to impact their learning in a PBL context is the tutor followed by team and class dynamics, while the influence of the worksheet was rated lowest. These findings suggest that scaffolds such as worksheets may not play a significant role in enhancing students' learning within the social constructivist framework of problem-based learning. On the other hand, the importance of the role of tutor and collaborative small group learning which are key features of PBL is reinforced.

Effects of tutor-related behaviours on the process of problem-based learning

Tutors in a Problem-Based Learning (PBL) curriculum are thought to play active roles in guiding students to develop frameworks for use in the construction of knowledge. This implies that both subject-matter expertise and the ability of tutors to facilitate the learning process must be important in helping students learn. This study examines the behavioural effects of tutors in terms of subject-matter expertise, social congruence and cognitive congruence on students' learning process and on their final achievement. The extent of students' learning at each PBL phase was estimated by tracking the number of relevant concepts recalled at the end of each learning phase, while student achievement was based on students' ability to describe and elaborate upon the relationship between relevant concepts learned. By using Analysis of Covariance, social congruence of the tutor was found to have a significant influence on learning in each PBL phase while all of the tutor-related behaviours had a significant impact on student achievement. The results suggest that the ability of tutors to communicate informally with students and hence create a less threatening learning environment that promotes a free flow exchange of ideas, has a greater impact on learning at each of the PBL phases as compared to tutors' subject-matter expertise and their ability to explain concepts in a way that is easily understood by students. The data presented indicates that these tutor-related behaviours are determinants of learning in a PBL curriculum, with social congruence having a greater influence on learning in the different PBL phases.

Exploring the Contribution of Virtual Worlds to Learning in Organizations

Despite the growing interest of business executives, there is limited academic research on the contributions of virtual worlds to learning in organizations. We address this limitation by using a recently developed typology of virtual world capabilities to investigate the potential contributions of virtual worlds to learning in organizations. Recognizing that learning occurs at three levels within the organization, we proceed to develop a theoretical framework that relates virtual world capabilities to learning at each level. Our research contributes to the field by integrating multiple theoretically anchored dimensions and offering a framework that should serve as a building block for research on, and use of, virtual worlds in learning interventions in organizational settings.

Evaluating training effectiveness in psychotherapy: lessons for the AOD field

Based on evaluations of effectiveness training on trainee and client outcome in the psychotherapy field, this paper presents a model and recommendations for the alcohol and other drug (AOD) field to consider when conducting investigations into training. Determining the effectiveness of training requires the consideration of a number of factors, including pre-existing trainee variables, methods of training and ability of trainers and the focus of training. The influence of each of these factors may be considered first in terms of proximal outcomes such as trainee satisfaction, improvements in clinical practice and knowledge, and secondly in terms of more distal outcomes, such as the impact that training may have on improving client outcome. The current literature regarding these factors pertaining to psychotherapy outcome is reviewed, and recommendations for evaluating training in the AOD field are made.

Mental models: an alternative evaluation of a sensemaking approach to ethics instruction

In spite of the wide variety of approaches to ethics training it is still debatable which approach has the highest potential to enhance professionals' integrity. The current effort assesses a novel curriculum that focuses on metacognitive reasoning strategies researchers use when making sense of day-to-day professional practices that have ethical implications. The evaluated trainings effectiveness was assessed by examining five key sensemaking processes, such as framing, emotion regulation, forecasting, self-reflection, and information integration that experts and novices apply in ethical decision-making. Mental models of trained and untrained graduate students, as well as faculty, working in the field of physical sciences were compared using a think-aloud protocol 6 months following the ethics training. Evaluation and comparison of the mental models of participants provided further validation evidence for sensemaking training. Specifically, it was found that trained students applied metacognitive reasoning strategies learned during training in their ethical decision-making that resulted in complex mental models focused on the objective assessment of the situation. Mental models of faculty and untrained students were externally-driven with a heavy focus on autobiographical processes. The study shows that sensemaking training has a potential to induce shifts in researchers' mental models by making them more cognitively complex via the use of metacognitive reasoning strategies. Furthermore, field experts may benefit from sensemaking training to improve their ethical decision-making framework in highly complex, novel, and ambiguous situations.

Integrating professionalism teaching into undergraduate medical education in the UK setting

This paper examines how professionalism teaching might be integrated into undergraduate medical education in the United Kingdom setting. It advocates adopting an outcome-based approach to curriculum planning, using the Scottish Deans' Medical Curriculum Group's (SDMCG) outcomes as a starting point. In discussing the curricular content, potential learning methods and strategies, theoretical considerations are explored. Student selection, assessment and strategies for optimising the educational environment are also considered.

An evaluation of performance by older persons on a simulated telecommuting task

Telecommuting work represents a strategy for managing the growing number of older people in the workforce. This study involved a simulated customer service telecommuting task that used e-mail to answer customer queries about media-related products and company policies. Participants included 27 "younger" older adults (50-65 years) and 25 "older" older adults (66-80 years). The participants performed the task for two 2-hr sessions a day over 4 consecutive days. Although both age groups showed significant improvement across sessions on many of the performance criteria, in general the improvements were more marked for the older age-group participants. However, the participants from both age groups had difficulty meeting some of the task performance requirements. These results are discussed in terms of training strategies for older workers.

Social constructivist perspectives on teaching and learning

Social constructivist perspectives focus on the interdependence of social and individual processes in the co-construction of knowledge. After the impetus for understanding the influence of social and cultural factors on cognition is reviewed, mechanisms hypothesized to account for learning from this perspective are identified, drawing from Piagetian and Vygotskian accounts. The empirical research reviewed illustrates (a) the application of institutional analyses to investigate schooling as a cultural process, (b) the application of interpersonal analyses to examine how interactions promote cognition and learning, and (c) discursive analyses examining and manipulating the patterns and opportunities in instructional conversation. The review concludes with a discussion of the application of this perspective to selected contemporary issues, including: acquiring expertise across domains, assessment, educational equity, and educational reform.

The 'consciousness primitive': a competence model of mind and will

Questions about mind and will are usually raised as though mind and will are either present or absent. Here, a view is presented to suggest that they are only a particular instantiation of a 'consciousness primitive', present in lower animals as well as in primitive portions of the human brain. Physiological variables, drugs and transmitters alter it in order to produce discontinuous products, such as learning, motivation, emotions etc., which are usually studied by performance models as though they are distinctive functions of the brain.

The design and delivery of crew resource management training: exploiting available resources

Despite widespread acceptance throughout commercial and military settings, crew resource management (CRM) training programs have not escaped doubts about their effectiveness. The current state of CRM training is an example of how an entire body of pertinent research and development has not had the impact on practice that it could. In this paper we outline additional resources (i.e., principles, information, findings, and guidelines) from the team training and training effectiveness research literatures that can be used to improve the design and delivery of CRM training. Some of the resources discussed include knowledge about training effectiveness, training teamwork-related skills, scenario design, and performance measurement. We conclude with a discussion of emerging resources as well as those that need to be developed. The purpose of this paper is to provide the CRM training developer with better access to resources that can be applied to the design and delivery of CRM training programs.