Prolonged training at threshold promotes robust retinotopic specificity in perceptual learning

Human perceptual learning is classically thought to be highly specific to trained stimuli's retinal location. Together with evidence that specific learning effects can result in corresponding changes in early visual cortex, researchers have theorized that specificity implies regionalization of learning in the brain. However, other research suggests that specificity can arise from learning readout in decision areas or through top-down processes. Notably, recent research using a novel double-training paradigm reveals dramatic generalization of perceptual learning to untrained locations when multiple stimuli are trained. These data provoked significant controversy in the field and challenged extant models of perceptual learning. To resolve this controversy, we investigated mechanisms that account for retinotopic specificity in perceptual learning. We replicated findings of transfer after double training; however, we show that prolonged training at threshold, which leads to a greater number of difficult trials during training, preserves location specificity when double training occurred at the same location or sequentially at different locations. Likewise, we find that prolonged training at threshold determines the degree of transfer in single training of a peripheral orientation discrimination task. Together, these data show that retinotopic specificity depends highly upon particularities of the training procedure. We suggest that perceptual learning can arise from decision rules, attention learning, or representational changes, and small differences in the training approach can emphasize some of these over the others.

Augmented reality in medical education?

Learning in the medical domain is to a large extent workplace learning and involves mastery of complex skills that require performance up to professional standards in the work environment. Since training in this real-life context is not always possible for reasons of safety, costs, or didactics, alternative ways are needed to achieve clinical excellence. Educational technology and more specifically augmented reality (AR) has the potential to offer a highly realistic situated learning experience supportive of complex medical learning and transfer. AR is a technology that adds virtual content to the physical real world, thereby augmenting the perception of reality. Three examples of dedicated AR learning environments for the medical domain are described. Five types of research questions are identified that may guide empirical research into the effects of these learning environments. Up to now, empirical research mainly appears to focus on the development, usability and initial implementation of AR for learning. Limited review results reflect the motivational value of AR, its potential for training psychomotor skills and the capacity to visualize the invisible, possibly leading to enhanced conceptual understanding of complex causality.

Symptom management of affective and cognitive disturbance with a group of cancer survivors

Cancer survivors 65 years of age and older experience treatment-induced memory impairments. However, clinicians do not intervene for these cognitive problems. This article describes the findings from a pilot study of a memory versus health training intervention and its adaptability for cancer survivors for symptom management.

DESIGN AND METHODS

A convenience sample of older adults was enrolled in a longitudinal study of a memory and health training intervention and tested on five occasions for 2 years postintervention. The memory training was designed to increase cognitive performance, reduce anxiety, decrease negative attributions, promote health, and increase memory self-efficacy. In this analysis, we included change over time for the first four of the five data collection points. We calculated means and standard deviations on the memory measures for cancer survivors in the intervention (n = 8) and comparison (n = 14) groups. The analysis consisted of a mixed design analysis of variance comparing the two intervention groups across four periods for 12 months.

RESULTS

The typical cancer survivor in the sample was a 74-year-old Caucasian female; 14% were minorities. Because of the small sample, some of the effects were not statistically significant. Moderate to large effects were revealed in everyday and verbal memory performance scores, memory self-efficacy, strategy use, and memory complaints. There were also moderate effects for group-by-time interactions on the visual memory performance measure, the memory self-efficacy measure, the depression, the trait anxiety measure, and the complaints subscale. The memory intervention group tended to improve more than the health training group, although this was not always consistent. The results suggested that the participants benefited from the memory training intervention.

IMPLICATIONS

Clinicians are often at a loss on how to intervene with cancer survivors who are experiencing cognitive problems following chemotherapy treatment. Evidenced-based interventions for this aspect of symptom management are almost nonexistent. The Cognitive Behavioral Model of Everyday Memory (CBMEM), derived from Self-Efficacy theory provides an evidence-based intervention for symptom management.

Effectiveness of a Web-Based Simulation in Improving Nurses' Workplace Practice With Deteriorating Ward Patients: A Pre- and Postintervention Study

Background

Nurses play an important role in detecting patients with clinical deterioration. However, the problem of nurses failing to trigger deteriorating ward patients still persists despite the implementation of a patient safety initiative, the Rapid Response System. A Web-based simulation was developed to enhance nurses’ role in recognizing and responding to deteriorating patients. While studies have evaluated the effectiveness of the Web-based simulation on nurses’ clinical performance in a simulated environment, no study has examined its impact on nurses’ actual practice in the clinical setting.

Objective

The objective of this study was to evaluate the impact of Web-based simulation on nurses' recognition of and response to deteriorating patients in clinical settings. The outcomes were measured across all levels of Kirkpatrick’s 4-level evaluation model with clinical outcome on triggering rates of deteriorating patients as the primary outcome measure.

Methods

A before-and-after study was conducted on two general wards at an acute care tertiary hospital over a 14-month period. All nurses from the two study wards who undertook the Web-based simulation as part of their continuing nursing education were invited to complete questionnaires at various time points to measure their motivational reaction, knowledge, and perceived transfer of learning. Clinical records on cases triggered by ward nurses from the two study wards were evaluated for frequency and types of triggers over a period of 6 months pre- and 6 months postintervention.

Results

The number of deteriorating patients triggered by ward nurses in a medical general ward increased significantly (P<.001) from pre- (84/937, 8.96%) to postintervention (91/624, 14.58%). The nurses reported positively on the transfer of learning (mean 3.89, SD 0.49) from the Web-based simulation to clinical practice. A significant increase (P<.001) on knowledge posttest score from pretest score was also reported. The nurses also perceived positively their motivation (mean 3.78, SD 0.56) to engage in the Web-based simulation.

Conclusions

This study provides evidence on the effectiveness of Web-based simulation in improving nursing practice when recognizing and responding to deteriorating patients. This educational tool could be implemented by nurse educators worldwide to address the educational needs of a large group of hospital nurses responsible for patients in clinical deterioration.

Auditory and Cognitive Training for Cognition in Adults With Hearing Loss: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis examined the efficacy of auditory training and cognitive training to improve cognitive function in adults with hearing loss. A literature search of academic databases (e.g., MEDLINE, Scopus) and gray literature (e.g., OpenGrey) identified relevant articles published up to January 25, 2018. Randomized controlled trials (RCTs) or repeated measures designs were included. Outcome effects were computed as Hedge’s g and pooled using random-effects meta-analysis (PROSPERO: CRD42017076680). Nine studies, five auditory training, and four cognitive training met the inclusion criteria. Following auditory training, the pooled effect was small and statistically significant for both working memory (g = 0.21; 95% CI [0.05, 0.36]) and overall cognition (g = 0.19; 95% CI [0.07, 0.31]). Following cognitive training, the pooled effect for working memory was small and statistically significant (g = 0.34; 95% CI [0.16, 0.53]), and the pooled effect for overall cognition was large and significant (g = 1.03; 95% CI [0.41, 1.66]). However, this was dependent on the classification of training approach. Sensitivity analyses revealed no statistical difference between the effectiveness of auditory and cognitive training for improving cognition upon removal of a study that used a combined auditory–cognitive approach, which showed a very large effect. Overall certainty in the estimation of effect was “low” for auditory training and “very low” for cognitive training. High-quality RCTs are needed to determine which training stimuli will provide optimal conditions to improve cognition in adults with hearing loss.

The Role of Interactional Quality in Learning from Touch Screens during Infancy: Context Matters

Interactional quality has been shown to enhance learning during book reading and play, but has not been examined during touch screen use. Learning to apply knowledge from a touch screen is complex for infants because it involves transfer of learning between a two-dimensional (2D) screen and three-dimensional (3D) object in the physical world. This study uses a touch screen procedure to examine interactional quality measured via maternal structuring, diversity of maternal language, and dyadic emotional responsiveness and infant outcomes during a transfer of learning task. Fifty 15-month-old infants and their mothers participated in this semi-naturalistic teaching task. Mothers were given a 3D object, and a static image of the object presented on a touch screen. Mothers had 5 min to teach their infant that a button on the real toy works in the same way as a virtual button on the touch screen (or vice versa). Overall, 64% of infants learned how to make the button work, transferring learning from the touch screen to the 3D object or vice versa. Infants were just as successful in the 3D to 2D transfer direction as they were in the 2D to 3D transfer direction. A cluster analysis based on emotional responsiveness, the proportion of diverse maternal verbal input, and amount of maternal structuring resulted in two levels of interactional quality: high quality and moderate quality. A logistic regression revealed the level of interactional quality predicted infant transfer. Infants were 19 times more likely to succeed and transfer learning between the touch screen and real object if they were in a high interactional quality dyad, even after controlling for infant activity levels. The present findings suggest that interactional quality between mother and infant plays an important role in making touch screens effective teaching tools for infants' learning.

Why is Anatomy Difficult to Learn? The Implications for Undergraduate Medical Curricula

The impact of the medical curricular reform on anatomy education has been inconclusive. A pervasive perception is that graduates do not possess a sufficient level of anatomical knowledge for safe medical practice; however, the reason is less well-studied. This qualitative study investigated the perceived challenges in learning anatomy, possible explanations, and ways to overcome these challenges. Unlike previous work, it explored the perceptions of multiple stakeholders in anatomy learning. Semi-structured interviews were conducted and the transcripts were analyzed by a grounded theory approach. Three main themes emerged from the data: (1) visualization of structures, (2) body of information, and (3) issues with curriculum design. The decreasing time spent in anatomy laboratories forced students to rely on alternative resources to learn anatomy but they lacked the opportunities to apply to human specimens, which impeded the "near" transfer of learning. The lack of clinical integration failed to facilitate the "far" transfer of learning. Learners also struggled to cope with the large amount of surface knowledge, which was pre-requisite to successful deep and transfer of learning. It was theorized that the perceived decline in anatomical knowledge was derived from this combination of insufficient surface knowledge and impeded "near" transfer resulting in impeded deep and "far" transfer of learning. Moving forward, anatomy learning should still be cadaveric-based coupled with complementary technological innovations that demonstrate "hidden" structures. A constant review of anatomical disciplinary knowledge with incremental integration of clinical contexts should also be adopted in medical curricula which could promote deep and far transfer of learning.

Transfer of Visual Learning Between a Virtual and a Real Environment in Honey Bees: The Role of Active Vision

To study visual learning in honey bees, we developed a virtual reality (VR) system in which the movements of a tethered bee walking stationary on a spherical treadmill update the visual panorama presented in front of it (closed-loop conditions), thus creating an experience of immersion within a virtual environment. In parallel, we developed a small Y-maze with interchangeable end-boxes, which allowed replacing repeatedly a freely walking bee into the starting point of the maze for repeated decision recording. Using conditioning and transfer experiments between the VR setup and the Y-maze, we studied the extent to which movement freedom and active vision are crucial for learning a simple color discrimination. Approximately 57% of the bees learned the visual discrimination in both conditions. Transfer from VR to the maze improved significantly the bees’ performances: 75% of bees having chosen the CS+ continued doing so and 100% of bees having chosen the CS− reverted their choice in favor of the CS+. In contrast, no improvement was seen for these two groups of bees during the reciprocal transfer from the Y-maze to VR. In this case, bees exhibited inconsistent choices in the VR setup. The asymmetric transfer between contexts indicates that the information learned in each environment may be different despite the similar learning success. Moreover, it shows that reducing the possibility of active vision and movement freedom in the passage from the maze to the VR impairs the expression of visual learning while increasing them in the reciprocal transfer improves it. Our results underline the active nature of visual processing in bees and allow discussing the developments required for immersive VR experiences in insects.

Evaluating pharmacists' ability to counsel on tobacco cessation using two standardized patient scenarios

OBJECTIVES

To evaluate the impact that role-playing two pre/post standardized patient scenarios within a tobacco cessation training program had on pharmacists' counseling skills. Second, to analyze the validity of the observation coding tool used to evaluate pharmacist's role-play performance.

METHODS

Pharmacists performed two role-playing scenarios which incorporated national guidelines, the 5A's counseling process, and the "preparation" and "action" phases of the transtheoretical model. Pharmacists' performance was evaluated with an observation coding tool.

RESULTS

Pharmacists' (n=25) counseling performance improved significantly post-training (p<0.02: Action Scenario; p<0.004: Preparation Scenario). More than 50% of pharmacists provided patient-directed tobacco consultation services in the one year following training. The observation tool score for the "action phase" scenario was highly associated with pharmacists' subsequent delivery of tobacco cessation services in community practice.

CONCLUSION

Role-playing facilitated pharmacists' skill development. The evaluation tool and Action Scenario may be powerful for predicting pharmacists' delivery of tobacco cessation services.

PRACTICE IMPLICATIONS

Incorporating role-playing and structured tools for performance evaluation can help enhance pharmacist performance during training and predict service delivery in community practice. Together they could facilitate tailored feedback to help pharmacists struggling with the difficult task of extending cognitive service roles in practice.

Transfer of Motor Learning Is More Pronounced in Proximal Compared to Distal Effectors in Upper Extremities

The current experiment investigated generalizability of motor learning in proximal versus distal effectors in upper extremities. Twenty-eight participants were divided into three groups: training proximal effectors, training distal effectors, and no training control group (CG). Performance was tested pre- and post-training for specific learning and three learning transfer conditions: (1) bilateral learning transfer between homologous effectors, (2) lateral learning transfer between non-homologous effectors, and (3) bilateral learning transfer between non-homologous effectors. With respect to specific learning, both training groups showed significant, similar improvement for the trained proximal and distal effectors, respectively. In addition, there was significant learning transfer to all three transfer conditions, except for bilateral learning transfer between non-homologous effectors for the distal training group. Interestingly, the proximal training group showed significantly larger learning transfer to other effectors compared to the distal training group. The CG did not show significant improvements from pre- to post-test. These results show that learning is partly effector independent and generalizable to different effectors, even though transfer is suboptimal compared to specific learning. Furthermore, there is a proximal-distal gradient in generalizability, in that learning transfer from trained proximal effectors is larger than from trained distal effectors, which is consistent with neuroanatomical differences in activation of proximal and distal muscles.

Computer-based learning: interleaving whole and sectional representation of neuroanatomy

The large volume of material to be learned in biomedical disciplines requires optimizing the efficiency of instruction. In prior work with computer-based instruction of neuroanatomy, it was relatively efficient for learners to master whole anatomy and then transfer to learning sectional anatomy. It may, however, be more efficient to continuously integrate learning of whole and sectional anatomy. A study of computer-based learning of neuroanatomy was conducted to compare a basic transfer paradigm for learning whole and sectional neuroanatomy with a method in which the two forms of representation were interleaved (alternated). For all experimental groups, interactive computer programs supported an approach to instruction called adaptive exploration. Each learning trial consisted of time-limited exploration of neuroanatomy, self-timed testing, and graphical feedback. The primary result of this study was that interleaved learning of whole and sectional neuroanatomy was more efficient than the basic transfer method, without cost to long-term retention or generalization of knowledge to recognizing new images (Visible Human and MRI).

Computerized cognitive training during physical inactivity improves executive functioning in older adults

The hippocampus is closely tied to spatial navigation, a central component in cognitive functioning, and critically involved in age-associated cognitive decline and dementia. This study evaluated a novel, cognitive computerized spatial navigation training (CSNT) program targeting the hippocampus, with expectation of mitigating possible cognitive decline with bed rest (BR). During a 14-day BR study with 16 healthy, older men (mean age = 60 ± 3, range = 55-65 years), half received CSNT for 12 days in 50-min sessions and half were controls (watching documentaries). This design uniquely controlled diet, sleep, and other personal and environmental activities. Although there were no cognitive declines in controls post-BR, CSNT participants demonstrated significant increases in executive/attention ability and processing speed, and continued spatial navigation testing showed improvement to 400 days post-BR. This intervention may prove useful to mitigate cognitive declines known to occur in long periods of immobilization and could have broader implications in protecting against age-related cognitive decline.

Learning to speak by listening: Transfer of phonotactics from perception to production

The language production and perception systems rapidly learn novel phonotactic constraints. In production, for example, producing syllables in which /f/ is restricted to onset position (e.g. as /h/ is in English) causes one's speech errors to mirror that restriction. We asked whether or not perceptual experience of a novel phonotactic distribution transfers to production. In three experiments, participants alternated hearing and producing strings of syllables. In the same condition, the production and perception trials followed identical phonotactics (e.g. /f/ is onset). In the opposite condition, they followed reverse constraints (e.g. /f/ is onset for production, but /f/ is coda for perception). The tendency for speech errors to follow the production constraint was diluted when the opposite pattern was present on perception trials, thus demonstrating transfer of learning from perception to production. Transfer only occurred for perceptual tasks that may involve internal production, including an error monitoring task, which we argue engages production via prediction.

Single-Session Anodal tDCS with Small-Size Stimulating Electrodes Over Frontoparietal Superficial Sites Does Not Affect Motor Sequence Learning

Due to the potential of anodal transcranial direct current stimulation (a-tDCS) for enhancement of fine sequenced movements and increasing interest in achieving high level of fine movements in the trained and untrained hands especially at initial stage of learning, we designed this study to investigate whether the application of single-session a-tDCS with small-size stimulating electrodes over FPN sites, such as dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1) or posterior parietal cortex (PPC) could enhance sequence learning with the trained hand and these effects are transferred into the untrained hand or not. A total of 51 right-handed healthy participants were randomly assigned to one of the four stimulation groups: a-tDCS of left M1, DLPFC, PPC, or sham. Stimulation was applied for 20 min during a sequential visual isometric pinch task (SVIPT). Eight blocks of training using SVIPT were completed with the right hand during stimulation. Two blocks of sequence training with each hand were performed by participants as assessment blocks at three time points: baseline, 15 min and one day following the intervention. Behavioral outcomes including movement time, error rate and skill were assessed in all assessment blocks across three time points. We also measured corticospinal excitability, short-interval intracortical inhibition, and intracortical facilitation using single- and paired-pulse transcranial magnetic stimulation. The results indicated that the behavioral outcomes were significantly improved with the right trained hand, but this learning effect was not modulated by a-tDCS with small-size stimulating electrodes over the FPN. Transfer of learning into the untrained hand was observed in all four groups for movement time but not for the error rate or skill. Our results suggest that sequential learning in SVIPT and its transfer into the untrained hand were not sensitive to a single-session a-tDCS with small-size stimulating electrodes over left M1, DLPFC or PPC in young healthy participants.

Training on a new, portable, simple simulator transfers to performance of complex bronchoscopy procedures

INTRODUCTION

Virtual-reality (VR) simulation provides a safe and effective learning environment prior to practicing on patients. However, existing bronchoscopy simulators are expensive and not easily portable.

OBJECTIVES

The aim of this study was to assess the effect of self-directed training on a new, portable, simple simulator measured by transfer of skills to performance of more complex bronchoscopy procedures on an advanced VR simulator.

METHODS

Twenty medical students participated in the study. After a general introduction to bronchoscopy, they were randomised into two groups, receiving either self-directed bronchoscopy training using a portable, simple simulator or no manual training. Subsequently, all participants were tested on complex scenarios in an advanced VR simulator using a validated bronchoscopy quality test. Bronchoscopy quality scores were compared using independent samples t-test and correlated with a previously established pass-fail standard.

RESULTS

The intervention group spent an average of 71-min training on the new simulator. The intervention group performed significantly better than the control group, mean bronchoscopy quality score 0.55 [standard deviation (SD) 0.16] vs 0.36 (SD 0.10), P = 0.005, effect size = 1.47. Eight out of 10 participants in the intervention group passed the test compared with only 1 out of 10 in the control group.

CONCLUSION

The effect of a brief, self-directed training session using a portable, simple simulator was substantial and transferred to performance of more complex skills.

Transfer of Problem Solving Skills from Touchscreen to 3D Model by 3- to 6-Year-Olds

Although much published research purports that young children struggle to solve problems from screen-based media and to transfer learning from a virtual to a physical modality, Huber et al. (2016)’s recent study on children solving the Tower of Hanoi (ToH) problem on a touchscreen app offers a clear counter example. Huber et al. (2016) reported that children transferred learning from media to the physical world. As this finding arguably differs from that of prior research in this area, the current study tests whether the Huber et al. (2016) results could be replicated. Additionally, we extended the scope of the Huber et al. (2016) work by testing a broader age range, including children as young as 3 years, and using a culturally distinct participant pool. The results of the current study verified Huber et al.’s (2016) conclusion that 4- to 6-year-old children are capable of transferring the ToH learning from touchscreen devices to the physical version of the puzzle. Children under 4 years of age, in contrast, showed little ability to improve at the ToH problem regardless of the practice modality—suggesting that a different problem-solving task is required to probe very young children’s ability to learn from touchscreen apps.

A Qualitative Exploration of Multiple Perspectives on Transfer of Learning Between Classroom and Clinical Workplace

Phenomenon: Transfer of learning between classroom and workplace appears to be difficult. Various conceptions about learning in either the classroom or the workplace exist among stakeholders, yet little is known about their conceptions of the transfer of learning between both settings. This study explored stakeholders' conceptions about transfer of learning between classroom-based learning and workplace practice.

APPROACH

Homogeneous focus groups with students, medical teachers, and workplace supervisors were conducted using a constructivist grounded theory approach.

FINDINGS

The 54 participants' conceptions mainly related to their beliefs about who was responsible for (a) preparing for transfer of learning, (b) being at the workplace and connecting back to classroom-based learning, and (c) reflecting on transfer of learning and continuing the process. A continuum was recognized between those who held medical teachers/workplace supervisors responsible and those who held students responsible. Insights: There appears to be a variety of conceptions about who is responsible for enabling the transfer process. These conceptions may influence learning and instructional activities. Hence, it may be necessary to make these beliefs explicit in order to better align stakeholders' conceptions. To this end, the conceptual framework created in this study may be a useful tool.

The Role of Nonlinear Pedagogy in Supporting the Design of Modified Games in Junior Sports

Nonlinear Pedagogy has been advocated as an approach that views acquisition of movement skills with a strong emphasis on exploratory behaviors and the development of individualized movement skills. Underpinned by Ecological Dynamics, Nonlinear Pedagogy provides key ideas on design principles to support a teaching and learning approach that accounts for dynamic interactions among constraints in the evolution of movement behaviors. In the context of junior sports, the manipulation of task constraints is central to how games can be re-designed for children to play that are age and body appropriate so that the games can still capture the key elements of representativeness as compared to the adult form of the game. Importantly, these games offer suitable affordances that promote sensible play that could be transferable to other contexts. In this paper, we provide an in-depth discussion on how Nonlinear Pedagogy is relevant in supporting the design and development of modified games in the context of junior sports. Practical implications are also provided to share how games can be modified for meaningful play to emerge.

Enhancing the Efficacy of Cognitive Bias Modification for Social Anxiety

Cognitive bias modification for interpretation (CBM-I) is a promising treatment modality for social anxiety disorder, but effect sizes are relatively small across investigations (Hallion & Ruscio, 2011). Additionally, the extent to which CBM-I impacts other cognitive, emotional, and behavioral outcomes is unclear. This study investigated whether two empirically supported treatment components for anxiety disorders, imaginal exposure (IE) and relaxation, augment the effects of CBM-I and increase the extent to which the effects of CBM-I generalize to behavioral and affective outcomes. We randomly assigned 111 undergraduate students with social anxiety to undergo IE, relaxation, or neutral thinking prior to CBM-I, then measured their interpretation biases, as well as their speaking time, anxiety, and subjective evaluations of performance during a speech task. Results indicated that individuals who received IE prior to CBM-I evidenced more adaptive interpretation biases and less behavioral avoidance during the speech task than did individuals who engaged in relaxation or neutral thinking. However, they did not report differential anxiety, habituation, or evaluations of their performance on the speech task. These findings suggest that the combination of CBM-I with adjunct components that target behavioral, rather than cognitive, mechanisms can facilitate transfer of the effects of CBM-I to reducing behavioral avoidance.

Learning from picture books: Infants' use of naming information

The present study investigated whether naming would facilitate infants’ transfer of information from picture books to the real world. Eighteen- and 21-month-olds learned a novel label for a novel object depicted in a picture book. Infants then saw a second picture book in which an adult demonstrated how to elicit the object’s non-obvious property. Accompanying narration described the pictures using the object’s newly learnt label. Infants were subsequently tested with the real-world object depicted in the book, as well as a different-color exemplar. Infants’ performance on the test trials was compared with that of infants in a no label condition. When presented with the exact object depicted in the picture book, 21-month-olds were significantly more likely to attempt to elicit the object’s non-obvious property than were 18-month-olds. Learning the object’s label before learning about the object’s hidden property did not improve 18-month-olds’ performance. At 21-months, the number of infants in the label condition who attempted to elicit the real-world object’s non-obvious property was greater than would be predicted by chance, but the number of infants in the no label condition was not. Neither age group nor label condition predicted test performance for the different-color exemplar. The findings are discussed in relation to infants’ learning and transfer from picture books.

Taking Affective Learning in Digital Education One Step Further: Trainees' Affective Characteristics Predicting Multicontextual Pre-training Transfer Intention

The past decades have shown an accelerated development of technology-enhanced or digital education. Although an important and recognized precondition for study success, still little attention has been paid to examining how an affective learning climate can be fostered in online training programs. Besides gaining insight into the dynamics of affective learning itself it is of vital importance to know what predicts trainees' intention to transfer new knowledge and skills to other contexts. The present study investigated the influence of five affective learner characteristics from the transfer literature (learner readiness, motivation to learn, expected positive outcomes, expected negative outcomes, personal capacity) on trainees' pre-training transfer intention. Participants were 366 adult students enrolled in an online course in information literacy in a distance learning environment. As information literacy is a generic competence, applicable in various contexts, we developed a novel multicontextual transfer perspective and investigated within one single study the influence of the abovementioned variables on pre-training transfer intention for both the students' Study and Work contexts. The hypothesized model has been tested using structural equation modeling. The results showed that motivation to learn, expected positive personal outcomes, and learner readiness were the strongest predictors. Results also indicated the benefits of gaining pre-training insight into the specific characteristics of multiple transfer contexts, especially when education in generic competences is involved. Instructional designers might enhance study success by taking affective transfer elements and multicontextuality into account when designing digital education.

Use of core concepts of physiology can facilitate student transfer of learning

Students often fail to utilize what they know about one topic (e.g., hemodynamics) when attempting to master another topic involving a similar phenomenon (e.g., airflow in airways). What accounts for this difficulty that students have? And how can students be assisted in doing a better job of applying what they already know to new topics? The phenomenon described above is an example of a failure of transfer of learning. However, much is known about the conditions that foster or promote transfer of learning. Applying this emerging knowledge and focusing on the core concepts of physiology can make learning physiology easier and provide students with tools to support lifelong learning.NEW & NOTEWORTHY Students often fail to utilize knowledge from prerequisite courses while learning physiology. They also fail to use what they know about one physiology topic when attempting to learn another topic. Much is known about the conditions that foster or promote transfer of learning. Applying this emerging knowledge and focusing on the core concepts of physiology can making learning physiology easier and provide students with tools to support lifelong learning.

Cognitive Model of Trust Dynamics Predicts Human Behavior within and between Two Games of Strategic Interaction with Computerized Confederate Agents

When playing games of strategic interaction, such as iterated Prisoner's Dilemma and iterated Chicken Game, people exhibit specific within-game learning (e.g., learning a game's optimal outcome) as well as transfer of learning between games (e.g., a game's optimal outcome occurring at a higher proportion when played after another game). The reciprocal trust players develop during the first game is thought to mediate transfer of learning effects. Recently, a computational cognitive model using a novel trust mechanism has been shown to account for human behavior in both games, including the transfer between games. We present the results of a study in which we evaluate the model's a priori predictions of human learning and transfer in 16 different conditions. The model's predictive validity is compared against five model variants that lacked a trust mechanism. The results suggest that a trust mechanism is necessary to explain human behavior across multiple conditions, even when a human plays against a non-human agent. The addition of a trust mechanism to the other learning mechanisms within the cognitive architecture, such as sequence learning, instance-based learning, and utility learning, leads to better prediction of the empirical data. It is argued that computational cognitive modeling is a useful tool for studying trust development, calibration, and repair.

The Barriers and Facilitators to Transfer of Ultrasound-Guided Central Venous Line Skills From Simulation to Practice: Exploring Perceptions of Learners and Supervisors

PHENOMENON: Ultrasound-guided central venous line insertion is currently the standard of care. Randomized controlled trials and systematic reviews show that simulation is superior to apprenticeship training. The purpose of this study is to explore, from the perspectives of participants in a simulation-training program, the factors that help or hinder the transfer of skills from simulation to practice.

APPROACH

Purposeful sampling was used to select and study the experience and perspective of novice fellows after they had completed simulation training and then performed ultrasound-guided central venous line in practice. Seven novice pediatric intensive care unit fellows and six supervising faculty in a university-affiliated academic center in a large urban city were recruited between September 2012 and January 2013. We conducted a qualitative study using semistructured interviews as our data source, employing a constructivist, grounded theory methodology.

FINDINGS

Both curricular and real-life factors influence the transfer of skills from simulation to practice and the overall performance of trainees. Clear instructions, the opportunity to practice to mastery, one-on-one observation with feedback, supervision, and further real-life experiences were perceived as factors that facilitated the transfer of skills. Concern for patient welfare, live trouble shooting, complexity of the intensive care unit environment, and the procedure itself were perceived as real-life factors that hindered the transfer of skills. Insights: As more studies confirm the superiority of simulation training versus apprenticeship training for initial student learning, the faculty should gain insight into factors that facilitate and hinder the transfer of skills from simulation to bedside settings and impact learners' performances. As simulation further augments clinical learning, efforts should be made to modify the curricular and bedside factors that facilitate transfer of skills from simulation to practice settings.