A global model for effective use and evaluation of e-learning in health.

Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

Motor learning of novel dynamics is not represented in a single global coordinate system: evaluation of mixed coordinate representations and local learning.

Successful motor performance requires the ability to adapt motor commands to task dynamics. A central question in movement neuroscience is how these dynamics are represented. Although it is widely assumed that dynamics (e.g., force fields) are represented in intrinsic, joint-based coordinates (Shadmehr R, Mussa-Ivaldi FA. J Neurosci 14: 3208-3224, 1994), recent evidence has questioned this proposal. Here we reexamine the representation of dynamics in two experiments. By testing generalization following changes in shoulder, elbow, or wrist configurations, the first experiment tested for extrinsic, intrinsic, or object-centered representations. No single coordinate frame accounted for the pattern of generalization. Rather, generalization patterns were better accounted for by a mixture of representations or by models that assumed local learning and graded, decaying generalization. A second experiment, in which we replicated the design of an influential study that had suggested encoding in intrinsic coordinates (Shadmehr and Mussa-Ivaldi 1994), yielded similar results. That is, we could not find evidence that dynamics are represented in a single coordinate system. Taken together, our experiments suggest that internal models do not employ a single coordinate system when generalizing and may well be represented as a mixture of coordinate systems, as a single system with local learning, or both.

A global model for effective use and evaluation of e-learning in health.

Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

Effects of the user model on simulation-based learning of dialogue strategies

Over the past decade, a variety of user models have been proposed for user simulation-based reinforcement-learning of dialogue strategies. However, the strategies learned with these models are rarely evaluated in actual user trials and it remains unclear how the choice of user model affects the quality of the learned strategy. In particular, the degree to which strategies learned with a user model generalise to real user populations has not be investigated. This paper presents a series of experiments that qualitatively and quantitatively examine the effect of the user model on the learned strategy. Our results show that the performance and characteristics of the strategy are in fact highly dependent on the user model. Furthermore, a policy trained with a poor user model may appear to perform well when tested with the same model, but fail when tested with a more sophisticated user model. This raises significant doubts about the current practice of learning and evaluating strategies with the same user model. The paper further investigates a new technique for testing and comparing strategies directly on real human-machine dialogues, thereby avoiding any evaluation bias introduced by the user model. © 2005 IEEE.

Reinforcement learning for parameter estimation in statistical spoken dialogue systems

Reinforcement techniques have been successfully used to maximise the expected cumulative reward of statistical dialogue systems. Typically, reinforcement learning is used to estimate the parameters of a dialogue policy which selects the system's responses based on the inferred dialogue state. However, the inference of the dialogue state itself depends on a dialogue model which describes the expected behaviour of a user when interacting with the system. Ideally the parameters of this dialogue model should be also optimised to maximise the expected cumulative reward. This article presents two novel reinforcement algorithms for learning the parameters of a dialogue model. First, the Natural Belief Critic algorithm is designed to optimise the model parameters while the policy is kept fixed. This algorithm is suitable, for example, in systems using a handcrafted policy, perhaps prescribed by other design considerations. Second, the Natural Actor and Belief Critic algorithm jointly optimises both the model and the policy parameters. The algorithms are evaluated on a statistical dialogue system modelled as a Partially Observable Markov Decision Process in a tourist information domain. The evaluation is performed with a user simulator and with real users. The experiments indicate that model parameters estimated to maximise the expected reward function provide improved performance compared to the baseline handcrafted parameters. © 2011 Elsevier Ltd. All rights reserved.

Phrase-based statistical language generation using graphical models and active learning

Most previous work on trainable language generation has focused on two paradigms: (a) using a statistical model to rank a set of generated utterances, or (b) using statistics to inform the generation decision process. Both approaches rely on the existence of a handcrafted generator, which limits their scalability to new domains. This paper presents BAGEL, a statistical language generator which uses dynamic Bayesian networks to learn from semantically-aligned data produced by 42 untrained annotators. A human evaluation shows that BAGEL can generate natural and informative utterances from unseen inputs in the information presentation domain. Additionally, generation performance on sparse datasets is improved significantly by using certainty-based active learning, yielding ratings close to the human gold standard with a fraction of the data. © 2010 Association for Computational Linguistics.