"Should I prioritize medical problem solving or attentive listening?": the dilemmas and challenges that medical students experience when learning to conduct consultations

Objective: Communication skills can be trained alongside clinical reasoning, history taking or clinical examination skills. This is advocated as a solution to the low transfer of communication skills. Still, students have to integrate the knowledge/skills acquired during different curriculum parts in patient consultations at some point. How do medical students experience these integrated consultations within a simulated environment and in real practice when dealing with responsibility?

Methods: Six focus groups were conducted with (pre-)/clerkship students.

Results: Students were motivated to practice integrated consultations with simulated patients and felt like 'real physicians'. However, their focus on medical problem solving drew attention away from improving their communication skills. Responsibility for real patients triggered students' identity development. This identity formation guided the development of an own consultation style, a process that was hampered by conflicting demands of role models.

Conclusion: Practicing complete consultations results in the dilemma of prioritizing medical problem solving above attention for patient communication. Integrated consultation training advances this dilemma to the pre-clerkship period. During clerkships this dilemma is heightened because real patients trigger empathy and responsibility, which invites students to define their role as doctor.

Practice Implications: When training integrated consultations, educators should pay attention to students' learning priorities and support the development of students' professional identity.

Enlivening, Invigorating & Enhancing Science:This session explores learning from a range of Primary Science Teaching Trust projects focused on invigorating the experience of children, teachers and whole school communities with primary science.

This session will provide you with opportunity to find out what is being achieved and explore the implications for your own practice.

Methodological issues for qualitative research with learning disabled children

This paper discusses key methodological issues for qualitative research with learning disabled children, based on the author's experience of involving learning disabled children in her doctoral study. The study was founded on the social model of disability and a sociological understanding of childhood that recognizes the abilities of disabled children as competent research participants. Issues that arose throughout the research process, from the early stages of gaining access to children, to communication challenges for interviewing learning disabled children, and the analysis and dissemination of data, are discussed. Within this context, this paper explores key methodological issues for researchers with regard to interviewing learning disabled children and actively involving them in qualitative research.

Increasing Staff and Student Capacity to Use the Communication Facility in Queen's Online in Order to Support Learning and Teaching on a BSW Programme

In this article the authors explore and evaluate developments in the use of information and communications technologies (ICT) within social work education at Queen's University Belfast since the inception of the new degree in social work. They look at the staff development strategy utilised to increase teacher confidence and competence in use of the Queen's Online virtual learning environment tools as well as the student experience of participation in modules involving online discussions. The authors conclude that the project provided further opportunity to reflect on how ICT can be used as a platform to support a whole course in a systematic and coordinated way and to ensure all staff remained abreast of ongoing developments in the use of ICT to support learning which is a normative expectation of students entering universities. A very satisfying outcome for the leaders is our observation of the emergence of other 'experts' in different aspects of use of ICT amongst the staff team. This project also shows that taking a team as opposed to an individual approach can be particularly beneficial

The role of previous experience and attitudes toward statistics in statistics assessment outcomes among undergraduate psychology students

Previous research has demonstrated that students’ cognitions about statistics are related to their performance in statistics assessments. The purpose of this research is to examine the nature of the relationships between undergraduate psychology students’ previous experiences of maths, statistics and computing; their attitudes toward statistics; and assessment on a statistics course. Of the variables examined, the strongest predictor of assessment outcome was students’ attitude about their intellectual knowledge and skills in relation to statistics at the end of the statistics curriculum. This attitude was related to students’ perceptions of their maths ability at the beginning of the statistics curriculum. Interventions could be designed to change such attitudes with the aim of improving students’ learning of statistics.

Reflections on Practice Learning in Northern Ireland and the Republic of Ireland: Lessons from Student Experiences

Practice learning is viewed as one of the most important components of social work education wherever in the world social work is practised. Northern Ireland and the Republic of Ireland provide an interesting case example of the educational impact on students resulting from their experience of different models of practice learning. Although sharing a common historical legacy, recent developments in policy in both jurisdictions have tended to engender greater divergences in how programmes organise and deliver social work education and practice learning. Drawing on findings from a joint-research project with students in Queen’s University, Belfast and Trinity College, Dublin, the authors highlight significant cross-border similarities as well as differences in the way practice learning is conceptualised, organised and delivered. Through comparing and contrasting student experiences, the authors reflect on how the findings might help to inform the future development of practice learning standards in both jurisdictions.

Chemosensory learning in the chicken embryo

Examined how exposure to a chemosensory stimulus prior to hatching affects subsequent chemosensory preferences of newly hatched chicks. The chicks' preferences were assessed at 2 days after hatching using an olfactory preference test (strawberry-smelling shavings vs water-coated shavings) and at 4 days after hatching using a gustatory preference test (strawberry-flavoured water vs unflavoured water). With no exposure to strawberry before hatching, strawberry was highly aversive to chicks after hatching. However, following exposure to strawberry before hatching, chicks expressed a greater preference for (or weaker aversion to) the strawberry stimulus. Chicks exposed to strawberry before hatching drank more strawberry-flavoured water and spent more time in a strawberry-scented area than chicks having no exposure before hatching. This change in preference was specific to the stimulus experienced before hatching and was present in the absence of any posthatching exposure to the stimulus. Results demonstrate that a chick's chemosensory preferences are changed as a result of experience with a stimulus before hatching and are suggestive of learning.

Evaluating the Effectiveness of Social Work Education: Preparing Students for Practice Learning

Evaluating the effectiveness of social work education has become a topic of major interest in the UK in the wake of a succession of child-care tragedies that have undermined confidence in the profession. However, many key aspects of social work education remain under-researched and/or contested and our knowledge of how students acquire and develop professional expertise remains limited. This paper reports on the first part of a longitudinal study aimed at developing evidence-based knowledge in this area by considering student perceptions at different stages of their social work education at Queen’s University Belfast. Focusing on the strengths and limitations of preparatory teaching, and their first experience of practice learning, this article considers the impact of demographic factors, including age, gender and experience, on how students experience the learning process. The findings indicate a significant level of disjunction between academic and practice learning and suggest that better integration between these two domains of learning is needed if social work students are to be more effectively prepared for the challenges they are likely to encounter in practice.

Learning design contingent valuation (LDCV): NOAA guidelines, preference learning and coherent arbitrariness

We extend the contingent valuation (CV) method to test three differing conceptions of individuals' preferences as either (i) a-priori well-formed or readily divined and revealed through a single dichotomous choice question (as per the NOAA CV guidelines [K. Arrow, R. Solow, P.R. Portney, E.E. Learner, R. Radner, H. Schuman, Report of the NOAA panel on contingent valuation, Fed. Reg. 58 (1993) 4601-4614]); (ii) learned or 'discovered' through a process of repetition and experience [J.A. List, Does market experience eliminate market anomalies? Q. J. Econ. (2003) 41-72; C.R. Plott, Rational individual behaviour in markets and social choice processes: the discovered preference hypothesis, in: K. Arrow, E. Colombatto, M. Perleman, C. Schmidt (Eds.), Rational Foundations of Economic Behaviour, Macmillan, London, St. Martin's, New York, 1996, pp. 225-250]; (iii) internally coherent but strongly influenced by some initial arbitrary anchor [D. Ariely, G. Loewenstein, D. Prelec, 'Coherent arbitrariness': stable demand curves without stable preferences, Q. J. Econ. 118(l) (2003) 73-105]. Findings reject both the first and last of these conceptions in favour of a model in which preferences converge towards standard expectations through a process of repetition and learning. In doing so, we show that such a 'learning design CV method overturns the 'stylised facts' of bias and anchoring within the double bound dichotomous choice elicitation format. (C) 2007 Elsevier Inc. All rights reserved.

Fast automatic two-stage nonlinear model identification based on the extreme learning machine

It is convenient and effective to solve nonlinear problems with a model that has a linear-in-the-parameters (LITP) structure. However, the nonlinear parameters (e.g. the width of Gaussian function) of each model term needs to be pre-determined either from expert experience or through exhaustive search. An alternative approach is to optimize them by a gradient-based technique (e.g. Newton’s method). Unfortunately, all of these methods still need a lot of computations. Recently, the extreme learning machine (ELM) has shown its advantages in terms of fast learning from data, but the sparsity of the constructed model cannot be guaranteed. This paper proposes a novel algorithm for automatic construction of a nonlinear system model based on the extreme learning machine. This is achieved by effectively integrating the ELM and leave-one-out (LOO) cross validation with our two-stage stepwise construction procedure [1]. The main objective is to improve the compactness and generalization capability of the model constructed by the ELM method. Numerical analysis shows that the proposed algorithm only involves about half of the computation of orthogonal least squares (OLS) based method. Simulation examples are included to confirm the efficacy and superiority of the proposed technique.

Incremental learning from stream data

Recent years have witnessed an incredibly increasing interest in the topic of incremental learning. Unlike conventional machine learning situations, data flow targeted by incremental learning becomes available continuously over time. Accordingly, it is desirable to be able to abandon the traditional assumption of the availability of representative training data during the training period to develop decision boundaries. Under scenarios of continuous data flow, the challenge is how to transform the vast amount of stream raw data into information and knowledge representation, and accumulate experience over time to support future decision-making process. In this paper, we propose a general adaptive incremental learning framework named ADAIN that is capable of learning from continuous raw data, accumulating experience over time, and using such knowledge to improve future learning and prediction performance. Detailed system level architecture and design strategies are presented in this paper. Simulation results over several real-world data sets are used to validate the effectiveness of this method.

A virtual surgery in general practice: evaluation of a novel undergraduate virtual patient learning package

Background: A suite of 10 online virtual patients developed using the IVIMEDS ‘Riverside’ authoring tool has been introduced into our undergraduate general practice clerkship. These cases provide a multimedia-rich experience to students. Their interactive nature promotes the development of clinical reasoning skills such as discriminating key clinical features, integrating information from a variety of sources and forming diagnoses and management plans.

Aims: To evaluate the usefulness and usability of a set of online virtual patients in an undergraduate general practice clerkship.
Method: Online questionnaire completed by students after their general practice placement incorporating the System Usability Scale questionnaire.

Results: There was a 57% response rate. Ninety-five per cent of students agreed that the online package was a useful learning tool and ranked virtual patients third out of six learning modalities. Questions and answers and the use of images and videos were all rated highly by students as useful learning methods. The package was perceived to have a high level of usability among respondents.

Conclusion: Feedback from students suggest that this implementation of virtual patients, set in primary care, is user friendly and rated as a valuable adjunct to their learning. The cost of production of such learning resources demands close attention to design.