P.132 Investigation of Simulation-Based Lumbar Puncture Teaching Paradigms for Novice Learners

Background: Simulation-based educations’ prevalence within clinical neuroscience is on the rise, however investigation into what environment is most conducive to optimizing learning performance is limited. We aimed to determine whether training a simple-to-complex (progressive) sequence would result in superior learning compared to complex-to-simple (mixed) or complex-only sequences. Methods: A three-arm, prospective, randomised experiment was conducted to determine the effects on novice learner LP performance and cognitive load during learning and a very complex simulated reality assessment test 9-11 days later. Results: During learning, sterility breaches decreased linearly over time (p<.01) with no group differences, and accuracy was higher in the progressive group compared to complex-only (p<.01) and trended in the mixed group (p<.09). Across the learning phase cognitive load increased in the progressive group (p<.01) and decreased across the mixed group (p<.01). At assessment, there were no group differences in number of sterility breaches (p=.66), needle passes (p=.68) or cognitive load (p=.25). Conclusions: Contrary to our hypothesis, equivocal assessment performance was found across groups. Our results suggest that successive progression in complexity of simulation does not increase novice learner outcomes. Further, a “one-size fits all” approach to simulated environment complexity in clinical neurosciences education may be warranted given equivocal learning and less resources necessary.

A Perceived Zone of Certainty and Uncertainty: Propositions for Research Development

Possessing expert schemas is a positive feat that may yield different types of adaptive outcomes (e.g., informing procedural understanding that may result in a student skipping a few of the solution steps involved). Limited schemas, in contrast, may deter progress of a novice learner, limiting his/her capability to flourish. Taken as a whole, it may be concluded that expert schemas are more advantageous than novice schemas, differentiating learners in terms of expert and novice. Having said this, however, more recently, researchers have argued that possessing expert schemas could serve as deterrence. Recently, researchers have acknowledged a theoretical concept known as cognitive entrenchment, which is defined as a high level of stability in domain schemas. This description interestingly suggests that “entrenchment” or “situated fixation” of a course of action (e.g., a subject matter) could hinder the progress and learning experience of a person, namely—his/her inability and/or unwillingness to adapt to a new context, and/or his/her inflexibility and insistence to stay on course without any intent to change. One example of cognitive entrenchment is observed in professional football, wherein it has been argued that some football coaches are cognitively entrenched within their expert schemas, resulting in their demised game plans and strategic acumen. We advance the study of cognitive entrenchment by proposing an alternative viewpoint, which we term as the “perceived zone of certainty and uncertainty.” This proposition counters the perspective of cognitive entrenchment by arguing that it is cognitive appraisal, judgment, mental resolute, and determination of a person in cognitive certainty of his/her success or failure, or the cognitive uncertainty of success or failure, that would explain the notion of inflexibility and/or unwillingness to adapt, and/or insistence to stay on course without any attempt to deviate. Moreover, we rationalize that certainty of success or failure would closely associate with a feeling of comfort, whereas uncertainty would associate with his/her feeling discomfort. In this analysis, we strongly believe that willingness to change and adapt, reluctance and insistence to remain on course, and/or inclination to embrace flexibility may not necessarily relate to the concept of cognitive entrenchment; rather, inflexibility and/or reluctance to change for the purpose of adaptation has more to do with the desire of a person to seek a state of comfort. Finally, our conceptual analysis of cognitive entrenchment also considers an interesting theoretical concept, which we termed as “perceived optimal efficiency.” Perceived optimal efficiency, similar to cognitive relevance theory, is concerned with the relationship between minimum investment of time, effort, cognitive resources, etc., and an optimal best outcome. The issue for discussion, from our point of view, is related to the extent to which the certainty of success or failure would associate with perceived optimal efficiency.

An Effective, Low Cost, Do-it-Yourself Suture and Knot Tying Training Kit for the Novice Learner

Introduction Too Err is Human: Building a Safer Health System is a seminal report that highlights how improved training and objective assessment are key to reducing medical errors. The purpose of this study is to design a low cost, do-it-yourself (DIY) suture and knot tying training kit that enhances the novice learner’s basic surgical skills and to evaluate the efficacy of this training kit. Materials and Methods: Pre-medical and medical students from the University of Hawaii were administered a pretest to evaluate their two-handed knot tying and simple interrupted suturing with instrument tie using an objective scoring system. Then, subjects were shown an instructional video and allowed to practice using a low-cost, DIY training kit. A posttest was administered in the same format as the pretest. The primary outcome was subject confidence level, and secondary outcomes were time and quality of suturing and knot tying. Results: 20 subjects were recruited. After using the training kit, mean confidence levels increased for two-handed knot tying (1.55 vs. 7.15, p<0.0001), suturing (1.75 vs. 6.95, p<0.0001), and instrument tie (1.50 vs. 6.95, p<0.0001). Mean time to complete two-handed knot tying (116.03 vs. 52.85 seconds, p<0.0001) and simple interrupted suturing with instrument tie (300.00 vs. 181.05 seconds, p<0.0001) both decreased. Mean quality of both knot tying (0 vs. 4.25, p<0.0001) and simple interrupted suturing with instrument tie (0 vs. 13.1, p<0.0001) increased. Conclusions: This low-cost, DIY suture and knot tying training kit increased the confidence and basic surgical skills of the novice learner.

An Overview of Biological Data Mining

The largest digital repository of information, the World Wide Web keeps growing exponentially and calls for data mining services to provide tailored web experiences. This chapter discusses the overview of information retrieval, knowledge discovery and data mining. It reviews the different stages of data mining and introduces the wide spread biological databanks, their explosion, integration, data warehousing, information retrieval, text mining, text repositories for biological research publications, domain specific search engines, web mining, biological networks and visualization, ontology and systems biology. This chapter also illustrates some technical jargon with picture analogy for a novice learner to understand the concepts clearly.

Meet them in the proximal zone: Introducing framework concepts to “novice learners” using reference sources

Striving to foster critical thinking and metacognition in relation to information literacy is the penultimate goal of instruction librarians. Yet, all effort to do so is futile if students are not being met in their own proximal zone of development. Within the descriptions, knowledge practices, and dispositions of the frames in the Framework for Information Literacy for Higher Education,1 the “novice learner” is often referenced and compared to the “expert learner.” So while first-year college students begin their journey into higher education with varied levels of experiences in academic research and writing, many are these novice learners referred to within the Framework. Recognizing, and more importantly, accepting where these students are within their own levels of information literacy development can help to determine how to best scaffold instruction by using appropriate teaching tools and pedagogy.

Does testing enhance learning in continuing medical education?

Background: There has been growing interest in using theory-driven research to develop and evaluate continuing medical education (CME) activities. Within health professions education, testing has been shown to promote learning in a variety of different contexts, an effect referred to as test-enhanced learning (TEL). However, the extent to which TEL generalizes to CME remains unclear. The purpose of this study was to investigate whether physicians who received two intervening tests following a CME event would experience a TEL effect relative to physicians who received additional study material to review without testing. Methods: Forty-nine physicians were recruited during a local CME activity. Physicians were randomized to either a) the test group (n=26), where participants completed two 20 multiple-choice question (MCQ) quizzes related to the lecture content or b) the study group (n=23), where participants studied the same information without testing. Testing and studying occurred independently during the CME activity, and then four weeks later online. At eight weeks, participants completed a final 20-item MCQ online test. A between-subjects t-test was used to compare performance on the final test as a function of the initial educational activity (test group vs. study group).Results: Performance on the final MCQ test was equivalent for both test (Mean (SD): 75% (9.9)) and study-only (77% (7.3)) conditions (t(47) = 0.94, p=0.35). Conclusion: The null findings in the present study are contrary to previous findings demonstrating TEL among novice learner populations. The lack of TEL highlights several programmatic considerations that should be factored in before implementing TEL as a part of CME.