外科医师临床培养中的矛盾与解决对策

外科医师临床培养中的矛盾,主要表现为师承的矛盾关系及实践的矛盾关系.在查房、病例讨论、外科手术操作等临床培养过程中,适当转换上级医师与其两者的角色地位,在层次提高过程中,采用请进来、送出去的开放式培养模式,有助于外科医师主动地实现认知知识向认知方法、知识向能力、学习基础知识向学习新知识新技术的多元综合转化.是矛盾解决、调动年轻医师学习主动性和积极性、引发其与上级医师互动学习的良好方法.     

认知任务分析方法及其在医学领域的应用

阐述了认知任务分析的认知理论基础、方法和操作等,强调了认知图式、无意识认知过程、自动化思维在过程性知识中的作用,呈现了认知任务分析方法在研究医疗专家知识中的重要性。举例说明了认知任务分析方法在外科医疗、护理和临床心理学中的有效应用．展现了认知任务分析方法在医学研究与实践中的广阔前景。     

内、外科医师认知方式与诊断关系的研究

本研究采用《认知方式图形测验》和以疾病症状、体征与实验室检查等明显矛盾为内容的测试题对接受测试的临床医生进行心理测量 ,以探讨研究临床医生的认知方式及其对临床医生诊断能力的影响 ;发现临床医生的认知方式水平对其诊断能力并无显著性的影响。因此 :1西医临床医师的内科与外科专业分化不会对医师的知觉去隐蔽能力 (场独立性 -依存性 )产生影响 ;2医生在通常情况下对实验室结果的过度依赖可能与其不愿承担相应的诊断责任而产生的人格上的特殊心理防御机制的作用有关。     

浅谈元认知知识的培养及其评定

元认知知识是元认知的主要成份之一,它由三部分知识组成:认知主体方面的知识、认知任务方面的知识和认知策略方面的知识。在教学过程中加强对学生元认知知识的培养与训练,有利于学生学会学习,从而达到最佳的学习效果。元认知知识的评定难以在大规模考试中实现,应该综合运用多种方法在日常教学中加以评定,并作为主要任务之一纳入学生的形成性评价。     

医科研究生对医患关系问题认知程度的调查分析

随着医学模式向生物-心理-社会模式的转变,医患关系的主体关系也发生了明显的变化.在医患协商新医患关系模式下,医师的职业道德观与价值观是否与之相适应已成为新时期卫生工作的重要问题.医科研究生除了学习丰富的理论知识和操作技能外,培养高尚的医德、学会正确处理医患关系,也成为合格医生的必备条件.本研究以在校临床专业的硕士研究生为研究对象,系统分析了医科研究生对医患关系问题的认知程度.     

摆在现代外科医师面前的若干矛盾现象

随着自然和社会科学的进步,现代外科在得到了空前发展的同时,许多矛盾现象也摆在外科医师的面前,例如手术和非手术、手术扩大与缩小、手工操作和器械使用、手术实施和手术风险、经验主义和循证、临床治愈和健康之间的矛盾,如何正视和解决这些矛盾问题,关系到到现代外科学长远发展。     

摆在现代外科医师面前的若干矛盾现象

随着自然和社会科学的进步,现代外科在得到了空前发展的同时,许多矛盾现象也摆在外科医师的面前,例如:手术和非手术、手术扩大与缩小、手工操作和器械使用、手术实施和手术风险、经验主义和循证、临床治愈和健康之间的矛盾,如何正视和解决这些矛盾问题,关系到到现代外科学长远发展.     

临床医师职业综合能力培养存在的问题及对策——以心血管外科为例

随着生活水平的提高,人们对健康的需求与日俱增,这就需要医师有较高的综合能力与之配合,那如何提高医师的岗位胜任力就成了重要问题。本文以心血管外科为例,综合分析了心血管外科医师综合能力培养的现状,指出了心血管外科医师职业胜任力培养存在的问题,并对问题进行了剖析,结合临床实际培养情况制定了对策,对医师胜任力培养进行了思考与探索。最后以某三级综合医院心脏大血管外科住院医师规范化培训经验为例,阐述了相关培养经验。     

教学基地建设与外科医生的培养

随着外科疾病诊疗技术的迅速发展,外科学已成为一门更加系统的学科.因此,如何培养优秀的外科医生已成为当前提高医疗卫生水平的重要课题.我院积极研究并率先实施了以教学基地建设促进外科医师培养的新模式,在建立良好培训制度以及利用丰富的临床、教学资源的基础上,通过成立专门的临床教学小组、加强培训医生的临床实践的强度、建立和完善临床教学资源平台系统以及充分利用现代网络技术等手段,在外科医师培养工作中取得了显著成效.     

自我解释的研究现状与展望

自我解释(self-explanation)是指学习者在学习过程中通过自己向自己解释学习内容而获得知识的过程。文章主要阐述了自我解释的含义、分类、三种自我解释效果的认知机制,并且提出自我解释研究中尚待解决的问题及对其进行展望。     

Effects of aging on implicit sequence learning: Accounting for sequence structure and explicit knowledge

The present research was intended to examine the sequence learning ability of elderly people — with a focus on comparing sequences with different structural characteristics and on properly assessing explicit knowledge. Experiment 1 showed that learning-related improvements in serial reaction time task performance were greater for young than elderly subjects, and elderly subjects were especially poor at learning a sequence with complex structural characteristics. Measures of recognition memory showed that neither young nor elderly subjects showed above-chance explicit knowledge of the sequences. Experiment 2 was designed to test the validity and sensitivity of the explicit recognition measures by comparing young subjects in groups given all random trials, given sequence trials with implicit instructions, or given sequence trials with explicit instructions. Experiment 2 confirmed the sensitivity of the recognition measures to explicit knowledge, so it is concluded that group effects in Exp. 1 reflect age-related differences in implicit learning.     

Diminished motor skill development in elderly: Indications for limited motor chunk use

The present study examined whether elderly use motor chunks after practicing discrete keying sequences, just like young adults, or whether they perhaps learn these movement patterns in a different way. To that end, elderly (75-88) and young adults (18-28) practiced as part of the discrete sequence production (DSP) task two fixed series of three and six key presses. The results demonstrate that elderly did improve with practice but this improvement was largely sequence-unspecific. Detailed analyses showed that, in contrast to young adults, most elderly did not use motor chunks, had little explicit sequence knowledge, and remained highly dependent on external stimuli. Still, elderly did show sequence-specific learning with a 6-key sequence that can be explained by an associative learning mechanism.     

The influence of intentional and incidental learning on acquiring spatial knowledge during navigation

In order to study the influence of intentional and incidental learning conditions on route learning, young adults walked a route through a university building. Half of the participants focused their attention on the route (intentional learning condition), while the other half did not (incidental learning condition). Five tests of spatial knowledge were employed: a route-length-estimation, landmark recognition, landmark ordering, map-drawing and navigation task. The intentional group performed better than the incidental group on the map-drawing and navigation task. No difference between the intentional and incidental group was found on the landmark-recognition and landmark-ordering task. Moreover, the intentional group overestimated the walking distance, while the incidental group underestimated it. These results suggest that route knowledge (landmark recognition and landmark ordering) requires less effortful processing than survey knowledge (developing a map-like representation and actual navigation).     

Contextual interference effects in sequence learning for young and older adults

Practice of different tasks in a random order induces better retention than practicing them in a blocked order, a phenomenon known as the contextual interference (CI) effect. Our purpose was to investigate whether the CI effect exists in sequence learning, such that practicing different sequences in a random order will result in better learning of sequences than practicing them in blocks, and whether this effect is affected by aging. Subjects practiced a serial reaction time task where a set of three 4-element sequences were arranged in blocks or in a random order on 2 successive days. Subjects were divided into 4 groups based on a 2-GROUP (young or old) by 2-ORDER (random or blocked practice) between-subject design. Three days after practice (Day 5), subjects were tested with practiced and novel sequences to evaluate sequence-specific learning. The results replicate the CI effect in sequence learning in both young and older adults. Older adults retained sequences better when trained in a random condition than in a blocked condition, although the random condition incurs greater task switching costs in older adults during practice. Our study underscores the distinction between age-related effects on learning vs. performance, and offers practical implications for enhancing skill learning in older adults.     

Three-year-old children can access their own memory to guide responses on a visual matching task

Many models of learning rely on accessing internal knowledge states. Yet, although infants and young children are recognized to be proficient learners, the ability to act on metacognitive information is not thought to develop until early school years. In the experiments reported here, 3.5-year-olds demonstrated memory-monitoring skills by responding on a non-verbal task originally developed for non-human animals, in which they had to access their knowledge states. Children learned a set of paired associates, and were given the option to skip uncertain trials on a recognition memory test. Accuracy for accepted items was significantly higher than for skipped on a subsequent memory task that included all items. Additionally, children whose memory-monitoring assessments more closely matched actual memory performance showed superior overall learning, suggesting a correlation between memory-monitoring and memory itself. The results suggest that children may have implicit access to internal knowledge states at very young ages, providing an explanation for how they are able to guide learning, even as infants.     

结合东巴文学习汉字对幼儿汉字字形记忆的影响

采用任务分离范式考察汉字学习的三种方式—只学习汉字、结合图画学习汉字、结合东巴文学习汉字对幼儿汉字字形记忆的影响。实验1采用再认任务考察学习方式对汉字字形外显记忆的影响, 分为学习、干扰、即时测试和延迟测试4个阶段。80名幼儿被分配进汉字组、东巴文组、东巴文-汉字组和图画-汉字组, 并接受统一的教学指导语。结果表明, 无论是即时测试还是延迟测试, 东巴文-汉字组的再认成绩均显著好于图画-汉字组和汉字组; 即时测试的再认成绩均好于延迟测试; 名词的再认成绩均好于动词。实验2采用偏好判断任务考察学习方式对汉字字形内隐记忆的影响。结果表明, 无论是即时测试 还是延时测试, 东巴文-汉字组的内隐启动量均显著大于其他各组; 即时测试与延迟测试的内隐启动量无显著差异; 名词的内隐启动量显著大于动词。整个研究表明, 东巴文对幼儿的汉字字形记忆具有明显的促进作用。所以如此, 既与东巴文的象形和表意性质有关, 也与东巴文与汉字的结构相似有关, 还与幼儿的认知特点有关。     

Exploring Initiative as a Signal of Knowledge Co‐Construction During Collaborative Problem Solving

Peer interaction has been found to be conducive to learning in many settings. Knowledge co‐construction (KCC) has been proposed as one explanatory mechanism. However, KCC is a theoretical construct that is too abstract to guide the development of instructional software that can support peer interaction. In this study, we present an extensive analysis of a corpus of peer dialogs that we collected in the domain of introductory Computer Science. We show that the notion of task initiative shifts correlates with both KCC and learning. Speakers take task initiative when they contribute new content that advances problem solving and that is not invited by their partner; if initiative shifts between the partners, it indicates they both contribute to problem solving. We found that task initiative shifts occur more frequently within KCC episodes than outside. In addition, task initiative shifts within KCC episodes correlate with learning for low pre‐testers, and total task initiative shifts correlate with learning for high pre‐testers. As recognizing task initiative shifts does not require as much deep knowledge as recognizing KCC, task initiative shifts as an indicator of productive collaboration are potentially easier to model in instructional software that simulates a peer.     

Implicit and Explicit Learning in Aged and Young Adults

There is a wealth of evidence that learning ability declines with age. In almost all of the studies however, the performance measures employed are explicit, even though research has consistently indicated that aged adults have well preserved implicit learning ability. This suggests that under certain circumstances aged adults should be at no great learning disadvantage in comparison to young adults. This experiment used the artificial grammar-learning paradigm, developed by Reber, in a 2 X 2 factorial design that involved systematic manipulation of grammatical complexity and rule provision. The study explored how each combination of conditions influenced explicit or implicit learning and the relationship between learning style and performance by aged and young adults. Learning was assessed primarily by recognition accuracy, involving correct and incorrect grammar exemplars. However, reaction time, error pattern, reliability, and verbal report data was also collected as a way of confirming and providing added detail on learning performance patterns. Aged adults, irrespective of experimental learning conditions, evidenced a remarkably consistent reaction time deficit. In contrast, the accuracy differential between age groups varied markedly across the four treatments. The most salient contrast occurred between complex grammar, without rules, where there was no difference in accuracy between the two age groups and simple grammar, with rules, where the difference was greatest. This change in learning performance between these two conditions indicates that aged adults will learn as well as young adults in situations where the knowledge domain is conducive to implicit learning.     

Feature distribution and background knowledge in category learning

Three experiments examined the interactions of category structure and prior knowledge in category learning.Experiment 1 examined the distribution of atypical or 'crossover' features in category learning. In real categories, crossover features may be unevenly distributed found primarily in very unusual examples of a category (like whales or ostriches). In contrast, in many psychology experiments, each item has exactly one crossover feature. Even versus uneven distribution of crossover features did not affect category learning when the features were neutral. However, when the features were connected by prior knowledge, it was much harder for subjects to learn the structure with the uneven distribution of crossover features. Experiments 2 and 3 found similar results with a slightly less uneven condition. We conclude that learning is a function of the interaction of category structure and prior knowledge rather than either one alone. Furthermore, knowledge benefits learning even when the category contains contradictions of the knowledge, so long as the contradictions are not very salient.     

The virtue of multiculturalism: personal transformation, character, and openness to the other

The social, intellectual, and moral movement known as multiculturalism has been enormously influential in psychology. Its ability to reshape psychology has been due to its ethical force, which derives from the attractiveness of its aims of inclusion, social justice, and mutual respect. The cultivation of cultural competence, presented as a developmental process of acquiring self-awareness, cultural knowledge, and skills, is an important emphasis in the multicultural literature. The authors place the cultural competence literature in dialogue with virtue ethics (a contemporary ethical theory derived from Aristotle) to develop a rich and illuminating way for psychologists to understand and embody the personal self-examination, commitment, and transformation required for learning and practicing in a culturally competent manner. According to virtue ethics, multiculturalism can be seen as the pursuit of worthwhile goals that require personal strengths or virtues, knowledge, consistent actions, proper motivation, and practical wisdom. The authors term the virtue of multiculturalism openness to the other and conclude by describing how attention to cultural matters also transforms virtue ethics in important and necessary ways.