An examination of learning processes during critical incident training: implications for the development of adaptable trainees

Three experiments are reported that examined the process by which trainees learn decision-making skills during a critical incident training program. Formal theories of category learning were used to identify two processes that may be responsible for the acquisition of decision-making skills: rule learning and exemplar learning. Experiments 1 and 2 used the process dissociation procedure (L. L. Jacoby, 1998) to evaluate the contribution of these processes to performance. The results suggest that trainees used a mixture of rule and exemplar learning. Furthermore, these learning processes were influenced by different aspects of training structure and design. The goal of Experiment 3 was to develop training techniques that enable trainees to use a rule adaptively. Trainees were tested on cases that represented exceptions to the rule. Unexpectedly, the results suggest that providing general instruction regarding the kinds of conditions in which a decision rule does not apply caused them to fixate on the specific conditions mentioned and impaired their ability to identify other conditions in which the rule might not apply. The theoretical, methodological, and practical implications of the results are discussed.     

Neuroprotection and stroke rehabilitation: modulation and enhancement of recovery

Recent advances in research are modifying our view of recovery after nervous system damage. New findings are changing previously held concepts and providing promising avenues for treatment of patients after stroke. This review discusses mechanisms of neuronal injury after brain ischemia and the attempts to study neuroprotection options based on such mechanisms. It also considers measures available at present to improve outcome after stroke and presents new areas of research, particularly stimulation techniques, neurogenesis and trophic factors to enhance recovery. In order to improve outcomes, medications that may be detrimental to recovery should be avoided, while symptomatic therapy of problems such as depression, pain syndromes and spasticity may contribute to better results. Continued surveillance and early treatment of complications associated with acute stroke, along with supportive care remain the mainstay of treatment for stroke patients in the recovery phase. Present research on limiting brain damage and improving recovery and plasticity enhance the prospects for better clinical treatments to improve recovery after stroke.     

Children's printed word database: Continuities and changes over time in children's early reading vocabulary

In this paper we introduce a comprehensive database of the vocabulary in reading materials used by 5 – 9 year old children in the UK. The database is available on‐line http:www.essex.ac.ukpsychologycpwd and allows researchers into early reading development the possibility of rigorous control over critical characteristics of experimental stimuli such as word frequency, regularity and length, frequency of grapheme‐phoneme correspondences, orthographic and phonological neighbourhoods etc. The on‐line database is also a resource that can be used by practitioners with interests in literacy development and literacy instruction. It can be used to obtain characteristics for a user‐generated list of words, or else to generate a list of words according to constraints specified by the user. Here we present an overview of the construction of the database, the materials entered into it, the survey of schools by which we obtained information about the books that were most likely to be used by children in each age group, and the search features available on the database website. We also discuss certain characteristics of the Vocabulary itself and compare these with those reported in an earlier non‐representative database reported in Stuart, Dixon, Masterson and Gray (2003). We then present a detailed analysis of the characteristics of Vocabulary in books used in the Reception year, against the background of recent recommendations for change in the early teaching of reading. Finally, we present data showing that the database is indeed already proving a useful resource for both practitioners and researchers.     

Structural properties of spatial representations in blind people: Scanning images constructed from haptic exploration or from locomotion in a 3-D audio virtual environment

When people scan mental images, their response times increase linearly with increases in the distance to be scanned, which is generally taken as reflecting the fact that their internal representations incorporate the metric properties of the corresponding objects. In view of this finding, we investigated the structural properties of spatial mental images created from nonvisual sources in three groups (blindfolded sighted, late blind, and congenitally blind). In Experiment 1, blindfolded sighted and late blind participants created metrically accurate spatial representations of a small-scale spatial configuration under both verbal and haptic learning conditions. In Experiment 2, late and congenitally blind participants generated accurate spatial mental images after both verbal and locomotor learning of a full-scale navigable space (created by an immersive audio virtual reality system), whereas blindfolded sighted participants were selectively impaired in their ability to generate precise spatial representations from locomotor experience. These results attest that in the context of a permanent lack of sight, encoding spatial information on the basis of the most reliable currently functional system (the sensorimotor system) is crucial for building a metrically accurate representation of a spatial environment. The results also highlight the potential of spatialized audio-rendering technology for exploring the spatial representations of visually impaired participants.     

Applied sport psychology: A view from britain

Abstract

Based on the findings of a field study with youth sport coaches, contextual factors in youth sport arc considered. Youth sport is discussed as a “developmental intervention” (Birkel, Lerner, &; Smyer, 1989). Although past research has examined a variety of issues in youth sport (e.g., coaching behavior, participation motivation), the dynamics of the context have been largely ignored. It is argued that situational factors may have important implications for the quality of children's youth sport experiences. Data arc presented to show the significance of contextual factors in coaches' experiences. Examples of previous interventions aimed at manipulating contexts arc offered and suggestions for future interventions, based on the present study, arc discussed. The roles of parents. spectator location. rules, and time are discussed in detail.     

From the Galleries to the Clinic: Applying Art Museum Lessons to Patient Care

Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation—often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises—Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside—from “Training the Eye: Improving the Art of Physical Diagnosis,” an elective museum-based course at Harvard Medical School. It is our opinion that while strategic interactions with the visual arts can improve skills, it is essential for students to apply them in a clinical context with faculty support—requiring educators across disciplines to learn from one another.     

Inside Out: The State of the Analyst and the State of the Patient

This paper presents my work with a man before and after my undergoing an emergency, life-threatening surgical episode, and subsequent experience of living with a temporary colostomy, that shifted me to a more ungrounded, bodily aware, vulnerable, nonlinear, spontaneous and risk-taking, and affectively intensified “right brain” state. My story represents one instance of how the contingent nature of the analyst's life and existential exposure, and the various chancy life circumstances governing the analyst's self-state, may constitute an impingement on clinical process with potential for inadvertent positive or negative impact on the therapeutic relationship and work. Much has been written about the causes and consequences of shifts in the analyst's self-state induced within the relational dynamics of the transference-countertransference matrix. Here I specifically consider that side of the intersubjective therapeutic equation generated by the effects of the analyst's own state on the patient and the dyad's interactive process.     

Applications,Implications, Complications: Reply to Reviews by Elkind,Gerson, and Levine

The author appreciates the careful reading and thoughtful reviews by Sue Elkind, Sam Gerson, and Howard Levine. Elkind's review particularly captures and articulates many of the key ideas in the book Building Bridges: The Negotiation of Paradox in Psychoanalysis and creatively applies concepts of negotiation, paradox, an inherently multiple “distributed self,” and metaphor in her own work consulting on treatment impasses. Gerson incisively focuses on the core idea of recognizing, accepting, and bridging differences and contradictions in personal, and national, perspectives; he also articulates an understanding of the attempt of relational analytic writers to bridge the intrapsychic and the interpersonal with due recognition of each. The author replies extensively to Levine's comparison of Pizer's work with that of Semrad and other “classical” analysts and challenges Levine's premise that a relational perspective, grounded as it is in a two-person contextual psychology, ignores or devalues interpretation, insight, free association, and autonomous mental functioning. Quoting from clinical material in his book, Pizer presents the outcome of a “relational” analysis in terms of the patient's increased access to internal “potential space,” unconscious experience, curiosity, and reflectiveness about the mental life of self and other, and an increased ability to value personal experience in relationship and in solitude.     

Is Memory for Head Orientation Based on a Left-Looking Schema?

Research has shown that people misremember right-looking heads on coins as facing to the left, suggesting a general memory schema that favors left-lookers. This hypothesis was investigated in a study of 241 subjects in three experiments who were shown photographs of faces looking to the left, to the right, or at the observer and were later asked to identify whether each one had subsequently been left-right reversed. Also, in Experiments 2 and 3, respectively, initial judgments of liking and of orientation were obtained. Unexpectedly, orientation memory accuracy was lower after a 5-s exposure than after a 1-s exposure, and after initial judgments of lateral orientation than after judgments of liking. Although the difference between left- and right-lookers was significant in only 2 of 14 comparisons, aggregated data showed that identification accuracy was generally higher for left-lookers, with a mean effect size of 0.16. Although small, this difference is consistent with the hypothesis of a left-looking schema for heads.