Using Technology to Train and Sustain Delivery of Evidence-Based Practices

Practitioners face three challenges in delivering evidence-based practice: limitations in the evidence available to guide routine clinical decisions; limitations in clinical judgment that are hard to remedy with typical work routines; and the practical difficulties of training and sustaining the breadth of skills relevant to meet diverse patient needs in a generalist practice. We recommend designing practice environments that support development of excellent clinical judgment with use of standardized work routines that help detect relationships between clinical decisions, interventions, and patient outcomes. We describe examples illustrating how technology can support training and supervision within this framework.     

Enhancing spatial skills of preschoolers from under-resourced backgrounds: A comparison of digital app vs. concrete materials

Spatial skills support STEM learning and achievement. However, children from low-socioeconomic (SES) backgrounds typically lag behind their middle- and high-SES peers. We asked whether a digital educational app—designed to mirror an already successful, spatial assembly training program using concrete materials—would be as effective for facilitating spatial skills in under-resourced preschoolers as the concrete materials. Three-year-olds (N = 61) from under-resourced backgrounds were randomly assigned to a business-as-usual control group or to receive 5 weeks of spatial training using either concrete, tangible materials or a digital app on a tablet. The spatial puzzles used were an extension of items from the Test of Spatial Assembly (TOSA). Preschoolers were pretested and posttested on new two-dimensional (2D) TOSA trials. Results indicate that both concrete and digital spatial training increased performance on the 2D-TOSA compared to the control group. The two trainings did not statistically differ from one another suggesting that educational spatial apps may be one route to providing early foundational skills to children from under-resourced backgrounds.     

Parents’ self-efficacy and the quality of supervised driving practice they provide for their children

Learner drivers must gain supervised driving practice in a wide variety of driving situations to prepare them for independent driving. This study investigated the way that sociodemographic factors, parental self-efficacy and driving self-efficacy of parents are associated with the quality of supervised driving practice they provide to their learner driver children. An online survey was completed by 293 fully licensed parents (female = 86%) of learner (52%) and provisional (intermediate; 48%) drivers from Queensland, Australia. A variable indicating quality of supervised practice was defined based on the understanding that higher frequency and greater variety of driving situations and environments represents higher quality supervised practice. Hierarchical multiple regression was used to analyse parent responses. As predicted, driving self-efficacy was significantly and positively associated with quality of supervised practice. However, no significant association was found between parental self-efficacy and quality of supervised practice. Parent gender and perceived level of involvement were also important predictors of supervised practice quality. The association between previous experience with providing supervised practice and supervised practice quality was unclear. A key implication of this research is that devising methods to improve the driving self-efficacy of parents may contribute to provision of more frequent and varied supervised practice.     

工作记忆训练诱发的神经可塑性——基于系列fMRI实验的脑区分布递减时空模型

工作记忆训练(Working Memory Training, WMT)诱发神经可塑性, 但其具体机制尚不明晰。为探索WMT改变正常人群大脑功能的时空特性, 以“扩展的智力顶额整合理论”和“神经效率假说”为依据, 采用逐层递进的5种方法, 分6个步骤来查究近20年来正常人群WMT的37篇fMRI文献。第一步, 用叙述性综述、频数分析和卡方检验法比较脑区激活模式和脑网络功能连接在WMT前后发生的改变, 发现WMT改变了大脑的5个联合区、7个宏观区和3个子区。其中, 额上回、顶下小叶和扣带回这3个子区各自激活减弱的报道文献数量多于其激活增强的, 且这种差异分别具有统计学意义。第二步, 采用激活似然估计法对其中26篇开展元分析, 发现大脑的3个子区激活减弱水平在WMT前后的差异具有统计学意义, 即额中回(BA6和8)、额上回(BA6)和前扣带回(BA24和32)。第三步, 综合定性和定量分析结果, 提出WMT脑区分布递减时空模型, 产生5个结果和讨论。第四步, 采用非参数检验进一步追踪WMT效应的调节因素, 发现训练的任务类型和时间分别对脑区激活的影响具有统计学意义。第五步, 针对正常人群WMT诱发神经可塑性的时空特性, 得出3个结论：第一, WMT改变了正常人群相应脑区的神经活动, 表现为减弱或增强, 但减弱更加突出, 且更新和较短时间的WMT倾向于诱发较多减弱; 第二, 这些神经活动变化主要发生在额顶叶联合区, 但也包括分别以颞叶、枕叶、扣带回及纹状体为主的联合区, 在一定范围内体现了整脑功能联合。这体现了WMT诱发神经可塑性的空间特性, 且符合“扩展的智力顶额整合理论”; 第三, 额中回、额上回、顶下小叶和扣带回(尤其前扣带回)这4个子区在激活减弱水平上重点展示了WMT神经可塑性的时间特性, 且符合“神经效率假说”, 恰好体现出“聪明的大脑更懒惰”。第六步, 指出WMT诱发神经可塑性的未来研究可能关注脑可塑性中的低活跃性、辨析额中回、额上回、顶下小叶和扣带回(尤其前扣带回)这4个子区在激活减弱水平上体现的时间特性、找寻训练减弱或增强大脑活动的综合性影响因素。     

Profils d’apprenti·e·s reflétant des tensions de rôle en formation professionnelle en alternance en Suisse

Role stress among apprentices are a key element in defining the quality of dual vocational education and training. However, few studies have examined the perceptions and importance of role tensions in this particular context. Accordingly, this contribution focuses on the role stress perceived by dual apprentices through a questionnaire survey. Latent profile analyses allowed to distinguish four apprentices’ profiles in terms of perceptions of role stress, ranging from minimal to prominent role stress. Differences in socio-demographic characteristics, motivation for choosing the training, professional identification, and intention to terminate the apprenticeship contract were also identified. The study provides information on the importance of considering apprentices as a heterogeneous population in terms of role stress, but also on the different motivational and identity issues associated with the profiles. Discussing such issues would also improve the learning experience.     

正念训练对康复期精神分裂症患者抑制控制的影响

探究正念训练对康复期精神分裂症患者正念觉知水平和抑制控制能力的影响。选取54名康复期精神分裂症住院患者随机分为正念组和对照组。对照组予以常规康复治疗,正念组在常规康复治疗基础上进行8周正念训练。结果发现：（1）在正念觉知方面,正念组后测得分显著高于前测,对照组前后测得分无显著差异;正念组后测得分显著高于对照组。（2）在抑制控制方面,正念组后测Stroop任务反应时显著低于前测,对照组前后测反应时无显著差异;正念组后测反应时显著低于对照组。结果表明,正念训练有助于提高康复期精神分裂症患者正念觉知水平和改善其抑制控制能力。     

Attitudes of clinical psychologists towards clients with personality disorders

Previous studies have found that a variety of mental health professionals hold negative attitudes towards clients diagnosed with a personality disorder. These negative attitudes may lead to clients receiving a lower quality of service. Specialist training has been found to improve attitudes towards personality disorders but no empirical studies in Australia have examined this among clinical psychologists. In this study, the attitudes of 81 clinical psychologists towards clients with personality disorders were examined. We were specifically interested in investigating the relationship between recency of specialist training and clinician's attitudes as well as the influence of percentage of personality disorder clients on the clinician's caseload. Results demonstrated that both recency of specialist training and percentage of clients seen were associated with more positive attitudes; however, a higher caseload of clients with personality disorders was the most important predictor of positive attitudes. The implication is that recent participation in specialist training for personality disorders appears to be valuable in improving clinician's attitudes but that more positive attitudes are associated with seeing a greater number of individuals with personality disorders.     

Issues in Professional Training to Implement Evidence‐based Parenting Programs: The Preferences of Indigenous Practitioners

Indigenous children have elevated risk for poor health, behavioural, emotional, and social outcomes. Significant evidence exists that parenting programs can reduce family risk factors and improve outcomes for children and families; however, mainstream programs have had slower uptake in Indigenous communities than other communities. Culturally sensitive delivery of evidence‐based programs can enhance engagement of parents, yet the development of a workforce to deliver programs to Indigenous parents faces many obstacles. This project seeks to identify professional training processes that enhance Indigenous practitioners’ skills and confidence in delivering an evidence‐based parenting program. A survey of trained parenting practitioners via an online practitioner network assessed their views of the training and post‐training support processes they had experienced. Respondents were 57 Indigenous and 720 non‐Indigenous practitioners from 15 countries. Most training processes were rated equally helpful by Indigenous and non‐Indigenous practitioners. However, several training processes were identified as important for the delivery of culturally competent training, such as tailoring the pace of training and simplifying the language in teaching resources. Practitioners with higher ratings of the helpfulness of peer support following training reported higher program uptake and implementation. Qualitative themes also focused on the helpfulness of program resources, and having a peer support network and mentoring. Increasing access to appropriate, flexibly delivered training and post‐training support for Indigenous professionals will support the development of a skilled workforce with local knowledge and connections, and further increase the reach of evidence‐based services in Indigenous communities.     

Improving arithmetic performance with number sense training: An investigation of underlying mechanism

A nonverbal primitive number sense allows approximate estimation and mental manipulations on numerical quantities without the use of numerical symbols. In a recent randomized controlled intervention study in adults, we demonstrated that repeated training on a non-symbolic approximate arithmetic task resulted in improved exact symbolic arithmetic performance, suggesting a causal relationship between the primitive number sense and arithmetic competence. Here, we investigate the potential mechanisms underlying this causal relationship. We constructed multiple training conditions designed to isolate distinct cognitive components of the approximate arithmetic task. We then assessed the effectiveness of these training conditions in improving exact symbolic arithmetic in adults. We found that training on approximate arithmetic, but not on numerical comparison, numerical matching, or visuo-spatial short-term memory, improves symbolic arithmetic performance. In addition, a second experiment revealed that our approximate arithmetic task does not require verbal encoding of number, ruling out an alternative explanation that participants use exact symbolic strategies during approximate arithmetic training. Based on these results, we propose that nonverbal numerical quantity manipulation is one key factor that drives the link between the primitive number sense and symbolic arithmetic competence. Future work should investigate whether training young children on approximate arithmetic tasks even before they solidify their symbolic number understanding is fruitful for improving readiness for math education.