Can older people remember medication reminders presented using synthetic speech?

Reminders are often part of interventions to help older people adhere to complicated medication regimes. Computer-generated (synthetic) speech is ideal for tailoring reminders to different medication regimes. Since synthetic speech may be less intelligible than human speech, in particular under difficult listening conditions, we assessed how well older people can recall synthetic speech reminders for medications. 44 participants aged 50-80 with no cognitive impairment recalled reminders for one or four medications after a short distraction. We varied background noise, speech quality, and message design. Reminders were presented using a human voice and two synthetic voices. Data were analyzed using generalized linear mixed models. Reminder recall was satisfactory if reminders were restricted to one familiar medication, regardless of the voice used. Repeating medication names supported recall of lists of medications. We conclude that spoken reminders should build on familiar information and be integrated with other adherence support measures. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: [email protected] numbered affiliations see end of article

Fostering Reflective Skills in Audiology Practice and Education

Reflection is considered a deliberate process of learning from experience with the goal of realizing effective and rewarding patient and personal outcomes. Reflective thinking has become incorporated into clinical practice and education across health-care professions. Facilitators for development of reflection and reflective practice include appropriate timing, a supportive environment, feedback, and mentorship. This article introduces the reader to models and forms of reflection, discusses facilitators and detractors to effective reflection, and reviews critical commentary. The Reflective Journal, 4 Habits of Effective Audiologic Service, and Self Reflection of Learning are three tools that guide students or practitioners in reflective activities.casl1 Johns C. Becoming a Reflective Practitioner. Hoboken, NJ: Wiley Blackwell; 2009 2 Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ Theory Pract 2009; 14: 595-621 3 Kinsella EA. Professional Development and Reflective Practice: Strategies for Learning through Professional Experience. Ottawa, Ontario, Canada: CAOT Publications ACE; 2000 4 Vygotsky L. Thought and Language, revised ed. Cambridge, MA: MIT Press; 1986 5 Knowles MS, Holton EF, Swanson RA. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. Burlington, MA: Elsevier; 2005 6 Dewey J. Experience and Education. New York, NY: Simon and Schuster; 1938 7 Clarke B, James C, Kelly J. Reflective practice: reviewing the issues and refocusing the debate. Int J Nurs Stud 1996; 33: 171-180 8 Hubbs D, Brand CF. The paper mirror: understanding reflective journaling. J Experiential Educ 2005; 28: 60-71 9 Clouder L. Reflective practice: realising its potential. Physiother 2000; 86: 517-522 10 McLeod A. An Introduction to Counseling, 4th ed. London, UK: Open University Press; 2009 11 Turock A. Immediacy in counseling: recognizing the client's unspoken messages. Pers Guid J 1980; 59: 168-172 12 Schn DA. The Reflective Practitioner: How Professionals Think in Action. London, UK; 1983 13 Argyris C, Schn DA. Organizational Learning: A Theory of Action Perspective. Reading, MA: Basic Books; 1978 14 Kolb DA. Experiential Learning. Englewood Cliffs, NJ: Prentice Hall; 1984 15 Gibbs G. Learning by Doing: A Guide to Teaching and Learning Methods. London, UK: Further Education Unit; 1988 16 Van Marren M. The Tact of Teaching. New York, NY: State of University of New York Press; 1991 17 Bleakley A. From reflective practice to holistic reflexivity. Stud High Educ 1999; 24: 315-330 18 Rolfe G, Freshwater D, Jasper M. Critical Reflection for Nursing and the Helping Professions: A User's Guide. London, UK: Palgrave Macmillan; 2001 19 Boud D. Using journal writing to enhance reflective practice. New Dir Adult Contin Educ 2001; 90: 9-17 20 Nelson-Jones R. Theory and Practice of Counselling and Therapy, 5th ed. Thousand Oaks, CA: Sage; 2010 21 Kerka S. Journal Writing and Adult Learning. Columbus, OH: ERIC Clearinghouse on Adult, Career, and Vocational Education, Center on Education and Training for Employment, College of Education, the Ohio State University; 1996 22 Frankel RM, Stein T. Getting the most out of the clinical encounter: the Four Habits Model. Permenente J 1999; 3: 79-88 23 Clark J, Maatman C, Gailey L. Moving patients forward: motivational engagement. Semin in Hearing 2012; 33: 35-45 24 Sobral DT. An appraisal of medical students' reflection-in-learning. Med Educ 2000; 34: 182-187 25 Leung D, Kember D. The relationship between approaches to learning and reflection upon practice. Educ Psychol 2003; 23: 61-71 26 Sobrol D. Medical students: reflection-in-learning in relation to approaches to study and academic achievement. Med Tcher 2001; 23: 508-513 27 Sobrol D. Medical students' mindset for reflective learning: a revalidation of the reflection in learning scale. Adv Health Sci Educ 2005; 10: 303-31433pub2912pub