Game-based learning and the role of feedback. A case study

Burgos, D., Nimwegen, C. v., Oostendorp, H. v., & Koper, E. J. R. (2007). Game-based learning and inmediate feedback. The case study of the Planning Educational Task. International Journal of Advanced Technology in Learning.Educational electronic games and simulations (or simply educational eGames) engage players. They are attractive to awake and keep the focus of a user, and are useful for learning while covering learning objectives and playable goals. In eGames, feedback can improve learning and help the learner to take decisions about his strategy and it also encourages the learner’s motivation. However, too much feedback can in some situations lead to a weaker strategy by the learner to solve the problem presented, resulting in a lower performance. In this paper, we first show the relevance of eGames for learning and its relation with feedback. We introduce the need for appropriate feedback in order to get a better performance, but we also state that feedback depends on the context and on the game and that it is not always required in order to achieve the best performance while solving a problem. We carried out a case study (Planning Educational Task) with real learners/players, to study the differences between having and not having instant destination feedback while solving a problem. We discuss the results and implications of the case study, namely that in the context of our planning game, leaving feedback out improved performance.This paper is partially supported by the European projects TENCompetence (IST-TEL/2004-2.4.10, www.tencompetence.org) and ProLearn (IST Contract number 507310, www.prolearn-project.org). We also thank Dr. Hermina Schijf from Utrecht University for her involvement and assistance during this research project

The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study

Contains fulltext : 51459.pdf ( ) (Open Access)BACKGROUND: Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection. METHODS: Thirty patients following breast cancer surgery and axillary lymph node dissection were included in a randomised controlled study. Assessments were made at baseline and after three and six months. The treatment group received standardised physiotherapy treatment of advice and exercises for the arm and shoulder for three months; the control group received a leaflet containing advice and exercises. If necessary soft tissue massage to the surgical scar was applied. Primary outcome variables were amount of pain in the shoulder/arm recorded on the Visual Analogue Scale, and shoulder mobility (flexion, abduction) measured using a digital inclinometer under standardized conditions.Secondary outcome measures were shoulder disabilities during daily activities, edema, grip strength of both hands and quality of life. The researcher was blinded to treatment allocation. RESULTS: All thirty patients completed the trial. After three and six months the treatment group showed a significant improvement in shoulder mobility and had significantly less pain than the control group. Quality of life improved significantly, however, handgrip strength and arm volume did not alter significantly. CONCLUSION: Physiotherapy reduces pain and improves shoulder function and quality of life following axillary dissection after breast cancer

Management of headache disorders: design of a randomised clinical trial screening for prognostic patient characteristics

Contains fulltext : 51576.pdf (publisher's version ) (Open Access)BACKGROUND: Treatment of headache disorders is not always optimal. Patients are treated in multiple ways, and the lack of scientific arguments for referral and the insufficient implementation of guidelines result in unclear treatment strategies. The coexistence of headache and neck pain can lead to the referral to a musculoskeletal physiotherapist. This treatment can only be successful if an underlying cervical segmental dysfunction is present. In such cases a physical treatment can be a valuable option that should be considered. The aim of this study is to identify prognostic therapeutic patient characteristics and to increase the number of correct physiotherapy referrals. METHODS/DESIGN: This trial is designed to identify patient characteristics which can influence the prognosis of the patient. Patients with recurrent headache and co-existent neck pain are recruited via a multicenter setup. After screening for eligibility, subjects are tested at baseline and randomly allocated to one of two treatment groups. Testing includes the administering of questionnaires (a Headache Diagnosis Questionnaire, Headache Inventory List and the Headache Impact Test (HIT-6)) and physical tests (Thermal Stimuli, Manual Cervical Spine Examination and Pressure Algometry). Treatment groups are a usual care group (UC) administered by the General Practitioner (GP) and a usual care plus musculoskeletal physiotherapy treatment group (UCMT). UC is based on the Dutch GP Guideline for Headache. UCMT consists of the UC plus a combination of exercises and spinal cervical mobilisations. Follow-up measurements consist of the completion of the Headache Inventory List, the HIT-6 and scoring of the global perceived effect (GPE). The latter allowing the distinction between responders (positive effect) and non-responders (no effect or worse). Logistic regression analysis will be used to identify the specific patient characteristics of the responders and the non-responders. The additional value of the musculoskeletal physiotherapy will be examined. Follow-up measurements up to 52 weeks are scheduled. DISCUSSION: This trial aims to identify prognostic patient characteristics, in order to supply a useful diagnostic tool for all health care workers, dealing with headache sufferers

Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study

BACKGROUND: Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme’s effectiveness and the fidelity, acceptability and feasibility of its implementation. METHODS: A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines’ main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen’s d). RESULTS: Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (−15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme’s multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. CONCLUSIONS: The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial

Modeling the His-Purkinje Effect in Non-invasive Estimation of Endocardial and Epicardial Ventricular Activation

Inverse electrocardiography (iECG) estimates epi- and endocardial electrical activity from body surface potentials maps (BSPM). In individuals at risk for cardiomyopathy, non-invasive estimation of normal ventricular activation may provide valuable information to aid risk stratification to prevent sudden cardiac death. However, multiple simultaneous activation wavefronts initiated by the His-Purkinje system, severely complicate iECG. To improve the estimation of normal ventricular activation, the iECG method should accurately mimic the effect of the His-Purkinje system, which is not taken into account in the previously published multi-focal iECG. Therefore, we introduce the novel multi-wave iECG method and report on its performance. Multi-wave iECG and multi-focal iECG were tested in four patients undergoing invasive electro-anatomical mapping during normal ventricular activation. In each subject, 67-electrode BSPM were recorded and used as input for both iECG methods. The iECG and invasive local activation timing (LAT) maps were compared. Median epicardial inter-map correlation coefficient (CC) between invasive LAT maps and estimated multi-wave iECG versus multi-focal iECG was 0.61 versus 0.31. Endocardial inter-map CC was 0.54 respectively 0.22. Modeling the His-Purkinje system resulted in a physiologically realistic and robust non-invasive estimation of normal ventricular activation, which might enable the early detection of cardiac disease during normal sinus rhythm

Content analysis: What are they talking about?

Quantitative content analysis is increasingly used to surpass surface level analyses in Computer-Supported Collaborative Learning (e.g., counting messages), but critical reflection on accepted practice has generally not been reported. A review of CSCL conference proceedings revealed a general vagueness in definitions of units of analysis. In general, arguments for choosing a unit were lacking and decisions made while developing the content analysis procedures were not made explicit. In this article, it will be illustrated that the currently accepted practices concerning the ‘unit of meaning’ are not generally applicable to quantitative content analysis of electronic communication. Such analysis is affected by ‘unit boundary overlap’ and contextual constraints having to do with the technology used. The analysis of e-mail communication required a different unit of analysis and segmentation procedure. This procedure proved to be reliable, and the subsequent coding of these units for quantitative analysis yielded satisfactory reliabilities. These findings have implications and recommendations for current content analysis practice in CSCL research

Effectief ontwikkelings­­­be­leid vergt cultuur van leren en betere evaluaties

Het Nederlandse ministerie van Buitenlandse Zaken spant zich in om de impact van ontwikkelingsprojecten te (laten) evalueren. Momenteel worden monitoring en evaluaties hoofdzakelijk ontworpen voor verantwoordingsdoeleinden, en zijn het soms alleen maar ‘afvinkoefeningen’. Hoe zou dit beter kunnen