Van dubbeltje tot kwartje

Rede, uitgesproken bij de aanvaarding van het ambt van hoogleraar Onderwijspsychologie, in het bijzonder de psychologie van het leren, aan de Erasmus Universiteit Rotterdam op vrijdag 27 februari 200

Self-directed learning in problem-based learning and its relationships with self-regulated learning

This study investigated the role of self-directed learning (SDL) in problem-based learning (PBL) and examined how SDL relates to self-regulated learning (SRL). First, it is explained how SDL is implemented in PBL environments. Similarities between SDL and SRL are highlighted. However, both concepts differ on important aspects. SDL includes an additional premise of giving students a broader role in the selection and evaluation of learning materials. SDL can encompass SRL, but the opposite does not hold. Further, a review of empirical studies on SDL and SRL in PBL was conducted. Results suggested that SDL and SRL are developmental processes, that the "self" aspect is crucial, and that PBL can foster SDL. It is concluded that conceptual clarity of what SDL entails and guidance for both teachers and students can help PBL to bring forth self-directed learners

Does Applying Biomedical Knowledge Improve Diagnostic Performance When Solving Electrolyte Problems?

Introduction. If physicians apply clinical rather than biomedical knowledge when diagnosing, why do we use the basic sciences as the foundation for clinical teaching? In this study we evaluated the contribution of biomedical knowledge to diagnostic performance when solving electrolyte problems. Method. We asked 13 medical students and 19 nephrologists to solve electrolyte problems while thinking aloud, and determined biomedical knowledge application by protocol analysis. We used logistic regression to study the association between biomedical concepts, clinical experience, and performance.Results. Students and nephrologists applied a similar number of biomedical concepts per case (1.8 (±1.1) vs. 1.8 (±1.2), respectively, p = 0.8), but nephrologists were more successful (86.8% vs. 63.5%, p = 0.003). We found a significant interaction between expertise and applying biomedical concepts (p < 0.05). For students the odds of success increased significantly with applying biomedical concepts (odds ratio 4.66 [2.07, 10.48], p < 0.001), whereas for nephrologists there was only a trend towards improved performance (odds ratio 1.72 [0.94, 3.11], p = 0.07). Conclusions. Our results suggest that improving biomedical knowledge of students should improve their performance on electrolyte problems. The performance of experienced physicians may also be improved, but this requires further study before teaching recommendations can be made

Diagnostic errors and reflective practice in medicine

Background: Adverse effects of medical errors have received increasing attention. Diagnostic errors account for a substantial fraction of all medical errors, and strategies for their prevention have been explored. A crucial requirement for that is better understanding of origins of medical errors. Research on medical expertise may contribute to that as far as it explains reasoning processes involved in clinical judgements. The literature has indicated the capability of critically reflecting upon one\'s own practice as a key requirement for developing and maintaining medical expertise throughout life. Objectives: This article explores potential relationships between reflective practice and diagnostic errors. Methods: A survey of the medical expertise literature was canducted. Origins of medical errors frequently reported in the literature were explored. The potential relationship between diagnostic errors and the several dimensions of reflective practice in medicine, brought to light by recent research, were theoretically explored. Results and Dissussion: Uncertainty and fallibility inherent to clinical judgements are discussed. Stages in the diagnostic reasoning process where errors could occur and their potential sources are highlighted, including the role of medical heuristics and biases. The authors discuss the nature of reflective practice in medicine, and explore whether and how the several behaviours and reasoning processes that constitute reflective practice could minimize diagnostic errors. Future directions for further research are discussed. They involve empirical research on the role of reflective practice in improving clinical reasoning and the development of educational strategies to enhancing reflective practice

The Effect of Testing on the Retention of Coherent and Incoherent Text Material

Research has shown that testing during learning can enhance the long-term retention of text material. In two experiments, we investigated the testing effect with a fill-in-the-blank test on the retention of text material. In Experiment 1, using a coherent text, we found no retention benefit of testing compared to a restudy (control) condition. In Experiment 2, text coherence was disrupted by scrambling the order of the sentences from the text. The material was subsequently presented as a list of facts as opposed to connected discourse. For the incoherent version of the text, testing slowed down the rate of forgetting compared to a restudy (control) condition. The results suggest that the connectedness of materials can play an important role in determining the magnitude of testing benefits for long-term retention. Testing with a completion test seems most beneficial for unconnected materials and less so for highly structured materials

Instructional Design for Advanced Learners: Establishing Connections between the Theoretical Frameworks of Cognitive Load and Deliberate Practice

Cognitive load theory (CLT) has been successful in identifying instructional formats that are more effective and efficient than conventional problem solving in the initial, novice phase of skill acquisition. However, recent findings regarding the “expertise reversal effect” have begun to stimulate cognitive load theorists to broaden their horizon to the question of how instructional design should be altered as a learner's knowledge increases. To answer this question, it is important to understand how expertise is acquired and what fosters its development. Expert performance research, and, in particular, the theoretical framework of deliberate practice have given us a better understanding of the principles and activities that are essential in order to excel in a domain. This article explores how these activities and principles can be used to design instructional formats based on CLT for higher levels of skills mastery. The value of these formats for e-learning environments in which learning tasks can be adaptively selected on the basis of online assessments of the learner's level of expertise is discussed

Experienced physicians benefit from analyzing initial diagnostic hypotheses

Background: Most incorrect diagnoses involve at least one cognitive error, of which premature closure is the most prevalent. While metacognitive strategies can mitigate premature closure in inexperienced learners, these are rarely studied in experienced physicians. Our objective here was to evaluate the effect of analytic information processing on diagnostic performance of nephrologists and nephrology residents. Methods: We asked nine nephrologists and six nephrology residents at the University of Calgary and Glasgow University to diagnose ten nephrology cases. We provided presenting features along with contextual information, after which we asked for an initial diagnosis. We then primed participants to use either hypothetico-deductive reasoning or scheme-inductive reasoning to analyze the remaining case data and generate a final diagnosis. Results: After analyzing initial hypotheses, both nephrologists and residents improved the accuracy of final diagnoses (31.1% vs. 65.6%, p < 0.001, and 40.0% vs. 70.0%, p < 0.001, respectively). We found a significant interaction between experience and analytic processing strategy (p = 0.002): nephrology residents had significantly increased odds of diagnostic success when using scheme-inductive reasoning (odds ratio [95% confidence interval] 5.69 [1.59, 20.33], p = 0.007), whereas the performance of experienced nephrologists did not differ between strategies (odds ratio 0.57 [0.23, 1.39], p = 0.2). Discussion: Experienced nephrologists and nephrology residents can improve their performance by analyzing initial diagnostic hypotheses. The explanation of the interaction between experience and the effect of different reasoning strategies is unclear, but may relate to preferences in reasoning strategy, or the changes in knowledge structure with experience

Building bridges in higher education: Student-faculty relationship quality, student engagement, and student loyalty

This study's aim was to investigate a hypothesized model examining the associations between students' perceptions of the quality of their relationship with their educational faculty and staff (i.e., relationship quality) and students' involvement. The relationship quality measurement included students' experiences with all educational faculty and staff, with the aim of predicting student engagement and student loyalty. Based on data from 454 higher education students, findings indicate that affective commitment and affective conflict are important relationship quality dimensions that influence the student engagement dimensions of absorption, dedication, and vigor. The main conclusion is that a relationship management approach in higher education is fruitful to achieve positive academic outcomes such as student engagement and student loyalty

Het belang van relatiekwaliteit in het hoger onderwijs

Relaties tussen studenten en hun opleiding spelen een belangrijke rolin het hoger onderwijs. Studenten ontwikkelen zich in die periode immers tot jonge professionals die na het behalen van hun diploma de arbeidsmarkt betreden. In dit artikel worden de belangrijkste inzichten over een proefschrift over relatiekwaliteit in het hoger onderwijs gepresenteerd. In het promotieonderzoek onderzochten we de relatie tussen studenten en hun opleiding, oftewel relatiekwaliteit, vanuit een studentperspectief. We bekeken welke invloed die relatie heeft op hun betrokkenheid (d.i. engagement en loyaliteit). In het onderzoek onder studenten en alumni werd aangetoond dat relatiekwaliteit een positieve invloed heeft op studentbetrokkenheid en studentloyaliteit. Ook als relatiekwaliteit over de tijd heen gemeten wordt (longitudinaal), blijkt ze studentbetrokkenheid en studentloyaliteit gunstig te beïnvloeden. Uit het onderzoek komt naar voren dat als hoger onderwijsinstellingen de relatiekwaliteit regelmatig monitoren, zij adequater kunnen reageren op wat studenten nodig hebben in de relatie met hun opleiding. De bevindingen van het proefschrift voorzien in een beter inzicht in de relatie van studenten met hun opleiding. Die kan ten goede komen bij het opstellen van onderwijsbeleid bijvoorbeeld gericht op de begeleiding en omgang met studenten. Voor hoger onderwijsinstellingen en studenten kan dit gunstig zijn. Een goede relatiekwaliteit maakt dat studenten meer betrokken zijn bij hun studie en ze een positieve band tussen onderwijsinstellingen en studenten bewerkstelligt, ook na het afstuderen. Afgestudeerden blijven zo eerder betrokken bij hun voormalig onderwijsinstituut bijvoorbeeld doordat ze gastlezingen geven, stageplekken aanbieden en ideeën voor praktijkgericht onderzoek aanbrengen

Attention Cueing as a Means to Enhance Learning from an Animation

The question how animations should be designed so that learning is optimised, is still under discussion. Animations are often cognitively very demanding, resulting in decreased learning outcomes. In this study, we tried to prevent cognitive overload and foster learning by focusing the learners’ attention to one element (i.e. process) of an animation using a cueing technique. Psychology students viewed an animation of the cardiovascular system and were subsequently given a comprehension test and a transfer test. One group studied the animation without a visual cue, while for another group a visual cue was added to the animation. Results indicated that cueing not only enhanced comprehension and transfer performance for cued information, but also for uncued information. It is concluded that cueing can be used as a technique to improve learning from an animation. Results are interpreted in terms of cognitive load theory (CLT)