Tag Archive: healthcare learning


Questioning strategies in Healthcare Training develop critical thinking, decision making, and problem solving in students. Bloom’s taxonomy of the six levels of cognitive learning can be used to provide a framework for creating questions. Bloom’s taxonomy starts from the simplest level of learning to the most complex level.  Simplest levels denote Knowledge and Complex levels denote Evaluation.

Sample Question for Knowledge Test:

Intravenous Urogram

Knowledge Test

Asking a learner to define Intravenous Urogram, (IVU) would test his/her knowledge levels.

Sample Question for Evaluation:

Intravenous Urogram

Complex Evaluation

A question is posed to the learner to  assess a request to perform an IVU on a patient allergic to iodine. Experiential activities/ simulations can be built to guide the learner in decision making. In this case, the learner gets to immerse in a simulated scenario, evaluate patient vitals, reports and assess the conditions under which an Iodine-allergic patient can be subjected to Intravenous Urogram.

Studies:

A baccalaureate nursing program study determined what proportion of terminal objectives for clinical nursing courses are high level objectives (analysis, synthesis, evaluation), and are the kinds of questions asked by teachers and students during clinical conferences of a high level also.  Despite the fact that stated objectives specified higher cognitive-level thinking, lower-level questions comprised 98.94% of the total number of questions asked by teachers and students in the clinical conferences surveyed.

Another study was performed within an Australian nursing program to examine clinical teachers’ use of questioning strategies.   The teachers’ years of classroom and clinical teaching experience, years of clinical experience, and academic qualifications were studied to see if an association between various qualifications and levels of questions existed.  Bloom’s taxonomy of the cognitive domain was used as a framework for the study.  The findings revealed clinical teachers asked more low-level questions (91.2%) than high-level questions (4.4%).

Lower level questioning do not promote critical thinking as they only trigger recall of information in the learner’s mind.  A simple recall of information does not enhance students’ understanding of the information in a meaningful way. Higher level questioning facilitates the development of critical thinking because it is aimed at higher cognitive levels, which involves application, analysis, synthesis and evaluation.   Educators should take advantage of stimulating questions more often to help create meaningful active learning instead of just prompting the simple recall of knowledge from students.

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Read More at http://goo.gl/7vhnO

Landamatics, or Algo-Heuristic Theory as it was originally called, was developed by Lev Landa in the early 1950’s.

Landa (1975) said, “It is common knowledge that pupils very often possess knowledge that is necessary in a certain subject, but they cannot solve problems. Psychologists and teachers often explain this by saying that their pupils do not know how to think properly, they are unable to apply their knowledge, the processes of analysis and synthesis had not been formed in their minds, . . .”.

Landa believes knowledge is made up of three elements:

1. image – the mental picture of an object,

2. concept – the knowledge of the characteristics of an object,

3. propositions – the relationships the object and it’s parts to other objects.

Specification of Theory
(a) Goals and preconditions
Problem-solving:
Processes – Sets of operations: Operations are transformations of (or changes to) material objects or mental models.

(b) Principles
1. It is more important to teach algo-heuristic processes versus prescriptions.
2. Processes can be taught through prescriptions and demonstrations of operations. (Operations = changes of mental or material knowledge)
3. Discovery of processes is more valuable than providing formulated processes.
4. Individualize instruction.

(c) Condition of learning
1. Instructional processes are influences directed by a “teacher” and directed at transformation. (teacher refers to any teaching agent, live or material, i.e. books, AV, computer)
2. Instructional processes are affected by teacher actions or instructional operations.
3. Instructional processes can be affected by certain conditions.
– external conditions, student psychology, teacher knowledge
4. There are three types of instructional rules: descriptive, prescriptive, and permissive. Descriptive rules are statements about what occurs. Prescriptive rules are statements about what should be done. Permissive rules indicate possible alternatives to prescriptive rules.

(d) Required media
None

(e) Role of facilitator
Teaching involves solving instructional problems; the teacher has to determine and perform actions that should be executed in order to meet objectives.

(f) Instructional strategies
Determining Content

1. Uncover process underlying expert learners and mastery level performers.
2. Describe the process with a hypothetical descriptive model.
3. Test the correctness of the model.
4. Improve the model if necessary.
5. Optimize the model if possible.
6. Design the final algorithmic or non-algorithmic process to allow the learners to perform on a mastery level.
7. Identify learning procedures leading to the development of algorithm or heuristic performance.
8. Design algo-heuristic teaching procedures.
9. Design algo-heuristic based training materials.
10. If necessary, create a computer-based or other media based programmed instruction.
11. Design methods for evaluation.

Instructional Method 1 – The step-by-step approach
1. Present the procedure to the student and demonstrate problem solving.
2. Develop the first operation.
3. Present a problem that requires the first operation and practice that operation.
4. Develop the second operation.
5. Present a problem that requires application of both operation and practice.
6. Develop the third operation.
7. Present a problem that represents all three problems.
8. Proceed until all problems are mastered.

Instructional Method 2 – Developing individual operations
1. Determine whether the student understands the meaning of a direction in the a prescription and its operations.
If yes:
2. Present a problem that requires application of the problem.
3. Name the operation (give the learner a self-command) before he/she executes the problem.
4. Present the next problem and have the learner give the command internally.
5. Continue practicing the operation until mastery.
If no:
2. Explain what the student does not understand.
3. Test the correctness of understanding and allow for practice. Provide extra explaination and practice.
4. Go to #2 under “yes” above.

(g) Assessment method
Student is able to complete the operation at a mastery level.

Application– Complex Sciences such Neurosciences.

strategic knowledge in neuroscience represented as an algorithm

Testimonials–  Allstate’s claim processing operation improved productivity 75% and quality 90%.