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BACKGROUND: After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve these goals. Adding dimensions to the visual feedback in addition to the mirror for real-time frontal view is proven to enhance the gait. It is, therefore, important to design additional real-time visual feedback in treadmill training, in particular for the sagittal view involved side. OBJECTIVE: The objective of this study is to test if the real-time sagittal visual feedback during treadmill training is superior to the conventional mirror feedback treadmill training program of equivalent intensity in improving walking speed and balance after stroke. METHODS/DESIGN: The RE-VISIT trial (Real-time Visual feedback after Stroke in Treadmill training) is registered in the Clinical Trial Registry of India (CTRI/2023/10/058299). In this two-arm randomized control trial, which will be a single-blinded study, 42 eligible stroke survivors undergoing rehabilitation will be randomly allocated (1:1 ratio) to either real-time visual sagittal feedback along with front mirror (experimental) group or only front mirror treadmill training (control) group, all the participants will receive 15 sessions of treadmill training for up to 15 min at a safe self-selected speed over 5-6 weeks. The RE-VISIT (experimental) group will receive real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and will be asked to modify their gait pattern. The control group will receive treadmill walking training only with the routine front mirror view feedback. Clinical and gait assessments will be conducted at the baseline, immediately following the final session of training, and at the 9th week during follow-up. The outcome measures of interest are walking speed (primary) and balance (secondary), which will be measured prior to baseline, post 15 sessions of training, and at the 9th week following training. DISCUSSION: This REVISIT trial will provide insight and contribute to the existing innovation and modifications of incorporating realtime visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help the better designing of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed, and balance for those who have greater difficulties in community ambulation. We anticipate that those in the REVISIT training will demonstrate improved walking ability.
CONTEXTO: Após o acidente vascular cerebral, a maioria dos pacientes frequentemente sofre redução da capacidade de caminhar e do equilíbrio. Restaurar a capacidade de caminhar e melhorar o equilíbrio são os principais objetivos da reabilitação do AVC. As esteiras são frequentemente usadas em ambientes clínicos para atingir esses objetivos. Está comprovado que adicionar dimensões ao feedback visual, além do espelho para visão frontal em tempo real, melhora a marcha. É, portanto, importante projetar feedbacks visuais adicionais em tempo real no treinamento em esteira, em particular para o lado envolvido na visão sagital. OBJETIVO: O objetivo deste estudo é testar se o feedback visual sagital em tempo real durante o treinamento em esteira é superior ao programa de treinamento em esteira com feedback de espelho convencional de intensidade equivalente na melhoria da velocidade de caminhada e equilíbrio após acidente vascular cerebral. MÉTODOS/ DESENHO: O ensaio RE-VISIT (feedback visual em tempo real após acidente vascular cerebral no treinamento em esteira) está registrado no Registro de Ensaios Clínicos da Índia (CTRI/2023/10/058299). Neste ensaio de controle randomizado de dois braços, que será um estudo cego, 42 sobreviventes de AVC elegíveis em reabilitação serão alocados aleatoriamente (proporção de 1:1) para feedback sagital visual em tempo real junto com grupo de espelho frontal (experimental) ou apenas Grupo de treinamento em esteira com espelho frontal (controle), todos os participantes receberão 15 sessões de treinamento em esteira por até 15 minutos em uma velocidade segura e autosselecionada durante 5-6 semanas. O grupo RE-VISIT (experimental) receberá feedback visual em tempo real da visão sagital da trajetória dos membros inferiores envolvidos, juntamente com a visão rotineira do espelho frontal durante o treinamento em esteira e será solicitado a modificar seu padrão de marcha. O grupo de controle receberá treinamento de caminhada em esteira apenas com o feedback rotineiro da visão do espelho frontal. Avaliações clínicas e de marcha serão realizadas no início do estudo, imediatamente após a sessão final de treinamento e na 9ª semana durante o acompanhamento. As medidas de resultados de interesse são a velocidade de caminhada (primária) e o equilíbrio (secundário), que serão medidos antes da linha de base, após a 15ª sessão de treinamento e na 9ª semana após o treinamento. DISCUSSÃO: este ensaio REVISIT fornecerá insights e contribuirá para a inovação e modificações existentes na incorporação de feedbacks visuais em tempo real durante o treinamento em esteira na reabilitação da marcha pós-AVC. As descobertas ajudarão no melhor desenho de um programa de reabilitação da marcha com esteira para indivíduos pós-AVC para melhorar a velocidade de caminhada e o equilíbrio para aqueles que têm maiores dificuldades na deambulação comunitária. Prevemos que aqueles no treinamento REVISIT demonstrarão melhor capacidade de caminhada.
Sujets)
Accident vasculaire cérébral , Rétroaction sensorielle , Vitesse de marcheRésumé
Introducción. El uso de la inteligencia artificial (IA) en la educación ha sido objeto de una creciente atención en los últimos años. La IA se ha utilizado para mejorar la personalización del aprendizaje, la retroalimentación y la evaluación de los estudiantes. Sin embargo, también hay desafíos y limitaciones asociados. El objetivo de este trabajo fue identificar las principales tendencias y áreas de aplicación de la inteligencia artificial en la educación, así como analizar los beneficios y limitaciones de su uso en este ámbito. Métodos. Se llevó a cabo una revisión sistemática que exploró el empleo de la inteligencia artificial en el ámbito educativo. Esta revisión siguió una metodología de investigación basada en la búsqueda de literatura, compuesta por cinco etapas. La investigación se realizó utilizando Scopus como fuente de consulta primaria y se empleó la herramienta VOSviewer para analizar los resultados obtenidos. Resultados. Se encontraron numerosos estudios que investigan el uso de la IA en la educación. Los resultados sugieren que la IA puede mejorar significativamente la personalización del aprendizaje, proporcionando recomendaciones de actividades y retroalimentación adaptadas a las necesidades individuales de cada estudiante. Conclusiones. A pesar de las ventajas del uso de la IA en la educación, también hay desafíos y limitaciones que deben abordarse, como la calidad de los datos utilizados por la IA, la necesidad de capacitación para educadores y estudiantes, y las preocupaciones sobre la privacidad y la seguridad de los datos de los estudiantes. Es importante seguir evaluando los efectos del uso de la IA en la educación para garantizar su uso efectivo y responsable.
Introduction. The use of artificial intelligence (AI) in education has been the subject of increasing attention in recent years. AI has been used to improve personalized learning, feedback, and student assessment. However, there are also challenges and limitations. The aim of this study was to identify the main trends and areas of application of artificial intelligence in education, as well as to analyze the benefits and limitations of its use in this field. Methods. A systematic review was carried out on the use of artificial intelligence in education, using a literature search research methodology with five stages, based on the Scopus query and the tool for analyzing results with VOSviewer. Results. Numerous studies investigating the use of AI in education were found. The results suggest that AI can significantly improve personalized learning by providing activity recommendations and feedback tailored to the individual needs of each student. Conclusions. Despite the advantages of using AI in education, there are also challenges and limitations that need to be addressed, such as the quality of data used by AI, the need for training for educators and students, and concerns about the privacy and security of student data. It is important to continue evaluating the effects of AI use in education to ensure its effective and responsible use.
Sujets)
Humains , Intelligence artificielle , Éducation , Apprentissage , Logiciel , Évaluation des acquis scolaires , Rétroaction formativeRésumé
ObjectiveTo explore the effect of multi-sensory artificial intelligence feedback gait training on the recovery of walking function in stroke patients based on enriched environment theory. MethodsFrom July, 2021 to June, 2023, a total of 80 stroke patients in Huashan Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation in the lying and seated positions, for 40 minutes. The control group received ground walking training, for 20 minutes, while the experimental group received multi-sensory feedback gait training in enriched environment, for 20 minutes. Before and after four weeks intervention, the digital motion monitoring treadmill was used to mearsure step speed, step length, hip and knee swing angle and weight symmetry. They were assessed with Berg Balance scale (BBS), Fugl-Meyer Assessment-Lower Extremities (FMA-LE) and Barthel Index (BI). ResultsAfter intervention, the hip swing angle, step length of both sides and step speed significantly improved in both groups (|t| > 3.162, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.568, P < 0.05); the average knee joint swing angle and bilateral weight-bearing symmetry significantly improved in the experimental group (|t| > 3.249, P < 0.01); the scores of BBS, FMA-LE and BI improved in both groups (|t| > 3.569, P < 0.01), and they were better in the experimental group than in the control group (|t| > 2.922, P < 0.05). ConclusionMulti-sensory feedback gait training based on enriched environment theory could effectively improve the walking and balance of stroke patients, and increase the ability of independence.
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Here we report the case of a female patient in her 70s with right hemiplegic stroke and severe sensory impairment whose walking ability was improved by visual and auditory feedback provided by a Gait Exercise Assist Robot (GEAR)．The patient was diagnosed with a left thalamic hemorrhage. Upon being admitted to the convalescent rehabilitation ward, she reported feeling no sensations in her right upper or lower limbs according to the Stroke Impairment Assessment Set (SIAS；both superficial and positional sensations)．Additionally, she had a Berg Balance Scale (BBS) score of 16 and Functional Ambulation Categories (FAC) score of 0. The patient underwent the GEAR intervention for approximately 40 min daily. She was provided visual feedback, in which images of her feet and the sagittal plane were presented on the monitor in front of her；and auditory feedback, in which her paralyzed lower limbs were loaded. No significant improvement was noted in her superficial or positional senses based on the SIAS score at 2 months post-intervention；however, the BBS and FAC scores improved to 46 and 3 points, respectively. These findings suggest that, although it is difficult to improve sensory impairment, repetitive gait training via GEAR-provided visual and auditory feedback and assistive function may improve the gait and walking ability of stroke patients with severe sensory impairment.
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Objective:To observe the effect of Tongguan Liqiao(opening orifices)needling plus tongue pressure resistance feedback training in treating post-stroke deglutition disorders. Methods:A prospective randomized controlled trial was conducted.A total of 120 patients with post-stroke deglutition disorders were divided into a control group and an observation group using the random number table method,with 60 cases in each group.Both groups were treated with routine treatments.The control group was treated with additional tongue pressure resistance feedback training,and the observation group was treated with additional Tongguan Liqiao needling based on the same intervention in the control group.After 4 weeks of treatment,the clinical efficacy was evaluated,and the complications that occurred during treatment were summarized.The FUJISHIMA Ichiro food intake level scale(FILS)and the swallowing quality of life questionnaire(SWAL-QOL)were scored before treatment and after 4 weeks of treatment. Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After 4 weeks of treatment,the FILS and SWAL-QOL scores in both groups were higher than those before treatment,and the scores in the observation group were higher than those in the control group(P<0.05).There was no statistical difference in the complication occurrence between the two groups(P>0.05). Conclusion:On the basis of routine treatments,Tongguan Liqiao needling plus tongue pressure resistance feedback training has a better effect in the treatment of post-stroke deglutition disorders.This method can effectively improve the swallowing function of patients,improve the quality of life,and is safe.
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ABSTRACT Objective: To understand the pedagogical elements necessary for the debriefing to favor the development of reflective thinking. Method: A single case study developed at the Centro de Simulación en Salud of the Escuela de Enfermería of the Universidad de Costa Rica in October 2018. Data were collected through interviews, observation and document analysis. For data analysis, the strategy of theoretical propositions and the construction of explanation technique were used. Results: The data originated two categories: 1) pedagogy of the organization, addressed elements thought by the professor to facilitate the dialogue; 2) facilitation pedagogy, brought elements from the dialogue itself that enrich the discussion, mobilize the group, provoke reflection and engagement. Final considerations: It is essential to include the following as pedagogical elements in order to favor the development of reflective thinking: prior planning, adequate environment, systematization, pedagogical training in facilitating debriefing, openness to dialogue, pedagogical respect, valorization of positive aspects, patience, and motivation.
RESUMEN Objetivo: Comprender los elementos pedagógicos necesarios para que el debriefing favorezca el desarrollo del pensamiento reflexivo. Método: La información sobre el tipo de estudio, muestra, período, lugar de la investigación, recolección y análisis de datos debe presentarse de manera clara y objetiva, sin excesivos detalles. El método debe alinearse con la sección de métodos del artículo completo, brindando información más detallada sobre el diseño del estudio y los procedimientos utilizados. Resultados: Los datos originaron dos categorías: 1) pedagogía de la organización, en que los elementos abordados pensados por el profesor para facilitar el diálogo; 2) pedagogía de la facilitación, en que el trajo elementos del propio diálogo que enriquecen la discusión, movilizan al grupo, provocan la reflexión y el compromiso. Consideraciones finales: Es imprescindible incluir como elementos pedagógicos que favorezcan el desarrollo del pensamiento reflexivo los siguientes: planeamiento previo, ambiente adecuado, sistematización, formación pedagógica en la facilitación del debriefing, apertura al diálogo, respeto pedagógico, valorización de los aspectos positivos, paciencia y motivación.
RESUMO Objetivo: Compreender os elementos pedagógicos necessários para que o debriefing favoreça o desenvolvimento do pensamento reflexivo. Método: Estudo de caso único desenvolvido no Centro de Simulaciónen Salud da Escuela de Enfermería da Universidad de Costa Rica em outubro de 2018. Os dados foram coletados por meio de entrevistas, observação e análise documental. Utilizaram-se a estratégia de proposições teóricas e a técnica de construção de explanação para a análise dos dados. Resultados: Os dados originaram duas categorias: 1) pedagogia da organização, a qual abordou elementos pensados pelo docente para facilitar o diálogo; 2) pedagogia da facilitação, a qual trouxe elementos do próprio diálogo que enriquecem a discussão, mobilizam o grupo, provocam a reflexão e o engajamento. Considerações finais: Torna-se imprescindível incluir como elementos pedagógicos que favoreçam o desenvolvimento do pensamento reflexivo os seguintes: planejamento prévio, ambiente adequado, sistematização, formação pedagógica em facilitação de debriefing, abertura ao diálogo, respeito pedagógico, valorização do positivo, paciência e motivação.
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RESUMO Introdução A percepção auditiva da voz e sua produção envolvem o feedback auditivo, as pistas cinestésicas e o sistema de feedforward, os quais produzem efeitos distintos para a voz. Os efeitos Lombard, Sidetone e o Pitch-Shift-Reflex são os mais estudados. O mapeamento de experimentos científicos sobre as modificações do feedback auditivo para o controle motor da voz possibilita examinar a literatura existente sobre o fenômeno e pode contribuir para o treinamento ou terapias da voz. Objetivo Mapear os experimentos e resultados das pesquisas com manipulação do feedback auditivo para o controle motor da voz de indivíduos adultos. Método Revisão de escopo seguindo o Checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension (PRISMA-ScR) para responder à pergunta: "Quais os métodos de investigação e principais achados das pesquisas sobre a manipulação do feedback auditivo no automonitoramento da voz de indivíduos adultos?". O protocolo de busca foi baseado na estratégia mnemônica População, Conceito e Contexto (PCC). A população são os indivíduos adultos; o conceito é a manipulação do feedback auditivo e o contexto é o controle motor da voz. Os artigos foram pesquisados nas bases de dados: BVS/ Biblioteca Virtual em Saúde, MEDLINE/Medical Literature Analysis and Retrieval Sistem on-line, COCHRANE, CINAHL/Cumulative Index to Nursing and Allied Health Literature, SCOPUS e WEB OF SCIENCE. Resultados Foram encontrados 60 artigos, sendo 19 da temática do Efeito Lombard, 25 do efeito Pitch-shift-reflex, 12 do efeito Sidetone e quatro sobre o efeito Sidetone/Lombard. Os estudos são concordantes que a inserção de um ruído que mascara o feedback auditivo provoca um aumento na intensidade de fala do indivíduo e que a amplificação do feedback auditivo promove a redução do nível de pressão sonora na produção da voz. Observa-se uma resposta reflexa à mudança de tom no feedback auditivo, porém, com características individuais em cada estudo. Conclusão O material e método dos experimentos são distintos, não há padronizações nas tarefas, as amostras são variadas, muitas vezes reduzidas. A diversidade metodológica dificulta a generalização dos resultados. Os principais achados das pesquisas a respeito o feedback auditivo sobre o controle motor da voz confirmam que, na supressão do feedback auditivo, o indivíduo tende a aumentar a intensidade da voz. Na amplificação do feedback auditivo, o indivíduo diminui a intensidade e tem maior controle sobre a frequência fundamental e, nas manipulações da frequência, o indivíduo tende a corrigir a manipulação. Os poucos estudos com sujeitos disfônicos mostram que eles se comportam diferentemente dos não disfônicos.
ABSTRACT Introduction The auditory perception of voice and its production involve auditory feedback, kinesthetic cues and the feedforward system that produce different effects for the voice. The Lombard, Sidetone and Pitch-Shift-Reflex effects are the most studied. The mapping of scientific experiments on changes in auditory feedback for voice motor control makes it possible to examine the existing literature on the phenomenon and may contribute to voice training or therapies. Purpose To map experiments and research results with manipulation of auditory feedback for voice motor control in adults. Method Scope review following the Checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension (PRISMA-ScR) to answer the question: "What are the investigation methods and main research findings on the manipulation of auditory feedback in voice self-monitoring of adults?". The search protocol was based on the Population, Concept, and Context (PCC) mnemonic strategy, in which the population is adult individuals, the concept is the manipulation of auditory feedback and the context is on motor voice control. Articles were searched in the databases: BVS/Virtual Health Library, MEDLINE/Medical Literature Analysis and Retrieval System online, COCHRANE, CINAHL/Cumulative Index to Nursing and Allied Health Literature, SCOPUS and WEB OF SCIENCE. Results 60 articles were found, 19 on the Lombard Effect, 25 on the Pitch-shift-reflex effect, 12 on the Sidetone effect and four on the Sidetone/Lombard effect. The studies are in agreement that the insertion of a noise that masks the auditory feedback causes an increase in the individual's speech intensity and that the amplification of the auditory feedback promotes the reduction of the sound pressure level in the voice production. A reflex response to the change in pitch is observed in the auditory feedback, however, with particular characteristics in each study. Conclusion The material and method of the experiments are different, there are no standardizations in the tasks, the samples are varied and often reduced. The methodological diversity makes it difficult to generalize the results. The main findings of research on auditory feedback on voice motor control confirm that in the suppression of auditory feedback, the individual tends to increase the intensity of the voice. In auditory feedback amplification, the individual decreases the intensity and has greater control over the fundamental frequency, and in frequency manipulations, the individual tends to correct the manipulation. The few studies with dysphonic individuals show that they behave differently from non-dysphonic individuals.
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Abstract Introduction: Institutional evaluation is an important tool for the constant improvement of medical courses, especially when they take the student's opinion as one of their focuses. Objective: The main objective of this study is to investigate which methods are used to conduct institutional evaluations involving student opinion through a scoping systematic review. Methodology: In compliance with the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR)", the searches were conducted in a standardized form, involving at least two researchers and consulting the Lilacs, Scielo, Pubmed, and Embase databases and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), using the software Rayyan, to signal duplicates and allow an independent and unbiased evaluation by the two reviewers. The inclusion criteria used were: Studies published between 2009 and 2019, containing the methodology of evaluation, which assessed medical courses and in which this evaluation was carried out by students at some stage. Also, the following exclusion criteria were used: studies written in languages other than Portuguese, English, French and Spanish; evaluations of a specific pedagogical intervention or limited to some subjects; and articles focusing on student self-assessment. The restriction of time and languages carries the risk of selection bias. Results: 2355 records were found and 12 articles were included. Most studies created their questionnaire and used mostly quantitative scales, although many also included some type of qualitative analysis with written questions. Most of the studies dealt with an occasional analysis and not with a project of permanent evaluation of the institution. Conclusion: Publications in the field of institutional evaluation that involve students and describe the questionnaire are still rare, especially when related to permanent evaluations.
Resumo Introdução: A avaliação institucional é uma importante ferramenta para o constante aperfeiçoamento dos cursos de Medicina, principalmente quando tomam a opinião discente como um de seus pontos. Objetivo: O estudo teve por objetivo averiguar, por meio de uma revisão sistemática de escopo, quais os métodos utilizados para realizar avaliações institucionais que contem com base na opinião discente através de uma revisão sistemática de escopo. Método: Em conformidade com o "Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA- ScR)", as buscas foram realizadas de modo padronizado, envolvendo no mínimo dois pesquisadores, e consultando as bases Lilacs, SciELO, PubMed, Embase e o banco de teses da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes). Por meio do software Rayyan, marcaram-se os estudos duplicados, o que permitiu a avaliação cega e independente dos dois revisores em cada etapa . Os critérios de inclusão utilizados foram: estudos publicados entre 2009 e 2019, que avaliassem cursos de Medicina e em que alguma etapa da avaliação tivesse sido realizada por estudantes. Adotaram-se os seguintes critérios de exclusão: trabalhos em idiomas diferentes do português, inglês, francês e espanhol; avaliações de uma intervenção pedagógica específica ou limitada a algumas disciplinas e artigos com foco na autoavaliação do aluno. Resultados: Foram encontrados 2.355 registros e incluídos 12 artigos. A maior parte dos trabalhos criou um questionário próprio e utilizou-se majoritariamente de escalas quantitativas, embora muitos tenham também incluído algum tipo de análise qualitativa com questões abertas. A maior parte dos estudos referia-se a uma análise pontual e não de a um projeto de avaliação permanente da instituição. Conclusão: Publicações no campo de avaliação institucional que envolvam os discentes e descrevam o questionário ainda são raras, principalmente quando se trata de avaliações permanentes.
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Los estudios en niños/as y adolescentes con Trastorno por Déficit de Atención e Hiperactividad (TDAH) suelen evidenciar dificultades en la toma de decisiones, vinculadas con comportamientos más riesgosos. El objetivo del presente estudio fue analizar y comparar el proceso de Toma de Decisiones Bajo Riesgo (TDBR) en niños/as y adolescentes con TDAH, considerando los tipos de retroalimentaciones utilizadas. Los tipos de retroalimentaciones se refieren al procesamiento de las consecuencias de las decisiones de los ensayos previos y a su influencia en las elecciones presentes y futuras. Se realizó un estudio descriptivo comparativo con un diseño ex post facto retrospectivo con dos grupos. La muestra estuvo compuesta por 100 niños/as y adolescentes de 8 a 15 años (68 niños y niñas de 8 a 11 años y 32 adolescentes de 12 a 16 años), divididos en grupo clínico y grupo control, pareados por sexo y edad. Para evaluar la TDBR se administró el Test de los Dados (The Game of Dice Task, GDT), la cual es una prueba informatizada en la que se deben tomar decisiones apostando para ganar puntos. Para analizar los tipos de retroalimentación se consideraron ocho tipos posibles. Los resultados evidenciaron un comportamiento con una tendencia a elegir opciones de riesgo en la población con TDAH, tanto en el tipo de elecciones realizadas como en la forma en que utilizan la retroalimentación al ganar o al perder, no vinculándose necesariamente con decisiones desfavorables. Estos hallazgos podrían contribuir al desarrollo de programas de intervención destinados a disminuir las dificultades en la toma de decisiones en personas con diagnóstico de TDAH.
Studies on children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) often show difficulties in decision-making, linked to riskier behaviors. The aim of the present study was to analyze and compare the process of Decision Making Under Risk (DMUR) in children and adolescents with ADHD considering the types of feedback used. Feedback types refer to processing the consequences of previous trial decisions and their influence on present and future choices. A comparative descriptive study was carried out with a retrospective ex post facto type design with two groups. The sample consisted of 100 boys, girls and adolescents from 8 to 15 years old, (68 boys and girls from 8 to 11 years old and 32 adolescents from 12 to 16 years old), divided into a clinical group and a control group paired by sex and age. To evaluate the DMUR, the Game of Dice Task (GDT) was administered, which is a computerized test in which betting decisions must be made to earn points. And to analyze the types of feedback, eight possible types were considered. The results showed a behavior with a tendency to choose risky options in the population with ADHD, both in the type of choices made and in the way, they use feedback when winning or losing, not necessarily linked to unfavorable decisions. These findings could contribute to the development of intervention programs aimed at reducing the difficulties in decision-making in people diagnosed with ADHD.
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The objective is to present a daily attitudes and professionalism assessment instrument for medical students in theoretical-practical activities. The development of the instrument was based on the manuals of the program for student integration with the community, on the program's pedagogical project, and on the National Curricular Guidelines for Undergraduate Programs in Medicine, and was carried out by professors. These were consulted in weekly 50-minute meetings held between August and November 2016. At the end of the process, a version of the instrument was consolidated with five items and six descriptors to discriminate learning situations that enable competency-based assessment from the simplest to the most complex level. With the use of the instrument, points considered important in medical training in theoretical-practical activities cannot be overlooked (AU).
Objetiva-se apresentar um instrumento de avaliação diária de atitudes e profissionalismo para estudantes de Medicina em atividades teórico-práticas. A elaboração do instrumento foi baseada nos manuais do programa de integração do aluno com a comunidade, projeto pedagógico do curso e nas Diretrizes Curriculares Nacionais da Graduação em Medicina, realizada por docentes. Os docentes foram consultados em reuniões com duração de 50 minutos, com periodicidade semanal, entre agosto e novembro de 2016. Ao final do processo foi consolidada uma versão do instrumento com cinco itens e seis descritores para discriminação de situações de aprendizagem que permitem a avaliação da competência de um nível mais simples até o mais complexo. Com a utilização do instrumento elaborado não se deixa de avaliar pontos considerados importantes para a formação médica em atividades teórico-prática (AU).
Sujets)
Écoles de médecine , Évaluation des acquis scolaires , Rétroaction , Performance scolaireRésumé
Tuberculosis is known as one of the long-standing and dominating health problems affecting people and the extent further escalates in a developing country like India. A pre-evaluated feedback structured questionnaire was validated and adopted to get their quantitative data from 424 respondents. In the present study urban respondents (60.8%) gave affirmative responses regarding awareness of TB, especially with mobile media as their major source of information, followed by information from healthcare workers. Rural respondents were less expressed and deficient on knowledge of TB transmission and preventive methods. Prevention practices toward TB are claimed to be high in urban population because 79.48% believed that early diagnosis, prompt treatment and avoiding poor hygiene and crowded environment are effective strategies to cease the transmission of TB. Effective preventive and informative strategies should be employed in rural border areas to make up for the knowledge gap found among rural and urban populations in this study.
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Resumo. Objetivo. Analisar os feedback de indivíduos com diagnóstico de obesidade que realizaram 8 sessões de Terapia Cognitivo Comportamental em Grupo (TCCG). Método. Participaram 13 pacientes com diagnóstico prévio de obesidade. O instrumento foi uma entrevista conduzida no último encontro da TCCG e, posteriormente, foi realizada a análise de conteúdo de Bardin. Resultados. Foram organizadas quatro categorias: benefícios da participação da intervenção, emagrecimento e autoestima, melhora na qualidade da alimentação, melhora na saúde física e qualidade de vida. Além do emagrecimento, houve uma melhora na qualidade da alimentação, perda de peso, bem-estar e autoestima e, consequentemente, na qualidade de vida. Além de sua aplicação no tratamento da obesidade, a TCCG pode ser uma abordagem promissora no tratamento de outros transtornos.
Abstract. Objective. The aim of this study was to analyze the feedback of individuals with obesity diagnosis after 8 Group Cognitive-Behavioral Therapy (GCBT) sessions. Method. 13 patients with previous obesity diagnosis participated. The instrument was an interview conducted at the last meeting of the GCBT; subsequently, a Bardin's content analysis was carried out. Results. The obtained data was organized into four categories: benefits of participation in the intervention; weight loss and self-esteem; improvement in nutrition quality; and improvement in physical health and life quality. Beyond weight loss, there was an improvement in the quality of nutrition, weight loss, well-being, self-esteem, and, consequently, in the quality of life. Aside from its application in obesity treatment, GCBT can be a promising approach in the treatment of other disorders.
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Humains , Mâle , Femelle , Adulte , Thérapie cognitive , Comportement compulsif , Obésité/psychologie , Qualité de vieRésumé
Background: Proper understanding of concepts of physiology forms basis of good clinical practice. To make the lectures in physiology more interesting and understanding, one has to review the teaching methods at regular intervals. Aims and Objectives: This study is designed to get feedback regarding teaching methods in physiology from MBBS students of Government Medical College, Kozhikode, to make teaching more effective. Materials and Methods: Two hundred randomly selected students who successfully completed 1st-year MBBS are included in the study group. The standard questionnaire is shared to study group through Google forms and adequate time is given to record their responses. Descriptive statistics are used. Frequency is expressed in percentage. Results: Most of students prefer interactive teaching methodologies such as group discussion as their preferred mode of learning rather than conventional didactic lectures in whole batch. Students also like to have integration with other subjects and early clinical exposure to understand the concepts precisely. Conclusion: Teaching in small groups with proper integration and alignment with other subjects will make maximum results rather than the traditional teacher centered medical education. Periodic review of teaching methods is very much essential to make the subject more interesting.
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Background: Competency-based medical education (CBME) curriculum has been implemented in India since 2019 with a goal to create an “Indian Medical Graduate” (IMG) possessing requisite knowledge, skills, attitudes, values, and responsiveness. Objectives: To explore teachers’ perceptions across India at medical colleges on the newly implemented competency-based medical education curriculum. Methods: This was a qualitative cross?sectional study conducted among teachers working at medical colleges across India, between February and April 2022 (n = 192). The data collection was done using Google forms online survey platform on teachers’ perception regarding CBME, its specific components, and perceived bottlenecks. We analyzed this qualitative data using manual, theoretical thematic content analysis following the steps endorsed in Braun and Clarke’s six-phase framework. Results: The majority of the teachers (64.1%) have positively responded to the CBME curriculum’s implementation. However, it came with a caution that the curriculum should continuously evolve and adapt to regional demands. The foundation course, early clinical exposure, and the family adoption program were the specific components of CBME curriculum over which the teachers raised concerns. The need for additional teachers in each department (department-specific teacher or faculty per hundred students ratio to be worked out) and the need for enabling faculty preparedness through adequate training was highlighted. Concerns were also raised regarding implementing CBME with teachers without a medical background (especially in preclinical departments). Conclusion: It is the need of the hour for the curriculum to incorporate a systematic feedback mechanism built into the system, though which such critical appraisals can be meaning collated and acted upon, to ultimately evolve, thereby creating an “Indian Medical Graduate” for the needs of todays’ society.
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Background: Providing immediate feedback to students has shown improvement in students’ knowledge, understanding, and confidence as it helps in identifying lacunae and loopholes in learning process. Despite the usefulness of feedback, common complaint from students is that they usually do not receive feedback immediately in their learning process. We also face similar situation with our students in institute. The aim of this study was to find out effect of giving immediate feedback and explore the views of medical students on immediate feedback during formative assessment. Aims and Objectives: The aims of this study were to evaluate the effect of immediate feedback on the medical students’ learning in medical education. Materials and Methods: The study was conducted in Department of Physiology, GMERS Medical College, Valsad on 183 students of 1st MBBS after ethical approval. Two types of modules were prepared on using “Hot Potatoes” software version 6.3. Module-1: Test 1 without feedback: consist of 20 MCQs and Module-2: Test 2 with feedback: consist of 20 MCQs, provide immediate feedback for each option of MCQ. Two modules were given one by one on WhatsApp group on mobile phone. Reflection writing and feedback from students were taken after that. Results: The qualitative data collected provided important information about the immediate feedback. Feedback responses of students on the questionnaire were analyzed using Likert scale. The Likert scale values were in strongly agree/agree part for Module-2 (with feedback). The students believed that immediate feedback was very helpful in clearing concepts, finding out lacunae, improvement in confidence, and self-learning. An excellent way for self-assessment and improved their deeper understanding of content areas. The students enjoyed innovative way of learning compared to conventional learning. Conclusion: Immediate feedback using this type of feedback modules should be implemented to improve students’ knowledge, understanding, memory, and confidence and can be used as self-directed learning tool.
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Background: Pharmacology, being both basic and applied science, is indeed the foundation of rational therapy. Pharmacology education needs constant reform and reorganization to review and adapt learning and teaching methods. It can be better achieved using student feedback. Aims and Objectives: The study was designed to obtain and evaluate the feedback of students on various teaching and evaluation methods in pharmacology. Materials and Methods: It is a cross-sectional study. A pre-tested questionnaire used for the purpose of this study. After obtaining permission from the Institutional Ethics Committee, a questionnaire was given to the students of Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery, Bachelors in science (Nursing), and Allied Health Sciences (AHS) courses. Students who completed pharmacology as a part of their course curriculum were enrolled in the study. Results: A total of 273 students participants took part in our study. The most common age was 20 years (147 students, 53.8%), more females (153 students, 56%), and the majority of them were MBBS students (153 students, 56%). Most of the students found that knowledge of chemotherapy will be useful during the post-course internship (26.4%) and the knowledge of autocoids will be the least useful in clinical practice (1.1%). Students preferred more than studying method for pharmacology (37.4%). Conclusion: An effective teaching program is beneficial to comprehend pharmacology. Any effort at obtaining constant feedback from students makes our methodologies more relevant and interesting. Any worthwhile effort in this direction will lead to more rational prescribers and/or health-care professionals in the future.
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Vascular interventional surgery is an important means to treat cardiovascular and cerebrovascular diseases, but the particularity of its working environment will bring greater radiation threat to doctors. Vascular interventional surgery robots can effectively improve the working environment of doctors and can provide more stable operations, improve the success rate of surgery. This study mainly introduces the current research status, key technologies, and future application of vascular interventional surgical robots.
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Robotique , Procédures de chirurgie vasculaire/méthodes , Coeur , TechnologieRésumé
Feedback is an educational activity that occurs in a variety of settings in medical education and has been widely discussed since 2008, when Ridder et al. defined it as "Specific information about the comparison between a trainee's observed performance and a standard, given with the intent to improve the trainee's performance." (Ridder et al., 2008, p.3). Since then, discussions on effective feedback have shifted from a behaviorist, instructor-centered approach to a more multifaceted approach that focuses on relationship and the learner as recipient of feedback, or the learner's potential ability to make use of feedback (self-regulated learning, feedback literacy).
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This article discusses the design and implementation strategy of Autopsy and Accident Authentication case seminar, with the aim of linking pathology to clinic medicine, theory to practice, and cultivating and improving the thinking ability of analyzing and solving problems for medical students in their medical study. The article investigates the effects and feedback of six rounds of classes, reports three aspects as strengthening the systemic understanding of basic medicine, improving the application and thinking ability, and promoting the thinking of medical humanism, and also discusses the teaching effects, students' feedback, and the significance and existing defects of the seminar.
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Objective:To observe the impacts of muscle visual feedback intervention combined with continuous nursing on exercise ability of patients with knee osteoarthritis (KOA), so as to provide a reference for improving the rehabilitation quality of KOA patients.Methods:Using a randomized controlled trial method. The 104 KOA patients admitted to the Department of Arthrology and Sports medicine of the Affiliated Hospital of Jining Medical University from December 2020 to December 2021 were selected as the research objects by convenient sampling method. They were divided into the control group and the research group according to the random number table method, with 52 cases in each group. The control group was given routine care, and the research group was given muscle visual feedback intervention combined with continuous care on the basis of the control group. Before and after the intervention, the knee joint function, range of motion of the affected knee joint and exercise ability of the two groups were compared.Results:After the intervention, the Hospital for Special Surgery (HSS) Knee scores of pain, function, range of motion, muscle strength, flexion deformity and stability in the study group were 21.39 ± 4.21, 17.08 ± 2.43, 13.92 ± 2.02, 8.52 ± 0.54, 8.12 ± 0.74 and 8.04 ± 0.89, which were higher than those of the control group 19.68 ± 4.14, 16.12 ± 2.08, 13.11 ± 1.89, 7.76 ± 0.62, 6.85 ± 0.68, 7.11 ± 0.94, and the differences were all statistically significant ( t values were 2.09-9.11, all P<0.05). After the intervention, the flexion-extension, internal rotation and external rotation of the affected knee in the study group were (90.83 ± 14.26)°, (20.89 ± 3.72)° and (30.72 ± 3.86) °, respectively, and those in the control group were (76.78 ± 24.74)°, (16.81 ± 4.63)° and (24.62 ± 5.07) °, respectively, and the differences were statistically significant ( t=3.55, 4.95, 6.90, all P<0.05). After the intervention, the Fugl-Meyer assessment scale score of the study group was 24.72 ± 4.38, which was higher than 21.15 ± 4.64 of the control group, and the difference was statistically significant ( t=4.04, P<0.05). Conclusions:Muscle visual feedback intervention combined with continuous nursing can improve the knee joint function, range of motion of the affected knee joint and exercise ability of KOA patients.