Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI)

Introduction: Self-estimation of performance implies the ability to understand one’s own performance with relatively objective terms. Up to date, few studies have addressed this topic in mild cognitive impairment (MCI) patients. The aim of the present study was to compare objective measures of performance with subjective perception of specific performance on cognitive tests and investigate differences in assessment between MCI patients and healthy elderly. Method: Thirty-five participants diagnosed with MCI (women = 16, men = 19, mean age = 65.09 years ±SD = 7.81, mean education = 12.83 years ±SD = 4.32) and 35 control subjects similar in terms of age and education (women = 20, men = 15, mean age = 62.46 years ± SD = 9.35, mean education = 14.26 ± SD = 2.84) were examined with an extended battery of neuropsychological tests. After every test they were asked to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. This self-evaluation was reported on a scale ranging from –100 to +100. Results: Significant differences were found in the self-assessment patterns of the two groups in memory measures of verbal and visual delayed recall, visuospatial perception, and tests of attention. MCI patients overestimated their performance on every cognitive domain while control participants underestimated their performance on measures of verbal memory. Conclusions: The present results indicate that accuracy of self-report is not uniform across groups and functional areas. The discrepancies in the MCI patients indicate unawareness of their memory deficits, which is contradictory to subjective memory complaints as being an important component for clinical diagnosis.     

Video-based self-assessment: Implementation and evaluation in an undergraduate nursing course

This research was performed to investigate the effects of video-based self-assessment on the ability of nursing students to accurately measure vital signs, their communication skills, and their satisfaction. This research was conducted between March 2007 and June 2007 as a quasi-experimental control-group, pretest–posttest design. The study population was composed of 40 second-year student nurses who enrolled in a fundamentals of nursing course of a college of nursing, Ajou University in Korea. Results of the research indicate that there was a statistically significant difference in exam scores for assessing long-term memory video-review group demonstrating higher scores. Student satisfaction was also significantly higher in the video-review group than in the control group. These results may suggest video-based self-assessment is a beneficial and effective instructional method of training undergraduate nursing students to develop awareness of their strengths and weaknesses, and to improve their clinical and communication skills.     

护理专业本科生自我接纳影响因素研究

目的探讨护理专业本科生自我接纳态度及其变化影响因素。方法采用自我接纳量表(SAQ),通过整群取样对4个年级,316名学生进行问卷调查。结果大四学生自我接纳总分及自我评价因子分低于其他3个年级,差异有统计学意义(χ2=11.820,P0.01);来自农村的学生自我接纳总分(χ2=12.748,P0.01)、自我接纳因子(χ2=7.363,P0.05)、自我评价因子(χ2=8.001,P0.05)评分均低于来自城镇的学生,差异有显著性;家庭经济状况较差的学生自我接纳总分(χ2=17.210,P0.01)、自我评价因子(χ2=24.896,P0.01)评分均低于家庭经济状况较好的学生,差异有显著性。性别、就读志愿、专业接受程度的差异对自我接纳评分的影响无统计学意义。结论成长环境是影响护理专业本科生自我接纳的主要因素,对专业发展的评价影响高年级护理本科生的自我接纳程度。     

The Group Objective Structured Clinical Experience: Building communication skills in the clinical reasoning context

Objective

Students are rarely taught communication skills in the context of clinical reasoning training. The purpose of this project was to combine the teaching of communication skills using SPs with clinical reasoning exercises in a Group Objective Structured Clinical Experience (GOSCE) to study feasibility of the approach, the effect on learners’ self-efficacy and attitude toward learning communication skills, and the effect of providing multiple sources of immediate, collaborative feedback.

Methods

GOSCE sessions were piloted in Pediatrics and Medicine clerkships with students assessing their own performance and receiving formative feedback on communication skills from peers, standardized patients (SPs), and faculty. The sessions were evaluated using a retrospective pre/post-training questionnaire rating changes in self-efficacy and attitudes, and the value of the feedback.

Results

Results indicate a positive impact on attitudes toward learning communication skills and self-efficacy regarding communication in the clinical setting. Also, learners considered feedback by peers, SPs, and faculty valuable in each GOSCE.

Conclusion

The GOSCE is an efficient and learner-centered method to attend to multiple goals of teaching communication skills, clinical reasoning, self-assessment, and giving feedback in a formative setting.

Practice implications

The GOSCE is a low-resource, feasible strategy for experiential learning in communication skills and clinical reasoning.     

Self-rated health and mortality: a follow-up study of a Spanish population

Objectives

Self-rated health (SRH) is known to be a valid indicator for the prediction of health outcomes. The aims of this study were to describe and analyse the associations between SRH and health status, socio-economic and demographic characteristics; and between SRH and mortality in a Spanish population.

Study design

Longitudinal study.

Methods

A sample of 5275 adults (age ≥21 years) residing in the Valencian Community (Spanish Mediterranean region) was surveyed in 2005 and followed for four years. SRH was categorized into good and poor health. The response variable was mortality (dead/alive), obtained from the local mortality register. Logistic regression models were adjusted in order to analyse the associations between SRH and health status, socio-economic and demographic characteristics; odds ratios were calculated to measure the associations. Poisson regression models were adjusted in order to analyse the associations between mortality and explanatory variables; the relative risk of death was calculated to measure the associations.

Results

Poor SRH was reported by 25.9% of respondents, and the mortality rate after four years of follow-up was 3.6%. An association was found between SRH and the presence of chronic disease and disability in men and women. A perception of poor health vs good health led to a mortality risk of 3.0 in men and 2.7 in women. SRH was predictive of mortality, even after adjusting for all other variables. In men and women, the presence of disability provided additional predictive ability.

Conclusions

SRH was predictive of mortality in both men and women, and acted as a mediator between socio-economic, demographic and health conditions and mortality.     

Resident self-assessment of operative performance

BACKGROUND: In medicine, the development of expertise requires the recognition of one's capabilities and limitations. This study aimed to verify the accuracy of self-assessment for the performance of a surgical task, and to determine whether self-assessment may be improved through self-observation or exposure to relevant standards of performance. METHODS: Twenty-six senior surgical residents were videotaped performing a laparoscopic Nissen fundoplication in a pig. Experts rated the videos using two scoring systems. Subjects evaluated their performances after performance of the Nissen, after self-observation of their videotaped performance, and after review of four videotaped "benchmark" performances. RESULTS: Expert interrater reliability was 0.66 (intraclass correlation coefficient). The correlation between experts' and residents' self-evaluations was initially moderate (r = 0.50, P <0.01), increasing significantly after the residents reviewed their own videotaped performance to r = 0.63 (Deltar = 0.13, P <0.01), yet did not change after review of the benchmarks. CONCLUSIONS: Self-observation of videotaped performance improved the residents' ability to self-evaluate.     

Gender differences in the self-assessment of surgical residents

BACKGROUND: Despite equivalent performance as assessed by objective external measures, women tend to underestimate their abilities compared with their male counterparts. METHODS: The difference in ordinal values from faculty and resident self-evaluations was calculated for each general and plastic surgery resident. Objective external performance measures were compared for female and male residents. RESULTS: Male and female residents performed equivalently. All residents underestimated their abilities compared with faculty assessment; however, general surgery residents did so to a greater degree (P < .05). Female residents demonstrated a greater degree of underestimation than did their male colleagues; however, this was not statistically significant. CONCLUSIONS: Although female resident surgeons are generally confident in their abilities, this may be in contrast to the self-perception of many female medical students. Consideration of gender differences in self-perception may be important when providing feedback to female students and residents.     

大学生心理状况调查

目的了解大学生的心理状况,以便及早发现心理问题,为学校心理教育提供依据。方法对120名大学生用症状自评量表(SCL-90)进行测试。结果大学生总分与各因子分均显著高于常模,不同性别无显著性差异,120人中存在中度心理问题的学生26人,检出率为21.7%。结论大学生心理问题发生率较高,有必要进行心理干预以有效预防心理疾病和心理危机事件的发生,促进大学生心理健康。     

血栓风险因素自我评估对提高深静脉 血栓形成预防的依从性效果

〔摘 要〕 目的：分析住院患者术后护理中引入患者自我评估血栓风险因素,对于提高深静脉血栓形成（DVT）的预防 工作依从性的效果。 方法：选取 2019 年 1 月至 2019 年 12 月在深圳市第二人民医院进行手术治疗的患者 113 例,随机分成 观察组 58 例和对照组 55 例,对照组给予由护士评估血栓风险因素的常规护理,观察组给予由护士指导落实、患者参与自 我评估风险因素的风险管理护理,比较两组患者在护理过程中预防措施落实的依从性、护理后 DVT 的发生率。 结果：两组 患者护理前的 Caprini 表 DVT 风险评估结果在各个等级均较为相近,差异均无统计学意义（P ＞ 0.05）;观察组患者 DVT 发生率 5.2 % 明显低于对照组的 14.5 %,差异具有统计学意义（P ＜ 0.05）;观察组患者自我行为管理评分在日常生活行 为管理、疾病医学管理、心理情绪管理 3 个维度及总分明显高于对照组,差异具有统计学意义（P ＜ 0.05）;在患者护理 过程中,观察组患者的总依从率 94.8 % 高于对照组的 82.8 %,差异具有统计学意义（P ＜ 0.05）。 结论：在住院患者 DVT 的预防工作中,引入患者自我评估血栓风险因素,对于提高患者在治疗中的自我行为管理水平,提升其护理依从性,减少 DVT,具有很大的作用。     

Smoothing Out Transitions: How Pedagogy Influences Medical Students’ Achievement of Self-regulated Learning Goals

Medical school is an academic and developmental path toward a professional life demanding self-regulation and self-education. Thus, many medical schools include in their goals for medical student education their graduates' ability to self-assess and self-regulate their education upon graduation and throughout their professional lives. This study explores links between medical students' use of self-regulated learning as it relates to motivation, autonomy, and control, and how these influenced their experiences in medical school. Subjects were medical students in two distinct medical school environments, “Problem-based learning” and “Traditional.” PBL students described a rough transition into medical school, but once they felt comfortable with the autonomy and control PBL gave them, they embraced the independence and responsibility. They found themselves motivated to learning for learning's sake, and able to channel their motivation into effective transitions from the classrooms into the clerkships. Traditional students had a rougher transition from the classrooms to the clerkships. In the first two years they relied on faculty to direct and control learning, and they channeled their motivation toward achieving the highest grade. In the clerkships, they found faculty expected them to be more independent and self-directed than they felt prepared to be, and they struggled to assume responsibility for their learning. Self-regulated learning can help smooth out the transitions through medical school by preparing first and second year students for expectations in the third and fourth years, which can then maximize learning in the clinical milieu, and prepare medical students for a lifetime of learning.