Bloom's taxonomy-Can evidence-based teaching improve junior medical officers' knowledge of the mental health and guardianship acts?

OBJECTIVE: To determine whether a brief educational intervention for Junior Medical Officers (JMOs), using teaching methods aimed at achieving higher outcomes on Bloom's Taxonomy, significantly improved participant confidence and knowledge in decision making about restrictive care. METHOD: JMOs received a teaching session on restrictive medical and mental health care. Groups were randomly assigned to either sessions including a component of modern pedagogical interventions (Think-Pair-Share and SNAPPS), or sessions including a control period focusing on reviewing a condensed summary of relevant information. Pre- and post-intervention measures were recorded for subjective self-ratings of confidence and scores on standardized clinically relevant extended matching questions (EMQs). RESULTS: There was no difference in subjective confidence improvement between groups; however, the group receiving the modern pedagogical intervention demonstrated significantly greater objective performance on knowledge-based EMQs. CONCLUSIONS: A brief modern pedagogical intervention using interactive teaching methods shows promise for improving knowledge of restrictive care and the Mental Health and Guardianship Acts. In the control group, similarly increased confidence in knowledge did not equate to increased competence on a knowledge assessment. Refurbishing educational interventions presents opportunities for improving clinical outcomes and engaging junior doctors in psychiatry.

Focusing on an illusion: Accommodating to perceived depth?

Ocular accommodation potentially provides information about depth but there is little evidence that this information is used by the human visual system. We use the hollow-face illusion, an illusion of depth reversal, to investigate whether accommodation is linked to perceived depth. In Experiment 1 accommodation, like vergence, was in front of the physical surface of the mask when the mask was upright and people reported experiencing the illusion. Accommodation to the illusory face did not differ significantly from accommodation to the physically convex back surface of the same mask. Only accommodation to the inverted mask seen as hollow was significantly less and, like the physical surface, beyond the mid-plane of the mask. The effect on accommodation was the same for monocular as binocular viewing, showing that accommodation is not driven by binocular disparities through vergence, although voluntary vergence remains a possibility. In Experiment 2 a projected random dot pattern was used to flip perception between convex and concave in all presentation conditions. Accommodation was again in front of the physical surface when the illusion was experienced. Experiment 3 showed that projected dots are more effective in disambiguating the illusion as concave when they are sharp and provide a good accommodative stimulus than when they are objectively blurred. We interpret Experiments 1 and 2 as showing that accommodation is tied to perceived depth, directly or indirectly, even in a situation where multiple depth cues are available and feedback is not artificially open-looped. Experiment 3 is consistent with accommodation helping to disambiguate depth while not ruling out alternative explanations.

Pinhole Viewing Strengthens the Hollow-Face Illusion.

A hollow (concave) mask appears convex when viewed from beyond a certain distance even when viewed stereoscopically-this is the hollow-face illusion. At close viewing distances, the same mask is seen as hollow even when disparity information is eliminated by monocular viewing. A potential source of nonpictorial, monocular information that favors a veridical percept at close distances is accommodation in conjunction with focus blur. In this article, we used pinhole viewing to minimize this potential source of information and test whether it affects whether a hollow mask is seen as veridical (concave) or illusory (convex). Since monocular viewing also facilitates the illusory (convex) percept, it was included in the design both as a comparison and to test whether any effect of accommodation depends on vergence. Pinhole viewing was found favor the illusory percept, and its effect was at least as large as, and added to, that of monocular viewing. A control experiment using tinted glasses that attenuate illumination at least as much as the pinholes did not strengthen the illusion ruling out explanations in terms of reduced luminance. For pinhole viewing, there was no difference between monocular and binocular conditions. The results are interpreted as evidence that focus driven depth information affects perceived three-dimensional shape at close distances even when other sources of depth information are available. The lack of a difference between monocular and binocular pinhole viewing suggests that, by disrupting accommodation, pinholes may also interfere with linked vergence cues to depth.