Learning in the tutorial group: a balance between individual freedom and institutional control.

The study investigates factors in problem-based learning tutorial groups which promote or inhibit learning. The informants were tutors and students from speech-language pathology and physiotherapy programmes. Semi-structured focus-group interviews and individual interviews were used. Results revealed three themes: Responsibility. Time and Support. Under responsibility, the delicate balance between individual and institutional responsibility and control was shown. Time included short and long-term perspectives on learning. Under support, supporting documents, activities and personnel resources were mentioned. In summary, an increased control by the program and tutors decreases student's motivation to assume responsibility for learning. Support in tutorial groups needs to adapt to student progression and to be well aligned to tutorial work to have the intended effect. A lifelong learning perspective may help students develop a meta-awareness regarding learning that could make tutorial work more meaningful.

Students' experiences of learning manual clinical skills through simulation.

Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students' experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten third-year undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in three themes: what the students learn, how the students learn, and the simulator's contribution to the students' learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

Long-standing oral mucosal lesions in solid organ-transplanted children-a novel clinical entity.

BACKGROUND: Acute oral angioedema is well documented in young pediatric liver-transplanted patients. This is a report of an identified novel entity of long-standing oral mucosal lesions (OML) in children who had undergone solid organ transplantation. METHODS: In conjunction with routine medical follow-ups, all solid organ-transplanted children were examined annually for OML. RESULTS: Eight children developed a novel entity of long-standing OML after solid organ transplantation. Seven of the eight children had undergone liver transplantation whereas one child was kidney transplanted. The children received tacrolimus immunosuppression after transplantation. All recipients presented with multiple spherical nodules on the dorsum of the tongue, which later on displayed a fissured appearance. Most patients also presented with mucosal tags or ridges and swollen lips similar to those found in patients with orofacial granulomatosis. In addition, most patients had a clinical history of immediate-onset food-induced allergic reactions, including transient angioedema, after transplantation, but this clinical manifestation appeared separately from the long-standing lesions. CONCLUSION: A novel entity of long-standing OML that share some features with orofacial granulomatosis has been identified in children after solid organ transplantation.

Learning features in computer simulation skills training.

New simulation tools imply new opportunities to teach skills and train health care professionals. The aim of this study was to investigate the learning gained from computer simulation skills training. The study was designed for optimal educational settings, which benefit student-centred learning. Twenty-four second year undergraduate nursing students practised intravenous catheterization with the computer simulation program CathSim. Questionnaires were answered before and after the skills training, and after the skills examination. When using CathSim, the students appreciated the variation in patient cases, the immediate feedback, and a better understanding of anatomy, but they missed having an arm model to hold. We concluded that CathSim was useful in the students' learning process and skills training when appropriately integrated into the curriculum. Learning features to be aware of when organizing curricula with simulators are motivation, realism, variation, meaningfulness and feedback.