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Performing a stressful task under pressure is challenging. Strategies to optimise our training must focus on learning a skill correctly, and then practising that skill deliberately to avoid compromising that performance in the cauldron of the clinical environment. This chapter discusses ways of learning and training better: the techniques are based on practical strategies employed in anaesthesia, but developed primarily from practical cognitive psychology, elite sport and the military. It involves taking a skill, practising it until it becomes a habit and over time making it part of normal behaviour. The philosophy is simple (but difficult to apply): control what you can control and always do your best. The best summary of this strategy is: learn it right, practise it right, perform it right.
As opposed to the simplistic promotion of one given technique or device, the multimodal airway management relies on the recognition that each individual approach may fail, that the maintenance of oxygenation during the procedure is a key point, that the prerequisites to the practical step of placing a tube in the trachea involve the knowledge of intelligent and intelligible algorithms and the previous acquisition of skills, with understanding of their foundations. An example of the ‘combination techniques’ using the specific advantages of one medical device to mitigate the limitations of another is the use of a videolaryngoscope to facilitate intubation with a flexible optical bronchoscope, which increases the ease and the success of the process during the clinical as well as the training phases. Other multimodal approaches such as the combination of bronchoscopy with the use of a supraglottic airway or with high flow nasal oxygen optimise the safety of the procedure by maintaining the delivery of oxygen. The multimodal approach is particularly useful for the anaesthesiologist and intensivist only occasionally exposed to the management of difficult airway situations. It improves high quality care of patients, education and training.
This chapter introduces Dar al-ʿUlum, a hybrid school founded in 1872 to train students from top religious schools such as al-Azhar to teach primary school subjects and Arabic within state-run civil schools. First, it locates Dar al-ʿUlum within the history of Egyptian teacher training. It explains how Dar al-ʿUlum formalised and expanded the path followed by reform-minded shaykhs since the early nineteenth century by providing a crash course in the subjects and habitus of the Egyptian civil school system, alongside advanced training in how to apply their specialist knowledge of Arabic and Islamic disciplines to teaching in a civil school. It then presents Dar al-ʿUlum as a hybrid institution whose mission was to bring religious knowledge into the civil system. As a result, it was structured as a civil school, but its curriculum and faculty combined civil and religious elements and expertise. The chapter demonstrates that Dar al-ʿUlum was founded not only because of state efforts to control and put Islamic knowledge to work, but also because of the value many Egyptians placed in the authentic connection to Egypt’s past provided by Islamic knowledge.
In this chapter, the authors build upon previous chapters that focus on LGBTQI populations and on the education of psychologists about human rights. Here, they focus on the human rights of sexually and gender-diverse people and communities and how best to prepare psychologists for the future direction of psychology as a field that engages in practice, research, advocacy, and outreach. The authors share an international context related to the current status of sexually and gender-diverse people and provide a strong rationale for the need for psychologists to understand the role of human rights in their work with this population. They describe the need for improved training for psychologists about human rights of sexually and gender-diverse people. They provide an overview of current training models and objectives, as well as recommendations for the future.
In this chapter, we provide a brief overview of the role of human rights in psychology education and training, particularly as it violates cultural and human rights. We believe the current conceptual framework for diversity training in psychology perpetuates an acontextual, ahistorical, and acultural paradigm. Based on the literature and historical background, we discuss the implications of the ongoing Euro-American domination of the field and present examples of integrating diversity and human rights education from a more inclusive perspective. We end the chapter with some recommendations for a more integrated psychology discipline that is grounded in human rights and social justice.
This chapter begins with a rationale for infusing human rights into psychology education and the training of psychology professionals. It then presents the field of human rights education (HRE), including its definition as well as international and regional policies and theories that have evolved over the past 25 years, pointing out their relevance for psychology. In the final section, the chapter proposes human rights–related themes and methodologies for human rights education for psychologists, and social issues that influence and can be informed by psychology.
The current coronavirus disease 2019 pandemic has caused unprecedented challenges to surgical training across the world. With the widespread cancellations of clinical and academic activities, educators are looking to technological advancements to help ‘bridge the gap’ and continue medical education.
Simulation-based training as the ‘gold standard’ for medical education has limitations that prevent widespread adoption outside suitably resourced centres. Virtual reality has the potential to surmount these barriers, whilst fulfilling the fundamental aim of simulation-based training to provide a safe, effective and realistic learning environment.
Current limitations and insights for future
The main limitations of virtual reality technology include comfort and the restrictive power of mobile processors. There exists a clear developmental path to address these restrictions. Continued developments of the hardware and software set to deepen immersion and widen the possibilities within surgical education.
In the post coronavirus disease 2019 educational landscape, virtual, augmented and mixed reality technology may prove invaluable in the training of the next generation of surgeons.
Depression is associated with lower educational attainment, but there has been little investigation of long-term educational trajectories in large cohorts with diagnosed depression.
To describe the educational attainment trajectories of children with a depression diagnosis in secondary care, and to investigate whether these trajectories vary by sociodemographic characteristics.
We identified new referrals to South London and Maudsley's NHS Foundation Trust between 2007 and 2013 who received a depression diagnosis at under 18 years old. Linking their health records to the National Pupil Database, we standardised their performance on three assessments (typically undertaken at ages 6–7 years (school Year 2), 10–11 (Year 6) and 15–16 (Year 11)) relative to the local reference population in each academic year. We used mixed models for repeated measures to estimate attainment trajectories.
In our sample of 1492 children, the median age at depression diagnosis was 15 years (interquartile range = 14–16). Their attainment showed a decline between school Years 6 and 11. Attainment was consistently lower among males and those eligible for free school meals. Black ethnic groups also showed lower attainment than White ethnic groups between Years 2 and 6, but showed a less pronounced drop in attainment at Year 11.
Those who receive a depression diagnosis during their school career show a drop in attainment in Year 11. Although this pattern was seen among multiple sociodemographic groups, gender, ethnicity and socioeconomic status predict more vulnerable subgroups within this clinical population who might benefit from additional educational support or more intensive treatment.
This chapter explores the role of violent pedagogic practices in the formation of elite males in the later Roman Empire. It draws on the work of the sociologists Pierre Bourdieu and Basil Bernstein to inform an analysis of education’s key role in social and cultural reproduction. Focusing on selected writings of two late-fourth century contemporaries, Libanius and Basil of Caesarea, the chapter suggests that violence of various sorts played a pivotal role in the formation of elite male subjects, whether in the school of the teacher of rhetoric (Libanius) or in monastic training (Basil). Violence played a pivotal role in both the form and content of late Roman education – as well as suffering and inflicting violence on others, students read about and performed violent narratives. The considered cultivation of feelings of fear was viewed as maintaining the pedagogic order and helping to form ideal masculine subjects. Through such experiences and by reflecting on them in pedagogic contexts, students learnt to understand the parameters of legitimate and illegitimate violence, enabling them to protect themselves and their community in a competitive social context.
Chapter 3 considers perceptions of and practices in writing on paper. The famous edict of Frederick II, declaring that paper was banned from his archives, is the initial occasion for this reflection. I then investigate the cultural significance of writing on paper and why paper was adopted in certain writing environments. Armando Petrucci’s proposition that a need to write rather than a need to read drives this process is explored in relation to his other suggestion—that the use of paper was never automatic but was always a choice, either voluntary or constrained by specific economic or social circumstances. The discussion then branches out into palaeographical considerations of cursivity, writing on paper and training. The chapter further considers the role of professional and non-professional hands in medieval literary culture. This reassessment suggests that it is difficult to maintain these boundaries in late medieval manuscript production, in particular for those books written on paper.
Around 400 AD, Augustine of Hippo wrote De catechizandis rudibus, which teaches others how to address non-Christians interested in converting to the religion. Written in a time of increasing state hostility to non-Christians, the text has been used to study ‘coercive conversions’ to Christianity. However, this elides the fact that a North African convert had a choice between two increasingly hostile Christian factions: the one Augustine belonged to, or that of the better established rival bishops Augustine labelled ‘Donatist’. This chapter argues that the treatise should be seen as an attempt by Augustine to use the frame of teacher training as a means of strengthening control over minor clergy in a context of episcopal conflict. De catechizandis rudibus does not address converts directly, but instead the minor clergy who taught them. This focus, in particular on managing their affect (and disciplining the insufficiently cheerful), fits with Augustine’s faction having less social power in comparison to the Donatists at the time of writing. Instead, Augustine used his considerable rhetorical prowess in this treatise to prevent minor clergy from becoming demoralised (or defecting to the opposing bishops) during the conflict.
Cognitive deficits at the first episode of schizophrenia are predictive of functional outcome. Interventions that improve cognitive functioning early in schizophrenia are critical if we hope to prevent or limit long-term disability in this disorder.
We completed a 12-month randomized controlled trial of cognitive remediation and of long-acting injectable (LAI) risperidone with 60 patients with a recent first episode of schizophrenia. Cognitive remediation involved programs focused on basic cognitive processes as well as more complex, life-like situations. Healthy behavior training of equal treatment time was the comparison group for cognitive remediation, while oral risperidone was the comparator for LAI risperidone in a 2 × 2 design. All patients were provided supported employment/education to encourage return to work or school.
Both antipsychotic medication adherence and cognitive remediation contributed to cognitive improvement. Cognitive remediation was superior to healthy behavior training in the LAI medication condition but not the oral medication condition. Cognitive remediation was also superior when medication adherence and protocol completion were covaried. Both LAI antipsychotic medication and cognitive remediation led to significantly greater improvement in work/school functioning. Effect sizes were larger than in most prior studies of first-episode patients. In addition, cognitive improvement was significantly correlated with work/school functional improvement.
These results indicate that consistent antipsychotic medication adherence and cognitive remediation can significantly improve core cognitive deficits in the initial period of schizophrenia. When combined with supported employment/education, cognitive remediation and LAI antipsychotic medication show separate significant impact on improving work/school functioning.
Recent studies in Alzheimer’s disease (AD) have suggested that AD patients are not always able to rely on their feeling of familiarity to improve their memory decisions to the same extent as healthy participants. This underuse of familiarity in AD could result from a learned reinterpretation of fluency as a poor cue for memory that would prevent them to attribute a feeling of fluency to a previous encounter. The primary goal of this study was to determine whether AD patients could relearn the association between processing fluency and past exposure after being repeatedly exposed to situations where using this association improves the accuracy of their memory decisions.
Thirty-nine patients with probable AD were recruited and asked to complete several recognition tests. During these tests, participants were put either in a condition where the positive contingency between fluent processing and previous encounters with an item was systematically confirmed (intervention condition) or in a condition where there was no correlation between fluency and prior exposure (control condition). The efficacy of the intervention was evaluated at three time points (baseline, posttest, and 3-month follow-up).
Our results indicated that all AD patients do not benefit to the same extent from the training. Two variables appeared to influence the likelihood that participants increase and maintain their reliance on the fluency cues after the intervention: the ability to detect the fluency manipulation and the preservation of implicit metacognitive skills.
These findings indicate the importance of metacognition for inferential attribution processes in memory.
In low- and middle-income countries, the number of people with mental illness receiving minimally adequate care ranges from 1 out of 25 to 1 out of a 100. Given this major treatment gap, the World Health Organization and other institutions advocate provision of mental health care by primary care workers. However, there has been limited delivery of services after primary care workers are trained in mental health. One reason is that training programs have focused on increasing knowledge while not addressing attitudes. Social neuroscience theories can improve mental health training by addressing affect and motivation of health workers. Social neuroscience highlights the need to reduce between-group identity distinctions and threat while fostering empathy. Promoting health worker self-efficacy and therapeutic allegiance also benefits service delivery. Ultimately, social neuroscience theories can strengthen strategies to increase mental health services for persons living in low resource settings around the world.
Life experiences have been associated with significant changes in brain structure and functioning. This experience-dependent plasticity is thought to reflect the capacity of our nervous systems to adapt to environmental demands, and ultimately shape cognition. This chapter focuses on how such experiences and environment can specifically impact the hippocampus, a structure important for learning, memory, and healthy cognition. The hippocampal memory system maintains a competitive relationship with other memory systems, in particular the caudate nucleus of the striatum, part of the basal ganglia. Specific types of behavior, such as spatial-based vs. response-based navigational strategies, can influence these memory systems both positively and negatively and lead to long-term neuroplastic changes. Overreliance on non-hippocampus dependent navigational strategies is associated with a reduction in hippocampus volume and activity across the lifespan. Emerging research is now pointing to the wide use of electronic devices – GPS, smartphones, and video games – as a contributing factor to greater reliance on non-hippocampus dependent memory. Given the limited, but concerning, evidence that reliance on electronic devices can interact with already established factors related to underuse of the hippocampal memory system, further study is needed to better understand how these imbalances occur and how they can be mitigated.
Numerous investigations have documented that age-related changes in the integrity of the corpus callosum are associated with age-related decline in the interhemispheric transfer of information. Conversely, there is accumulating evidence for more efficient white matter organization of the corpus callosum in individuals with extensive musical training. However, the relationship between making music and accuracy in interhemispheric transfer remains poorly explored.
To test the hypothesis that musicians show enhanced functional connectivity between the two hemispheres, 65 professional musicians (aged 56–90 years) and 65 age- and sex-matched non-musicians performed the fingertip cross-localization test. In this task, subjects must respond to a tactile stimulus presented to one hand using the ipsilateral (intra-hemispheric test) or contralateral (inter-hemispheric test) hand. Because the transfer of information from one hemisphere to another may imply a loss of accuracy, the value of the difference between the intrahemispheric and interhemispheric tests can be utilized as a reliable measure of the effectiveness of hemispheric interactions.
Older professional musicians show significantly greater accuracy in tactile interhemispheric transfer than non-musicians who suffer from age-related decline.
Musicians have more efficient interhemispheric communication than age-matched non-musicians. This finding is in keeping with studies showing that individuals with extensive musical training have a larger corpus callosum. The results are discussed in relation to relevant data suggesting that music positively influences aging brain plasticity.
This chapter addresses the backgrounds of choirboys of the era and the support network offered by their mother church. Their progress through the ranks, including the peculiarly St-Omer rank of ‘escotier’ aimed at maturing choirboys of limited means, leads the reader through to achievement of their training as vicars, chaplains, masters of the boys and, in a few significant cases, endowed canonries and even the lofty position of cantor. As elsewhere, musical skill could lead to high achievement. Patronage through university training was also an expected part of career support. The highest, or at least most noticeable, talent could lead to impressment into the choirs of the ruling dynasty, in this case that of Burgundy-Habsburg, and glittering careers. The role of direct patronage in such cases of the Habsburgs Mary of Hungary and Charles V is illustrated via the cases of individual St-Omer boys.
In this chapter, we discuss the evolving role of the school psychologist working in early childhood settings, and highlight the importance of early learning and early intervention, standards for training and education of school psychologists to work with young children, and the role of the school psychologist in transitioning young children to kindergarten. We believe that early learning and early childhood education are critical to a healthy, thriving society, including the United States. However, most school psychology graduate programs do not offer knowledge of or experience in early childhood learning, assessment, diagnosis, or intervention. Given the importance of early childhood education and school psychologists’ evolving roles and responsibilities, they are strongly encouraged to engage in professional development activities around early childhood learning, education, assessment, and intervention in order to serve young children optimally. Multiple resources are provided at the end of the chapter to assist school psychologists in increasing their knowledge base regarding early childhood topics.
Addiction is a global health problem with a chronic relapsing nature for which there are few treatment options. In the past few decades, neuroimaging has allowed us to better understand the neurobiology of addiction. Functional neuroimaging paradigms have been developed to probe the neural circuits underlying addiction, including reward, inhibitory control, stress, emotional processing and learning/memory networks. Functional neuroimaging has also been used to provide biological support for the benefits of psychosocial and pharmacological interventions, although evidence remains limited and often inconclusive in this area, which may contribute to the variability in treatment efficacy. In this article, we discuss the changing definitions and clinical criteria that describe and classify addictive disorders. Using examples from functional neuroimaging studies we summarise the neurobiological mechanisms that underpin drug use, dependence, tolerance, withdrawal and relapse. We discuss the links between functional neuroimaging and treatment, outline clinical management in the UK and give an overview of future directions in research and addiction services.
Evidence-based treatment for panic disorder consists of disorder-specific cognitive behavioural therapy (CBT) protocols. However, most measures of CBT competence are generic and there is a clear need for disorder-specific assessment measures.
To fill this gap, we evaluated the psychometric properties of the Cognitive Therapy Competence Scale (CTCP) for panic disorder.
CBT trainees (n = 60) submitted audio recordings of CBT for panic disorder that were scored on a generic competence measure, the Cognitive Therapy Scale – Revised (CTS-R), and the CTCP by markers with experience in CBT practice and evaluation. Trainees also provided pre- to post-treatment clinical outcomes on disorder-specific patient report measures for cases corresponding to their therapy recordings.
The CTCP exhibited strong internal consistency (α = .79–.91) and inter-rater reliability (ICC = .70–.88). The measure demonstrated convergent validity with the CTS-R (r = .40–.54), although investigation into competence classification indicated that the CTCP may be more sensitive at detecting competence for panic disorder-specific CBT skills. Notably, the CTCP demonstrated the first indication of a relationship between therapist competence and clinical outcome for panic disorder (r = .29–.35); no relationship was found for the CTS-R.
These findings provide initial support for the reliability and validity of the CTCP for assessing therapist competence in CBT for panic disorder and support the use of anxiety disorder-specific competence measures. Further investigation into the psychometric properties of the measure in other therapist cohorts and its relationship with clinical outcomes is recommended.