Fredrick D. Pociask

Reducing cognitive load while teaching complex instruction to occupational therapy students

Cognitive load theory is a field of research used to improve the learning of complex cognitive tasks by matching instruction to the learners cognitive architecture. We used an experimental posttest control-group design to test the effectiveness of instruction designed to reduce cognitive load (CL) and improve instructional effectiveness in teaching complex instruction to 24 first-year masters students under authentic classroom conditions. We modified historically taught instruction using an isolated-to-interacting-elements sequencing approach intended to reduce high CL levels. We compared control and modified instructional formats using written assessment scores, subjective ratings of CL, and task completion times. Analysis of variance revealed significant differences for postinstruction, posttest CL ratings, and delayed written posttest scores (p < .05). No significant differences were identified for posttest completion times. Findings suggest that this approach can be used to improve instructional efficiency in teaching human locomotion to occupational therapy students.

Diabetes self-management among Arab Americans: patient and provider perspectives.

BackgroundArab Americans have a high burden of diabetes and poor outcomes compared to the general U.S. population. Diabetes self-management (DSM) requires a partnership between patients and providers that fosters mutual understanding and shared decision-making. Cultural factors influence this process; however, little is known regarding the cultural impact on DSM or if perceptions differ between patients and providers.MethodsQualitative content analysis was used to analyze five focus groups–two groups with Arab American providers (n = 8) and three groups with adult Arab Americans with diabetes (n = 23). Focus groups examined patient and provider perspectives on the meaning of DSM and cultural barriers and facilitators among Arab American patients.ResultsFour distinct themes included limited resources for DSM education and support, stigma as a barrier to ongoing support, family support as an opportunity and challenge, and Arab American patient-provider relationships.ConclusionsFindings indicate several domains should be considered for clinical practice including a need to develop linguistically and culturally reliant educational materials and relevant supports for use in the Arab American population. Findings highlight differing views among providers and patients on the familial role in supporting DSM efforts and why some patients feel dissatisfied with clinical encounters.

Managing Cognitive Load While Teaching Human Gait to Novice Health Care Science Students

Introduction. Human working memory becomes increasingly prone to errors as learning tasks become more complex. This is of particular importance to those working with instruction that requires the novice learner to simultaneously maintain and manipulate many elements of information for learning with understanding to occur. Under such circumstances, cognitive load theory provides support for the use of instructional principles that improve learning of complex cognitive tasks by matching instruction and instructional processes with the limitations of human memory. The purpose of this study was to test the effectiveness of instructional materials designed to reduce cognitive load and improve instructional effectiveness in the teaching of introductory human gait to novice health care science students using instructional sequencing principles under authentic classroom conditions. Subjects. Participants included 54 firstyear Doctor of Physical Therapy and Master of Occupational Therapy students from a large Midwestern university that were recruited on a voluntary basis and were randomly assigned to either a modified instruction group or a control group. Methods. Aspects of traditional teaching methods and materials expected to impose high levels of cognitive load were modified using instructional sequencing principles designed to reduce cognitive load. The traditional and modified instructional formats were compared under authentic classroom conditions using delayed written examination scores, ratings of cognitive load, and task completion times. Results. Multivariate analysis of variance yielded an overall significant difference between the control and modified instruction group (Pillais Trace: F [4, 49] = 10.529, P < .001, h2 = + 0.46). Support was provided for hypotheses predicting superior delayed posttest performance, lower ratings of reported cognitive load on instruction, and lower ratings of reported cognitive load on assessment tasks for the modified instruction group. No significant difference was identified for time to complete assessment questions. Discussion and Conclusion. Results from this study suggest that instructional designers, such as those teaching introductory human gait to novice physical therapy and occupational therapy students, can increase instructional effectiveness with the use of an isolated‐tointeracting elements approach designed to reduce intrinsic cognitive load under certain conditions.

The Impact of Arab American Culture on Diabetes Self-management Education

Purpose The purpose of this study was to better understand barriers and facilitators of diabetes self-management education (DSME) among Arab American patients with diabetes. Little is known about the impact of Arab culture on DSME. Methods Arab American adults (N = 23) with medically managed diabetes participated in 1 of 3 focus groups. An Arabic-speaking, trained moderator conducted video-recorded sessions. Verbatim Arabic transcripts were translated into English. Transcripts underwent a qualitative content analysis approach. Results Arab American cultural traditions such as food sharing, religious beliefs, and gender roles both facilitated and at times impeded DSME. Patients also held conflicting views about their interactions with their providers; some participants praised the authoritative patient-physician relationship style while others perceived the gaps in communication to be a product of Arab culture. Participants expressed that lack of available educational and supportive resources are key barriers to DSME. Conclusion Arab American culture affects DSM activities, and culturally sensitive educational resources are lacking. Development of DSME programs tailored to address relevant aspects of Arab culture might improve DSME outcomes in Arab American population.

The contribution of head position, standing surface and vision to postural control in young adults

Postural control requires the integration of sensory information and is essential for performing every day movements and activities. Integrating sensory information from multiple sources may be challenging when competing sources of sensory information are affected. To further understand this complex relationship, this study investigated the contribution of varying sources of sensory information to postural control in healthy, young participants. Sixty young healthy adults (n=22 males; mean age, 24.6 ± 2.1 SD years and (n=38 females, mean age 24.0 ± 1.4 SD years) were asked to maintain a stable posture under conditions that varied standing surface, head position and the availability of visual information. Sway velocity was largest when standing on foam with eyes closed and head extended (2.07°/s) however, under the same visual-surface conditions with the head in a neutral position, sway velocity (1.59°/s) was smaller yet remained significant. Findings from this study suggest that postural sway responses are dependent on the combined integration of available sources of sensory information. It is anticipated that such baseline information will allow us to apply our findings to the clinical management of individuals suffering from balance and vestibular impairments.

Diabetes Is Devastating, and Insulin Is a Death Sentence: Provider Perspectives of Diabetes Self-Management in Arab-American Patients

IN BRIEF The purpose of this qualitative study was to examine providers’ perspectives on cultural barriers and facilitators to diabetes self-management (DSM) in Arab Americans to identify factors to enhance DSM education in the Arab-American community. The main barriers to DSM from the providers’ perspective were the disease itself and patients’ denial or refusal to recognize it, reflecting the stigma of the disease. Cultural aspects also included overlapping themes that both facilitated and presented barriers to DSM. These results suggest that DSM education for Arab Americans will be most effective if developed and delivered in a manner consistent with the cultural facilitators and barriers noted by providers.

Concurrent Validity of the International Family Quality of Life Survey

ABSTRACT The measurement of the social construct of Family Quality of Life (FQOL) is a parsimonious alternative to the current approach of measuring familial outcomes using a battery of tools related to individual-level outcomes. The purpose of this study was to examine the internal consistency and concurrent validity of the International FQOL Survey (FQOLS-2006), using cross-sectional data collected from 65 family caregivers of children with developmental disabilities. It shows a moderate correlation between the total FQOL scores of the FQOLS-2006 and the Beach Centers FQOL scale. The validity of five FQOLS-2006 domains was supported by the correlations between conceptually related domains.

Dementia in the context of disability

ABSTRACT Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed with dementia provides insight into the negative impact of these tragic, dependent views of dementia throughout and following the diagnosis process. Viewing her experiences through the lens of disability scholarship can increase awareness and improve the quality of care on the part of both therapists and family caregivers.

Erratum to: Diabetes self-management among Arab Americans: patient and provider perspectives

Unfortunately, the original version of this article [1] contained an error. The acknowledgements section was included incorrectly and should have acknowledged The Martha Schnebly Endowed Research Fund.

Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults

Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance.