Acquisition Of Attitudes Research Articles

Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study

ObjectiveTo assess the impact of a training program targeted to Primary Care (PC) professionalson the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use. MethodsA quasi-experimental, pre- and post-intervention study was performed in PC centers of Cordoba (Spain). Family doctors, residents and nurses participated in the study. The intervention was based on a motivational interviewing training program, which consisted in a workshop on learning skills, attitudes and knowledge about the alcohol management. PC providers were videotaped with a standardized patient in order to check the clinical and communication competencies acquired. A descriptive, bivariate and multivariate analysis was carried out (p < 0.05). ResultsPC providers’ communication skills and attitudes showed significant improvements in the variables studied (p < 0.001), as well as in the clinical interview evaluation parameters. ConclusionThe present study reveals the impact of a training program targeted to PC professionals on communication skills, attitudes, and knowledge about the prevention and management of patients with unhealthy alcohol use. Practice implicationsTraining activities targeted to PC providers represent a valuable strategy to improve communication skills, attitudes and knowledge of these professionals in their clinical practice.

Factors Influencing Medicine Use Behavior in Adolescents in Japan Using a Bayesian Network Analysis.

Background: Medicine education in Japan was introduced to junior high schools in 2012. However, the effectiveness of existing education programs is limited. In order to develop more effective programs for high school students, the present study investigated the variables that directly influence medicine use behavior and the magnitude of their influence, using a Bayesian network analysis.Methods: A national cross-sectional survey was conducted in 2017. Eighty-three public high schools across Japan were randomly selected, and questionnaires were administered to 15–16 years old 10th grade students. The number of valid responses was 17,437 (effective response rate was 98.46%). Responses were analyzed to measure students’ behavior toward, attitudes regarding, and knowledge of medicines, and awareness of their prior medicine education.Results: Students’ “attitude score” and “awareness of a class” directly influenced their “behavior score.” The “score on attitude,” which had a large influence on “score on behavior,” was directly influenced by “score on knowledge of proper use” and “awareness of class.”Conclusion: The present study argues that acquiring knowledge of appropriate medicine use leads to the acquisition of favorable attitudes, which may result in behavioral change. Therefore, for medicine education, it is expected that incorporating content related to knowledge acquisition for changing attitudes will be important for promoting behavioral change.

Similarity-based and rule-based generalisation in the acquisition of attitudes via evaluative conditioning

ABSTRACTGeneralisation in learning means that learning with one particular stimulus influences responding to other novel stimuli. Such generalisation effects have largely been overlooked within research on attitude acquisition via Evaluative Conditioning (i.e. EC effects). In five experiments, we investigated whether and when generalisation of EC effects is based on similarity or on abstract rules. Experiments 1, 2a, 2b and 3 showed that participants who abstracted a rule during the learning phase used that rule for category judgments of novel stimuli. However, evaluative ratings of the same stimuli were unaffected by the learned rule but followed the similarity to learned stimuli. Experiment 4 showed that this similarity-based pattern of generalisation is not specific to evaluative ratings. Rather, resemblance between judgment task and learning task seems to determine whether acquired rules are taken into account. We discuss how dual-process and single-process models of EC may account for the obtained generalisation results.

Transforming a U.S. scholarly concentrations program internationally: lessons learned

BackgroundScholarly Concentrations programs in U.S. medical schools aim to instill passion for critical thinking and promote careers in academic medicine. The rise of these programs has seen variable goals, structure, and outcomes. Transformation of these programs internationally is in its infancy.MethodsWe describe implementation of the Johns Hopkins School of Medicine Scholarly Concentrations program, offering Basic Science, Clinical Science, Medical Ethics/Healing Arts, History of Medicine, and Public Health/Community Service, at Bezmiâlem Vakif University in Istanbul, Turkey. Over six modules in the preclinical years, students develop a faculty-mentored experience which encourages the acquisition of attitudes and skills for self-directed, lifelong learning and scholarship. This culminates in abstract and project presentation. We report program characteristics (context and logistics) and outcomes (student engagement and experiences).ResultsThe Scholarly Concentrations program at Bezmiâlem began in 2014, with nearly two completed cohorts of students. In comparison to Johns Hopkins, students at Bezmiâlem begin at an earlier age (thus do not have as much prior research experience) and are subsequently evaluated for residency in terms of test scores rather than scholarship and publications, but have a similar level of intellectual curiosity and desire to take ownership of their project. Eighty-two percent of Bezmiâlem students stated the project they pursued was either their own idea or was an idea they formed after meeting with their mentor. Students at Bezmialem were more likely to choose Clinical Science projects (p = 0.009). Only 5% of Bezmiâlem students in end-of-course survey felt dissatisfied with the level of ownership they experienced with their project, a frequency similar to that seen by Johns Hopkins students (2%).ConclusionsScholarly Concentrations programs play an important role in U.S. medical schools, and these programs can be successfully implemented internationally. The Scholarly Concentrations program at Johns Hopkins has been transformed to a program at Bezmiâlem in Istanbul, the first program outside North America or the European Union. When designing these programs, one must consider the context, logistics, student engagement, and outcomes. While long-term outcomes are needed, this can serve as a model for implementation elsewhere.

The relationship between task mastery, role clarity, social acceptance, and stress: An intensive longitudinal study with a sample of newly registered nurses

BackgroundTransitioning into a new professional role is challenging. Unfortunately, little is currently known about how to reduce experiences of stress among new professionals. The socialization processes role clarity, task mastery, and social acceptance are assumed to reduce experiences of stress as they mediate new professionals’ acquisition of knowledge, skills, attitudes, and behaviors. However, little prospective data is available on the actual effect of the processes on stress. ObjectivesTo prospectively investigate how the socialization processes relate to experiences of stress among new nurses during the first three months of professional working life. Specifically, to investigate development over time, as well as how episodes of increased or decreased levels of the socialization processes relate to concurrent levels of stress. The general purpose of this investigation was to examine the suitability of the socialization processes as targets of an intervention seeking to reduce stress among new professionals. DesignAn intensive longitudinal study with weekly data collections over three months. Participants264 newly graduated Swedish nurses who started their first job during the period of the study. MethodsThe participants were followed prospectively during 14 consecutive weeks after their professional entry. Data on stress (Stress and Energy Questionnaire), role clarity (General Questionnaire for Psychological and Social Factors at Work), task mastery, and social acceptance (Needs Satisfaction and Frustration Scale) were collected weekly using digital surveys (mean response rate 82.7%). Data was analyzed using a multilevel model for intensive longitudinal data. ResultsFor the typical nurse, stress decreased by 0.13 units per month, role clarity and task mastery increased by 0.08 and 0.05 units, and social acceptance decreased by 0.08 units. In addition, the slopes of 95 percent of the new nurses varied within 1.18 (stress), 0.72 (role clarity), 0.44 (task mastery), and 0.86 (social acceptance) units of the typical nurse. Most importantly, when the new nurses experienced higher levels of task mastery, role clarity, and social acceptance, they experienced lower levels of stress (within-person parameter estimates: task mastery −0.40, p = .001; role clarity −0.34, p = .001; and social acceptance −0.33, p = .001). ConclusionsSupporting the development of the socialization processes could be one theoretically based strategy to reduce levels of stress among new nurses. As stress among new professionals is not unique to the nursing profession, and the processes are considered important mediators of new professionals’ adaptation in general, the results from this study should likely be generalizable to other professions.

Exploring first-year undergraduates’ perceptions of poetry and their acquisition of skills in reading poetry for study at university

There is significant evidence drawn from student evaluations that students embarking on undergraduate English degrees feel uneasy about studying poetry and that this anxiety has an effect on the course choices they make as they progress through the three years of their programme. This study aims to investigate the causes of students’ responses to poetry and to make a beginning in looking at the implications that this has for teaching and learning. It explores students’ acquisition of skills and attitudes that make poetry-reading a rewarding activity. Data has been gathered from focus groups with first-year undergraduate students in an English department at a UK university to discover what perceptions of poetry are held by students and what factors in teaching contribute to the development and/or perpetuation of these perceptions. In brief, the study finds that for effective teaching the cultivation of enthusiasm for poetry is just as important as building technical vocabulary and learning techniques of formal analysis. There is some evidence that the latter flows out of the former. It also finds that students feel the former is often overlooked in the classroom.

Comparing stuttering attitudes of preschool through 5th grade children and their parents in a predominately rural Appalachian sample

BackgroundTheories relating to young children’s social cognitive maturity and their prevailing social groups play important roles in the acquisition of attitudes. Previous research has shown that preschool and kindergarten children’s stuttering attitudes are characterized by stronger negative beliefs and self reactions than those of parents. By contrast, 12 year-old children’s stuttering attitudes have been shown to be similar to their parents’ attitudes. Other research indicates that parental stuttering attitudes are no different from attitudes of adults who are not parents. PurposeThe purpose of this study was to explore children’s stuttering attitudes of preschool through 5th grade children and to compare them to their parents’ attitudes. MethodChildren and parents from a rural Appalachian elementary school and child/parent pairs from other areas in the region responded to child and adult versions of the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S/Child and POSHA–S). Seven grade levels were included: preschool, kindergarten, 1st grade, 2nd grade, 3rd grade, 4th grade, and 5th grade. ResultsConfirming earlier research, younger children’s attitudes toward stuttering were considerably less positive than those of their parents. As children matured up to the fifth grade, however, their stuttering attitudes progressively were more positive. Parents’ stuttering attitudes were quite consistent across all seven grade levels. ConclusionsConsistent with theories of attitudinal development, between the ages of 4 and 11 years, children’s measured attitudes toward stuttering improved and gradually approximated the attitudes of their parents and the general public.

THE IMPACT OF CARICATURE DRAWINGS IN THE ACQUISITION OF SCIENTIFIC CONCEPTS AND ATTITUDES OF 4TH GRADE STUDENTS FOR BASIC EDUCATION TOWARDS SCIENCE

This research aimed to examine the impact of caricature drawings in the acquisition of scientific concepts and attitudes of 4th grade students for basic education towards science. The sample of the research consisted of 162 students from 4th grade. The results revealed that there were statistically significant differences at (p = .001) between the two groups in acquisition of scientific concepts in favour of experimental group. In addition to that, females scored significantly more than males in the post-test (p = .001), whereas the interaction between group and gender was not significant. The results also indicated that there were statistically significant differences (p = .001) between the two group in the attitudes towards science in favour of experimental group scores. The gender also has a significant impact on developing positive attitudes towards science in favour of females, whereas the interaction between group and gender was not significant. Finally, there was a statistically significant difference (p = .001) between pre- and post-application of students’ attitudes towards science scale in favour of post-application for the experimental group. Accordingly, the research recommends the use of caricature drawings to help students’ in the acquisition of scientific concept and developing positive attitudes towards science. Keywords: attitudes towards science, caricature drawings, scientific concepts.

El fútbol como estrategia para el desarrollo de la inteligencia emocional del alumnado de educación primaria: una experiencia didáctica

Se presenta una experiencia práctica llevada a cabo en el CEIP Bernardo Barco (La Campana, Sevilla) con el alumnado de 6º de educación primaria, basada en el desarrollo y en la adquisición de actitudes y valores positivos que vayan encaminados al desarrollo de nuevos aprendizajes vinculados con la inteligencia emocional. Las actividades desarrolladas a lo largo de las seis semanas de implantación de la propuesta didáctica han revelado que existe un aumento de las conductas positivas y de la mejora de los valores y el trabajo en equipo, lo cual repercute positivamente en el clima de aula de esta y las demás asignaturas en las que participa el alumnado. El trabajo a través de los componentes básicos de la inteligencia emocional utilizando como eje conductor el fútbol ha permitido dotar al alumnado de herramientas de trabajo en grupo, habilidades comunicativas, herramientas para la resolución de conflictos y estrategias para la toma de decisiones.

Importância e desafios do treinamento simulado em saúde

The use of simulation in health education expands learning opportunities, contributing in a relevant way to the prevention of errors during professional activity. However, there are several challenges to achieving efficient simulated training, including the need to adapt the knowledge produced in different contexts. How should a simulation center be organized? How to take into account the peculiarities of the students in applying the concept of debriefing? Have the evaluation tools been validated for the population in which they are being applied? What elements should be included in simulation-based teaching to improve acquisition and/or retention of skills, knowledge, and attitudes? At what point, in the curriculum, should every possibility of simulated training be introduced in order to make the investment valid? In this editorial, the authors point out the importance of simulation training in healthcare and the need for research aimed at understanding the different situations and providing answers to these questions.

Oral health-related quality of life among Belgrade adolescents

Background/Aim. Adolescents are vulnerable group in term of acquisition of oral health-related knowledge, habits and attitudes. That is why the aim of this study was to investigate the associations between dental status, dental anxiety and oral health-related behavior and oral healthrelated quality of life as captured by Oral Impacts on Daily Performances (OIDP) index. Methods. This crosssectional survey included representative sample of 404 adolescents (15 years old), randomly recruited from high schools in Belgrade, Serbia. The adolescents were interviewed using Serbian versions of eight-item OIDP index, Hiroshima University Dental Behavior Inventory (HUDBI) and modified Corah?s Dental Anxiety Scale (MDAS). Three previously trained and calibrated dentists examined the subjects in the classrooms to determine the oral health status of adolescents [the Decayed, missing, filled teeth (DMFT) index and visual signs of gingivitis]. Results. At least one oral impact was reported in 49.50% of adolescents. Most frequently, oral health problems affected eating (26.73%), tooth cleaning (27.47%) and sleep and relaxation (16.83%). In comparison with adolescents without oral impacts, the adolescents with at least one oral impact reported, had higher DMFT score, more often reported problems with bleeding gums, usage of hard toothbrush, worries about the color of their teeth and seeing the dentist because of the symptoms. Logistic regression showed that dental anxiety (MDAS score), dental behavior (HUDBI score) and worrying about the color of the teeth significantly affected OIDP score. Conclusion. Oral healthrelated quality of life among adolescents was affected by their behavior and dental anxiety levels. Implementing public health policies that target adolescents with poor oral health or bad habits might be helpful in improving their oral health-related quality of life.

Predicting gainful learning in Higher Education; a goal-orientation approach

We present data that may not only provide direction to those who are interested in developing a measure of learning gain, but also provide a route for those wishing to directly enhance student performance through gainful learning. Richardson found that student performance showed moderate correlations with only three self-regulatory variables academic self-efficacy, grade goal and effort regulation. We examine how student self-regulatory behaviours and predict these predict feedback engagement and behavioural change. Data provide converging evidence suggesting that mastery approach goal orientations, challenging interventions from feedback, and motivational intentions are essential personal constructs linked to behavioural change. These tentative findings support the suggestion that measures of gainful learning could be operationalised as ‘self-reported behaviours that suggest the productive acquisition of beneficial skills, knowledge and attitudes through study and experience’. Evidence is also offered indicating that more research is necessary to understand the measurement of mindset.

Preceptor Knowledge on Preceptorship in an Academic Hospital in Kenya.

Clinical preceptorship is critical for the acquisition of knowledge, skills, and attitudes in nursing care. Cardinal to the development of these competences is the preceptor's knowledge on preceptorship. In low-income countries, the responsibility of preceptorship rests with staff nurses whose knowledge on preceptorship is largely unknown. A survey was conducted among 254 nurses using a 3-point Likert scale questionnaire. Mean scale scores were computed for knowledge score. Association between training on preceptorship and level of knowledge was explored using chi square. The mean knowledge score was 1.71 (SD ± 0.41). Few had undergone training on preceptorship; knowledge on preceptorship had been acquired experientially or through role modeling. More nurses who had undergone training agreed that preceptor-trainee roles should be clearly defined at the beginning of clinical placement, χ2(1) = 15.54, p = .016. Although nurses were knowledgeable about preceptorship, few had been trained. A formal training program on preceptorship is warranted. J Contin Educ Nurs. 2017;48(11):496-500.

Analysis of the essential factors for the adoption of mobile learning in higher education: A case study of students of the University of Technology

This paper analyzed the adoption of using mobile learning (m-learning) in higher education. Mobile Learning as a model of e-learning refers to the acquisition of knowledge, skills and attitudes by utilizing mobile technologies. With the increasing coverage of mobile networks, learning services can play the increasing and effective role in education at any time and place. Continuous access via mobile devices creates special facilities like sending and saving the learning content to learners etc, it is accompanied with continuous education. This paper, with a study of “what is the impact of the mobile phone usage in education?” provides approaches and theories of mobile learning in training. The paper aimed to evaluate the essential factors for the adoption and application of education information system that has been created by students. The survey was based on the history of technology adoption and covered students. Furthermore, a case study from students of K. N. Toosi University in Iran was presented to indicate the performance of this method in practice. The statistical society included 300 members from Information Technology students of Iran's K. N. Toosi University of Technology. The factors related to adoption of mobile learning in higher education was classified into seven main categories as: ease of use, trust, characters and personal qualities, context, perceived usefulness of using, behavioral intention, and culture of using a research model. From the results, mobile learning could be one of the promising educational technologies for development in educational environments and culture of using. The context of applications has a significant positive effect on the ease of use factor and usefulness and the ease of use has a positive effect on the usefulness factor. The trust factor has a positive and significant effect on the behavioral intention. The personal features and characters factor have a significant positive effect on the culture of using and the culture of using the application has a significant positive effect on the behavioral intention.

SOCIETAL PERCEPTIONS ABOUT BEING A GOOD TEACHER IN LATVIA

Teacher is one of the most responsible professions in the world because the teacher builds a sustainable society. There is an ongoing discussion about a professional competency of the teacher and changes in the requirements for teachers in the acquisition of knowledge, skills and attitudes required from teachers. There are numerous researches being carried out about the professional competency of teaching competency. The professional teaching standard that was ratified in 2004 is outdated but the new teaching standard is not designed yet because policy makers cannot come to an agreement about what a good teacher needs to know. For the changes to take place, the main aim of the study is to explore and to analyze societal opinion about the notion of a good teacher and competencies required for a good teacher. The research was carried out from May, 2016 until September with a participation of 160 respondents from different age groups. To ensure the validity of the study the authors used a questionnaire. Acquired data indicate that there exists a significant difference between the opinion expressed by the school age children and the opinion of adults. By describing the ideal of a good teacher pupils pay more attention to personal features of a teacher but adults pay closer attention to the skills and knowledge needed for a teacher.

EQuality: a Process Model to Develop an Integrated, Comprehensive Medical Education Curriculum for LGBT, Gender Nonconforming, and DSD Health

Patients who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming (GNC), or born with differences of sex development (DSD) face significant health disparities. Many of these disparities originate from discrimination and systemic biases that decrease access to care and from inadequate provider knowledge that contributes to unmet medical needs. Provider training to deliver equitable care for these populations is thus critical, but such training is deficient at most medical institutions. The authors developed an integrated educational model, eQuality, that sought to drive educational and system innovation by teaching and assessing the acquisition of attitudes, knowledge, and skills needed to provide competent care for LGBT/GNC/DSD individuals. This paper outlines the process of its implementation for other programs to model. With input from an LGBT/GNC community advisory panel, eQuality incorporated new teaching sessions and revised existing content in 50.5 h of required curriculum. This curriculum involved 23 teaching faculty and included direct student-LGBT/GNC/DSD patient interactions for 320 students. The program was piloted in the first and second years of medical school and is being expanded into medical school years 3 and 4 with clinical assessments to ensure that curriculum translates into improved patient care. eQuality demonstrates that promoting healthcare equity for LGBT/GNC/DSD populations through medical education is feasible. Forthcoming baseline data will also enable future longitudinal comparisons as eQuality cultivates exceptional insight into the evolution of LGBT/GNC/DSD health knowledge and awareness among both students and faculty.

A statewide screening, brief intervention, and referral to treatment (SBIRT) curriculum for medical residents: Differential implementation strategies in heterogeneous medical residency programs

ABSTRACTBackground: Many screening, brief intervention, and referral to treatment (SBIRT) training curricula have been implemented within graduate medical residency training programs, with varying degrees of success. The authors examined the implementation of a uniform, but adaptable, statewide SBIRT curriculum in 7 diverse residency training programs and whether it could improve resident knowledge, skills, and attitudes regarding SBIRT and unhealthy alcohol and other drug (AOD) use. Methods: The authors assessed the implementation of the Pennsylvania SBIRT Medical and Residency Training (SMaRT) curriculum at 7 residency sites training a variety of disciplines. Faculty could use a variety of training modalities, including (1) Web-based self-directed modules; (2) didactic lectures; (3) small-group sessions; and/or (4) skill-transfer interactions with standardized or real patients in preceptor-led encounters. Acquisition of knowledge, skills, and attitudes regarding SBIRT and unhealthy AOD use–associated patient care were assessed via a pre- and post-survey instrument with 4 domains: Resident Knowledge, Resident Competence, Resident Skills and Attitudes (Alcohol), and Resident Skills and Attitudes (Drug). Responses to the pre- and post-surveys (N = 365) were compared and analyzed with t tests and Wilcoxon signed-rank tests. Results: The diverse modalities allowed each of the residency programs to adapt and implement the SMaRT curriculum based on their needs and environments. Residents' knowledge, skills, and attitudes regarding SBIRT and working with unhealthy AOD use, as assessed by survey, generally improved after completing the SMaRT curriculum, despite the variety of models used. Specifically, Resident Knowledge and Resident Competence domains significantly improved (P < .000). Residents improved the least for survey items within the Resident Skills and Attitudes (Alcohol) domain. Conclusions: Adaptable curricula, such as SMaRT, may be a viable step towards developing a nationwide curriculum.

The newsroom: uso de una serie de televisión para la formación ética de futuros profesionales de la información

How can we foster ethical professional behavior in communication students? In order to answer this question, this article describes how a TV series was used in university teaching as a learning tool. This article consists of three sections: first, university teaching is presented as the context and professional ethics as the curricular space where the proposal is developed; second, we show why the use of TV dramas, besides motivating student interest, facilitates the acquisition of knowledge, skills, and ethical attitudes; third, we describe the use of a TV series, The newsroom, in the classroom and some testimonies that demonstrate the effectiveness of the strategy for the understanding of the subject content.

An innovative, residency-based, interprofessional faculty development program.

The impact of an interprofessional faculty development fellowship (FDF) on pharmacy graduates' careers is described. The FDF instructional approach is a longitudinal acquisition and application of knowledge, skills, and attitudes fostered by clinical care delivery, teaching experiences, structured reflection, the giving and receiving of feedback, research and scholarly projects, and leadership development and exercises. Interprofessional FDF fellows teach, learn, and provide care together in both inpatient and outpatient clinical settings as a part of the evidence-based medicine curriculum, providing educational sessions for medical students, pharmacy students, medical residents, attending family medicine physicians, and clinical pharmacy faculty throughout the year. Twenty-seven of the 30 pharmacist graduates of the fellowship (90% response rate) responded to an electronic survey about the influence of the FDF on their careers. Overall, pharmacy graduates were very satisfied with the fellowship. The fellowship fostered a clear pattern of continued, collaborative learning. While additional training beyond a pharmacy residency program is not necessary for a successful clinical career, 41% of graduates pursued additional training after completing the fellowship. Open-ended responses for motivations for completing the FDF and influences the FDF had on their careers fell unforced into the FDF curriculum domains, which reinforced the belief that these are the right areas to target for development. Pharmacy residents participated in a broad, interprofessional faculty development curriculum, which fostered teaching, scholarship, leadership, professional development, and clinical skills. Pharmacist graduates indicated that the experience significantly influenced their careers and professional development.

Relation and technique in psychotherapy: Two partly overlapping categories.

The terms relation and technique are frequently used in discussions of what is effective in psychotherapy, but often on the assumption that they refer to conceptually separate phenomena. The present article questions this dichotomy between relationship and technique. This is done on the basis of a theoretical analysis of the concepts of technique and relationship, and the variety of phenomena they refer to. Techniques are defined as procedures prescribed as the means to reach some goal, that are made available to individuals through various kinds of training, education, and apprenticeship, and that result in the acquisition of skills and attitudes. It is argued that there are 2 basic categories of techniques in psychotherapy: (a) relational techniques, which the therapist uses either explicitly or implicitly in the interaction with the patient, and (b)self-techniques, which the therapist teaches the patient to use (or applies to him/herself). In addition, it is argued that the therapeutic relationship involves a number of nontechnical aspects that need to be systematically addressed. This model of technique and relationship as partly overlapping categories is illustrated with examples from psychodynamic therapy, cognitive– behavioral therapies and humanistic-experiential therapy. It is argued that the development of a comprehensive theory of psychotherapy would benefit from a systematic search through the literature to identify techniques that have been advocated by various therapists, and the use of thematic analysis to analyze the content of these techniques in terms of skills and attitudes.