A study to determine the difference in clinical judgment abilities between BSN and non-BSN graduates.

PubMed

Sanford, M; Genrich, S; Nowotny, M

1992-02-01

The purpose of this retrospective study is to determine the difference in clinical judgment abilities of recent baccalaureate nurses (BSN) seeking employment in a large metropolitan hospital and of nurses without a baccalaureate degree. Using an ex post facto design, the orientation records of 116 newly hired nurses were analyzed to determine the clinical judgment abilities using video vignettes produced by Medcom, Inc. Findings indicated that there was no difference in clinical judgment in newly hired BSN and non-BSN graduates. These findings indicate a need for more research studies to determine how clinical judgment is developed and to evaluate teaching strategies that facilitate clinical judgment.

Consistency of physicians' legal standard and personal judgments of competency in patients with Alzheimer's disease.

PubMed

Marson, D C; Earnst, K S; Jamil, F; Bartolucci, A; Harrell, L E

2000-08-01

To investigate the consistency of physician judgments of treatment consent capacity (competency) for patients with Alzheimer's disease (AD) when specific legal standards (LS) for competency are used, and to identify the LS most clinically relevant to experienced physicians. Control and AD patient participants were videotaped being administered a measure of capacity to consent to medical treatment. Study physicians viewed videotapes of these assessments individually and made competency judgments for each participant under different LS followed by their own personal judgment of competency. A university medical center. Participants were 10 older controls and 21 patients with AD (10 with mild and 11 with moderate AD). Five physicians with experience assessing the competency of AD patients were recruited from the geriatric psychiatry, geriatric medicine, and neurology services of a university medical center. The 31 participants were videotaped performing on a measure of treatment consent capacity (Capacity to Consent to Treatment Instrument) (CCTI). The CCTI consists of two clinical vignettes (A-neoplasm and B-cardiac) that test competency under five LS. Vignette A and B assessments were videotaped separately for each participant (total videotapes for sample = 62). Each study physician viewed each videotaped vignette individually, made judgments under each of the LS (competent or incompetent), and then made his/her own personal competency judgment. Physicians were blinded to participant diagnosis. Within participant group, consistency of physician judgments was evaluated across LS and personal judgments using percentage agreement and kappa. Agreement between personal and LS judgments for the AD group was evaluated for each physician using logistic regression. As expected, physicians as a group generally demonstrated very high percentage agreement in their LS and personal competency judgments for the control group. For the AD group, mean percentage judgment agreement among physicians ranged from a high of 84% (LS1) (evidencing a treatment choice) to a low of 67% (LS3) (appreciating consequences of treatment choice). Mean percentage agreement for personal competency judgments was 76%. For the AD sample, kappa analyses for physicians as a group demonstrated significant agreement not attributable to chance for LS5 (understanding treatment situation/choices) (k = 0.57, P = .001), LS4 (providing rational reasons for treatment choice) (k = 0.39, P = .04), and also for personal judgments (k = 0.48, P = .009). Analysis of LS judgment agreement within physician indicated that physicians applied the LS as discrete standards. Within-physician and for the AD sample, personal competency judgments were associated significantly with judgments on LS5 (P = .001), LS4 (P = .004), and LS3 (P < .04). Experienced physicians demonstrated significant agreement assessing competency in AD patients when judgments were based upon specific legal standards. Personal competency judgments of physicians showed a substantially higher level of agreement than found in a previous study, where specific LS were not used. These results suggest that consistency of physician competency judgments can be enhanced if they are guided by knowledge of specific LS. Physicians' personal competency judgments were most closely associated with comprehension and reasoning LS, the most conservative and clinically appropriate standards for deciding competency.

Face-to-Face and Online: An Investigation of Children's and Adolescents' Bullying Behavior through the Lens of Moral Emotions and Judgments

ERIC Educational Resources Information Center

Conway, Lauryn; Gomez-Garibello, Carlos; Talwar, Victoria; Shariff, Shaheen

2016-01-01

The current study investigated the influence of type of aggression (cyberbullying or traditional bullying) and participant role (bystander or perpetrator) on children and adolescents' self-attribution of moral emotions and judgments, while examining the influence of chronological age. Participants (N = 122, 8-16 years) evaluated vignettes and were…

Beauty and the Eye of the Beholder: Gender and Attractiveness Affect Judgments in Teacher Sex Offense Cases.

PubMed

Mackelprang, Emily; Becker, Judith V

2017-06-01

The present study investigated the effects of gender and attractiveness on judgments of bail requirements, incarceration, and sex offender registration lengths, and attitudes toward offenders and victims in a teacher-student sexual perpetration scenario. Researchers presented 432 undergraduate students at a large southwestern university with one of four vignettes detailing a sexual relationship between a 35-year-old teacher and a 14-year-old student. Vignettes varied by both attractiveness and gender of the offender (using heterosexual offender-victim dyads). Results indicate that both gender and attractiveness affect judgments of sex offenders; specifically, female sexual offenders were viewed more leniently and judged less punitively than male sexual offenders. Although attractive female sexual offenders were given particularly lenient treatment, attractiveness did not affect judgments toward male sex offenders. In addition, although male and female participants tended to rate male offenders similarly, male participants were more lenient toward female offenders than were female participants. Finally, post hoc analyses revealed that, for many variables, unattractive female sexual offenders may not be viewed differently from male sexual offenders. These results have serious implications for the legal system, sex offender management, and societal views regarding male and female sexual offenders and their victims.

Schema Effects of Rape Myth Acceptance on Judgments of Guilt and Blame in Rape Cases: The Role of Perceived Entitlement to Judge

ERIC Educational Resources Information Center

Eyssel, Friederike; Bohner, Gerd

2011-01-01

Two experiments (N = 330) examined conditions that facilitate biasing effects of rape myth acceptance (RMA) on judgments of blame in rape cases. In both experiments, participants read a short vignette depicting a rape case. In Experiment 1, the amount of case-irrelevant information about defendant and plaintiff was varied. As predicted, high-RMA…

Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services.

PubMed

Holley, Jessica; Gillard, Steven

2018-02-01

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.

Patronizing the young: forms and evaluations.

PubMed

Giles, H; Williams, A

1994-01-01

Exploratory work indicated that Californian undergraduates were frequently, and irritatingly, patronized by older adults in a variety of ways. In a follow-up, using multidimensional scaling procedures, three distinct clusters representing young adults' own conceptions of patronizing speech emerged ("non-listening," "disapproving," and "parental"). In the main study, young adults were provided with a single vignette of a short conversation between an older and younger person. Eight versions of this vignette were devised independently varying elder's age (40- vs. 70-years) and speech style (neutral vs. non-listening vs. disapproving vs. parental). Participants were required to evaluate both vignette-targets. As expected, the patronizing elders were negatively perceived. An evaluative hierarchy differentiated between the three patronizing forms, and in ways that differed depending on the nature of the judgmental task. Content analyses of open-ended data also revealed interesting differences in interpretive responses to the various vignette conditions.

The Utility of the Frailty Index in Clinical Decision Making.

PubMed

Khatry, K; Peel, N M; Gray, L C; Hubbard, R E

2018-01-01

Using clinical vignettes, this study aimed to determine if a measure of patient frailty would impact management decisions made by geriatricians regarding commonly encountered clinical situations. Electronic surveys consisting of three vignettes derived from cases commonly seen in an acute inpatient ward were distributed to geriatricians. Vignettes included patients being considered for intensive care treatment, rehabilitation, or coronary artery bypass surgery. A frailty index was generated through Comprehensive electronic Geriatric Assessment. For each vignette, respondents were asked to make a recommendation for management, based on either a brief or detailed amount of clinical information and to reconsider their decision after the addition of the frailty index. The study suggests that quantification of frailty might aid the clinical judgment now employed daily to proceed with usual care, or to modify it based on the vulnerability of the person to whom it is aimed.

Cultural differences in the primacy effect for person perception.

PubMed

Noguchi, Kenji; Kamada, Akiko; Shrira, Ilan

2014-06-01

Previous work has shown there are robust differences in how North Americans and East Asians form impressions of people. The present research examines whether the tendency to weigh initial information more heavily-the primacy effect-may be another component of these cultural differences. Specifically, we tested whether Americans would be more likely to use first impressions to guide person perception, compared to Japanese participants. In this experiment, participants read a vignette that described a target person's behaviour, then rated the target's personality. Before reading the vignette, some trait information was given to create an expectation about the target's personality. The data revealed that Americans used this initial information to guide their judgments of the target, whereas the Japanese sample based their judgments on all the information more evenly. Thus, Americans showed a stronger primacy effect in their impression formation than Japanese participants, who engaged in more data-driven processing. © 2013 International Union of Psychological Science.

Using vignettes to explore work-based learning: part 2.

PubMed

Wareing, Mark

This is the second of two articles exploring the use of vignettes as an alternative method of presenting the data arising from interviews. The interviews were carried out as part of research into work-based learning: both articles are based on findings from a hermeneutic phenomenological study into the lived experience of foundation degree mentors and their students-healthcare assistants undertaking a foundation degree in health and social care in order to become assistant practitioners. Part 2 presents a vignette of a notional assistant practitioner, Michelle, that describes her lived experience as a foundation degree student. Michelle's perspective is a distillation of data arising from interviews with 11 former foundation degree students. The vignette attempts to demonstrate the features of 'knowing' and 'becoming' in the practice of foundation degree students, and the impact that being a work-based learner has on students' perceptions of lifelong learning.

Using vignettes to explore work-based learning: Part 1.

PubMed

Wareing, Mark

This is the first of two articles exploring the use of vignettes as an alternative method of presenting the data arising from interviews. The interviews were carried out as part of research into work-based learning: both articles are based on findings from a hermeneutic phenomenological study into the lived experience of foundation degree mentors and their students-healthcare assistants undertaking a foundation degree in health and social care in order to become assistant practitioners. Part 1 presents a vignette of a notional workplace mentor (Staff Nurse Sophie) that describes her lived experience supporting two equally notional foundation degree students. Sophie's perspective will be a distillation of data arising from interviews with eight workplace mentors, all employed on acute wards within a large NHS hospital trust. The vignette attempts to demonstrate the role of the workplace mentor in the support of work-based learning, and the interprofessional factors that determine the landscape of workplace learning for foundation degree students. The potential of a vignette to assist in a deeper hermeneutic understanding of meanings arising from data will be explored, and the limitations of the approach considered.

Development of cognitive processing and judgments of knowledge in medical students: Analysis of progress test results.

PubMed

Cecilio-Fernandes, Dario; Kerdijk, Wouter; Jaarsma, A D Debbie C; Tio, René A

2016-11-01

Beside acquiring knowledge, medical students should also develop the ability to apply and reflect on it, requiring higher-order cognitive processing. Ideally, students should have reached higher-order cognitive processing when they enter the clinical program. Whether this is the case, is unknown. We investigated students' cognitive processing, and awareness of their knowledge during medical school. Data were gathered from 347 first-year preclinical and 196 first-year clinical students concerning the 2008 and 2011 Dutch progress tests. Questions were classified based upon Bloom's taxonomy: "simple questions" requiring lower and "vignette questions" requiring higher-order cognitive processing. Subsequently, we compared students' performance and awareness of their knowledge in 2008 to that in 2011 for each question type. Students' performance on each type of question increased as students progressed. Preclinical and first-year clinical students performed better on simple questions than on vignette questions. Third-year clinical students performed better on vignette questions than on simple questions. The accuracy of students' judgment of knowledge decreased over time. The progress test is a useful tool to assess students' cognitive processing and awareness of their knowledge. At the end of medical school, students achieved higher-order cognitive processing but their awareness of their knowledge had decreased.

Cultural concepts of tuberculosis and gender among the general population without tuberculosis in rural Maharashtra, India.

PubMed

Atre, Sachin R; Kudale, Abhay M; Morankar, Sudhakar N; Rangan, Sheela G; Weiss, Mitchell G

2004-11-01

Gender-specific patterns of experience, meaning, and behaviour for tuberculosis (TB) require consideration to guide control programmes. To clarify concepts of gender, culture, and TB in a rural endemic population of Maharashtra, India, this study of 80 men and 80 women employed qualitative and quantitative methods of cultural epidemiology, using a locally adapted semi-structured Explanatory Model Interview Catalogue (EMIC) interviews are instruments for cultural epidemiological study of the distribution of illness-related experiences, meanings, and behaviours. This interview queried respondents without active disease about vignettes depicting a man and woman with typical features of TB. Emotional and social symptoms were frequently reported for both vignettes, but more often considered most distressing for the female vignette; specified problems included arranging marriages, social isolation, and inability to care for children and family. Job loss and reduced income were regarded most troubling for the male vignette. Men and women typically identified sexual experience as the cause of TB for opposite-sex vignettes. With wider access to information about TB, male respondents more frequently recommended allopathic doctors and specialty services. Discussion considers the practical significance of gender-specific cultural concepts of TB.

Communicating Uncertain Experimental Evidence

ERIC Educational Resources Information Center

Davis, Alexander L.; Fischhoff, Baruch

2014-01-01

Four experiments examined when laypeople attribute unexpected experimental outcomes to error, in foresight and in hindsight, along with their judgments of whether the data should be published. Participants read vignettes describing hypothetical experiments, along with the result of the initial observation, considered as either a possibility…

Utilitarian Moral Judgment Exclusively Coheres with Inference from Is to Ought

PubMed Central

Elqayam, Shira; Wilkinson, Meredith R.; Thompson, Valerie A.; Over, David E.; Evans, Jonathan St. B. T.

2017-01-01

Faced with moral choice, people either judge according to pre-existing obligations (deontological judgment), or by taking into account the consequences of their actions (utilitarian judgment). We propose that the latter coheres with a more general cognitive mechanism – deontic introduction, the tendency to infer normative (‘deontic’) conclusions from descriptive premises (is-ought inference). Participants were presented with vignettes that allowed either deontological or utilitarian choice, and asked to draw a range of deontic conclusions, as well as judge the overall moral rightness of each choice separately. We predicted and found a selective defeasibility pattern, in which manipulations that suppressed deontic introduction also suppressed utilitarian moral judgment, but had little effect on deontological moral judgment. Thus, deontic introduction coheres with utilitarian moral judgment almost exclusively. We suggest a family of norm-generating informal inferences, in which normative conclusions are drawn from descriptive (although value-laden) premises. This family includes deontic introduction and utilitarian moral judgment as well as other informal inferences. We conclude with a call for greater integration of research in moral judgment and research into deontic reasoning and informal inference. PMID:28690572

Labelling effects and adolescent responses to peers with depression: an experimental investigation.

PubMed

Dolphin, Louise; Hennessy, Eilis

2017-06-24

The impact of illness labels on the stigma experiences of individuals with mental health problems is a matter of ongoing debate. Some argue that labels have a negative influence on judgments and should be avoided in favour of information emphasising the existence of a continuum of mental health/illness. Others believe that behavioral symptoms are more powerful influencers of stigma than labels. The phenomenon has received little attention in adolescent research, despite the critical importance of the peer group at this developmental stage. This study employs a novel experimental design to examine the impact of the depression label and continuum information on adolescents' responses to peers with depression. Participants were 156 adolescents, 76 male, 80 female (M = 16.25 years; SD = .361), assigned to one of three conditions (Control, Label, Continuum). Participants respond to four audio-visual vignette characters (two clinically depressed) on three occasions. Outcome measures included judgment of the mental health of the vignette characters and emotional responses to them. Neither the provision of a depression label or continuum information influenced perceptions of the mental health of the characters in the audio-visual vignettes or participants' emotional responses to them. The findings have implications for the design of interventions to combat depression stigma with adolescents. Interventions should not necessarily target perceptions of psychiatric labels, but rather perceptions of symptomatic behaviour.

Developmental and Gender Differences in Preadolescents' Judgments of the Veracity of Gossip.

ERIC Educational Resources Information Center

Kuttler, Ami Flam; Parker, Jeffrey G.; La Greca, Annette M.

2002-01-01

Used hypothetical vignettes to examine 384 preadolescents' understanding of gossip in varying circumstances. Found that children correctly labeled talk about nonpresent others as gossip and considered it inappropriate. Skepticism was higher for gossip than for firsthand information and was greatest with cues suggesting that speakers were…

Children's Judgments of Parental Fairness: An Indian Perspective

ERIC Educational Resources Information Center

Laddu, Nandini; Kapadia, Shagufa

2007-01-01

The study examined children's moral reasoning with specific reference to adult interventions, across age and gender. Seventy-two children from the age groups 6-8 years and 10-12 years respectively were presented with two hypothetical vignettes pertaining to Piaget's justice framework of moral reasoning. Chi-square analysis and descriptive analysis…

Patients' Contexts and Their Effects on Clinicians' Impressions of Conduct Disorder Symptoms

ERIC Educational Resources Information Center

De Los Reyes, Andres; Marsh, Jessecae K.

2011-01-01

The purpose of this study was to examine whether contextual information about patients' clinical presentations affected clinicians' judgments of conduct disorder symptoms. Forty-five clinicians read vignettes describing hypothetical patients who displayed one conduct disorder symptom alongside information about the patients' home, school, and peer…

Subjective experience of coercion in psychiatric care: a study comparing the attitudes of patients and healthy volunteers towards coercive methods and their justification.

PubMed

Mielau, J; Altunbay, J; Gallinat, J; Heinz, A; Bermpohl, F; Lehmann, A; Montag, C

2016-06-01

Under certain conditions, coercive interventions in psychotic patients can help to regain insight and alleviate symptoms, but can also traumatize subjects. This study explored attitudes towards psychiatric coercive interventions in healthy individuals and persons suffering from schizophrenia, schizoaffective or bipolar disorder. The impact of personal history of coercive treatment on preferences concerning clinical management of patients unable to consent was investigated. Six case vignettes depicting scenarios of ethical dilemmas and demanding decisions in favour of or against coercive interventions were presented to 60 healthy volunteers and 90 patients. Structured interviews focusing on experienced coercion were performed in conjunction with the Coercion Experience Scale and the Admission Experience Survey. Symptom severity, psychosocial functioning and insight into illness were assessed as influencing variables. Student's t tests compared patients' and controls' judgments, followed by regression analyses to define the predictive value of symptoms and measures of coercion on judgments regarding the total patient sample and patients with experience of fixation. Patients and non-psychiatric controls showed no significant difference in their attitudes towards involuntary admission and forced medication. Conversely, patients more than controls significantly disapproved of mechanical restraint. Subjective experience of coercive interventions played an important role for the justification of treatment against an individual's "natural will". Factors influencing judgments on coercion were overall functioning and personal experience of treatment effectiveness and fairness. Qualitative and quantitative aspects of perceived coercion, in addition to insight into illness, predicted judgments of previously fixated patients. Results underline the importance of the quality of practical implementation and care, if coercive interventions cannot be avoided.

Perceptions of Sexual Intent: The Impact of Condom Possession

ERIC Educational Resources Information Center

Hynie, Michaela; Schuller, Regina A.; Couperthwaite, Lisa

2003-01-01

This study examined whether knowing that a victim of a sexual assault was carrying a condom influenced perceptions of her sexual intention and subsequent judgments of the sexual assault. Participants (N = 165) read a vignette describing a date that culminated in an alleged sexual assault. Condom possession (carrying a condom, not carrying a…

Can Knowledge of Client Birth Order Bias Clinical Judgment?

ERIC Educational Resources Information Center

Stewart, Allan E.

2004-01-01

Clinicians (N = 308) responded to identical counseling vignettes of a male client that differed only in the client's stated birth order. Clinicians developed different impressions about the client and his family experiences that corresponded with the prototypical descriptions of persons from 1 of 4 birth orders (i.e., first, middle, youngest, and…

Impact of a Risk Calculator on Risk Perception and Surgical Decision Making: A Randomized Trial.

PubMed

Sacks, Greg D; Dawes, Aaron J; Ettner, Susan L; Brook, Robert H; Fox, Craig R; Russell, Marcia M; Ko, Clifford Y; Maggard-Gibbons, Melinda

2016-12-01

The aim of this study was to determine whether exposure to data from a risk calculator influences surgeons' assessments of risk and in turn, their decisions to operate. Little is known about how risk calculators inform clinical judgment and decision-making. We asked a national sample of surgeons to assess the risks (probability of serious complications or death) and benefits (recovery) of operative and nonoperative management and to rate their likelihood of recommending an operation (5-point scale) for 4 detailed clinical vignettes wherein the best treatment strategy was uncertain. Surgeons were randomized to the clinical vignettes alone (control group; n = 384) or supplemented by data from a risk calculator (risk calculator group; n = 395). We compared surgeons' judgments and decisions between the groups. Surgeons exposed to the risk calculator judged levels of operative risk that more closely approximated the risk calculator value (RCV) compared with surgeons in the control group [mesenteric ischemia: 43.7% vs 64.6%, P < 0.001 (RCV = 25%); gastrointestinal bleed: 47.7% vs 53.4%, P < 0.001 (RCV = 38%); small bowel obstruction: 13.6% vs 17.5%, P < 0.001 (RCV = 14%); appendicitis: 13.4% vs 24.4%, P < 0.001 (RCV = 5%)]. Surgeons exposed to the risk calculator also varied less in their assessment of operative risk (standard deviations: mesenteric ischemia 20.2% vs 23.2%, P = 0.01; gastrointestinal bleed 17.4% vs 24.1%, P < 0.001; small bowel obstruction 10.6% vs 14.9%, P < 0.001; appendicitis 15.2% vs 21.8%, P < 0.001). However, averaged across the 4 vignettes, the 2 groups did not differ in their reported likelihood of recommending an operation (mean 3.7 vs 3.7, P = 0.76). Exposure to risk calculator data leads to less varied and more accurate judgments of operative risk among surgeons, and thus may help inform discussions of treatment options between surgeons and patients. Interestingly, it did not alter their reported likelihood of recommending an operation.

Conversation, development, and gender: a study of changes in children's concepts of punishment.

PubMed

Leman, Patrick J; Björnberg, Marina

2010-01-01

One hundred thirty-three children, average age 9.58 years, were read vignettes describing a moral transgression and then discussed what would constitute a fair punishment. Children's gender influenced conversation dynamics (use of interruption and other simultaneous speech) but not conversation content (justifications for judgments). All children who engaged in conversation showed development in judgments after 8 weeks compared with a control (no interaction) group. However, there was no relation between conversation dynamics or content and development, or any effects of gender, on the developmental process. The benefits of peer collaboration were general rather than specific to the stimulus story.

The ADHD Label, Analogue Methodology, and Participants' Geographic Location on Judgments of Social and Attentional Skills

ERIC Educational Resources Information Center

Koonce, Danel A.; Cruce, Michael K.; Aldridge, Jennifer O.; Langford, Courtney A.; Sporer, Amy K.; Stinnett, Terry A.

2004-01-01

Two hundred fifty-nine preservice teachers at a medium-sized university in the Southwest participated in the current study. The participants were randomly assigned to a labeled condition, Attention Deficit Hyperactivity Disorder, or nonlabeled condition, and were presented a vignette in one of three forms: a written case study, a video clip, or a…

Devising a Supportive Climate Based on Clinical Vignettes of College Students with Attention Deficit Disorder.

ERIC Educational Resources Information Center

Willis, Christy; And Others

1995-01-01

Interviews with five students with Attention Deficit Disorder (ADD) at The George Washington University (District of Columbia), their families, and professionals in student disabilities resulted in five clinical vignettes representing a spectrum of ADD students. Six recurring personal issues emerged: self-esteem, family/peer support, stress,…

The Interactive Candidate Assessment Tool: A New Way to Interview Residents.

PubMed

Platt, Michael P; Akhtar-Khavari, Vafa; Ortega, Rafael; Schneider, Jeffrey I; Fineberg, Tabitha; Grundfast, Kenneth M

2017-06-01

The purpose of the residency interview is to determine the extent to which a well-qualified applicant is a good fit with a residency program. However, questions asked during residency interviews tend to be standard and repetitive, and they may not elicit information that best differentiates one applicant from another. The iCAT (interactive Candidate Assessment Tool) is a novel interview instrument that allows both interviewers and interviewees to learn about each other in a meaningful way. The iCAT uses a tablet computer to enable the candidate to select questions from an array of video and nonvideo vignettes. Vignettes include recorded videos regarding some aspect of the program, while other icons include questions within recognizable categories. Postinterview surveys demonstrated advantages over traditional interview methods, with 93% agreeing that it was an innovative and effective tool for conducting residency program interviews. The iCAT for residency interviews is a technological advancement that facilitates in-depth candidate assessment.

Medical Students' Development of Ethical Judgment - Exploring the Learners' Perspectives using a mixed methods approach.

PubMed

Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W

2016-01-01

Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students' perspectives on their development in ethical judgment has received less attention. Better insights in the learners' experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient's parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant's preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants' responses changed overtime. Accepting parents' autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents' decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the participants seemed to increasingly frame the presented vignette as a medical problem. To optimize the development of ethical judgment teaching of ethics should be more integrated in clinical teaching. In addition to the analysis of rare and extreme cases, teaching ethics should also expand on challenges students and junior doctors commonly encounter themselves to promote ethical sensitivity and confidence in students.

Medical Students’ Development of Ethical Judgment – Exploring the Learners’ Perspectives using a mixed methods approach

PubMed Central

Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W.

2016-01-01

Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students’ perspectives on their development in ethical judgment has received less attention. Better insights in the learners’ experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient’s parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant’s preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants’ responses changed overtime. Accepting parents’ autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents’ decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the participants seemed to increasingly frame the presented vignette as a medical problem. To optimize the development of ethical judgment teaching of ethics should be more integrated in clinical teaching. In addition to the analysis of rare and extreme cases, teaching ethics should also expand on challenges students and junior doctors commonly encounter themselves to promote ethical sensitivity and confidence in students. PMID:27990470

Lessons from the use of vignettes in the study of mental health service disparities.

PubMed

Lapatin, Sheri; Gonçalves, Marta; Nillni, Anna; Chavez, Ligia; Quinn, Roxana Llerena; Green, Alexander; Alegría, Margarita

2012-06-01

To examine the development, feasibility, and use of a vignette approach as an important tool in health services disparities research. Interviews with vignette developers and qualitative data from a novel mental health services disparities study that used vignettes in two samples: (1) predominantly low-income parents of children attending mental health specialty care who were Latino or non-Latino White and (2) Latino and non-Latino mental health clinicians who treat children in their practice. We conduct a content analysis of qualitative data from patients and providers in the Ethnic Differences Study to explore the feasibility of vignette methodology in health services disparities research, and we identify lessons learned that may guide future vignette development. Vignettes provide a valuable approach that is acceptable to participants, elicits important insight on participant experience and services, and sheds light on factors that can help optimize study design for exploring health disparities questions. Researchers, clinicians, and others should consider a set of factors that help determine when a vignette approach is warranted in research, training, or for other uses, including how best to address identified weaknesses. © Health Research and Educational Trust.

Judgments of laypersons and general practitioners on justifiability and legality of providing assistance to die to a terminally ill patient: a view from New Zealand.

PubMed

Mitchell, Kay; Glynn Owens, R

2004-07-01

As part of a larger study, four decisions related to a vignette scenario of the elective death of a terminally ill patient suffering intractable pain are examined (doctor supplying information and drugs, assisting patient to take the drugs, or administering a lethal injection). Judgments on justifiability and legality of actions were obtained from laypersons and general practitioners (GPs) in Auckland, New Zealand. The results show that over 72% of laypersons and over 30% of GPs judged all four actions justified. Despite illegality a significant number of laypersons and some doctors were unsure of the legal status of actions. The current law in New Zealand prohibiting physician-assisted death may not reflect judgments by the majority of laypersons or 30% of general practitioners on the justifiability of elective death options for a terminally ill patient with intractable pain. Judgments on justifiability may be related to confusion over the legality of actions.

Toward a Methodology for Evaluating the Impact of Technologies on Infantry Situation Awareness

DTIC Science & Technology

2004-10-01

enhanced free - play exercise was conducted to investigate the effect of the ISR on SA. Ten Air Field Defence Guards participated in two vignettes, loosely...post- experiment interview), this result again seems logical. The DQT and free - play methodology was able to successfully discriminate between baseline...8 3.1.6 Free - play Vignettes

Estimating minimally important difference (MID) in PROMIS pediatric measures using the scale-judgment method.

PubMed

Thissen, David; Liu, Yang; Magnus, Brooke; Quinn, Hally; Gipson, Debbie S; Dampier, Carlton; Huang, I-Chan; Hinds, Pamela S; Selewski, David T; Reeve, Bryce B; Gross, Heather E; DeWalt, Darren A

2016-01-01

To assess minimally important differences (MIDs) for several pediatric self-report item banks from the National Institutes of Health Patient-Reported Outcomes Measurement Information System(®) (PROMIS(®)). We presented vignettes comprising sets of two completed PROMIS questionnaires and asked judges to declare whether the individual completing those questionnaires had an important change or not. We enrolled judges (including adolescents, parents, and clinicians) who responded to 24 vignettes (six for each domain of depression, pain interference, fatigue, and mobility). We used item response theory to model responses to the vignettes across different judges and estimated MID as the point at which 50 % of the judges would declare an important change. We enrolled 246 judges (78 adolescents, 85 parents, and 83 clinicians). The MID estimated with clinician data was about 2 points on the PROMIS T-score scale, and the MID estimated with adolescent and parent data was about 3 points on that same scale. The MIDs enhance the value of PROMIS pediatric measures in clinical research studies to identify meaningful changes in health status over time.

School Principals' Perceptions of Ethically Just Responses to a Teacher Sexting Vignette: Severity of Administrator Response, Principals' Personality, and Offender Gender and Race

ERIC Educational Resources Information Center

Wagner, Kenneth

2012-01-01

Site level administrators make decisions during the course of a day that have ethical dimensions that challenge their personal values and ethics. This study examined the extent to which particular factors would affect principals' and vice principals' judgments of the ethicality of sanctions given a teacher who had been sending sexually…

Children's moral judgments and moral emotions following exclusion of children with disabilities: relations with inclusive education, age, and contact intensity.

PubMed

Gasser, Luciano; Malti, Tina; Buholzer, Alois

2013-03-01

We investigated relations between children's moral judgments and moral emotions following disability-based exclusion and inclusive education, age, and contact intensity. Nine- and 12-year-old Swiss children (N=351) from inclusive and noninclusive classrooms provided moral judgments and moral emotion attributions following six vignettes about social exclusion of children with disabilities. Children also reported on their level of sympathy towards children with disabilities and their contact intensity with children with disabilities. Overall, children condemned disability-based exclusion, attributed few positive emotions to excluder targets, and expressed high sympathy for children with disabilities, independent of age and educational setting. However, younger children from inclusive classrooms exhibited more moral judgments and moral emotions than younger children from noninclusive classrooms. Moreover, children who expressed high sympathy towards children with disabilities were more likely to report frequent contact with children with disabilities. The findings extend existing research on social exclusion by examining disability-based exclusion and are discussed with respect to developmental research on social and moral judgments and emotions following children's inclusion and exclusion decisions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Children's Event Reports: Factors Affecting Responses to Repeated Questions in Vignette Scenarios and Event Recall Interviews

ERIC Educational Resources Information Center

Howie, Pauline; Nash, Laura; Kurukulasuriya, Nadezhda; Bowman, Alison

2012-01-01

When adults repeat questions, children often give inconsistent answers. This study aimed to test the claim that these inconsistencies occur because children infer that their first answer was unsatisfactory, and that the adult expects them to change their answer. Children aged 4, 6, and 8 years (N= 134) were asked about vignettes in which an adult…

Praiseworthiness: predictors of positive interpersonal judgments.

PubMed

Ogletree, Shirley M; Covington, Jennifer A; Archer, Richard L

2013-06-01

Deterministic attitudes, information about a person's background, one's perceived similarity to a target person, and attributions of effort and ability may affect praiseworthiness. Two vignette studies with college student participants were conducted to consider this issue. Based on regression analyses, attributing achievement to effort was the strongest predictor of praiseworthiness across both studies. In addition, evidence for an augmenting effect of an impoverished background on praiseworthiness was found. In the first study, perceived similarity to the target individual and religious-philosophical determinism were also predictors of praiseworthiness, while belief in free will predicted praiseworthiness in the second study. Judgments of praiseworthiness may be tied to a number of factors; among the most important of these are overcoming an impoverished childhood background and the attributed effort required for success.

Six characteristics of nutrition education videos that support learning and motivation to learn.

PubMed

Ramsay, Samantha A; Holyoke, Laura; Branen, Laurel J; Fletcher, Janice

2012-01-01

To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus group interview, 3-8 participants (n = 37) viewed video vignettes and participated in a facilitated focus group discussion that was audiorecorded, transcribed, and analyzed. Primary characteristics of video vignettes child care providers perceived as supporting learning and motivation to learn about feeding young children were identified: (1) use real scenarios; (2) provide short segments; (3) present simple, single messages; (4) convey a skill-in-action; (5) develop the videos so participants can relate to the settings; and (6) support participants' ability to conceptualize the information. These 6 characteristics can be used by nutrition educators in selecting and developing videos in nutrition education. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

'More than a feeling': An empirical investigation of hedonistic accounts of animal welfare.

PubMed

Robbins, Jesse; Franks, Becca; von Keyserlingk, Marina A G

2018-01-01

Many scientists studying animal welfare appear to hold a hedonistic concept of welfare -whereby welfare is ultimately reducible to an animal's subjective experience. The substantial advances in assessing animal's subjective experience have enabled us to take a step back to consider whether such indicators are all one needs to know if one is interested in the welfare of an individual. To investigate this claim, we randomly assigned participants (n = 502) to read one of four vignettes describing a hypothetical chimpanzee and asked them to make judgments about the animal's welfare. Vignettes were designed to systematically manipulate the descriptive mental states the chimpanzee was described as experiencing: feels good (FG) vs. feels bad (FB); as well as non-subjective features of the animal's life: natural living and physical healthy (NH) vs. unnatural life and physically unhealthy (UU); creating a fully-crossed 2 (subjective experience) X 2 (objective life value) experimental design. Multiple regression analysis showed welfare judgments depended on the objective features of the animal's life more than they did on how the animal was feeling: a chimpanzee living a natural life with negative emotions was rated as having better welfare than a chimpanzee living an unnatural life with positive emotions. We also found that the supposedly more purely psychological concept of happiness was also influenced by normative judgments about the animal's life. For chimpanzees with positive emotions, those living a more natural life were rated as happier than those living an unnatural life. Insofar as analyses of animal welfare are assumed to be reflective of folk intuitions, these findings raise questions about a strict hedonistic account of animal welfare. More generally, this research demonstrates the potential utility of using empirical methods to address conceptual problems in animal welfare and ethics.

`No One Should Destroy the Forest': Using photo-based vignette interviews to understand Kenyan teachers' views of the environment

NASA Astrophysics Data System (ADS)

Quigley, Cassie F.; Miller, Zachary D.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

2014-11-01

In the midst of the current environmental crisis, scientists, academics, authors, and politicians worldwide are urging citizens to create sustainable communities. However, there is little capability to build a sustainable society without an informed, active, and engaged populous. This requires more than just environmentally knowledgeable citizens. It requires a society that understands the principles of the environment and can also exemplify them in daily life. In order to create a more environmentally literate world, there has been a push for environmental education integrated into schools. This qualitative study sought to examine Kenyan teachers' perspectives on the human-nature interaction by conducting vignette focus-group interviews. It is a subject not widely explored but vital for conservation not only in this area, but also other areas that seek to have an ecological informed populous. The vignettes were created using photographs and explanations of the photographs that the participants collected and emailed to the authors. For the focus-group vignette interviews, there were a total of 55 participants (30 females and 25 males). After InVivo analysis, we had 6 codes (resentment, pride, perils, blame, pragmatism, and self-interested) within 3 major themes. This study has implications for informing science education to combat these traditions of subjecting students to a science curriculum that demotes Kenyan cultural heritage and lifestyle. By incorporating local knowledge such as the ideas discussed in this paper into Kenyan science education, Kenyans can reach one of most challenging objectives of education, which is to produce children who are fundamentally aware of their environment.

Mental health literacy: A cross-cultural study from Britain, Hong Kong and Malaysia.

PubMed

Loo, Phik-Wern; Wong, Sharon; Furnham, Adrian

2012-06-01

A cross-cultural study was conducted on the identification of psychiatric problems comparing British, Hong Kong and Malaysian participants. To investigate the ability to correctly identify different psychiatric problems and recommend strategies for treatment. A total of 440 participants were shown vignettes of schizophrenia, obsessive compulsive disorder (OCD), social phobia, depression, bipolar disorder, stress, child attention-deficit hyperactivity disorder (ADHD), child depression and child "daily troubles". In each they were asked to say what they thought the person's problem was and how they could be helped as well as give their confidence ratings on both judgments. The British were the most adept at correctly identifying the cases of mental disorders in the vignettes followed by the Hong Kong Chinese and Malaysians. Overall, the depression cases were the best identified and social phobia was the least identified. In terms of help recommendation, a higher percentage of British participants endorsed professional help as useful for the person in the vignette compared to Hong Kong and Malaysian participants. The findings were discussed along with suggestions on how to improve mental health literacy. The ethnocentric nature of applying Western concepts in the East was acknowledged. Copyright © 2012 Blackwell Publishing Asia Pty Ltd.

Addressing gaps in the maturity of judgment literature: age differences and delinquency.

PubMed

Modecki, Kathryn Lynn

2008-02-01

Over the past decade, a majority of states have legislated to expand their capacity to try adolescents as adults [Griffin (2003). Trying and sentencing juveniles as adults: An analysis of state transfer and blended sentencing laws. Pittsburgh, PA: National Center for Juvenile Justice]. In response, researchers have investigated factors that may affect adolescent culpability [Steinberg and Scott (Am Psychol 58(12):1009-1018, 2003)]. Research on immature judgment posits that psychosocial influences on adolescent decision processes results in reduced criminal responsibility [Cauffman and Steinberg (Behav Sci Law 18(6):741-760, 2000); Scott, Reppucci, and Woolard (Law Hum Behav 19(3):221-244, 1995); Steinberg and Cauffman (Law Hum Behav 20(3):249-272, 1996)]. The current study utilizes hypothetical vignettes and standardized measures of maturity of judgment (responsibility, temperance, and perspective) to examine gaps in previous maturity of judgment findings (Cauffman and Steinberg 2000). This work suggests that adolescents (ages 14-17) display less responsibility and perspective relative to college students (ages 18-21), young-adults (ages 22-27), and adults (ages 28-40). Further, this research finds no maturity of judgment differences between delinquent and non-delinquent youth, but does find significant maturity of judgment differences between high and low delinquency male youth. Finally, results show that maturity of judgment predicts self-reported delinquency beyond the contributions of age, gender, race, education level, SES, and antisocial decision making. Implications for the juvenile justice system are discussed.

Perception of male drinkers as a function of their alcoholic beverage preference.

PubMed

Curtin, L; Fisher, R D

1993-05-01

The present study examined perception of a man's likelihood of driving after drinking and his ability to do so as a function of his choice of beverage. Perceptions of his social characteristics were also examined. The sample was composed of 200 volunteer undergraduate psychology students. Equal numbers of male and female subjects read one of four vignettes which varied only in the male protagonist's choice of beverage: beer, wine, shots of distilled spirits, or cola. After reading the story, subjects answered multiple-choice questions about the character, tapping social judgments, situational judgments and drinking and driving judgments. Subject drinking habits were also assessed. The most notable result was the consistently positive perception of the protagonist portrayed as an abstainer. The lack of a consistent alcoholic beverage distinction implies that the beer-spirits double standard is far from a clear-cut discrimination. Possible explanations for results are discussed. This study questions the robustness of the alcoholic beverage type bias and reflects the need for future research.

Are corporations people too? The neural correlates of moral judgments about companies and individuals.

PubMed

Plitt, Mark; Savjani, Ricky R; Eagleman, David M

2015-04-01

To investigate whether the legal concept of "corporate personhood" mirrors an inherent similarity in the neural processing of the actions of corporations and people, we measured brain responses to vignettes about corporations and people while participants underwent functional magnetic resonance imaging. We found that anti-social actions of corporations elicited more intense negative emotions and that pro-social actions of people elicited more intense positive emotions. However, the networks underlying the moral decisions about corporations and people are strikingly similar, including regions of the canonical theory of mind network. In analyzing the activity in these networks, we found differences in the emotional processing of these two types of vignettes: neutral actions of corporations showed neural correlates that more closely resembled negative actions than positive actions. Collectively, these findings indicate that our brains understand and analyze the actions of corporations and people very similarly, with a small emotional bias against corporations.

Caring for 'Very Important Patients'--Ethical Dilemmas and Suggestions for Practical Management.

PubMed

Alfandre, David; Clever, Sarah; Farber, Neil J; Hughes, Mark T; Redstone, Paul; Lehmann, Lisa Soleymani

2016-02-01

The care of Very Important Patients (VIPs) is different from other patients because they may receive greater access, attention, and resources from health care staff. Although the term VIP is used regularly in the medical literature and is implicitly understood, in practice it constitutes a wide and heterogeneous group of patients that have a strong effect on health care providers. We define a VIP as a very influential patient whose individual attributes and characteristics (eg, social status, occupation, position), coupled with their behavior, have the potential to significantly influence a clinician's judgment or behavior. Physicians, celebrities, the politically powerful, and philanthropists, may all become VIPs in the appropriate context. The quality of care may be inferior because health care professionals may deviate from standard practices when caring for them. Understanding the common features among what may otherwise be very different groups of patients can help health care providers manage ethical concerns when they arise. We use a series of vignettes to demonstrate how VIPs behavior and status can influence a clinician's judgment or actions. Appreciating the ethical principles in these varied circumstances provides health care professionals with the tools to manage ethical conflicts that arise in the care of VIPs. We conclude each vignette with guidance for how health care providers and administrators can manage the ethical concern. Published by Elsevier Inc.

Using simulation to test critical thinking skills of nursing students.

PubMed

Johannsson, S L; Wertenberger, D H

1996-10-01

The purpose of this pilot study was to evaluate the effectiveness of using simulations to test critical thinking ability of nursing students. Nine medical and surgical videotaped vignettes were selected from the critical thinking component of the Performance Based Development System (PBDS). Pathology, difficulty rating and the obviousness of cues varied between vignettes. Each student was rated as acceptable, partially acceptable or unacceptable in their ability to identify a problem and provide appropriate nursing interventions with rationale for each vignette. A paper and pencil exercise and interviews were used to validate findings obtained from the video simulations. The pros and cons of using video simulations to assess critical thinking abilities of nursing students are discussed.

Invisible Disability Disclosure in an Employment Interview: Impact on Employers' Hiring Decisions and Views of Employability

ERIC Educational Resources Information Center

Dalgin, Rebecca Spirito; Bellini, James

2008-01-01

This study investigated the impact of disclosure of invisible disabilities (physical and psychiatric) within the employment interview process. Both the type of disability and the extent of disclosure were manipulated in an analogue experimental design. Employers (N = 60) were exposed to a short interview vignette of a potential candidate and were…

Access to resources shapes maternal decision making: evidence from a factorial vignette experiment.

PubMed

Kushnick, Geoff

2013-01-01

The central assumption of behavioral ecology is that natural selection has shaped individuals with the capacity to make decisions that balance the fitness costs and benefits of behavior. A number of factors shape the fitness costs and benefits of maternal care, but we lack a clear understanding how they, taken together, play a role in the decision-making process. In animal studies, the use of experimental methods has allowed for the tight control of these factors. Standard experimentation is inappropriate in human behavioral ecology, but vignette experiments may solve the problem. I used a confounded factorial vignette experiment to gather 640 third-party judgments about the maternal care decisions of hypothetical women and their children from 40 female karo Batak respondents in rural Indonesia. This allowed me to test hypotheses derived from parental investment theory about the relative importance of five binary factors in shaping maternal care decisions with regard to two distinct scenarios. As predicted, access to resources--measured as the ability of a woman to provide food for her children--led to increased care. A handful of other factors conformed to prediction, but they were inconsistent across scenarios. The results suggest that mothers may use simple heuristics, rather than a full accounting for costs and benefits, to make decisions about maternal care. Vignettes have become a standard tool for studying decision making, but have made only modest inroads to evolutionarily informed studies of human behavior.

How much dentists are ethically concerned about overtreatment; a vignette-based survey in Switzerland.

PubMed

Kazemian, Ali; Berg, Isabelle; Finkel, Christina; Yazdani, Shahram; Zeilhofer, Hans-Florian; Juergens, Philipp; Reiter-Theil, Stella

2015-06-19

Overtreatment (or unnecessary treatment) is when medical or dental services are provided with a higher volume or cost than is appropriate. This study aimed to investigate how a group of dentists in Switzerland, a wealthy country known to have high standards of healthcare including dentistry, evaluated the meaning of unnecessary treatments from an ethical perspective and, assessed the expected frequency of different possible behaviors among their peers. A vignette describing a situation that is susceptible for overtreatment of a patient was presented to a group of dentists. The vignette was followed by five options. A questionnaire including the vignette was posted to 2482 dentists in the German-speaking areas of Switzerland. The respondents were asked to rate each option according to their estimation about its prevalence and their judgment about the degree to which the behavior is ethically sound. 732 completed questionnaires were returned. According to the responses, the most ethical and the most unethical options are considered to be the most and the least prevalent behaviors among dentists practicing in Switzerland, respectively. Suggesting unnecessary treatments to patients seems to be an ethically unacceptable conduct in the eyes of a sample of dentists in Switzerland. Although the respondents believed their colleagues were very likely to behave in an ethical way in response to a situation that is susceptible to overtreatment, they still seemed to be concerned about the prevalence of unethical behaviors in this regard.

Conflict Resolution among Preschool Children: The Appeal of Negotiation in Hypothetical Disputes.

ERIC Educational Resources Information Center

Iskandar, Niveen; And Others

1995-01-01

Using hypothetical puppet interviews, 48 preschool children were interviewed about their preferences for teacher methods of conflict intervention. Puppet vignettes contrasted conflict issue, peer status, and resolution strategy (negotiation, power assertion, and disengagement). Results showed that preschoolers preferred negotiation strategies over…

Influence of gender on mental health literacy in young Australians.

PubMed

Cotton, Sue M; Wright, Annemarie; Harris, Meredith G; Jorm, Anthony F; McGorry, Patrick D

2006-09-01

To determine the effects of gender on mental health literacy in young people between 12 and 25 years of age. Computer-Assisted Telephone Interviewing was employed to conduct a cross-sectional structured interview focusing on young people's awareness of depression and psychosis. The sample comprised 1207 young Australians (539 males and 668 females) between the ages of 12-25 recruited from two metropolitan and two regional areas within Victoria. Six hundred and six respondents were presented a depression vignette and 601 were presented a psychosis vignette. Female respondents (60.7%) were significantly more likely to correctly identify depression in the vignette as compared to male respondents (34.5%). No significant gender differences were noted for the psychosis vignette. Males were less significantly likely to endorse seeing a doctor or psychologist/counsellor for the treatment of psychosis. Males were also significantly more likely than females to endorse alcohol as a way of dealing with depression and antibiotics as useful for dealing with psychosis. Gender differences in mental health literacy are striking. Males showed significantly lower recognition of symptoms associated with mental illness and were more likely endorse the use alcohol to deal with mental health problems. Such factors may contribute to the delays in help seeking seen in young males. Further research is needed to delineate how these gender differences in young people may obstruct help seeking, early intervention and other aspects of mental health service delivery.

40 CFR 194.26 - Expert judgment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... judgment elicitation processes and the reasoning behind those results. Documentation of interviews used to elicit judgments from experts, the questions or issues presented for elicitation of expert judgment... expert judgment elicitation comports with the level of knowledge required by the questions or issues...

40 CFR 194.26 - Expert judgment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... judgment elicitation processes and the reasoning behind those results. Documentation of interviews used to elicit judgments from experts, the questions or issues presented for elicitation of expert judgment... expert judgment elicitation comports with the level of knowledge required by the questions or issues...

Vignettes of Interviews to Enhance an Ethnographic Account

ERIC Educational Resources Information Center

Jacobsen, Alice Juel

2014-01-01

This article explores challenges of applying an ethnographic approach, combining participant observation and interviews, to a study of organizational change. The exploration is connected to reform changes, as they are constructed in the interaction between managers and teachers, in a Danish Upper Secondary High School. The data material is…

Virtual standardized patients: an interactive method to examine variation in depression care among primary care physicians

PubMed Central

Hooper, Lisa M.; Weinfurt, Kevin P.; Cooper, Lisa A.; Mensh, Julie; Harless, William; Kuhajda, Melissa C.; Epstein, Steven A.

2009-01-01

Background Some primary care physicians provide less than optimal care for depression (Kessler et al., Journal of the American Medical Association 291, 2581–90, 2004). However, the literature is not unanimous on the best method to use in order to investigate this variation in care. To capture variations in physician behaviour and decision making in primary care settings, 32 interactive CD-ROM vignettes were constructed and tested. Aim and method The primary aim of this methods-focused paper was to review the extent to which our study method – an interactive CD-ROM patient vignette methodology – was effective in capturing variation in physician behaviour. Specifically, we examined the following questions: (a) Did the interactive CD-ROM technology work? (b) Did we create believable virtual patients? (c) Did the research protocol enable interviews (data collection) to be completed as planned? (d) To what extent was the targeted study sample size achieved? and (e) Did the study interview protocol generate valid and reliable quantitative data and rich, credible qualitative data? Findings Among a sample of 404 randomly selected primary care physicians, our voice-activated interactive methodology appeared to be effective. Specifically, our methodology – combining interactive virtual patient vignette technology, experimental design, and expansive open-ended interview protocol – generated valid explanations for variations in primary care physician practice patterns related to depression care. PMID:20463864

‘More than a feeling’: An empirical investigation of hedonistic accounts of animal welfare

PubMed Central

Franks, Becca; von Keyserlingk, Marina A. G.

2018-01-01

Many scientists studying animal welfare appear to hold a hedonistic concept of welfare -whereby welfare is ultimately reducible to an animal’s subjective experience. The substantial advances in assessing animal’s subjective experience have enabled us to take a step back to consider whether such indicators are all one needs to know if one is interested in the welfare of an individual. To investigate this claim, we randomly assigned participants (n = 502) to read one of four vignettes describing a hypothetical chimpanzee and asked them to make judgments about the animal’s welfare. Vignettes were designed to systematically manipulate the descriptive mental states the chimpanzee was described as experiencing: feels good (FG) vs. feels bad (FB); as well as non-subjective features of the animal’s life: natural living and physical healthy (NH) vs. unnatural life and physically unhealthy (UU); creating a fully-crossed 2 (subjective experience) X 2 (objective life value) experimental design. Multiple regression analysis showed welfare judgments depended on the objective features of the animal’s life more than they did on how the animal was feeling: a chimpanzee living a natural life with negative emotions was rated as having better welfare than a chimpanzee living an unnatural life with positive emotions. We also found that the supposedly more purely psychological concept of happiness was also influenced by normative judgments about the animal’s life. For chimpanzees with positive emotions, those living a more natural life were rated as happier than those living an unnatural life. Insofar as analyses of animal welfare are assumed to be reflective of folk intuitions, these findings raise questions about a strict hedonistic account of animal welfare. More generally, this research demonstrates the potential utility of using empirical methods to address conceptual problems in animal welfare and ethics. PMID:29529090

Disgust, Gender, and Social Change : Testing Alternative Explanations for the Decline of Cousin Marriage in Karo Society.

PubMed

Kushnick, Geoff; Fessler, Daniel M T; Zuska, Fikarwin

2016-12-01

Among the Karo of Indonesia, the frequency of matrilateral cross-cousin (impal) marriage has declined in recent decades. We conducted a vignette experiment to assess the contributions of a handful of factors in shaping this pattern. Surprisingly, we found that cosocialization of a hypothetical woman with her impal led to increased judgments of marriage likelihood and decreased feelings of disgust in male and female respondents (n = 154). We also found that females, more than males, judged impal marriage more likely when there were practical advantages. Finally, we found that younger men expressed more disgust in response to impal marriages than did older men, while women displayed an opposite but weaker reaction. This suggests the existence of gender-specific changes in attitudes toward the practice, indicating that a full understanding may require the application of sexual conflict theory. Our study illustrates the potential utility-and limitations-of vignette experiments for studying social change.

How Veterans Health Administration Suicide Prevention Coordinators Assess Suicide Risk.

PubMed

Pease, James L; Forster, Jeri E; Davidson, Collin L; Holliman, Brooke Dorsey; Genco, Emma; Brenner, Lisa A

2017-03-01

This cross-sectional study was designed to examine the suicide risk assessment practices of Suicide Prevention Coordinators (SPCs) within the Veterans Health Administration. Specifically, this study sought to (1) identify factors SPCs consider most important in assessing risk and patient priority; (2) measure the level of consistency and agreement between SPCs in assessing suicide risk and prioritizing cases; and (3) measure individual SPC consistency between cases. SPCs (n = 63) responded to online survey questions about imminent and prolonged risk for suicide in response to 30 fictional vignettes. Combinations of 12 acute and chronic suicide risk factors were systematically distributed throughout the 30 vignettes using the Fedorov () procedure. The SPCs were also asked to identify the level of priority for further assessment both disregarding and assuming current caseloads. Data were analysed using clinical judgement analysis. Suicidal plan, β = 1.64; 95% CI (1.45, 1.82), and preparatory behaviour, β = 1.40; 95% CI (1.23, 1.57), were considered the most important acute or imminent risk factors by the SPCs. There was less variability across clinicians in the assessment of risk when alcohol use (p = 0.02) and hopelessness (p = 0.03) were present. When considering acute or imminent risk factors, there was considerable variability between clinicians on a vignette-by-vignette basis, median SD = 0.86 (range = 0.47, 1.13), and within individual clinicians across vignettes, median R 2  = 0.80 (0.49, 0.95). These findings provide insight into how this group of providers think about acute and chronic risk factors contributing to imminent suicide risk in Veterans. Copyright © 2016 John Wiley & Sons, Ltd. Identifies factors that practitioners consider most important in suicide risk assessment Discusses how to distinguish between chronic and acute risk for suicide Identifies factors that lead to more consistent clinical judgments. Copyright © 2016 John Wiley & Sons, Ltd.

The neural basis of the interaction between theory of mind and moral judgment

PubMed Central

Young, Liane; Cushman, Fiery; Hauser, Marc; Saxe, Rebecca

2007-01-01

Is the basis of criminality an act that causes harm, or an act undertaken with the belief that one will cause harm? The present study takes a cognitive neuroscience approach to investigating how information about an agent's beliefs and an action's consequences contribute to moral judgment. We build on prior developmental evidence showing that these factors contribute differentially to the young child's moral judgments coupled with neurobiological evidence suggesting a role for the right temporoparietal junction (RTPJ) in belief attribution. Participants read vignettes in a 2 × 2 design: protagonists produced either a negative or neutral outcome based on the belief that they were causing the negative outcome (“negative” belief) or the neutral outcome (“neutral” belief). The RTPJ showed significant activation above baseline for all four conditions but was modulated by an interaction between belief and outcome. Specifically, the RTPJ response was highest for cases of attempted harm, where protagonists were condemned for actions that they believed would cause harm to others, even though the harm did not occur. The results not only suggest a general role for belief attribution during moral judgment, but also add detail to our understanding of the interaction between these processes at both the neural and behavioral levels. PMID:17485679

Note-taking in the employment interview: effects on recall and judgments.

PubMed

Middendorf, Catherine Houdek; Macan, Therese Hoff

2002-04-01

Although note-taking in the employment interview is highly recommended, little research has examined its effects. This study investigated the effects of note-taking styles, review of the notes, and content of the notes on participants' cued recall of information and decisions made from videotaped employment interviews. Note-taking increased recall accuracy but not judgment accuracy. Being able to review notes resulted in increased judgment accuracy for those taking conventional-style notes. The content of the notes also had important implications for conventional note-takers, suggesting some benefits of recording notes using the key-points style. The findings suggest that the act of note-taking may be more important for memory and legal reasons than for improving the decisions made by interviewers.

Interactive effects of characteristics of defendant and mock juror on U.S. participants' judgment and sentencing recommendations.

PubMed

Abwender, D A; Hough, K

2001-10-01

The authors examined the effects of interactions (a) between defendant attractiveness and juror gender and (b) between defendant race and juror race on judgment and sentencing among 207 Black, Hispanic, and White participants in the United States. After reading a vehicular-homicide vignette in which the defendant's attractiveness and race varied, the participants rated guilt and recommended sentences. The women treated the unattractive female defendant more harshly than they treated the attractive female defendant; the men showed an opposite tendency. The Black participants showed greater leniency when the defendant was described as Black rather than White. The Hispanic participants showed an opposite trend, and the White participants showed no race-based leniency. The findings on racial effects were consistent (a) with in-group favorability bias among the Black participants and (b) with attribution effects unrelated to race among the White participants.

International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: VI. Trends in recommendations for the pharmacotherapy of anxiety disorders, 1992-1997.

PubMed

Uhlenhuth, E H; Balter, M B; Ban, T A; Yang, K

1999-01-01

To assemble expert clinical experience and judgment regarding the treatment of anxiety disorders in a systematic, quantitative manner, particularly with respect to changes during the preceding five years. A panel of 73 internationally recognized experts in the pharmacotherapy of anxiety and depression was constituted by multistage peer nomination. Sixty-six completed a questionnaire in 1992, and 51 of those completed a follow-up questionnaire in 1997. This report focuses on the experts' responses to questions about therapeutic options relevant to seven vignettes describing typical cases of different anxiety disorders. The preferred initial treatment strategy in 1992 was a combination of medication with a psychological therapy for all vignettes except simple phobia, where a psychological procedure alone was favored. There was little change in 1997, primarily some decrease in the choice of psychological therapy and some increase in the choice of medication for social phobia. Experts recommending a medication in 1992 most often chose as first-line treatment a benzodiazepine anxiolytic (BZ) for panic disorder (PD), generalized anxiety disorder (GAD), simple phobia, and adjustment disorder. They recommended a beta-blocker most often for social phobia and a tricyclic anti-depressant (TCA) for agoraphobia and obsessive-compulsive disorder (OCD). Nearly a fourth chose a combination of medications, usually a TCA plus a BZ. In 1997, the expert panel's most frequent recommendation for agoraphobia, PD, and OCD changed to a specific serotonin reuptake inhibitor (SSRI); and they also recommended these compounds more often for GAD, social phobia, and simple phobia. Fewer experts chose BZs or TCAs. However, in 1997 many again chose a combination of medications, often a BZ plus a SSRI, so that, overall, there was only a small decline in recommendations for BZs. As second-line medications (1997 only), the experts recommended SSRIs most often for most vignettes, but a TCA for PD and GAD. Recommendations for a combination of medications rose substantially for most vignettes, usually a BZ plus an antidepressant. Combined cognitive-behavioral therapy plus medication was highly favored by the experts as the initial treatment strategy for anxiety disorders. During the preceding five years, SSRIs displaced older antidepressants as the experts' first-line choices for the pharmacotherapy of anxiety disorders. In case of an unsatisfactory response, the experts' second-line choices more often were an older antidepressant or a combination of an antidepressant plus a BZ. According to the experts' judgements, the BZs, especially combined with an antidepressant, remain mainstays of pharmacotherapy for anxiety disorders.

Making Judgments on the Basis for Workplace Learning: Towards an Epistemology of Practice.

ERIC Educational Resources Information Center

Beckett, David; Hager, Paul

2000-01-01

Interviews illustrating professional judgment support characteristics of informal workplace learning: contingent, practical, process, particular, and affective-social. Growth in the capacity to make judgments occurs in three ways (1) ability to separate initial need from actualization of judgment; (2) ability to interpret conative-emotive and…

Plastic with personality: Increasing student engagement with manikins.

PubMed

Power, Tamara; Virdun, Claudia; White, Haidee; Hayes, Carolyn; Parker, Nicola; Kelly, Michelle; Disler, Rebecca; Cottle, Amanda

2016-03-01

Simulation allows students to practice key psychomotor skills and gain technical proficiency, fostering the development of clinical reasoning and student confidence in a low risk environment. Manikins are a valuable learning tool; yet there is a distinct lack of empirical research investigating how to enhance engagement between nursing students and manikins. To describe student perspectives of a layered, technology enhanced approach to improve the simulation learning experience. Tanner's Model of Clinical Judgment underpins the entire curriculum. This study additionally drew on the principles of narrative pedagogy. Across ten teaching weeks, five separate case studies were introduced to students through short vignettes. Students viewed the vignettes prior to their laboratory class. In the labs, manikins were dressed in the props used in the vignettes. The innovation was trialed in a second year core subject of a Bachelor of Nursing program in a large urban university in the autumn semester of 2014. Following ethics approval, students were emailed a participant information sheet. A focus group of nine students was held. The discussion was digitally recorded and transcribed verbatim prior to being subject to thematic analysis. Students' comments (143) about the vignettes in their standard subject specific student feedback surveys were also considered as data. Four themes were identified: Getting past the plastic; knowing what to say; connecting and caring; and, embracing diversity. The feedback indicated that these measures increased students ability to suspend disbelief, feel connected to, and approach the manikins in a more understanding and empathetic fashion. In addition to achieving increased engagement with manikins, other advantages such as students reflecting on their own values and pre-conceived notions of people from diverse backgrounds were realized. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social trait judgment and affect recognition from static faces and video vignettes in schizophrenia

PubMed Central

McIntosh, Lindsey G.; Park, Sohee

2014-01-01

Social impairment is a core feature of schizophrenia, present from the pre-morbid stage and predictive of outcome, but the etiology of this deficit remains poorly understood. Successful and adaptive social interactions depend on one’s ability to make rapid and accurate judgments about others in real time. Our surprising ability to form accurate first impressions from brief exposures, known as “thin slices” of behavior has been studied very extensively in healthy participants. We sought to examine affect and social trait judgment from thin slices of static or video stimuli in order to investigate the ability of schizophrenic individuals to form reliable social impressions of others. 21 individuals with schizophrenia (SZ) and 20 matched healthy participants (HC) were asked to identify emotions and social traits for actors in standardized face stimuli as well as brief video clips. Sound was removed from videos to remove all verbal cues. Clinical symptoms in SZ and delusional ideation in both groups were measured. Results showed a general impairment in affect recognition for both types of stimuli in SZ. However, the two groups did not differ in the judgments of trustworthiness, approachability, attractiveness, and intelligence. Interestingly, in SZ, the severity of positive symptoms was correlated with higher ratings of attractiveness, trustworthiness, and approachability. Finally, increased delusional ideation in SZ was associated with a tendency to rate others as more trustworthy, while the opposite was true for HC. These findings suggest that complex social judgments in SZ are affected by symptomatology. PMID:25037526

Proportionate Responses to Life Events Influence Clinicians’ Judgments Of Psychological Abnormality

PubMed Central

Kim, Nancy S.; Paulus, Daniel J.; Gonzalez, Jeffrey S.; Khalife, Danielle

2012-01-01

Psychological abnormality is a fundamental concept in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; APA, 2000) and in all clinical evaluations. How do practicing clinical psychologists use the context of life events to judge the abnormality of a person’s current behaviors? The appropriate role of life-event context in assessment has long been the subject of intense debate and scrutiny among clinical theorists, yet relatively little is known about clinicians’ own judgments in practice. We propose a proportionate-response hypothesis, such that judgments of abnormality are influenced by whether the behaviors are a disproportionate response to past events, rendering them difficult to understand or explain. We presented licensed, practicing clinical psychologists (N=77) with vignettes describing hypothetical people’s behaviors (disordered, mildly distressed, or unaffected) that had been preceded by either traumatic or mildly distressing events. Experts’ judgments of abnormality were strongly and systematically influenced by the degree of mismatch between the past event and current behaviors in strength and valence, such that the greater the mismatch, the more abnormal the person seemed. A separate, additional group of clinical psychologists (N=20) further confirmed that the greater the degree of mismatch, the greater the perceived difficulty in understanding the patient. These findings held true across clinicians of different theoretical orientations and in disorders for which these patterns of judgments ran contrary to formal recommendations in the DSM-IV-TR (APA, 2000). The rationality of these effects and implications for clinical decision science are discussed. PMID:22142425

New Interview and Observation Measures of the Broader Autism Phenotype: Description of Strategy and Reliability Findings for the Interview Measures.

PubMed

Parr, Jeremy R; De Jonge, Maretha V; Wallace, Simon; Pickles, Andrew; Rutter, Michael L; Le Couteur, Ann S; van Engeland, Herman; Wittemeyer, Kerstin; McConachie, Helen; Roge, Bernadette; Mantoulan, Carine; Pedersen, Lennart; Isager, Torben; Poustka, Fritz; Bolte, Sven; Bolton, Patrick; Weisblatt, Emma; Green, Jonathan; Papanikolaou, Katerina; Baird, Gillian; Bailey, Anthony J

2015-10-01

Clinical genetic studies confirm the broader autism phenotype (BAP) in some relatives of individuals with autism, but there are few standardized assessment measures. We developed three BAP measures (informant interview, self-report interview, and impression of interviewee observational scale) and describe the development strategy and findings from the interviews. International Molecular Genetic Study of Autism Consortium data were collected from families containing at least two individuals with autism. Comparison of the informant and self-report interviews was restricted to samples in which the interviews were undertaken by different researchers from that site (251 UK informants, 119 from the Netherlands). Researchers produced vignettes that were rated blind by others. Retest reliability was assessed in 45 participants. Agreement between live scoring and vignette ratings was very high. Retest stability for the interviews was high. Factor analysis indicated a first factor comprising social-communication items and rigidity (but not other repetitive domain items), and a second factor comprised mainly of reading and spelling impairments. Whole scale Cronbach's alphas were high for both interviews. The correlation between interviews for factor 1 was moderate (adult items 0.50; childhood items 0.43); Kappa values for between-interview agreement on individual items were mainly low. The correlations between individual items and total score were moderate. The inclusion of several factor 2 items lowered the overall Cronbach's alpha for the total set. Both interview measures showed good reliability and substantial stability over time, but the findings were better for factor 1 than factor 2. We recommend factor 1 scores be used for characterising the BAP. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

The effect of dentists' body-weight size on student social judgments of dental skill and patients' behavioural intentions: a vignette study.

PubMed

Asimakopoulou, Koula; Ignatius, Jessica; While, Alison; Newton, Tim

2015-02-01

Where previous work has suggested that over-weight individuals may be subject to negative social judgments, a finding also seen in judgments applied to healthcare professionals (HCPs), this study investigated whether these findings extend to judgments made about dental practitioners. A photo of a normal weight male and one of a normal weight female dentist were digitally modified to reliably show them as overweight, giving a total of 4 conditions. In a single-blind quasi-randomised controlled study of 302 undergraduate and postgraduate student participants used a 5 point Likert scale to appraise a single, gender-matched colour photograph as to whether they thought the dentist depicted was competent, professional, caring, had patients' best interests at heart, and was a good dentist. They further rated their future intentions to follow behavioural advice (reduce snacking and take-up flossing) given by the depicted dentist. The data were analysed using independent sample t-tests. There were no differences in outcomes as a function of the weight status of the depicted dentist in any of the variables explored with the exception of the normal-weight images being rated as more caring than the overweight ones (p<.04). Images of overweight dentists do not receive lower social judgement ratings than images of normal-weight dentists. Previous research in medicine reporting adverse social judgments made of over-weight HCPs does not apply to dental practitioners. Future research should focus on factors that may explain these findings. Dentists appear to be protected from the adverse effect of overweight on social judgments of their personal characteristics and on their health-promoting advice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using media to teach how not to do psychotherapy.

PubMed

Gabbard, Glen; Horowitz, Mardi

2010-01-01

This article describes how using media depictions of psychotherapy may help in teaching psychiatric residents. Using the HBO series In Treatment as a model, the authors suggest how boundary transgressions and technical errors may inform residents about optimal psychotherapeutic approaches. The psychotherapy vignettes depicted in In Treatment show how errors in judgment may grow out of therapists' good intentions. These errors can be understood and used constructively for teaching. With the growing interest in depicting psychotherapy on popular TV series, the use of these sessions avoids confidentiality problems and may be a useful adjunct for teaching psychotherapy.

Medical Judgments Across the Range of Reported Pain Severity: Clinician and Lay Perspectives.

PubMed

Tait, Raymond C; Chibnall, John T; House, Kylie; Biehl, Joann

2016-07-01

While increasing evidence suggests that observers discount high-severity chronic pain, factors that occasion such discounting are poorly understood, particularly regarding health provider vs lay perspectives. This study examined the effects of supporting medical evidence and comorbid psychological distress (pain behavior) on medical student and lay clinical judgments of increasingly severe patient pain reports. In a 2 × 2 × 2 × (7) mixed between- and within-subject design, participants (medical students vs lay) made clinical judgments after reading vignettes describing a hypothetical patient that varied in levels of medical evidence and pain behavior (low vs high) and pain severity (4/10-10/10). Fourth-year medical students (N = 115) and lay persons in the community (N = 300) participated in this research. While both medical student and lay judgments plateaued at high levels of pain severity, judgments regarding cause (medical vs psychological), treatment (opioid prescription), and disability showed growing divergence as levels of reported pain severity increased. Divergence relative to medical and psychological causes of pain was found irrespective of the level of supporting medical evidence; divergence relative to opioid treatment and support for a disability claim was found when supporting medical evidence was low. The results indicate differing expectations of chronic pain treatment for health care providers relative to the lay public that could impact clinical care, especially at high pain severity levels, where lay expectations diverge significantly from those of health professionals. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Social trait judgment and affect recognition from static faces and video vignettes in schizophrenia.

PubMed

McIntosh, Lindsey G; Park, Sohee

2014-09-01

Social impairment is a core feature of schizophrenia, present from the pre-morbid stage and predictive of outcome, but the etiology of this deficit remains poorly understood. Successful and adaptive social interactions depend on one's ability to make rapid and accurate judgments about others in real time. Our surprising ability to form accurate first impressions from brief exposures, known as "thin slices" of behavior has been studied very extensively in healthy participants. We sought to examine affect and social trait judgment from thin slices of static or video stimuli in order to investigate the ability of schizophrenic individuals to form reliable social impressions of others. 21 individuals with schizophrenia (SZ) and 20 matched healthy participants (HC) were asked to identify emotions and social traits for actors in standardized face stimuli as well as brief video clips. Sound was removed from videos to remove all verbal cues. Clinical symptoms in SZ and delusional ideation in both groups were measured. Results showed a general impairment in affect recognition for both types of stimuli in SZ. However, the two groups did not differ in the judgments of trustworthiness, approachability, attractiveness, and intelligence. Interestingly, in SZ, the severity of positive symptoms was correlated with higher ratings of attractiveness, trustworthiness, and approachability. Finally, increased delusional ideation in SZ was associated with a tendency to rate others as more trustworthy, while the opposite was true for HC. These findings suggest that complex social judgments in SZ are affected by symptomatology. Copyright © 2014 Elsevier B.V. All rights reserved.

Public perceptions toward mental illness in Japan.

PubMed

Kasahara-Kiritani, Mami; Matoba, Tomoko; Kikuzawa, Saeko; Sakano, Junko; Sugiyama, Katsumi; Yamaki, Chikako; Mochizuki, Mieko; Yamazaki, Yoshihiko

2018-05-16

The purpose was to characterize public perceptions in Japan of mental illness and how they related to stigma-related attitudes for the same. Data were obtained using a vignette survey conducted as a part of the Stigma in Global Context - Mental Health Study and contained a nationally representative sample (n = 994). The survey was conducted using a multi-mode approach (face-to-face interviews, the drop-off-and-pick-up, postal collection) from September to December 2006, with a multi-stage probability sample of Japanese residents aged 18-64 years. Respondents were randomly assigned one of four vignette conditions that described psychiatric disorders meeting the diagnostic criteria for schizophrenia and major depressive disorder (one vignette for each gender exhibiting each diagnosis). We compared respondents' stigma-related attitudes and perceptions toward mental illness between vignettes. Over 80% of Japanese participants believed that depressive disorder or schizophrenia could be cured via treatment. However, Japanese people still had relatively strong vigilance and denial of competency toward schizophrenia. Participants expressed the belief that mental illnesses are curable, but stigma toward people with schizophrenia was still relatively strong. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinical Interview Assessment of Financial Capacity in Older Adults with Mild Cognitive Impairment and Alzheimer’s Disease

PubMed Central

Marson, Daniel C.; Martin, Roy C.; Wadley, Virginia; Griffith, H. Randall; Snyder, Scott; Goode, Patricia S.; Kinney, F. Cleveland; Nicholas, Anthony P.; Steele, Terri; Anderson, Britt; Zamrini, Edward; Raman, Rema; Bartolucci, Alfred; Harrell, Lindy E.

2009-01-01

Objectives To investigate financial capacity in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) using a clinician interview approach. Design Cross-sectional. Setting Tertiary care medical center. Participants Healthy older adults (N=75), patients with amnestic MCI (N=58), mild AD (N=97), and moderate AD (N=31). Measurements The investigators and five study physicians developed a conceptually based, semi-structured clinical interview for evaluating seven core financial domains and overall financial capacity (Semi-Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made capacity judgments (capable, marginally capable, or incapable) for each financial domain and for overall capacity. Results Study physicians made a total of over 11,000 capacity judgments across the study sample (N=261). Very good inter-rater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall financial capacity, 95 percent of physician judgments for older controls were rated as capable, as compared to only 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD. Conclusion Financial capacity in cognitively impaired older adults can be reliably evaluated by physicians using a relatively brief, semi-structured clinical interview. Financial capacity shows mild impairment in MCI, emerging global impairment in mild AD, and advanced global impairment in moderate AD. MCI patients and their families should proactively engage in financial and legal planning given these patients’ risk of developing AD and accelerated loss of financial abilities. PMID:19453308

The Social Context of Reference Work: Assessing the Effects of Gender and Communication Skill on Observers' Judgments of Competence.

ERIC Educational Resources Information Center

Harris, Roma M.; Michell, B. Gillian

1986-01-01

Public library users made judgments about the competence of reference librarians whom they observed in videotaped interviews. Two social factors were varied in the interviews: the gender of the librarian, patron, and observers; and the communication behavior exhibited by the reference librarian toward the patron. Nineteen references are cited.…

Medicines management: an interview study of nurses at a secure psychiatric hospital.

PubMed

Haw, Camilla; Stubbs, Jean; Dickens, Geoff

2015-02-01

To explore mental health nurses' knowledge, attitudes and clinical judgement concerning medicines management in an inpatient setting with a view to enhancing training. Medicines management is a key role of mental health nurses, but little research has been conducted into their training needs. An exploratory mixed-methods design was used involving individual interviews with participants to investigate their responses to hypothetical medicine administration scenarios. Interviews were held with a convenience sample of 50 Registered Nurses working in a specialist mental health hospital between November 2012-February 2013. Participants were presented with clinical vignettes describing eight scenarios they might encounter as part of their medicines management role and asked about how they would respond. Responses were assessed by two independent raters against ten quality standards underpinning the vignettes. The median number of responses that were judged to demonstrate adequate awareness of associated quality standards was 4 (range 1-7), indicating that many participants did not appear to be aware of, or compliant with, current UK medicines management guidance and local policy. Many would not report a 'near miss' or medicines administration error. There was a lack of awareness of guidance on verbal prescribing, consent to treatment rules and the administration of off-label/unlicensed drugs. Past year attendance on a medicines management course, time since registration and self-reported knowledge of national standards for medicines administration did not discriminate between total score on the 10 quality standards. The medicines management training needs of participants appeared not to be fully met by the existing learning sources. The use of vignettes to assess nurses' training needs requires evaluation in other settings. © 2014 John Wiley & Sons Ltd.

CDE Perspectives of Providing New-Onset Type 1 Diabetes Education Using Formal Vignettes and Simulation.

PubMed

Ramchandani, Neesha; Johnson, Kim; Cullen, Karen; Hamm, Terri; Bisordi, Jean; Sullivan-Bolyai, Susan

2017-02-01

Purpose The purpose of this article is to describe the 4 Parent Education Through Simulation-Diabetes (PETS-D) nurse certified diabetes educators' (CDEs) perspectives of teaching parents of children with newly diagnosed type 1 diabetes mellitus (T1DM) early diabetes management skills using formal vignettes and a human patient simulator/human patient simulation (HPS) to augment/enhance the teaching-learning process. Methods A qualitative descriptive approach was used. Four CDEs were interviewed by phone about their teaching experiences. Meticulous notes were taken. Data were analyzed using qualitative content analysis. Results The vignettes (and use of HPS) provided structure, especially for parents who were struggling to learn. Certified diabetes educators described a short learning curve to master the use of the HPS manikin. Human patient simulation-enhanced education was described as helpful for teaching multiple caregivers about diabetes. Certified diabetes educators also described factors that affect parent learning, mechanical issues with the HPS, and additional space requirements for HPS-enhanced education. Conclusion Vignettes and HPS-enhanced education can successfully be used to educate parents of children with new-onset T1DM and were preferred by the CDEs when compared with previous teaching strategies. The results of this study support the use of both vignette-based and HPS-enhanced education when a child is newly diagnosed with T1DM. Further studies need to be done to see if these effects persist with different populations, during different stages of the disease, and for individuals with other chronic illnesses.

Varying ethics rules in clinical research and routine patient care – research ethics committee chairpersons’ views in Finland

PubMed Central

2014-01-01

Background To present empirical data on how the variation in regulating clinical research and patient care was perceived in Finland between 2009 and 2012. Methods Notes of interviews with 22 research ethics committee (REC) chairpersons were analyzed to identify whether differences in the regulation of clinical research and patient care were addressed. REC chairpersons’ opinions on three imaginary cases of clinical research projects challenging current research ethics rules (vignettes) were requested with a questionnaire; 18 of the 22 interviewed chairpersons responded. Results Based on REC chairpersons’ interviews, the differences between care and research regulation were not considered important issues in Finland. In the vignettes, REC chairpersons’ assumptions on how their REC would decide varied in regard to allowing research without informed consent, while solutions that are not allowed by current law were even anticipated. Mostly, but not always, the chairpersons’ own personal view agreed with their REC. Conclusions The distinction between care and research regulation has not been publicly challenged by Finnish RECs, even though it is a challenge when research relevant to health care is carried out. There is a need for debate and changes in laws and practices. PMID:24666735

Social context, the struggle with uncertainty, and subjective risk as meaning-rich constructs for explaining HBP noncompliance.

PubMed

Proulx, Michelle; Leduc, Nicole; Vandelac, Louise; Grégoire, Jean-Pierre; Collin, Johanne

2007-09-01

To identify the reasons for which people fail to take blood-pressure-lowering medication regularly, a qualitative study was conducted. Interviews lasting approximately 90 min were conducted with 27 patients (15 women, 12 men) aged 40-70. The verbatim of the 27 interviews was first read and divided into segments with explanatory value. This was followed by the production of a final text in vignette form for all interviews. An integrative, analytical phase consisted of identifying trends, significant central themes, regularities, and divergences in the vignettes. Analysis revealed the explanatory power that 3 broad groups of subjective meanings could hold for given medication noncompliance scenarios. These scenarios are expressing the role of: (1) stress and living conditions in the occasional skipping or deferral of medication-taking; (2) doubt as the motivating factor for transitory, irregular medication use; (3) subjective risk as the motivating factor for persistent irregular use. Life and social contexts, doubt and risk subsume extremely meaning-rich constructs that can help identify dilemmas facing people about medication-taking. By discussing these dimensions with their patients, health professionals will be better able to understand patient medication behaviors that sometimes run counter to their recommendations.

Implicit Theories and Offender Representativeness in Judgments About Sexual Crime.

PubMed

Harper, Craig A; Bartels, Ross M

2018-04-01

Implicit theories structure the way people understand and respond to various human actions. Typically, people believe attributes are either fixed (entitists) or malleable (incrementalists). The present study aimed to examine (a) whether attitudes toward sexual offenders differ depending upon one's implicit theory about human nature and sexual offenders, and (b) whether implicit theories are associated with judgments made about different types of child abusers. A sample of 252 community participants was recruited. Their attitudes, implicit theories, and political orientation were assessed via self-report. One of three vignettes describing an incidence of child sexual abuse was then presented. The cases were identical except the perpetrator was either an adult male, an adult female, or a male juvenile. Participants then made judgments about the offender's deserved sentence and moral character. Entitists (across both domains) held more negative attitudes than incrementalists, although the magnitude of the difference was greatest when examining implicit theories about sexual offenders. Compared with those with an incremental theory of sexual offenders, entity theorists judged sexual offending to be more (a) indicative of the perpetrator's moral character and (b) deserving of punishment. However, scores were greater toward the adult male relative to the adult female and juvenile. The findings suggest that implicit theories about sexual offenders are domain specific. They also indicate that judgments made by those with an entity theory (about sexual offenders) are affected by whether a case is representative of a stereotypical sexual offender. Implications of the findings are discussed, along with limitations and future research.

Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis

PubMed Central

2012-01-01

Background The importance of respecting women’s wishes to give birth close to their local community is supported by policy in many developed countries. However, persistent concerns about the quality and safety of maternity care in rural communities have been expressed. Safe childbirth in rural communities depends on good risk assessment and decision making as to whether and when the transfer of a woman in labour to an obstetric led unit is required. This is a difficult decision. Wide variation in transfer rates between rural maternity units have been reported suggesting different decision making criteria may be involved; furthermore, rural midwives and family doctors report feeling isolated in making these decisions and that staff in urban centres do not understand the difficulties they face. In order to develop more evidence based decision making strategies greater understanding of the way in which maternity care providers currently make decisions is required. This study aimed to examine how midwives working in urban and rural settings and obstetricians make intrapartum transfer decisions, and describe sources of variation in decision making. Methods The study was conducted in three stages. 1. 20 midwives and four obstetricians described factors influencing transfer decisions. 2. Vignettes depicting an intrapartum scenario were developed based on stage one data. 3. Vignettes were presented to 122 midwives and 12 obstetricians who were asked to assess the level of risk in each case and decide whether to transfer or not. Social judgment analysis was used to identify the factors and factor weights used in assessment. Signal detection analysis was used to identify participants’ ability to distinguish high and low risk cases and personal decision thresholds. Results When reviewing the same case information in vignettes midwives in different settings and obstetricians made very similar risk assessments. Despite this, a wide range of transfer decisions were still made, suggesting that the main source of variation in decision making and transfer rates is not in the assessment but the personal decision thresholds of clinicians. Conclusions Currently health care practice focuses on supporting or improving decision making through skills training and clinical guidelines. However, these methods alone are unlikely to be effective in improving consistency of decision making. PMID:23114289

Understanding Lay Assessments of Alcohol Use Disorder: Need for Treatment and Associated Stigma.

PubMed

Weine, Erienne R; Kim, Nancy S; Lincoln, Alisa K

2016-01-01

Three-quarters of people with an alcohol use disorder in the USA never receive treatment. Our understandings of who receives care are informed by sociological perspectives, theories and models, each of which discuss the role of lay people's understanding of illness. However, comparatively little work has been done to unpack the cognitive processes underlying lay assessment. In the context of the Framework Integrating Normative Influences on Stigma (FINIS), we aim to understand key factors guiding lay people's stigmatizing attitudes, perceptions and assessments of alcohol use disorder behaviors. Lay people read a vignette depicting a male or female adult with a diagnosable alcohol use disorder, along with either a causal life-event explanation for the alcohol use disorder behaviors or no explanation. They then made judgments of the need for treatment, psychological abnormality and the stigma they felt toward the person depicted. Causal life-event explanations decreased lay judgments of the need for treatment, psychological abnormality and stigma. The results suggest that the availability of a causal life-event explanation may have a complex effect on lay judgments, decreasing the likelihood of recommending treatment for alcohol use disorders, yet simultaneously reducing stigmatizing perceptions (and presumably social distance). © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

DOES TRAINING IN THE CIRCLE OF SECURITY FRAMEWORK INCREASE RELATIONAL UNDERSTANDING IN INFANT/CHILD AND FAMILY WORKERS?

PubMed

McMahon, Catherine; Huber, Anna; Kohlhoff, Jane; Camberis, Anna-Lisa

2017-09-01

This article evaluated whether attendance at Circle of Security training workshops resulted in attendees showing greater empathy and attachment-related knowledge and understanding, and fewer judgmental responses to viewing a stressful parent-child interaction. Participants were 202 practitioners who attended and completed a 2-day (n = 70), 4-day (n = 105), or 10-day (n = 27) COS training workshop in Australia or New Zealand in 2015. In a pre/post design, participant reactions to a video clip of a challenging parent-child interaction were coded for empathic, judgmental, or attachment-focused language. Attachment understanding was coded in response to questions about the greatest challenge that the dyad faced. In all training conditions, participants provided significantly more attachment-focused descriptors and showed significantly greater attachment understanding after training, but significantly fewer empathic descriptors. While participants at the longer workshops provided significantly fewer judgmental/critical descriptors, there was no change for those attending the 2-day workshop. Irrespective of workshop duration or professional background, participants took a more relational perspective on the vignette after the training workshops. More detailed research is required to establish the extent to which this increased knowledge and understanding is retained and integrated into infant mental health practice with parents and young children. © 2017 Michigan Association for Infant Mental Health.

Social cognition in Intermittent Explosive Disorder and aggression

PubMed Central

Coccaro, Emil F.; Fanning, Jennifer R.; Keedy, Sarah K.; Lee, Royce J.

2017-01-01

Social-emotional information processing (SEIP) was assessed in individuals with current DSM-5 Intermittent Explosive Disorder (IED: n = 100) and in healthy (n = 100) and psychiatric (n = 100) controls using a recently developed and validated self-rated questionnaire. SEIP vignettes depicted both direct aggressive and relationally aggressive scenarios of a socially ambiguous nature and were followed by questions assessing subjects' reactions and judgments about the vignettes. IED subjects differed from both healthy and psychiatric controls in all SEIP components. While hostile attribution was highly related to history of aggression, it was also directly correlated with negative emotional response. Further analysis revealed that this component, as well as response valuation and response efficiency, rather than hostile attribution, best explained history of aggressive behavior. A reformulated SEIP model, including self-reported history of childhood trauma, found that negative emotional response and response efficiency were the critical correlates for history of aggressive behavior. Psychosocial interventions of aggressive behavior in IED subjects may do well to include elements that work to reduce the emotional response to social threat and that work to restructure social cognition so that the tendency towards overt, or relationally, aggressive responding is reduced. PMID:27621104

Social cognition in Intermittent Explosive Disorder and aggression.

PubMed

Coccaro, Emil F; Fanning, Jennifer R; Keedy, Sarah K; Lee, Royce J

2016-12-01

Social-emotional information processing (SEIP) was assessed in individuals with current DSM-5 Intermittent Explosive Disorder (IED: n = 100) and in healthy (n = 100) and psychiatric (n = 100) controls using a recently developed and validated self-rated questionnaire. SEIP vignettes depicted both direct aggressive and relationally aggressive scenarios of a socially ambiguous nature and were followed by questions assessing subjects' reactions and judgments about the vignettes. IED subjects differed from both healthy and psychiatric controls in all SEIP components. While hostile attribution was highly related to history of aggression, it was also directly correlated with negative emotional response. Further analysis revealed that this component, as well as response valuation and response efficiency, rather than hostile attribution, best explained history of aggressive behavior. A reformulated SEIP model, including self-reported history of childhood trauma, found that negative emotional response and response efficiency were the critical correlates for history of aggressive behavior. Psychosocial interventions of aggressive behavior in IED subjects may do well to include elements that work to reduce the emotional response to social threat and that work to restructure social cognition so that the tendency towards overt, or relationally, aggressive responding is reduced. Copyright © 2016. Published by Elsevier Ltd.

Views of Intimate Partner Violence in Same- and Opposite-Sex Relationships

ERIC Educational Resources Information Center

Sorenson, Susan B.; Thomas, Kristie A.

2009-01-01

Attitudes toward same-sex intimate relationships and intimate partner violence (IPV) are changing. Little research, however, has examined norms about IPV in same-sex relationships. Using a fractional factorial (experimental vignette) design, we conducted random-digit-dialed interviews in four languages with 3,679 community-residing adults.…

White Teachers' Reactions to the Racial Treatment of Middle-School Black Boys

ERIC Educational Resources Information Center

Battle, Stefan

2017-01-01

This qualitative exploratory study, informed by grounded theory, used questionnaires and unstructured interviews based on fictionalized vignettes to examine urban, public, middle-school White teachers' attitudes about middle-school Black boys, questioning whether and how such attitudes might influence classroom interactions. Twenty-four…

Associations between Individual and Family Level Characteristics and Parenting Practices in Incarcerated African American Fathers

ERIC Educational Resources Information Center

Modecki, Kathryn L.; Wilson, Melvin N.

2009-01-01

We investigated the reported parenting practices of fifty incarcerated African American fathers. Fathers were interviewed using hypothetical vignettes adapted from the Parenting Dimensions Inventory (PDI) and received scores on two parenting practices: responsive and restrictive. Father's individual level (education and length of time spent…

[GP medication prioritisation in older patients with multiple comorbidities recently discharged from hospital: a case-based bottom-up approach].

PubMed

Herrmann, M L H; von Waldegg, G H; Kip, M; Lehmann, B; Andrusch, S; Straub, H; Robra, B-P

2015-01-01

After the hospital discharge of older patients with multiple morbidities, GPs are often faced with the task of prioritising the patients' drug regimens so as to reduce the risk of overmedication. How do GPs prioritise such medications in multimorbid elderly patients at the transition between inpatient and home care? The experience by the GPs is documented in typical case vignettes. 44 GPs in Sachsen-Anhalt were recruited--they were engaged in focus group discussions and interviewed using semi-standardised questionnaires. Typical case vignettes were developed, relevant to the everyday care that elderly patients would typically receive from their GPs with respect to their drug optimisation. According to the results of the focus groups, the following issues affect GPs' decisions: drug and patient safety, their own competence in the health system, patient health literacy, evidence base, communication between secondary and primary care (and their respective influences on each other). When considering individual cases, patient safety, patient wishes, and quality of life were central. This is demonstrated by the drug dispositions of one exemplary case vignette. GPs do prioritise drug regimens with rational criteria. Initial problem delineation, process documentation and the design of a transferable product are interlinking steps in the development of case vignettes. Care issues of drug therapy in elderly patients with multiple morbidities should be investigated further with larger representative samples in order to clarify whether the criteria used here are applied contextually or consistently. Embedding case vignettes into further education concepts is also likely to be useful. © Georg Thieme Verlag KG Stuttgart · New York.

A coordination class analysis of college students' judgments about animated motion

NASA Astrophysics Data System (ADS)

Thaden-Koch, Thomas Christian

The coordination class construct was invented by di5essa and Sherin to clarify what it means to learn and use scientific concepts. A coordination class is defined to consist of readout strategies, which guide observation, and the causal net, which contains knowledge necessary for making inferences from observations. A coordination class, as originally specified, reliably extracts a certain class of information from a variety of situations. The coordination class construct is relatively new. To examine its utility, transcripts of interviews with college students were analyzed in terms of the coordination class construct. In the interviews, students judged the realism of several computer animations depicting balls rolling on a pair of tracks. When shown animations with only one ball, students made judgments consistent with focusing on the ball's speed changes. Adding a second ball to each animation strongly affected judgments made by students taking introductory physics courses, but had a smaller effect on judgments made by students taking a psychology course. Reasoning was described in this analysis as the coordination of readouts about animations with causal net elements related to realistic motion. Decision-making was characterized both for individual students and for groups by the causal net elements expressed, by the types of readouts reported, and by the coordination processes involved. The coordination class construct was found useful for describing the elements and processes of student decision-making, but little evidence was found to suggest that the students studied possessed reliable coordination classes. Students' causal nets were found to include several appropriate expectations about realistic motion. Several students reached judgments that appeared contrary to their expectations and reported mutually incompatible expectations. Descriptions of students' decision-making processes often included faulty readouts, or feedback loops in which causal net elements or readouts were adjusted. Comparisons of the interviewed groups' coordination were found to echo differences and similarities in animation judgments made by larger groups of students who were not interviewed.

Young people's mental health first aid intentions and beliefs prospectively predict their actions: findings from an Australian National Survey of Youth.

PubMed

Yap, Marie Bee Hui; Jorm, Anthony Francis

2012-04-30

Little is known about whether mental health first aid knowledge and beliefs of young people actually translate into actual behavior. This study examined whether young people's first aid intentions and beliefs predicted the actions they later took to help a close friend or family member with a mental health problem. Participants in a 2006 national survey of Australian youth (aged 12-25 years) reported on their first aid intentions and beliefs based on one of four vignettes: depression, depression with alcohol misuse, psychosis, and social phobia. At a two-year follow-up interview, they reported on actions they had taken to help any family member or close friend with a problem similar to the vignette character since the initial interview. Of the 2005 participants interviewed at follow-up, 608 reported knowing someone with a similar problem. Overall, young people's first aid intentions and beliefs about the helpfulness of particular first aid actions predicted the actions they actually took to assist a close other. However, the belief in and intention to encourage professional help did not predict subsequent action. Findings suggest that young people's mental health first aid intentions and beliefs may be valid indicators of their subsequent actions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

PubMed

Kermode, Michelle; Bowen, Kathryn; Arole, Shoba; Pathare, Soumitra; Jorm, Anthony F

2009-12-01

People with mental disorders experience discrimination as a consequence of stigmatising attitudes that are largely socio-culturally constructed. Thus, there is a need to understand local contexts in order to develop effective programs to change such attitudes. We undertook a mental health literacy survey in rural Maharashtra, India, prior to developing a mental health training program for village health workers (VHWs) in a primary health care setting. A cross-sectional mental health literacy survey was undertaken in late 2007, which involved interviewer-administration of a questionnaire to 240 systematically sampled community members, and 60 purposively sampled VHWs. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked about attitudes towards, and desired social distance from, the people in the vignettes (the latter being a proxy measure for stigma). Linear regression modelling was undertaken to identify predictors of social distance. Although the community was relatively accepting of people with mental disorders, false beliefs and negative attitudes were still evident. Desired social distance was consistently greater for the person depicted in the psychosis vignette compared to the depression vignette. For both vignettes, the main predictor of greater social distance was perceiving the person as dangerous, and the predictors of reduced social distance were being a VHW, and seeing the problem as a sign of personal weakness. For depression, believing the cause to be family tensions also reduced social distance. For psychosis, labelling the disorder as a mind/brain problem, and believing the cause to be lack of control over life or genetic factors increased social distance. The vast majority did not agree that the problems experienced in the vignettes were 'a real medical illness'. Promoting bio-medical explanations for mental disorders in this setting may exacerbate discriminatory attitudes. Provision of contextually relevant mental health training for the VHWs so that they are able to communicate, model and shape more positive attitudes is the next step.

Causal explanations of distress and general practitioners' assessments of common mental disorder among punjabi and English attendees.

PubMed

Bhui, Kamaldeep; Bhugra, Dinesh; Goldberg, David

2002-01-01

The literature on the primary care assessment of mental distress among Indian subcontinent origin patients suggests frequent presentations to general practitioner, but rarely for recognisable psychiatric disorders. This study investigates whether cultural variations in patients' causal explanatory models account for cultural variations in the assessment of non-psychotic mental disorders in primary care. In a two-phase survey, 272 Punjabi and 269 English subjects were screened. The second phase was completed by 209 and 180 subjects, respectively. Causal explanatory models were elicited as explanations of two vignette scenarios. One of these emphasised a somatic presentation and the other anxiety symptoms. Psychiatric disorder was assessed by GPs on a Likert scale and by a psychiatrist on the Clinical Interview Schedule. Punjabis more commonly expressed medical/somatic and religious beliefs. General practitioners were more likely to assess any subject giving psychological explanations to vignette A and English subjects giving religious explanations to vignette B as having a significant psychiatric disorder. Where medical/somatic explanations of distress were most prevalent in response to the somatic vignette, psychological, religious and work explanations were less prevalent among Punjabis but not among English subjects. Causal explanations did not fully explain cultural differences in assessments. General practitioners' assessments and causal explanations are related and influenced by culture, but causal explanations do not fully explain cultural differences in assessments.

Theorizing College Governance across Epistemic Differences: Awareness Contexts of College Administrators and Faculty

ERIC Educational Resources Information Center

Muzzin, Linda

2016-01-01

Awareness contexts are useful concepts in symbolic interactionist research, which focusses on how everyday realities are constructed. To provide a fresh perspective on governance in Canada's colleges, I sorted vignettes in interview data collected from administrators and faculty into four types of contexts originally derived from observation of…

Six Characteristics of Nutrition Education Videos That Support Learning and Motivation to Learn

ERIC Educational Resources Information Center

Ramsay, Samantha A.; Holyoke, Laura; Branen, Laurel J.; Fletcher, Janice

2012-01-01

Objective: To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Methods: Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus…

Clinical Approach to the Heavy Cannabis User in the Age of Medical Marijuana.

PubMed

Cermak, Timmen L

2016-01-01

This article begins with a case vignette exemplifying the common clinical problem of heavy marijuana users. The epidemiology and basic science underlying cannabis dependence is outlined, followed by clinical strategies for basing a therapeutic alliance on known research findings and using motivational interviewing to deal with typical patterns of denial.

Learning to think like a nurse: the development of clinical judgment in nursing students.

PubMed

Ashley, Jane; Stamp, Kelly

2014-09-01

The purpose of this project was to examine the clinical judgment and reasoning skills of nursing students in high-fidelity simulation. Two levels of students (N = 104), novices and those who are slightly more advanced, participated in individual videotaped simulations. Afterward, interviews were conducted to explore what the student was thinking and feeling during simulation. Five themes emerged from the interviews: thinking like a nurse, assessment, looking for answers, communication, and magical or reflective thinking. There was a clear distinction in the reasoning skills of the novice students compared with students with more clinical experience. Tanner's model of clinical judgment in nursing is used to understand the findings of the study. Copyright 2014, SLACK Incorporated.

Developmental frontal lobe imaging in moral judgment: Arthur Benton's enduring influence 60 years later.

PubMed

Eslinger, Paul J; Robinson-Long, Melissa; Realmuto, Jennifer; Moll, Jorge; deOliveira-Souza, Ricardo; Tovar-Moll, Fernanda; Wang, Jianli; Yang, Qing X

2009-02-01

Early prefrontal cortex damage has been associated with developmental deficits in social adaptation, moral behavior, and empathy that alter the maturation of social cognition and social emotions. The seminal case of Ackerly and Benton (1948) continues to provide the most striking clinical example of prefrontal-related neurodevelopmental impairments, with more recent case reports confirming and elaborating these influential observations. This study investigated the prefrontal hypothesis of moral decision making in healthy, typically developing children and adolescents (10-17 years of age) using functional magnetic resonance imaging (fMRI). Participants judged the actions in age-appropriate moral vignettes as right or wrong, and results were contrasted to a nonsocial/nonmoral baseline condition requiring similar right versus wrong judgments. Results confirmed a predominant cluster of activity in the most rostral-medial (frontal polar) prefrontal region across moral judgment conditions, along with left lateroposterior orbitofrontal/ventrolateral prefrontal, left temporoparietal junction, midline thalamus and globus pallidus, and bilateral inferior occipital clusters. Trials entailing ambiguous moral situations activated considerably more prefrontal and parietal regions than did routine moral situations, suggesting the need for more neurocognitive resources. While age regression analysis identified a few regions of greater or lesser activity with age, the frontal polar activations did not change with age. Findings confirm a significant role for anterior-medial prefrontal cortex in the typical development and maturation of moral decision making, consistent with clinical lesion case descriptions.

Psychiatric Diagnostic Interviews for Children and Adolescents: A Comparative Study

ERIC Educational Resources Information Center

Angold, Adrian; Erkanli, Alaattin; Copeland, William; Goodman, Robert; Fisher, Prudence W.; Costello, E. Jane

2012-01-01

Objective: To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). Method: Roughly equal numbers of…

Evaluation of a rule base for decision making in general practice.

PubMed Central

Essex, B; Healy, M

1994-01-01

BACKGROUND. Decision making in general practice relies heavily on judgmental expertise. It should be possible to codify this expertise into rules and principles. AIM. A study was undertaken to evaluate the effectiveness, of rules from a rule base designed to improve students' and trainees' management decisions relating to patients seen in general practice. METHOD. The rule base was developed after studying decisions about and management of thousands of patients seen in one general practice over an eight year period. Vignettes were presented to 93 fourth year medical students and 179 general practitioner trainees. They recorded their perception and management of each case before and after being presented with a selection of relevant rules. Participants also commented on their level of agreement with each of the rules provided with the vignettes. A panel of five independent assessors then rated as good, acceptable or poor, the participants' perception and management of each case before and after seeing the rules. RESULTS. Exposure to a few selected rules of thumb improved the problem perception and management decisions of both undergraduates and trainees. The degree of improvement was not related to previous experience or to the stated level of agreement with the proposed rules. The assessors identified difficulties students and trainees experienced in changing their perceptions and management decisions when the rules suggested options they had not considered. CONCLUSION. The rules developed to improve decision making skills in general practice are effective when used with vignettes. The next phase is to transform the rule base into an expert system to train students and doctors to acquire decision making skills. It could also be used to provide decision support when confronted with difficult management decisions in general practice. PMID:8204334

Why doesn't a family member of a person with advanced dementia use a substituted judgment when making a decision for that person?

PubMed

Hirschman, Karen B; Kapo, Jennifer M; Karlawish, Jason H T

2006-08-01

The objective of this study was to identify what standard of decision making a family member uses when making medical decisions for their relative with advanced dementia. Thirty family members of patients with advanced dementia from an Alzheimer disease center and a suburban long-term care facility were interviewed using a semistructured interview. All interviews were audiotaped, transcribed, and analyzed using qualitative data analysis techniques. Family members were split almost evenly in the standard they used when making medical decisions for their relative: substituted judgment (43%) or best interests (57%). However, few who used the substituted judgment standard viewed it as distinct from best interests. Instead, both standards were taken into consideration when making medical decisions. In addition to not having discussions about healthcare preferences, the reasons for not using a substituted judgment included: the need for family consensus, unrealistic expectations of the patient, the need to incorporate their relative's quality of life into the decision, and the influence of healthcare professionals. Family members who did not have discussions about healthcare preferences identified various barriers to the discussion, including waiting too long, avoiding the topic, and the patient's denial of dementia. These data suggest several reasons why surrogate decision-makers for persons with advanced dementia do not use the substituted judgment standard and the potential value of interventions that would allow patients with early-stage dementia and their family members to discuss healthcare preferences.

Electronic health record tools' support of nurses' clinical judgment and team communication.

PubMed

Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin

2013-11-01

Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.

STEM learning research through a funds of knowledge lens

NASA Astrophysics Data System (ADS)

Civil, Marta

2016-03-01

This article examines STEM learning as a cultural process with a focus on non-dominant communities. Building on my work in funds of knowledge and mathematics education, I present three vignettes to raise some questions around connections between in-school and out-of-school mathematics. How do we define competence? How do task and environment affect engagement? What is the role of affect, language, and cognition in different settings? These vignettes serve to highlight the complexity of moving across different domains of STEM practice—everyday life, school, and STEM disciplines. Based on findings from occupational interviews I discuss characteristics of learning and engaging in everyday practices and propose several areas for further research, including the nature of everyday STEM practices, valorization of knowledge, language choice, and different forms of engagement.

Where Would You Turn for Help? Older Adults' Awareness of Community Support Services

ERIC Educational Resources Information Center

Denton, M.; Ploeg, J.; Tindale, J.; Hutchison, B.; Brazil, K.; Akhtar-Danesh, N.; Quinlan, M.; Lillie, J.; Plenderleith, J. Millen; Boos, L.

2008-01-01

Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults…

"No One Should Destroy the Forest": Using Photo-Based Vignette Interviews to Understand Kenyan Teachers' Views of the Environment

ERIC Educational Resources Information Center

Quigley, Cassie F.; Miller, Zachary D.; Dogbey, James; Che, S. Megan; Hallo, Jeffrey

2014-01-01

In the midst of the current environmental crisis, scientists, academics, authors, and politicians worldwide are urging citizens to create sustainable communities. However, there is little capability to build a sustainable society without an informed, active, and engaged populous. This requires more than just environmentally knowledgeable citizens.…

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda.

PubMed

Nalukenge, W; Martin, F; Seeley, J; Kinyanda, E

2018-05-02

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5-17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5-11 years) and adolescents (12-17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28-69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem  and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.

Associations between awareness of beyondblue and mental health literacy in Australian youth: Results from a national survey.

PubMed

Yap, Marie B; Reavley, Nicola J; Jorm, Anthony F

2012-06-01

The aim of this paper is to examine whether Australian young people's awareness of beyondblue is associated with better recognition of depression and anxiety disorders, and better quality of beliefs about possible interventions and first-aid actions for these problems. In 2011, a telephone interview was conducted with a national sample of 3021 Australians aged between 15 and 25 years. Participants were presented with a vignette portraying depression, depression with suicidal thoughts, social phobia, post-traumatic stress disorder or psychosis in a young person. They were then asked about recognition of the disorder portrayed, their beliefs about the helpfulness or harmfulness of various interventions and first-aid actions, and their awareness of beyondblue. The quality of youths' beliefs was scored against health professionals' ratings of the same list of interventions and first-aid actions. Beyondblue awareness was associated with more accurate recognition of the disorder portrayed in all vignettes except social phobia. It was also associated with beliefs about the helpfulness of first-aid actions that were more closely aligned with professional ratings for the depression, psychosis and social phobia vignettes. However, it was associated with beliefs about interventions for the psychosis vignette only. Overall, the associations of beyondblue awareness with better mental health literacy were not specific to depression and anxiety disorders, which are their main focus. Beyondblue awareness is mostly unrelated to treatment beliefs, but seems to have non-specific associations with recognition of disorders and first-aid beliefs.

Are We Preparing or Training Teachers? Developing Professional Judgment in and beyond Teacher Preparation Programs

ERIC Educational Resources Information Center

Scales, Roya Q.; Wolsey, Thomas DeVere; Lenski, Susan; Smetana, Linda; Yoder, Karen K.; Dobler, Elizabeth; Grisham, Dana L.; Young, Janet R.

2018-01-01

This three phase longitudinal multiple-case study, framed by positioning theory, investigated how four novice teachers learned to use professional judgment in their literacy instruction. Data sources from coursework, student teaching, and novice teaching were included. Interviews, observations, researchers' observational notes, and school and…

Suicide in Children Younger than Age Fourteen: Clinical Judgment and Assessment Issues.

ERIC Educational Resources Information Center

Wise, Amy J.; Spengler, Paul M.

1997-01-01

Discusses the importance of accurate information about childhood suicide to prevent clinical judgment errors. Describes available methods for evaluating suicide risk in children. Looks at myths and misconceptions surrounding childhood suicide; risk factors, such as family dysfunction and distress; and evaluation techniques, such as interviews and…

Influencing Perception About Children with Autism and their Parents Using Disclosure Cards.

PubMed

Austin, Jillian E; Zinke, Vanessa L; Davies, W Hobart

2016-08-01

Parents of children with autism often report feeling judged and are increasingly using disclosure cards to reduce negative perceptions. However, no empirical research has been conducted on the effectiveness of these cards. The present study used vignettes of a parent-child interaction in which the child was misbehaving and investigated the efficacy on 160 parents' perceptions. A unique survey was developed with two factors (Maternal Skill Deficit and Negative Reaction) and a single item (Sympathy for Mother). Those who received the disclosure card reported significantly lower Maternal Skill Deficit and Negative Reaction to the Dyad and no difference in Sympathy for the Mother. These results provide preliminary validation for the use of autism disclosure cards in buffering negative judgment.

More Than a Feeling: Public Expectations About Emotional Responses to Criminal Victimization.

PubMed

Wrede, Olof; Ask, Karl

2015-01-01

Crime victims' emotional display in legal settings has been found to influence credibility judgments. The specific nature of public expectations about crime victims' emotional responses have, however, not been adequately investigated. In an experimental vignette study, respondents in a community sample (N = 404) estimated the likelihood that female and male victims would experience 7 distinct emotions in response to 5 types of crimes. Across all crime types, female victims were expected to experience significantly more situation-focused (anxiety, fear) and inward-focused (guilt, shame, sadness) emotions, and significantly less other-focused emotions (hatred, anger) than male victims. This calls for an increased focus on distinct emotions in future research on victim's emotions. Implications for victims in legal and social settings are discussed.

Levels of Emotional Awareness: a model for conceptualizing and measuring emotion-centered structural change.

PubMed

Subic-Wrana, Claudia; Beutel, Manfred E; Garfield, David A S; Lane, Richard D

2011-04-01

The need to establish the efficacy of psychoanalytic long-term treatments has promoted efforts to operationalize psychic structure and structural change as key elements of psychoanalytic treatments and their outcomes. Current, promising measures of structural change, however, require extensive interviews and rater training. The purpose of this paper is to present the theory and measurement of Levels of Emotional Awareness (LEA) and to illustrate its use based on clinical case vignettes. The LEA model lays out a developmental trajectory of affective processing, akin to Piaget's theory of sensory-cognitive development, from implicit to explicit processing. Unlike other current assessments of psychic structure (Scales of Psychological Capacities, Reflective Functioning, Operationalized Psychodynamic Diagnostics) requiring intensive rater and interviewer training, it is easily assessed based on a self-report performance test. The LEA model conceptualizes a basic psychological capacity, affect processing. As we will illustrate using two case vignettes, by operationalizing implicit and explicit modes of affect processing, it provides a clinical measure of emotional awareness that is highly pertinent to the ongoing psychoanalytic debate on the nature and mechanisms of structural change. Copyright © 2011 Institute of Psychoanalysis.

Does a Physician's Attitude toward a Patient with Mental Illness Affect Clinical Management of Diabetes? Results from a Mixed-Method Study.

PubMed

Welch, Lisa C; Litman, Heather J; Borba, Christina P C; Vincenzi, Brenda; Henderson, David C

2015-08-01

To determine whether physician's attitudes toward patients with comorbid mental illness affect management of a chronic disease. A total of 256 primary care physicians interviewed in 2010. This randomized factorial experiment entailed physicians observing video vignettes of patient-actors with poorly controlled diabetes. Patients were balanced across age, gender, race, and comorbidity (schizophrenia with bizarre or normal affect, depression, eczema). Physicians completed structured and semistructured interviews plus chart notes about clinical management and attitudes. Physicians reported more negative attitudes for patients with schizophrenia with bizarre affect (SBA). There were few differences in clinical decisions measured quantitatively or in charting, but qualitative data revealed less trust of patients with SBA as reporters, with more reliance on sources other than engaging the patient in care. Physicians often alerted colleagues about SBA, thereby shaping expectations before interactions occurred. Results are consistent with common stereotypes about people with serious mental illness. Vignettes did not include intentional indication of unreliable reporting or danger. Reducing health care disparities requires attention to subtle aspects of managing patients--particularly those with atypical affect--as seemingly slight differences could engender disparate patient experiences over time. © Health Research and Educational Trust.

The pathway to consultation for rheumatoid arthritis: exploring anticipated actions between the onset of symptoms and face-to-face encounter with a healthcare professional.

PubMed

Simons, Gwenda; Lumley, Sophie; Falahee, Marie; Kumar, Kanta; Mallen, Christian D; Stack, Rebecca J; Raza, Karim

2017-06-14

When people first experience symptoms of rheumatoid arthritis (RA) they often delay seeking medical attention resulting in delayed diagnosis and treatment. This research assesses behaviours people might engage in prior to, or instead of, seeking medical attention and compares these with behaviours related to illnesses which are better publicised. Thirty-one qualitative interviews with members of the general public explored intended actions in relation to two hypothetical RA vignettes (with and without joint swelling) and two non-RA vignettes (bowel cancer and angina). The interviews were audio-recorded and transcribed. Analysis focused on intended information gathering and other self-management behaviours in the interval between symptom onset and help-seeking. Participants were more likely to envision self-managing symptoms when confronted with the symptoms of RA compared to the other vignettes. Participants would look for information to share responsibility for decision making and get advice and reassurance. Others saw no need for information seeking, perceived the information available as untrustworthy or, particularly in the case of bowel cancer and angina, would not want to delay seeking medical attention. Participants further anticipated choosing not to self-manage the symptoms; actively monitoring the symptoms (angina/ bowel cancer) or engaging in self-treatment of symptom(s). These results help define targets for interventions to increase appropriate help-seeking behaviour for people experiencing the initial symptoms of RA, such as educational interventions directed at allied healthcare professionals from whom new patients may seek information on self-management techniques, or the development of authoritative and accessible informational resources for the general public.

An Investigation of the Nontechnical Skills Required to Maximize the Safety and Productivity of U.S. Navy Divers

DTIC Science & Technology

2005-04-01

experience. The critical incident interview uses recollection of a specific incident as its starting point and employs a semistructured interview format...context assessment, expectancies, and judgments. The four sweeps in the critical incident interview include: Sweep 1 - Prompting the interviewee to

Profiles of neurological outcome prediction among intensivists.

PubMed

Racine, Eric; Dion, Marie-Josée; Wijman, Christine A C; Illes, Judy; Lansberg, Maarten G

2009-12-01

Advances in intensive care medicine have increased survival rates of patients with critical neurological conditions. The focus of prognostication for such patients is therefore shifting from predicting chances of survival to meaningful neurological recovery. This study assessed the variability in long-term outcome predictions among physicians and aimed to identify factors that may account for this variability. Based on a clinical vignette describing a comatose patient suffering from post-anoxic brain injury intensivists were asked in a semi-structured interview about the patient's specific neurological prognosis and about prognostication in general. Qualitative research methods were used to identify areas of variability in prognostication and to classify physicians according to specific prognostication profiles. Quantitative statistics were used to assess for associations between prognostication profiles and physicians' demographic and practice characteristics. Eighteen intensivists participated. Functional outcome predictions varied along an evaluative dimension (fair/good-poor) and a confidence dimension (certain-uncertain). More experienced physicians tended to be more pessimistic about the patient's functional outcome and more certain of their prognosis. Attitudes toward quality of life varied along an evaluative dimension (good-poor) and a "style" dimension (objective-subjective). Older and more experienced physicians were more likely to express objective judgments of quality of life and to predict a worse quality of life for the patient than their younger and less experienced counterparts. Various prognostication profiles exist among intensivists. These may be dictated by factors such as physicians' age and clinical experience. Awareness of these associations may be a first step to more uniform prognostication.

When is physician assisted suicide or euthanasia acceptable?

PubMed

Frileux, S; Lelièvre, C; Muñoz Sastre, M T; Mullet, E; Sorum, P C

2003-12-01

To discover what factors affect lay people's judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact. Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design--that is, all combinations of patient's age (three levels); curability of illness (two levels); degree of suffering (two levels); patient's mental status (two levels), and extent of patient's requests for the procedure (three levels). Convenience sample of 66 young adults, 62 middle aged adults, and 66 older adults living in western France. In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants' characteristics were investigated by means of both graphs and ANOVA. Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability. People's judgments concur with legislation to require a repetition of patients' requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient's age itself than do older people.

Gender Norms in Portuguese College Students' Judgments in Familial Homicides: Bad Men and Mad Women.

PubMed

Saavedra, Luísa; Cameira, Miguel; Rebelo, Ana Sofia; Sebastião, Cátia

2015-05-08

The gender of the offender has been proved to be an important factor in judicial sentencing. In this study, we analyze the judgments of College students regarding perpetrators of familial homicides to evaluate the presence of these gender norms and biases in the larger society. The sample included 303 college students (54.8% female) enrolled in several social sciences and engineering courses. Participants were asked to read 12 vignettes based on real crimes taken from Portuguese newspapers. Half were related to infanticide, and half were related to intimate partner homicide. The sex of the offender was orthogonally manipulated to the type of crime. The results show that gender had an important impact on sentences, with males being more harshly penalized by reasons of perversity and women less penalized by reason of mental disorders. In addition, filicide was more heavily penalized than was intimate partner homicide. The results also revealed a tendency toward a retributive conception of punishment. We discuss how gender norms in justice seem to be embedded in society as well as the need for intervention against the punitive tendency of this population. © The Author(s) 2015.

Preschool Children's Judgments of Moral and Personal Events Involving Physical Harm and Property Damage.

ERIC Educational Resources Information Center

Tisak, Marie S.

1993-01-01

Three studies examined preschoolers' judgments of moral and personal rules. Children were interviewed about punishment, the relative importance of various rule violations, and authority. Children reported that moral transgressions were more wrong than personal rule violations and that moral rule violators deserved greater punishment than did…

Effect of Physical Attractiveness on Therapists' Initial Judgments of a Person's Self-concept

ERIC Educational Resources Information Center

Hobfoll, Stevan E.; Penner, Louis A.

1978-01-01

Investigated effect of a person's physical attractiveness on a therapist's initial judgment of that person's self-concept. Videotapes and audiotapes were made of interviews with attractive and unattractive males and females. Physically attractive persons of both sexes were rated as having better self-concepts than unattractive persons. (Author)

General practitioners' judgment of their elderly patients' cognitive status.

PubMed

Pentzek, Michael; Fuchs, Angela; Wiese, Birgitt; Cvetanovska-Pllashniku, Gabriela; Haller, Franziska; Maier, Wolfgang; Riedel-Heller, Steffi G; Angermeyer, Matthias C; Bickel, Horst; Mösch, Edelgard; Weyerer, Siegfried; Werle, Jochen; van den Bussche, Hendrik; Eisele, Marion; Kaduszkiewicz, Hanna

2009-12-01

General practitioners (GP) play an important role in detecting cognitive impairment among their patients. To explore factors associated with GPs' judgment of their elderly patients' cognitive status. Cross-sectional data from an observational cohort study (AgeCoDe study); General practice surgeries in six German metropolitan study centers; home visits by interviewers. 138 GPs, 3,181 patients (80.13 +/- 3.61 years, 65.23% female). General practitioner questionnaire for each patient: familiarity with the patient, patient morbidity, judgment of cognitive status. Home visits by trained interviewers: sociodemographic and clinical data, psychometric test performance. Multivariate regression analysis was used to identify independent associations with the GPs' judgment of "cognitively impaired" vs. "cognitively unimpaired." Less familiar patients (adjusted odds ratio [aOR] 2.42, 95% CI 1.35-4.32, for poor vs. very high familiarity), less mobile patients (aOR 1.29, 95% CI 1.13-1.46), patients with impaired hearing (aOR 5.46, 95% CI 2.35-12.67 for serious vs. no problems), and patients with greater comorbidity (aOR 1.15, 95% CI 1.08-1.22) were more likely to be rated as "cognitively impaired" by their GPs. The associations between GPs' assessments of cognitive impairment and their familiarity with their patients and patients' mobility, hearing, and morbidity provide important insights into how GPs make their judgments.

Beliefs about dangerousness of people with mental health problems: the role of media reports and personal exposure to threat or harm.

PubMed

Reavley, N J; Jorm, A F; Morgan, A J

2016-09-01

To assess the associations between beliefs about the dangerousness of people with mental health problems and exposure to media reports of violence or personal experiences of fear, threat or harm. Telephone interviews were carried out with 5220 Australians aged 18+. Respondents heard a vignette of a person with depression or early schizophrenia and were asked whether they believed him to be dangerous. Other questions covered past 12-month recall of media reports of violence and mental health problems, contact with and experiences of fear, threat or harm by people with mental health problems. Multinomial logistic regression was used to assess the associations between beliefs about dangerousness and media and these types of contact with people with mental health problems. For the early schizophrenia vignette, recall of media reports and having felt afraid of someone were associated with beliefs about dangerousness. For the depression vignette, media reports about violence and mental health problems or the experiences of feeling afraid or having been threatened or harmed were not strongly associated with beliefs about dangerousness. For both vignettes, knowing someone with a mental health problem and having a higher level of education were associated with less belief in dangerousness. Media reports may play a greater role in forming attitudes in low prevalence disorders and further efforts to reduce any adverse impact of media reporting should focus on these disorders. The study also supports the effectiveness of contact with people with mental health problems in reducing beliefs about dangerousness.

An assessment of preventive care offered to orthodontic patients by oral health therapists in NSW Australia.

PubMed

Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A

2015-08-01

The aim of this study was to record preventive oral health care planned by dental therapists and oral health therapists (therapists) for patients with poor oral hygiene undergoing orthodontic treatment. A cross-sectional survey, using a clinical vignette of a patient with poor oral hygiene undergoing therapy with a fixed appliance, was undertaken to record the preventive care offered to this individual by therapists working across 15 Local Health Districts (LHDs). This orthodontic vignette was inserted between two dental caries-related vignettes. Data were coded and descriptive statistics were used to report the findings. One-hundred and seventeen therapists returned questionnaires (giving a response rate of 64.6%), of whom 82.0% (n = 95) completed the orthodontic vignette. Adopting motivational interviewing techniques to facilitate communication with the patient and their parent was recommended by 88.4% (n = 84) respondents, 98.0% (n = 93) offered oral-hygiene instruction, 70.5% (n = 67) recorded plaque levels and used disclosing solution and 60.0% (n = 57) offered dietary advice. Products recommended for use at home included fluoride toothpaste [1,450 ppm F (80.0%; n = 76) and 5,000 ppm F (59.0%; n = 24)] and casein phosphopeptide amorphous phosphates plus fluoride (CPP-ACPF) paste (33.3%; n = 32). Less than 20% offered fissure sealants. Preventive advice and care was offered inconsistently by therapists in this study. To ensure that all therapists adopt a scientifically based approach to prevention, LHD clinical directors should implement continuous professional education programmes for therapists to improve patient's health outcomes. © 2015 FDI World Dental Federation.

Syndrome-Related Stigma in the General Social Environment as Reported by Women with Classical Congenital Adrenal Hyperplasia.

PubMed

Meyer-Bahlburg, Heino F L; Reyes-Portillo, Jazmin A; Khuri, Jananne; Ehrhardt, Anke A; New, Maria I

2017-02-01

Stigma defined as "undesired differentness" (Goffman, 1963) and subtyped as "experienced" or "enacted," "anticipated," and "internalized" has been documented for patients with diverse chronic diseases. However, no systematic data exist on the association of stigma with somatic intersexuality. The current report concerns women with classical congenital adrenal hyperplasia (CAH), the most prevalent intersex syndrome, and provides descriptive data on CAH-related stigma as experienced in the general social environment (excluding medical settings and romantic/sexual partners) during childhood, adolescence, and adulthood. A total of 62 adult women with classical CAH [41 with the salt-wasting (SW) variant and 21 with the simple-virilizing (SV) variant] underwent a qualitative retrospective interview, which focused on the impact of CAH and its medical treatment on many aspects of women's lives. Deductive content analysis was performed on the transcribed texts. The women's accounts of CAH-related stigma were identified and excerpted as vignettes, and the vignettes categorized according to social context, stigma type, and the associated features of the CAH condition. Nearly two-thirds of women with either variant of CAH provided stigma vignettes. The vignettes included all three stigma types, and most involved some somatic or behavioral feature related to sex or gender. Stigma situations were reported for all ages and all social contexts of everyday life: family, peers, colleagues at work, strangers, and the media. We conclude that there is a need for systematic documentation of stigma in intersexuality as a basis for the development of improved approaches to prevention and intervention.

"His skin doesn't match what he wants to do": Children's perceptions of stereotype threat.

PubMed

Wegmann, Kate M

2017-01-01

Stereotype threat is a key contributor to chronic racial/ethnic disparities in mental health, physical health, and academic outcomes. Emerging evidence suggests that stereotype threat may be a critical concern for narrowing these disparities. The objective of the current study is to determine whether children between the ages of 7-11 consciously perceive stereotype threat, and to examine children's descriptions of the phenomenon. Age-appropriate vignettes illustrated 6 forms of stereotype threat. 15 children from diverse racial/ethnic backgrounds read and responded to 3 vignettes each. Interview transcripts were analyzed to determine if participants identified and articulated the core concept and eliciting conditions for each form of threat. All children were able to recognize and describe the core concept for at least 1 form of stereotype threat. Threats to a person's own self-concept were the most commonly identified, whereas threats directed toward a group were less easily recognized and articulated. Children were able to describe conditions associated with threat, although not all conditions were recognized in the context of each particular vignette. Children's responses to the vignettes illustrating stereotype threat suggest that children are able to perceive and describe stereotype threat in ways similar to adults. The primary importance of threats to the self and secondary importance of group threats may be explained by the developmental context of children's emerging social perspective taking skills. Addressing the effects of stereotype threat at younger ages may prevent persistent and cumulative disparities in health, mental health, and academic outcomes from arising. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Children's thinking about diversity of belief in the early school years: judgments of relativism, tolerance, and disagreeing persons.

PubMed

Wainryb, Cecilia; Shaw, Leigh A; Langley, Marcie; Cottam, Kim; Lewis, Renee

2004-01-01

Children's thinking about diversity of belief in 4 realms--morality, taste, facts, and ambiguous facts--was examined. Ninety-six participants (ages 5, 7, and 9) were interviewed about beliefs different from their own that were endorsed by characters with different status; their judgments of relativism, tolerance, and disagreeing persons were assessed. Five-year-olds made fewer relative and tolerant judgments than 7- and 9-year-olds. Nevertheless, participants of all ages organized their judgments according to the realm of diversity, thought that some beliefs are relative and some are nonrelative, and made tolerant judgments of some divergent beliefs (and their proponents) but not of others. The findings suggest that, in the early school years, children have multiple and well-differentiated perspectives on belief diversity.

A Closer Look at Bilingual Students' Use of Multimodality in the Context of an Area Comparison Problem from a Large-Scale Assessment

ERIC Educational Resources Information Center

Fernandes, Anthony; Kahn, Leslie H.; Civil, Marta

2017-01-01

In this article, we use multimodality to examine how bilingual students interact with an area task from the National Assessment of Educational Progress in task-based interviews. Using vignettes, we demonstrate how some of these students manipulate the concrete materials, and use gestures, as a primary form of structuring their explanations and…

What Are They Thinking? The Moral Judgment of Children with Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Hardman, Elizabeth L.

2015-01-01

This study was conducted to describe the moral judgment of 12 third- through fifth-grade children with and without emotional and behavioral disorders (EBD) and to explore how feelings affected their thought processes. Data were gathered via three individually conducted moral dilemma interviews with each child participant. These procedures produced…

Adolescent Judgments and Reasoning about the Failure to Include Peers with Social Disabilities

ERIC Educational Resources Information Center

Bottema-Beutel, Kristen; Li, Zhushan

2015-01-01

Adolescents with autism spectrum disorder often do not have access to crucial peer social activities. This study examines how typically developing adolescents evaluate decisions not to include a peer based on disability status, and the justifications they apply to these decisions. A clinical interview methodology was used to elicit judgments and…

Moral understanding in children with autism.

PubMed

Grant, Cathy M; Boucher, Jill; Riggs, Kevin J; Grayson, Andrew

2005-07-01

Children with autism were compared with control groups on their ability to make moral judgements. Participants were presented with pairs of vignettes in which actions were either deliberate or accidental and caused injury to a person or damage to property. Participants were asked to judge which protagonist was the naughtier and to verbally justify this judgement. Results showed that the children with autism were as likely as controls to judge culpability on the basis of motive, and to judge injury to persons as more culpable than damage to property. Children with autism also offered some appropriate verbal justifications for their judgments although most justifications were of poor quality and reiterated the story. Results are discussed in terms of theory of mind and the possible role of deficits in complex reasoning and executive functions.

Modern Prejudice and Same-Sex Parenting: Shifting Judgments in Positive and Negative Parenting Situations

PubMed Central

MASSEY, SEAN G.; MERRIWETHER, ANN M.; GARCIA, JUSTIN R.

2013-01-01

The current study compares the effects of traditional and modern anti-homosexual prejudice on evaluations of parenting practices of same-sex and opposite-sex couples. Undergraduate university student participants (N = 436) completed measures of traditional and modern anti-homosexual prejudice and responded to a vignette describing a restaurant scene in which parents react to their child’s undesirable behavior. The parents’ sexual orientation and the quality of their parenting (positive or negative quality) were varied randomly. It was predicted that participants who score higher in modern prejudice would rate the negative parenting behaviors of same-sex parents more negatively than similar behaviors in opposite-sex parents. It was also predicted that this modern prejudice effect would be most pronounced for male participants. Both hypotheses were supported. PMID:23667347

How Well Can Analytic Hierarchy Process be Used to Elicit Individual Preferences? Insights from a Survey in Patients Suffering from Age-Related Macular Degeneration.

PubMed

Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Gross, Christian; Stock, Stephanie

2016-10-01

In this study, we tested the feasibility of an interviewer-assisted analytic hierarchy process (AHP) in a special patient population with age-related macular degeneration (AMD). One aim was to generate preference weights regarding AMD treatment characteristics. A secondary aim was to explore the consistency of preference judgments and reasons for inconsistency. We generated quantitative importance weights for decision criteria using the matrix multiplication method. A qualitative study component in the form of asking patients to think aloud throughout their judgments was implemented to facilitate understanding of quantitative findings. Consistency ratios were calculated as a measure of logical judgment performance within AHP. If consistency ratios exceeded 0.2, we explored reasons for inconsistency. We interviewed 86 patients and generated preference weights for criteria. Patients rated the injection's effect on visual function the highest (0.44), followed by the frequency of monitoring visits (0.18), approval status (0.13), injection frequency (0.13), and side effects (0.12). Inconsistency in judgments was prevalent at the subcriteria level. Whereas much of the observed inconsistency was due to an excessive use of high/extreme value judgments, these judgments seemed to result from patients reasonably trying to highlight their strong preferences. Our study combines quantitative with qualitative data to explore patients' preference weights and decision processes using the AHP. It suggests that the type of inconsistency observed in judgments of AMD patients mostly results from rational decision making, not from error or lack of understanding. Further research should address which type and extent of inconsistency might be acceptable in different AHP settings.

Primary Care Physicians’ Evaluation and Treatment of Depression

PubMed Central

Epstein, Steven A.; Hooper, Lisa M.; Weinfurt, Kevin P.; DePuy, Venita; Cooper, Lisa A.; Harless, William G.; Tracy, Cynthia M.

2009-01-01

Little is known about how patient and primary care physician characteristics are associated with quality of depression care. The authors conducted structured interviews of 404 randomly selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying depressed patients. Vignettes varied along the dimensions of medical comorbidity, attributions regarding the cause of depression, style, race/ethnicity, and gender. Results show that physicians showed wide variation in treatment decisions; for example, most did not inquire about suicidal ideation, and most did not state that they would inform the patient that there can be a delay before an antidepressant is therapeutic. Several physician characteristics were significantly associated with management decisions. Notably, physician age was inversely correlated with a number of quality-of-care measures. In conclusion, quality of care varies among primary care physicians and appears to be associated with physician characteristics to a greater extent than patient characteristics. PMID:18832109

The Impact of Novice Counselors' Note-Taking Behavior on Recall and Judgment

ERIC Educational Resources Information Center

Lo, Chu-Ling; Wadsworth, John

2014-01-01

Purpose: To examine the effect of note-taking on novice counselors' recall and judgment of interview information in four situations: no notes, taking notes, taking notes and reviewing these notes, and reviewing notes taken by others. Method: The sample included 13 counselors-in-training recruited from a master's level training program in…

Unifying Kohlberg with Information Integration: The Moral Algebra of Recompense and of Kohlbergian Moral Informers

ERIC Educational Resources Information Center

Hommers, Wilfried; Lee, Wha-Yong

2010-01-01

In order to unify two major theories of moral judgment, a novel task is employed which combines elements of Kohlberg's stage theory and of the theory of information integration. In contrast to the format of Kohlberg's moral judgment interview, a nonverbal and quantitative response which makes low demands on verbal facility was used. Moral…

Nurses’ Clinical Judgment Development: A Qualitative Research in Iran

PubMed Central

Seidi, Jamal; Alhani, Fatemeh; Salsali, Mahvash

2015-01-01

Background: Clinical judgment development is necessary because it leads to appropriate nursing diagnoses, clinical decision-making and health promotion. Objectives: In this study we explored the process of Iranian nurses’ development in clinical judgment. Patients and Methods: This qualitative study was conducted in 2013 at hospitals of Kurdistan University of Medical Sciences, located in the Sanandaj city of Iran. The data were collected based on semi-structured interviews and the study included 24 participants. Data analysis was carried out concurrently with data collection using the grounded theory method. Results: The study participants’ main concern was ‘being non-professional in clinical judgment’. In response to this concern, they were struggling for gaining professional autonomy, striving for integrating clinical judgment skills, scrambling to make effective educational interventions and striving for professional and inter professional collaboration in clinical judgment. The core category was ‘struggling for becoming professional in clinical judgment development’. When nurses were supported professionally, they were able to develop their professional clinical judgment. Conclusions: The findings of this study provided critical information about nurses’ professionalization in clinical judgment. Accordingly, the participants adopted different strategies to develop their clinical judgment ability. Integrating these strategies into nursing theory and clinical education can improve nurses’ clinical judgment ability. PMID:26473075

Cultural adaptation of patient and observational outcome measures: a methodological example using the COMFORT behavioral rating scale.

PubMed

Andersen, Randi Dovland; Jylli, Leena; Ambuel, Bruce

2014-06-01

There is little empirical evidence regarding the translation and cultural adaptation of self-report and observational outcome measures. Studies that evaluate and further develop existing practices are needed. This study explores the use of cognitive interviews in the translation and cultural adaptation of observational measures, using the COMFORT behavioral scale as an example, and demonstrates a structured approach to the analysis of data from cognitive interviews. The COMFORT behavioral scale is developed for assessment of distress and pain in a pediatric intensive care setting. Qualitative, descriptive methodological study. One general public hospital trust in southern Norway. N=12. Eight nurses, three physicians and one nurse assistant, from different wards and with experience caring for children. We translated the COMFORT behavior scale into Norwegian before conducting individual cognitive interviews. Participants first read and then used the translated version of the COMFORT behavioral scale to assess pain based on a 3-min film vignette depicting an infant in pain/distress. Two cognitive interview techniques were applied: Thinking Aloud (TA) during the assessment and Verbal Probing (VP) afterwards. In TA the participant verbalized his/her thought process while completing the COMFORT behavioral scale. During VP the participant responded to specific questions related to understanding of the measure, information recall and the decision process. We audio recorded, transcribed and analyzed interviews using a structured qualitative method (cross-case analysis based on predefined categories and development of a results matrix). Our analysis revealed two categories of problems: (1) Scale problems, warranting a change in the wording of the scale, including (a) translation errors, (b) content not understood as intended, and (c) differences between the original COMFORT scale and the revised COMFORT behavioral scale; and (2) Rater-context problems caused by (a) unfamiliarity with the scale, (b) lack of knowledge and experience, and (c) assessments based on a film vignette. Cognitive interviews revealed problems with both the translated and the original versions of the scale and suggested solutions that enhanced the validity of both versions. Cognitive interviews might be seen as a complement to current published best practices for translation and cultural adaptation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Public attitudes towards people with depression in times of uncertainty: results from three population surveys in Germany.

PubMed

Angermeyer, Matthias C; Matschinger, Herbert; Schomerus, Georg

2013-09-01

The recent increase of so-called precarious work conditions plus the current financial crisis have led to a growing sense of uncertainty among the public. This may have repercussions on attitudes towards people with mental illness. Particularly, the public may have become more reluctant to support access to work for these people. In 1990, 2001 and 2011, population surveys were conducted in the "old" states of Germany, using the same sampling procedure, interview mode and measures. Within the context of a fully structured interview respondents were presented a case-vignette depicting a person with symptoms of depression. They were then asked how willing they would be to accept the person in the vignette in various social relationships. While the German public's unwillingness to recommend an individual with depression for a job remained unchanged during the 1990s, it increased significantly during the subsequent decade. By contrast, in all other social relationships studied, no increase of the desire for social distance could be observed during this time period. The trend towards withholding access to jobs was most pronounced among employed respondents. The results of our study underline the importance of macro-social factors for the discrimination of people with mental illness.

Does a Physician’s Attitude toward a Patient with Mental Illness Affect Clinical Management of Diabetes? Results from a Mixed-Method Study

PubMed Central

Welch, Lisa C; Litman, Heather J; Borba, Christina PC; Vincenzi, Brenda; Henderson, David C

2015-01-01

Objective To determine whether physician’s attitudes toward patients with comorbid mental illness affect management of a chronic disease. Data Source A total of 256 primary care physicians interviewed in 2010. Study Design This randomized factorial experiment entailed physicians observing video vignettes of patient-actors with poorly controlled diabetes. Patients were balanced across age, gender, race, and comorbidity (schizophrenia with bizarre or normal affect, depression, eczema). Data Collection Physicians completed structured and semistructured interviews plus chart notes about clinical management and attitudes. Principal Findings Physicians reported more negative attitudes for patients with schizophrenia with bizarre affect (SBA). There were few differences in clinical decisions measured quantitatively or in charting, but qualitative data revealed less trust of patients with SBA as reporters, with more reliance on sources other than engaging the patient in care. Physicians often alerted colleagues about SBA, thereby shaping expectations before interactions occurred. Conclusions Results are consistent with common stereotypes about people with serious mental illness. Vignettes did not include intentional indication of unreliable reporting or danger. Reducing health care disparities requires attention to subtle aspects of managing patients—particularly those with atypical affect—as seemingly slight differences could engender disparate patient experiences over time. PMID:25487069

Post-acute rehabilitation care for older people in community hospitals and general hospitals--philosophies of care and patients' and caregivers' reported experiences: a qualitative study.

PubMed

Small, Neil; Green, John; Spink, Joanna; Forster, Anne; Young, John

2009-01-01

This article contrasts community hospital and general hospital philosophies of care and examines how they relate to patients' and caregivers' experiences. Semi-structured interviews with 42 staff were used to produce care setting vignettes in six community hospitals and four general hospitals in the midlands and north of England. The vignettes were used with 26 patients and 10 caregivers in semi-structured interviews. Community hospital and general hospital staff identified shared understandings of requirements for post-acute rehabilitation care for older people. Distinctive features were: general hospital--medical efficiency, helping patients get better, high standard of care, need for stimulation; community hospital--home-like setting, quiet, calm ambience, good views, orientated to elderly people, encouragement of social interaction, involvement of relatives in care. In the main there was symmetry between staff aspirations and patients' experience. However some concepts used and assumptions made by staff were not recognised by patients. These were characteristically reframed in patients' answers as if they were discussing subjective dimensions of care. There was patient and caregiver preference for the home-like environment of community hospitals. In care of older people, where the focus is rehabilitation, patient preferences are particularly pertinent and should be considered alongside clinical outcomes and cost-effectiveness.

"Passive victim – strong survivor"? Perceived meaning of labels applied to women who were raped

PubMed Central

Papendick, Michael

2017-01-01

Three experiments (total N = 464) were conducted in parallel with English- and German-speaking participants to examine the perceived meanings and effects of the labels "victim" versus "survivor" (and their German equivalents) when applied to a woman who was raped. In Study 1 (N = 179), participants read a rape vignette and then rated the meaning of the label it contained (either "victim" or "survivor") on a 15-item semantic differential. Independent of language and participant gender, "survivor" was perceived more positively overall (e.g., as strong, brave, active) than was "victim" (weak, passive, but also innocent). In Study 2 (N = 95), labels were varied within items assessing judgments of an acquaintance-rape case (e.g., "Does the victim [survivor] … carry a certain responsibility for what happened?"), focusing on short-term outcomes. Significant interaction effects of label and participants’ gender emerged on case-related judgments. Participants in both language samples judged "survivor" to be a less appropriate term than "victim". In Study 3 (N = 190), participants read a text in which a woman who had been raped labeled herself as either "victim" or "survivor", focusing on the coping with sexual violence. As in Study 2, German-language participants showed no significant effects of the label on their case judgments but rejected the term "survivor" as inappropriate; English-language participants, by contrast, perceived the woman describing herself as "survivor" to be more psychologically stable and regarded the use of both labels as appropriate. Results are discussed in terms of their applied relevance for communicating about sexual violence. PMID:28493976

Emotion and Deliberative Reasoning in Moral Judgment

PubMed Central

Cummins, Denise Dellarosa; Cummins, Robert C.

2012-01-01

According to an influential dual-process model, a moral judgment is the outcome of a rapid, affect-laden process and a slower, deliberative process. If these outputs conflict, decision time is increased in order to resolve the conflict. Violations of deontological principles proscribing the use of personal force to inflict intentional harm are presumed to elicit negative affect which biases judgments early in the decision-making process. This model was tested in three experiments. Moral dilemmas were classified using (a) decision time and consensus as measures of system conflict and (b) the aforementioned deontological criteria. In Experiment 1, decision time was either unlimited or reduced. The dilemmas asked whether it was appropriate to take a morally questionable action to produce a “greater good” outcome. Limiting decision time reduced the proportion of utilitarian (“yes”) decisions, but contrary to the model’s predictions, (a) vignettes that involved more deontological violations logged faster decision times, and (b) violation of deontological principles was not predictive of decisional conflict profiles. Experiment 2 ruled out the possibility that time pressure simply makes people more like to say “no.” Participants made a first decision under time constraints and a second decision under no time constraints. One group was asked whether it was appropriate to take the morally questionable action while a second group was asked whether it was appropriate to refuse to take the action. The results replicated that of Experiment 1 regardless of whether “yes” or “no” constituted a utilitarian decision. In Experiment 3, participants rated the pleasantness of positive visual stimuli prior to making a decision. Contrary to the model’s predictions, the number of deontological decisions increased in the positive affect rating group compared to a group that engaged in a cognitive task or a control group that engaged in neither task. These results are consistent with the view that early moral judgments are influenced by affect. But they are inconsistent with the view that (a) violation of deontological principles are predictive of differences in early, affect-based judgment or that (b) engaging in tasks that are inconsistent with the negative emotional responses elicited by such violations diminishes their impact. PMID:22973255

Attitudes and beliefs of the French public about schizophrenia and major depression: results from a vignette-based population survey

PubMed Central

2013-01-01

Background In their study ‘Mental Health in the General Population: Images and Realities’ Jean-Luc Roelandt et al. found a huge divide between the French public’s conceptualizations of insanity and depression. The study aims to examine whether such differences can be replicated using modern operationalized diagnostic criteria for schizophrenia and major depressive disorder. Methods In 2012, an online survey was conducted using a representative sample drawn from the adult French population (N = 1600). After presentation of a case-vignette depicting a person with either schizophrenia or major depressive disorder a fully structured interview was carried out. Results Despite some similarities marked differences between both disorders emerge regarding beliefs and attitudes. While respondents presented with the schizophrenia vignette more frequently defined symptoms as the expression of an illness with a stronger biological component and a less favorable prognosis, demanding psychiatric treatment, respondents presented with the depression vignette considered the occurrence of symptoms more frequently as the consequence of current psychosocial stress, benefitting not only from established but also from alternative treatments. People with schizophrenia were more frequently perceived as unpredictable and dangerous, there was a stronger need to separate one-self from them, they were more frequently met with fear and less frequently reacted to with pro-social feelings, and they also faced more rejection. Conclusions The French public draws a clear line between schizophrenia and major depressive disorder. This applies equally to beliefs about both disorders and to attitudes towards the persons afflicted. There is a need for interventions trying to reduce existing misconceptions in order to improve the care of patients. PMID:24252540

Coordination of knowledge in judging animated motion

NASA Astrophysics Data System (ADS)

Thaden-Koch, Thomas C.; Dufresne, Robert J.; Mestre, Jose P.

2006-12-01

Coordination class theory is used to explain college students’ judgments about animated depictions of moving objects. diSessa’s coordination class theory models a “concept” as a complex knowledge system that can reliably determine a particular type of information in widely varying situations. In the experiment described here, fifty individually interviewed college students judged the realism of two sets of computer animations depicting balls rolling on a pair of tracks. The judgments of students from an introductory physics class were strongly affected by the number of balls depicted (one or two), but the judgments of students from an educational psychology class were not. Coordination analysis of interview transcripts supports the interpretation that physics students’ developing physics knowledge led them to consistently miss or ignore some observations that the other students consistently paid attention to. The analysis highlights the context sensitivity and potential fragility of coordination systems, and leads to the conclusion that students’ developing knowledge systems might not necessarily result in consistently improving performance.

Exploring the theoretical pathways through which asthma app features can promote adolescent self-management.

PubMed

Carpenter, Delesha M; Geryk, Lorie L; Sage, Adam; Arrindell, Courtney; Sleath, Betsy L

2016-12-01

Asthma apps often lack strong theoretical underpinnings. We describe how specific features of asthma apps influenced adolescents' self-observation, self-judgment, and self-reactions, which are key constructs of Self-Regulation Theory (SRT). Adolescents (ages 12-16) with persistent asthma (n = 20) used two asthma self-management apps over a 1-week period. During semi-structured interviews, participants identified their asthma goals and the app features that best promoted self-observation, self-judgment, and fostered positive self-reactions. Interviews were digitally recorded, transcribed verbatim, and analyzed thematically using MAXQDA. Adolescents' goals were to reduce the impact of asthma on their lives. Adolescents reported that self-check quizzes, reminders, and charting features increased their ability to self-observe and self-judge their asthma, which, in turn, helped them feel more confident they could manage their asthma independently and keep their asthma well-controlled. Asthma apps can positively influence adolescents' self-management behaviors via increased self-observation, self-judgment, and increased self-efficacy.

Who Is the Rotten Apple? Mock Jurors' Views of Teacher-Student Sexual Contact.

PubMed

Anderson, Alissa; Wingrove, Twila; Fox, Paul; McLean, Kyle; Styer, Erin

2018-05-01

The present study investigated mock jurors' ( N = 541) perceptions of a hypothetical case of teacher-student sexual contact. Mock jurors read a brief vignette describing an alleged sexual encounter where the gender and age of both the teacher and student were manipulated. Participants rendered legal decisions (i.e., verdict, degree of guilt, and sentence length), as well as culpability judgments pertaining to both the teacher and the student (i.e., blame, cause, and desire for the sexual contact). In addition, the effects of mock juror gender and attitudes regarding both rape myth acceptance and homophobia were investigated. Teacher gender and both teacher and student age predicted mock jurors' recommended sentences, with male teachers, older teachers, and younger students leading to greater sentences. Overall, student age was most consistently related to multiple culpability judgments, and the culpability judgments regarding the victim were the most consistently predicted by the independent variables. We did not find any evidence of homosexist attitudes, meaning that same-gender teacher-student contact was not judged any differently than opposite-gender contact. Worth noting, we found an interaction such that male students victimized by female teachers were judged to have wanted the contact more than any other gender combination, especially by male participants. The authors discuss these findings in the context of the child sexual abuse (CSA) literature concluding that many of the findings of more prototypical CSA cases extend to the teacher-student context. We also discuss the implications of these findings in terms of gendered judgments of adolescents who are victimized by teachers, possibly decided by legal professionals, school administrators, and jurors themselves. In particular, the three-way gender interaction can be interpreted in the context of stereotypes regarding sexual development marking sexual contact between adolescent males and older females as a "rite of passage" into adulthood.

Religious Conviction, Morality and Social Convention among Finnish Adolescents

ERIC Educational Resources Information Center

Vainio, Annukka

2011-01-01

The assumptions of Kohlberg, Turiel and Shweder regarding the features of moral reasoning were compared empirically. The moral reasoning of Finnish Evangelical Lutheran, Conservative Laestadian and non-religious adolescents was studied using Kohlberg's Moral Judgment Interview and Turiel Rule Transgression Interview methods. Religiosity and choice…

The Use of Music and Other Forms of Organized Sound as a Therapeutic Intervention for Students with Auditory Processing Disorder: Providing the Best Auditory Experience for Children with Learning Differences

ERIC Educational Resources Information Center

Faronii-Butler, Kishasha O.

2013-01-01

This auto-ethnographical inquiry used vignettes and interviews to examine the therapeutic use of music and other forms of organized sound in the learning environment of individuals with Central Auditory Processing Disorders. It is an investigation of the traditions of healing with sound vibrations, from its earliest cultural roots in shamanism and…

Sarah's birth. How the medicalisation of childbirth may be shaped in different settings: Vignette from a study of routine intervention in Jeddah, Saudi Arabia.

PubMed

Scamell, Mandie; Altaweli, Roa; McCourt, Christine

2017-02-01

The expansion of the medicalisation of childbirth has been described in the literature as being a global phenomenon. The vignette described in this paper, selected from an ethnographic study of routine intervention in Saudi Arabian hospitals illustrates how the worldwide spread of the bio-medical model does not take place within a cultural vacuum. To illuminate the ways in which the medicalisation of birth may be understood and practised in different cultural settings, through a vignette of a specific birth, drawn as a typical case from an ethnographic study that investigated clinical decision-making in the second stage of labour in Saudi Arabia. Ethnographic data collection methods, including participant observation and interviews. The data presented in this paper are drawn from ethnographic field notes collected during field work in Saudi Arabia, and informed by analysis of a wider set of field notes and interviews with professionals working in this context. While the medicalisation of care is a universal phenomenon, the ways in which the care of women is managed using routine medical intervention are framed by the local cultural context in which these practices take place. The ethnographic data presented in this paper shows the medicalisation of birth thesis to be incomplete. The evidence presented in this paper illustrates how local belief systems are not so much subsumed by the expansion of the bio-medical model of childbirth, rather they may actively facilitate a process of localised reinterpretation of such universalised and standardised practices. In this case, aspects of the social and cultural context of Jeddah operates to intensify the biomedical model at the expense of respectful maternity care. In this article, field note data on the birth of one Saudi Arabian woman is used as an illustration of how the medicalisation of childbirth has been appropriated and reinterpreted in Jeddah, Saudi Arabia. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Clinical Intuition in Family Medicine: More Than First Impressions

PubMed Central

Woolley, Amanda; Kostopoulou, Olga

2013-01-01

PURPOSE The clinical literature advises physicians not to trust their intuition. Studies of clinical intuition, however, equate it to early impressions, the first thing that comes to the physician’s mind. This study aimed to investigate the validity of this perspective by examining real cases of intuition in family medicine. METHODS Eighteen family physicians were interviewed about patient cases in which they believed that they had experienced an intuition. Cases were included if (1) participants were unaware of the basis of their judgment, or (2) participants talked about the basis of their judgment but believed that it was irrational or unsubstantiated. During the interview, case descriptions were systematically probed following the Critical Decision Method. Transcripts were coded for judgments, informational cues, expectancies, goals, and actions and were reordered into chronological accounts of the decision process. The 2 authors independently categorized cases into 3 emerging decision process types. RESULTS Participants reported 31 cases, 24 of which met inclusion criteria. Three types of decision process emerged: gut feelings, recognitions, and insights (κ = 0.78). In all cases, participants thought that their intuitive judgment was in conflict with a more rational explanation or what other colleagues would do. CONCLUSIONS Automatic, nonanalytical processes in clinical judgment extend beyond first impressions. Rather than admonishing clinicians not to trust their intuition, it should be acknowledged that little is currently known about the different types of intuitive processes and what determines their success or failure. Research on the conditions for accurate clinical intuitions is needed. PMID:23319507

Clinical intuition in family medicine: more than first impressions.

PubMed

Woolley, Amanda; Kostopoulou, Olga

2013-01-01

The clinical literature advises physicians not to trust their intuition. Studies of clinical intuition, however, equate it to early impressions, the first thing that comes to the physician's mind. This study aimed to investigate the validity of this perspective by examining real cases of intuition in family medicine. Eighteen family physicians were interviewed about patient cases in which they believed that they had experienced an intuition. Cases were included if (1) participants were unaware of the basis of their judgment, or (2) participants talked about the basis of their judgment but believed that it was irrational or unsubstantiated. During the interview, case descriptions were systematically probed following the Critical Decision Method. Transcripts were coded for judgments, informational cues, expectancies, goals, and actions and were reordered into chronological accounts of the decision process. The 2 authors independently categorized cases into 3 emerging decision process types. Participants reported 31 cases, 24 of which met inclusion criteria. Three types of decision process emerged: gut feelings, recognitions, and insights (κ = 0.78). In all cases, participants thought that their intuitive judgment was in conflict with a more rational explanation or what other colleagues would do. Automatic, nonanalytical processes in clinical judgment extend beyond first impressions. Rather than admonishing clinicians not to trust their intuition, it should be acknowledged that little is currently known about the different types of intuitive processes and what determines their success or failure. Research on the conditions for accurate clinical intuitions is needed.

Promises and Pitfalls of Anchoring Vignettes in Health Survey Research

PubMed Central

Verdes-Tennant, Emese; McEniry, Mary; Ispány, Márton

2016-01-01

Data harmonization is a topic of growing importance to demographers, who increasingly conduct domestic or international comparative research. Many self-reported survey items cannot be directly compared across demographic groups or countries because these groups differ in how they use subjective response categories. Anchoring vignettes, already appearing in numerous surveys worldwide, promise to overcome this problem. However, many anchoring vignettes have not been formally evaluated for adherence to the key measurement assumptions of vignette equivalence and response consistency. This article tests these assumptions in some of the most widely fielded anchoring vignettes in the world: the health vignettes in the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE) and World Health Survey (WHS) (representing 10 countries; n = 52,388), as well as similar vignettes in the Health and Retirement Study (HRS) (n = 4,528). Findings are encouraging regarding adherence to response consistency, but reveal substantial violations of vignette equivalence both cross-nationally and across socioeconomic groups. That is, members of different sociocultural groups appear to interpret vignettes as depicting fundamentally different levels of health. The evaluated anchoring vignettes do not fulfill their promise of providing interpersonally comparable measures of health. Recommendations for improving future implementations of vignettes are discussed. PMID:26335547

President Nixon and the Role of Intelligence in the 1973 Arab-Israeli War

DTIC Science & Technology

2013-01-30

the judgments of the DO, not those of “those DI bastards.” George Lauder , interview by Harold P. Ford, summary notes, Washington, DC, 3 March 1987...hereafter cited as Lauder interview by Ford, 1987) 10 For the INR, CIA, DIA assessments immediately before the Egyptian-Syrian attacks, see Kissinger...text here] interview by Ford, 16 March 1987); Lauder interview by Ford, 1987; [Name not declassifi ed] ex-Intelligence Community Staff offi - cer

From aggregation to interpretation: how assessors judge complex data in a competency-based portfolio.

PubMed

Oudkerk Pool, Andrea; Govaerts, Marjan J B; Jaarsma, Debbie A D C; Driessen, Erik W

2018-05-01

While portfolios are increasingly used to assess competence, the validity of such portfolio-based assessments has hitherto remained unconfirmed. The purpose of the present research is therefore to further our understanding of how assessors form judgments when interpreting the complex data included in a competency-based portfolio. Eighteen assessors appraised one of three competency-based mock portfolios while thinking aloud, before taking part in semi-structured interviews. A thematic analysis of the think-aloud protocols and interviews revealed that assessors reached judgments through a 3-phase cyclical cognitive process of acquiring, organizing, and integrating evidence. Upon conclusion of the first cycle, assessors reviewed the remaining portfolio evidence to look for confirming or disconfirming evidence. Assessors were inclined to stick to their initial judgments even when confronted with seemingly disconfirming evidence. Although assessors reached similar final (pass-fail) judgments of students' professional competence, they differed in their information-processing approaches and the reasoning behind their judgments. Differences sprung from assessors' divergent assessment beliefs, performance theories, and inferences about the student. Assessment beliefs refer to assessors' opinions about what kind of evidence gives the most valuable and trustworthy information about the student's competence, whereas assessors' performance theories concern their conceptualizations of what constitutes professional competence and competent performance. Even when using the same pieces of information, assessors furthermore differed with respect to inferences about the student as a person as well as a (future) professional. Our findings support the notion that assessors' reasoning in judgment and decision-making varies and is guided by their mental models of performance assessment, potentially impacting feedback and the credibility of decisions. Our findings also lend further credence to the assertion that portfolios should be judged by multiple assessors who should, moreover, thoroughly substantiate their judgments. Finally, it is suggested that portfolios be designed in such a way that they facilitate the selection of and navigation through the portfolio evidence.

Do physician outcome judgments and judgment biases contribute to inappropriate use of treatments? Study protocol

PubMed Central

Brehaut, Jamie C; Poses, Roy; Shojania, Kaveh G; Lott, Alison; Man-Son-Hing, Malcolm; Bassin, Elise; Grimshaw, Jeremy

2007-01-01

Background There are many examples of physicians using treatments inappropriately, despite clear evidence about the circumstances under which the benefits of such treatments outweigh their harms. When such over- or under- use of treatments occurs for common diseases, the burden to the healthcare system and risks to patients can be substantial. We propose that a major contributor to inappropriate treatment may be how clinicians judge the likelihood of important treatment outcomes, and how these judgments influence their treatment decisions. The current study will examine the role of judged outcome probabilities and other cognitive factors in the context of two clinical treatment decisions: 1) prescription of antibiotics for sore throat, where we hypothesize overestimation of benefit and underestimation of harm leads to over-prescription of antibiotics; and 2) initiation of anticoagulation for patients with atrial fibrillation (AF), where we hypothesize that underestimation of benefit and overestimation of harm leads to under-prescription of warfarin. Methods For each of the two conditions, we will administer surveys of two types (Type 1 and Type 2) to different samples of Canadian physicians. The primary goal of the Type 1 survey is to assess physicians' perceived outcome probabilities (both good and bad outcomes) for the target treatment. Type 1 surveys will assess judged outcome probabilities in the context of a representative patient, and include questions about how physicians currently treat such cases, the recollection of rare or vivid outcomes, as well as practice and demographic details. The primary goal of the Type 2 surveys is to measure the specific factors that drive individual clinical judgments and treatment decisions, using a 'clinical judgment analysis' or 'lens modeling' approach. This survey will manipulate eight clinical variables across a series of sixteen realistic case vignettes. Based on the survey responses, we will be able to identify which variables have the greatest effect on physician judgments, and whether judgments are affected by inappropriate cues or incorrect weighting of appropriate cues. We will send antibiotics surveys to family physicians (300 per survey), and warfarin surveys to both family physicians and internal medicine specialists (300 per group per survey), for a total of 1,800 physicians. Each Type 1 survey will be two to four pages in length and take about fifteen minutes to complete, while each Type 2 survey will be eight to ten pages in length and take about thirty minutes to complete. Discussion This work will provide insight into the extent to which clinicians' judgments about the likelihood of important treatment outcomes explain inappropriate treatment decisions. This work will also provide information necessary for the development of an individualized feedback tool designed to improve treatment decisions. The techniques developed here have the potential to be applicable to a wide range of clinical areas where inappropriate utilization stems from biased judgments. PMID:17555586

Neural correlates of conventional and harm/welfare-based moral decision-making.

PubMed

White, Stuart F; Zhao, Hui; Leong, Kelly Kimiko; Smetana, Judith G; Nucci, Larry P; Blair, R James R

2017-12-01

The degree to which social norms are processed by a unitary system or dissociable systems remains debated. Much research on children's social-cognitive judgments has supported the distinction between "moral" (harm/welfare-based) and "conventional" norms. However, the extent to which these norms are processed by dissociable neural systems remains unclear. To address this issue, 23 healthy participants were scanned with functional magnetic resonance imaging (fMRI) while they rated the wrongness of harm/welfare-based and conventional transgressions and neutral vignettes. Activation significantly greater than the neutral vignette baseline was observed in regions implicated in decision-making regions including rostral/ventral medial frontal, anterior insula and dorsomedial frontal cortices when evaluating both harm/welfare-based and social-conventional transgressions. Greater activation when rating harm/welfare-based relative to social-conventional transgressions was seen through much of ACC and bilateral inferior frontal gyrus. Greater activation was observed in superior temporal gyrus, bilateral middle temporal gyrus, left PCC, and temporal-parietal junction when rating social-conventional transgressions relative to harm/welfare-based transgressions. These data suggest that decisions regarding the wrongness of actions, irrespective of whether they involve care/harm-based or conventional transgressions, recruit regions generally implicated in affect-based decision-making. However, there is neural differentiation between harm/welfare-based and conventional transgressions. This may reflect the particular importance of processing the intent of transgressors of conventional norms and perhaps the greater emotional content or salience of harm/welfare-based transgressions.

Moral emotions and moral judgments in children's narratives: comparing real-life and hypothetical transgressions.

PubMed

Gutzwiller-Helfenfinger, Eveline; Gasser, Luciano; Malti, Tina

2010-01-01

How children make meaning of their own social experiences in situations involving moral issues is central to their subsequent affective and cognitive moral learning. Our study of young children's narratives describing their interpersonal conflicts shows that the emotions and judgments constructed in the course of these real-life narratives differ from the emotions and judgments generated in the context of hypothetical transgressions. In the narratives, all emotions mentioned spontaneously were negative. In contrast, emotions attributed in the interview part covered a broader spectrum. One's own real-life transgressions were judged less severe and more justified than hypothetical transgressions. © Wiley Periodicals, Inc.

Health Care Students’ Attitudes About Alcohol Consumption During Pregnancy: Responses to Narrative Vignettes

PubMed Central

Coons, Kelly D.; Watson, Shelley L.; Yantzi, Nicole M.; Lightfoot, Nancy E.; Larocque, Sylvie

2017-01-01

This article explores medical, midwifery, and nurse practitioner students’ attitudes about women who may consume alcohol throughout their pregnancies. Twenty-one health care students responded to a scenario-based vignette addressing alcohol consumption during pregnancy, as well as a semistructured interview, which were analyzed using Braun and Clarke’s thematic analysis approach. Two primary themes related to students’ attitudes concerning alcohol consumption during pregnancy were identified: (a) divergent recommendations for different women, based on perceptions of their level of education, culture/ethnicity, and ability to stop drinking; and (b) understanding the social determinants of health, including the normalization of women’s alcohol consumption and potential partner violence. Health care professionals in training need further education about the risks of alcohol consumption during pregnancy and fetal alcohol spectrum disorder (FASD). In addition, health care students need training in how to engage in reflective practice to identify their own stereotypical beliefs and attitudes and how these attitudes may affect their practice. PMID:29164171

Moral Judgments of In-Group and Out-Group Harm in Post-conflict Urban and Rural Croatian Communities

PubMed Central

Moncrieff, Michael A.; Lienard, Pierre

2018-01-01

Our research brings to light features of the social world that impact moral judgments and how they do so. The moral vignette data presented were collected in rural and urban Croatian communities that were involved to varying degrees in the Croatian Homeland War. We argue that rapid shifts in moral accommodations during periods of violent social strife can be explained by considering the role that coordination and social agents' ability to reconfigure their social network (i.e., relational mobility) play in moral reasoning. Social agents coordinate on (moral) norms, a general attitude which broadly facilitates cooperation, and makes possible the collective enforcement of compliance. During social strife interested parties recalibrate their determination of others' moral standing and recast their established moral circle, in accordance with their new or prevailing social investments. To that extent, social coordination—and its particular promoters, inhibitors, and determinants—effects significant changes in individuals' ranking of moral priorities. Results indicate that rural participants evaluate the harmful actions of third parties more harshly than urban participants. Coordination mediates that relationship between social environment and moral judgment. Coordination also matters more for the moral evaluation of the harmful actions of moral scenarios involving characters belonging to different social units than for scenarios involving characters belonging to the same group. Participants high in relational mobility—that ability to recompose one's social network—moralize similarly wrongdoings perpetrated by both in- and out-group members. Those low in relational mobility differentiate when an out-group member causes the harm. Additionally, perceptions of third-party guilt are also affected by specifics of the social environment. Overall, we find that social coordination and relational mobility affect moral reasoning more so than ethnic commitment. PMID:29527183

The effects of physical activity vignettes on physical activity-related social cognitions among people with spinal cord injury.

PubMed

Foulon, Brianne L; Ginis, Kathleen A Martin

2013-01-01

The purpose of this study was to explore the effectiveness of informational portrait vignettes for enhancing physical activity-related psychosocial cognitions in adults with spinal cord injury (n = 90). Using the Health Action Process Approach (HAPA), participants were classified as being in the motivational or volitional phase of behavior change. Half of the participants were randomly allocated to read an experimental vignette, which described the physical activity behaviours, thoughts, and feelings of a character demographically similar to the reader. The remainder read a control vignette. Social cognitions were measured one-week before, and immediately after reading the vignette. Analyses revealed no significant effects of the vignettes on social cognitions (p > 0.05). Informational portrait vignettes describing a physically active person with SCI and targeting multiple HAPA-based social cognitions are not recommended as a physical activity promotional strategy for people with SCI. The effectiveness of other types of vignettes should be examined. Until further research is completed to determine whether social comparison strategies play a meditational role in accounting for the impact of a tailored informational portrait vignette to alter leisure time physical activity among those with spinal cord injury, these types of informational intervention should not be utilized in a rehabilitation, or real-world, setting. Although informational portrait vignettes may not be effective in altering leisure time physical activity social cognitions among those with spinal cord injury, different types of vignettes, such as composite vignettes, should be explored.

Client Verbal and Nonverbal Reinforcement of Counselor Behavior: Its Impact on Interviewing Behavior and Postinterview Evaluation.

ERIC Educational Resources Information Center

Lee, Dong Yul; And Others

1979-01-01

Examined effects of client reinforcement on counselor behavior and on attitudinal judgments about the client. Counselor-trainees interviewed a standard client. Counselors in verbal and verbal plus nonverbal conditions showed increases in reflection of feeling statements. Differences in counselor attraction and clinical impression of the client…

The Disputatiousness of Canadian Politicians of Education: A Partial Report of a National Study.

ERIC Educational Resources Information Center

Townsend, Richard G.

For an exploration of the components and sources of disputatiousness, Canadian education administrators identified 181 legislators and school board members in 5 regions (British Columbia, Quebec, Prairie provinces, Atlantic provinces, and Ontario) who provided data in interviews. Two coders' judgments of interview transcripts subjected to factor…

Exploring the Educational Value of Clinical Vignettes from the Society of General Internal Medicine National Meeting in the Internal Medicine Clerkship

PubMed Central

Wofford, James L; Singh, Sonal

2006-01-01

INTRODUCTION Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE To explore the relevance and learning value of clinical vignettes from the SGIM national meeting in the Internal Medicine clerkship. SETTING Third year Ambulatory Internal Medicine clerkship at one academic medical center (academic year 2005 to 2006). METHODS Students were introduced to the clinical vignette and oriented to the database of clinical vignettes available through the SGIM annual meeting website. Students then reviewed 5 to 10 clinical vignettes using a worksheet, and rated the learning value of each vignette using a 5-point Likert scale (1 = least, 5 = greatest). A single investigator evaluated congruence of the vignette with the Clerkship Directors of Internal Medicine (CDIM)-SGIM curriculum to assess relevance. MAIN RESULTS A total of 42 students evaluated 371 clinical vignettes from the 2004 and 2005 meetings. The clinical vignettes were curriculum-congruent in 42.6% (n = 175), and clearly incongruent in 40.4% (n = 164). The mean rating for learning value was 3.8 (±1.0) (5 signifying greatest learning value). Curriculum-congruent vignettes had a higher mean learning value compared with curriculum-incongruent vignettes (4.0 vs 3.6, Student's t-test, P =.017). CONCLUSION The clinical vignettes presented at the national SGIM meeting offer clinical content that is relevant and of some educational value for third year clerkship students. Based on this pilot study, the educational value and strategies for their use in the clinical clerkships deserve further study. PMID:17026730

Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study

PubMed Central

2015-01-01

Objective To evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management. Methods A multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others. Results Thirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001). Conclusions Dynamic case-vignettes accurately reflect actual practices in complex emergency situations. Therefore, they can be used to assess the quality of management in these situations. PMID:26383261

Interviewing Suspects in Denial: On How Different Evidence Disclosure Modes Affect the Elicitation of New Critical Information

PubMed Central

May, Lennart; Granhag, Pär Anders; Tekin, Serra

2017-01-01

This study examines how different evidence disclosure modes affect the elicitation of new critical information. Two modes derived from the Strategic Use of Evidence (SUE) framework were compared against an early disclosure mode (i.e., the evidence was disclosed at the outset of the interview). Participants (N = 88) performed a mock crime consisting of several actions before they were interviewed as suspects. In both SUE conditions the interviewer elicited and disclosed statement-evidence inconsistencies in two phases after an introductory phase. For the SUE-Confrontation (SUE-C) condition, the interview was introduced in a business-like manner, and the interviewer confronted the suspects with the in/consistencies without giving them a chance to comment on these. For the SUE-Introduce-Present-Respond (SUE-IPR) condition, the interviewer introduced the interview in a non-guilt-presumptive way, presented the in/consistencies and allowed the suspects to comment on these, and then responded to their comments; at all times in a non-judgmental manner. Both SUE conditions generated comparatively more statement-evidence inconsistencies. The SUE-IPR condition resulted in more new critical information about the phase of the crime for which the interviewer lacked information, compared to the Early disclosure condition. A likely explanation for this was that (for the SUE-IPR condition) the interviewer used the inconsistencies to create a fostering interview atmosphere and made the suspects overestimate the interviewer's knowledge about the critical phase of the crime. In essence, this study shows that in order to win the game (i.e., obtaining new critical information), the interviewer needs to keep the suspect in the game (i.e., by not being too confrontational and judgmental). PMID:28769829

Interviewing Suspects in Denial: On How Different Evidence Disclosure Modes Affect the Elicitation of New Critical Information.

PubMed

May, Lennart; Granhag, Pär Anders; Tekin, Serra

2017-01-01

This study examines how different evidence disclosure modes affect the elicitation of new critical information. Two modes derived from the Strategic Use of Evidence (SUE) framework were compared against an early disclosure mode (i.e., the evidence was disclosed at the outset of the interview). Participants ( N = 88) performed a mock crime consisting of several actions before they were interviewed as suspects. In both SUE conditions the interviewer elicited and disclosed statement-evidence inconsistencies in two phases after an introductory phase. For the SUE-Confrontation (SUE-C) condition, the interview was introduced in a business-like manner, and the interviewer confronted the suspects with the in/consistencies without giving them a chance to comment on these. For the SUE-Introduce-Present-Respond (SUE-IPR) condition, the interviewer introduced the interview in a non-guilt-presumptive way, presented the in/consistencies and allowed the suspects to comment on these, and then responded to their comments; at all times in a non-judgmental manner. Both SUE conditions generated comparatively more statement-evidence inconsistencies. The SUE-IPR condition resulted in more new critical information about the phase of the crime for which the interviewer lacked information, compared to the Early disclosure condition. A likely explanation for this was that (for the SUE-IPR condition) the interviewer used the inconsistencies to create a fostering interview atmosphere and made the suspects overestimate the interviewer's knowledge about the critical phase of the crime. In essence, this study shows that in order to win the game (i.e., obtaining new critical information), the interviewer needs to keep the suspect in the game (i.e., by not being too confrontational and judgmental).

Emergency physicians' knowledge and attitudes of clinical decision support in the electronic health record: a survey-based study.

PubMed

Ballard, Dustin W; Rauchwerger, Adina S; Reed, Mary E; Vinson, David R; Mark, Dustin G; Offerman, Steven R; Chettipally, Uli K; Graetz, Ilana; Dayan, Peter; Kuppermann, Nathan

2013-04-01

The objective was to investigate clinician knowledge of and attitudes toward clinical decision support (CDS) and its incorporation into the electronic health record (EHR). This was an electronic survey of emergency physicians (EPs) within an integrated health care delivery system that uses a complete EHR. Randomly assigned respondents completed one of two questionnaires, both including a hypothetical vignette and self-reported knowledge of and attitudes about CDS. One vignette version included CDS, and the other did not (NCDS). The vignette described a scenario in which a cranial computed tomography (CCT) is not recommended by validated prediction rules (the Pediatric Emergency Care Applied Research Network [PECARN] rules). In both survey versions, subjects responded first with their likely approach to evaluation and then again after receiving either CDS (the PECARN prediction rules) or no additional support. Descriptive statistics were used for self-reported responses and multivariate logistic regression was used to identify predictors of self-reported knowledge and use of the PECARN rules, as well as use of vignette responses. There were 339 respondents (68% response rate), with 172 of 339 (51%) randomized to the CDS version. Initially, 25% of respondents to each version indicated they would order CCTs. After CDS, 30 of 43 (70%) of respondents who initially would order CCTs changed their management decisions to no CCT versus two of 41 (5%) with the NCDS version (chi-square, p = 0.003). In response to self-report questions, 81 of 338 respondents (24%) reported having never heard of the PECARN prediction rules, 122 of 338 (36%) were aware of the rules but not their specifics, and 135 of 338 (40%) reported knowing the rules and their specifics. Respondents agreed with favorable statements about CDS (75% to 96% agreement across seven statements) and approaches to its implementation into the EHR (60% to 93% agreement across seven statements). In multivariable analyses, EPs with tenure of 5 to 14 years (odds ratio [AOR] = 0.51, 95% confidence interval [CI] = 0.30 to 0.86) and for 15 years or more (AOR = 0.37, 95% CI = 0.20 to 0.70) were significantly less likely to report knowing the specifics of the PECARN prediction rules compared with EPs who practiced for fewer than 5 years. In addition, in the initial vignette responses (across both versions), physicians with ≥15 years of ED tenure compared to those with fewer than 5 years of experience (AOR = 0.30, 95% CI = 0.13 to 0.69), and those reporting knowing the specifics of the PECARN prediction rules were less likely to order CCTs (AOR = 0.53, 95% CI = 0.30 to 0.92). EPs incorporated pediatric head trauma CDS via the EHR into their clinical judgment in a hypothetical scenario and reported favorable opinions of CDS in general and their inclusion into the EHR. © 2013 by the Society for Academic Emergency Medicine.

The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth.

PubMed

Yap, Marie Bee Hui; Jorm, Anthony Francis

2011-11-01

Young people are an important source of first aid for mental health problems in people they are close to, but their first aid skills remain inadequate. Research into the factors that influence mental health first aid skills are required to reveal targets for improving these skills. This study examined the influence of stigma on first aid actions taken by young people to help someone close to them with a mental health problem. Participants in a national telephone survey of Australian youth (aged 12-25 years) reported on their stigmatising attitudes based on one of three disorders in vignettes: depression, depression with alcohol misuse, and social phobia. At a two-year follow-up interview, they were asked if they knew a family member or close friend with a problem similar to the vignette character since the initial interview, and those who did reported on the actions taken to help the person. Of the 1520 participants interviewed at follow up, 507 reported knowing someone with a similar problem. Young people's stigmatising attitudes (weak-not-sick, social distance and dangerousness/unpredictability) influenced their first aid actions. Social desirability could have affected the assessment of stigma, we could not assess the severity of the first aid recipient's problem or the benefit derived from the first aid provided, and the proportion of variance explained was modest. Reducing stigma may help to improve the first aid that people with mental health problems can receive from young people who are close to them. Copyright © 2011 Elsevier B.V. All rights reserved.

We perceive a mind in a robot when we help it

PubMed Central

Hashimoto, Takaaki; Karasawa, Kaori

2017-01-01

People sometimes perceive a mind in inorganic entities like robots. Psychological research has shown that mind perception correlates with moral judgments and that immoral behaviors (i.e., intentional harm) facilitate mind perception toward otherwise mindless victims. We conducted a vignette experiment (N = 129; Mage = 21.8 ± 6.0 years) concerning human-robot interactions and extended previous research’s results in two ways. First, mind perception toward the robot was facilitated when it received a benevolent behavior, although only when participants took the perspective of an actor. Second, imagining a benevolent interaction led to more positive attitudes toward the robot, and this effect was mediated by mind perception. These results help predict what people’s reactions in future human-robot interactions would be like, and have implications for how to design future social rules about the treatment of robots. PMID:28727735

Child Rearing Antecedents of Identification Model in Young Adult Men: Dominance and Emotional Intimacy.

ERIC Educational Resources Information Center

Luetgert, M. J.; Greenwald, Barry S.

Seventy-five male Ph.D. candidates were interviewed individually to determine which parent seemed more influential as an identification model. The interview also yielded judgments as to which parent offered more emotional intimacy and which parent was dominant in the family. A chi-square analysis between these characteristics and judged…

A Randomized Trial Testing the Impact of Narrative Vignettes vs. Guideline Summaries on Provider Response to a Professional Organization Clinical Policy for Safe Opioid Prescribing

PubMed Central

Meisel, Zachary F.; Metlay, Joshua P.; Sinnenberg, Lauren; Kilaru, Austin S.; Grossestreuer, Anne; Barg, Frances K.; Shofer, Frances S.; Rhodes, Karin V.; Perrone, Jeanmarie

2016-01-01

Background Clinical guidelines are known to be underused by practitioners. In response to the challenges of treating pain amidst a prescription opioid epidemic, the American College of Emergency Physicians published an evidence-based clinical policy for opioid prescribing in 2012. Evidence-based narratives, an effective method of communicating health information in a variety of settings, offer a novel strategy for disseminating guidelines to physicians and engaging providers with clinical evidence. Objectives To compare whether narrative vignettes embedded in the American College of Emergency Physician (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared to traditional summary text. Methods A prospective randomized controlled study, entitled Stories to Promote Information using Narrative (SPIN) trial, was performed. Derived from qualitative interviews with 61 ACEP physicians, 4 narrative vignettes were selected and refined, using a consensus panel of clinical and implementation experts. All ACEP members were then block randomized by state of residence to receive alternative versions of a daily emailed newsletter for a total of 24 days during a 9 week period. Narrative newsletters contained a selection of vignettes that referenced opioid prescription dilemmas. Control newsletters contained a selection of descriptive text about the clinical policy using similar length and appearance to the narrative vignettes. Embedded in the newsletters were web links to the complete vignette or traditional summary text, as well as additional links to the full ACEP clinical policy and a website providing assistance with prescription drug monitoring program enrollment. The newsletters were otherwise identical. Outcomes measured were the percentage of subjects who visited any of the web pages that contained additional guideline related information and the odds of any unique physician visiting these web pages during the study. Results 27,592 physicians were randomized and 21,226 received the newsletter during the study period. When counting each physician once over the study period, there were 509 unique visitors in the narrative group and 173 unique visitors in the control group (4.8% vs. 1.6%, difference 3.2% 95%CI 2.7%-3.7%). There were 744 gross visits from the e-newsletter to any of the three web pages in the narrative group compared to 248 in the control group (7.0% vs. 2.3%, OR 3.2 (95% CI 2.7-3.6). Over the course of the study, the odds ratio of any physician in the narrative group visiting one of the three informational web sites compared to the control group was 3.1 (95% CI 2.6-3.6). Conclusion Among a national sample of emergency physicians, narrative vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions. PMID:27133392

'Heart attack' symptoms and decision-making: the case of older rural women.

PubMed

Jackson, M N G; McCulloch, B J

2014-01-01

Women are just as vulnerable to 'heart attacks' (used throughout this study to mean 'myocardial infarction') as men and are often unaware of many associated symptoms. Researchers have illustrated that women have difficulty identifying the symptoms of cardiovascular disease, with patients often delaying treatment after the onset of symptoms. Some individuals wait hours or even days before seeking medical care. This is particularly concerning for older rural women because the rates of death from cardiovascular disease and cancer are higher in some rural areas. Despite idealistic views of country life as being active, less stressful, and possessing strong social and community support, rural Americans are more likely than their urban counterparts to face challenges to maintaining health.
The purpose of this paper is to utilize information gathered from a qualitative study exploring older rural women's identification of symptoms and health decision-making specific to heart attack vignettes. Snowball sampling was the main approach utilized to access participants; after an initial contact was successful, participants contacted additional older rural women to see if they might be willing to participate in an interview. This resulted in a final sample of 33 women who resided in rural Midwestern areas of the USA, were 65 years or older, lived in a county defined as rural by the US Census, and were willing to participate in a face-to-face interview. Each interview included a demographic questionnaire, a health questionnaire, and three health vignettes with follow-up questions. Vignettes provided a way of initiating discussions about health decisions without invading the privacy known to be important to rural residents. The term 'heart attack' was used in the interviews because it was thought to be better recognised than the medical term 'myocardial infarction'. All data were audio taped, transcribed, and coded using line-by-line coding. Data were analyzed using content analysis. The study showed that women had difficulty identifying heart attack symptoms when they did not have previous exposure to the symptoms either through personal experience or educational programs. Individuals incorrectly identified symptoms of a heart attack by associating symptoms with sleep problems, stroke, arthritis, stiffness in the neck, influenza, nerve damage, osteoporosis, bone cancer, tooth infection, and a pulled muscle. Misdiagnosis of symptoms most often led to a delay in seeking treatment in these women. Additionally, the women in this study discussed a reluctance to access care because of concerns related to maintaining their privacy, belief that the ambulance would take too long to reach them, and they did not want to bother their relatives for help. The findings of this study suggest implications for educational programs and interventions in rural environments and provide information that can facilitate better-informed communication between healthcare professionals and rural women.

Learning to think like a nurse: stories from new nurse graduates.

PubMed

Etheridge, Sharon A

2007-01-01

One aim of nursing education is to help students learn to be beginning practitioners, which includes making clinical judgments that ensure patient safety. Clinical judgments often determine how quickly nurses detect a life-threatening complication, how soon patients leave the hospital, or how quickly patients learn to take care of themselves. However, current research shows that new graduates do not perform well when making clinical judgments, despite having graduated from accredited schools of nursing and passing the NCLEX examination. This descriptive, qualitative study examined the perceptions of recent nursing graduates about learning to make clinical judgments. Graduates with baccalaureate degrees in nursing were interviewed three times in 9 months to determine their perceptions of how they learned to think like nurses. The results of this study should be useful in identifying strategies to help new graduates make the transition from students to registered nurses.

Slipping Anchor? Testing the Vignettes Approach to Identification and Correction of Reporting Heterogeneity

ERIC Educational Resources Information Center

d'Uva, Teresa Bago; Lindeboom, Maarten; O'Donnell, Owen; van Doorslaer, Eddy

2011-01-01

We propose tests of the two assumptions under which anchoring vignettes identify heterogeneity in reporting of categorical evaluations. Systematic variation in the perceived difference between any two vignette states is sufficient to reject "vignette equivalence." "Response consistency"--the respondent uses the same response…

Imagining wrong: Fictitious contexts mitigate condemnation of harm more than impurity.

PubMed

Sabo, John S; Giner-Sorolla, Roger

2017-01-01

Over 5 experiments, we test the fictive pass asymmetry hypothesis. Following observations of ethics and public reactions to media, we propose that fictional contexts, such as reality, imagination, and virtual environments, will mitigate people's moral condemnation of harm violations, more so than purity violations. That is, imagining a purely harmful act is given a "fictive pass," in moral judgment, whereas imagining an abnormal act involving the body is evaluated more negatively because it is seen as more diagnostic of bad character. For Experiment 1, an undergraduate sample (N = 250) evaluated 9 vignettes depicting an agent committing either violations of harm or purity in real life, watching them in films, or imagining them. For Experiments 2 and 3, online participants (N = 375 and N = 321, respectively) evaluated a single vignette depicting an agent committing a violation of harm or purity that either occurred in real life, was imagined, watched in a film, or performed in a video game. Experiment 4 (N = 348) used an analysis of moderated mediation to demonstrate that the perceived wrongness of fictional purity violations is explained both by the extent to which they are seen as a cue to, and a cause of, a poor moral character. Lastly, Experiment 5 (N = 484) validated our manipulations and included the presumption of desire as an additional mediator of the fictive pass asymmetry effects. We discuss implications for moral theories of act and character, anger and disgust, and for media use and regulation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Development of Clinical Vignettes to Describe Alzheimer's Disease Health States: A Qualitative Study

PubMed Central

Oremus, Mark; Xie, Feng; Gaebel, Kathryn

2016-01-01

Aims To develop clinical descriptions (vignettes) of life with Alzheimer’s disease (AD), we conducted focus groups of persons with AD (n = 14), family caregivers of persons with AD (n = 20), and clinicians who see persons with AD in their practices (n = 5). Methods Group participants read existing descriptions of AD and commented on the realism and comprehensibility of the descriptions. We used thematic framework analysis to code the comments into themes and develop three new vignettes to describe mild, moderate, and severe AD. Results Themes included the types of symptoms to mention in the new vignettes, plus the manner in which the vignettes should be written. Since the vignette descriptions were based on focus group participants’ first-hand knowledge of AD, the descriptions can be said to demonstrate content validity. Conclusion Members of the general public can read the vignettes and estimate their health-related quality-of-life (HRQoL) as if they had AD based on the vignette descriptions. This is especially important for economic evaluations of new AD medications, which require HRQoL to be assessed in a manner that persons with AD often find difficult to undertake. The vignettes will allow the general public to serve as a proxy and provide HRQoL estimates in place of persons with AD. PMID:27589604

New relationships and intimacy in long-term care: The views of relatives of residents with dementia and care home staff.

PubMed

Wiskerke, Esther; Manthorpe, Jill

2018-05-01

Background There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives' feelings, managing their possible distress and conflict. Methods This exploratory study investigated the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person. It reports the themes that emerged in qualitative interviews with eight relatives of people with dementia and with 12 frontline care home staff working in two English care homes. Interviews took place in 2015 using a hypothetical vignette that unfolded in four stages. Thematic analysis was used to analyse the data. Findings The views of care home staff and relatives had similarities in general terms regarding the problems arising around expressions of sexuality in care homes: indicting that a light-hearted or non-physical connection between residents is deemed acceptable, but the moment it becomes a sexual relationship then decision making becomes more complicated. Staff were inclined to turn to managers for advice and to consider separating residents. They expressed familiarity with distracting residents from situations that were of concern. Relatives were considerate of the difficulties and dilemmas faced by care home staff. Conclusion The use of a vignette facilitated discussion of a potentially sensitive topic. Areas for further research are identified.

Measuring Management Abilities and Motivation.

ERIC Educational Resources Information Center

Howard, Ann

1983-01-01

The complexity of managerial abilities and motivation is displayed in the assessment center method, where judgments depend on a comprehensive package of such techniques as paper-and-pencil tests, interviews, simulations, and projective tests. (Author)

28 CFR 802.29 - Exemption of the Pretrial Services Agency System.

Code of Federal Regulations, 2010 CFR

2010-07-01

...). (iii) Interview and Treatment Files (CSOSA/PSA-3). (iv) Pretrial Realtime Information Systems Manager... of a criminal or other investigation. (B) Relevancy and necessity are questions of judgment and...

28 CFR 802.29 - Exemption of the Pretrial Services Agency System.

Code of Federal Regulations, 2011 CFR

2011-07-01

...). (iii) Interview and Treatment Files (CSOSA/PSA-3). (iv) Pretrial Realtime Information Systems Manager... of a criminal or other investigation. (B) Relevancy and necessity are questions of judgment and...

Professional identity as a resource for talk: exploring the mentor-student relationship.

PubMed

Shakespeare, Pam; Webb, Christine

2008-12-01

This paper discusses a study examining how mentors in nurse education make professional judgments about the clinical competence of their pre-registration nursing students. Interviews were undertaken with nine UK students and 15 mentors, using critical incidents in practice settings as a focus. The study was undertaken for the English National Practice-Based Professional Learning Centre for Excellence in Teaching and Learning. This paper reports on the conversation analytic thread of the work. The mentor role with pre-registration nursing students is not only supportive but involves formal assessment. Central to the relationship is communication. In professional education, communication is seen as a skill to be applied and assessed in practice settings but is also the medium mentors and mentees use to talk about the relationship. Analysis of excerpts of conversation in the interviews shows that episodes of communication are used as topics of conversation to establish professional identity. It also reveals that judgments about the extent of professional capacity of both students and mentors are grounded in everyday behaviours (for example, enthusiasm, indifference and confidence) as well as professional competence. In addition to focusing on clinical issues, mentors can and do use mundane communication as a resource for judgments about competence.

Expert scientific judgment and cancer risk assessment: a pilot study of pharmacokinetic data.

PubMed

Hawkins, N C; Graham, J D

1988-12-01

When high-dose tumor data are extrapolated to low doses, it is typically assumed that the dose of a carcinogen delivered to target cells is proportional to the dose administered to test animals, even at exposure levels below the experimental range. Since pharmacokinetic data are becoming available that in some cases question the validity of this assumption, risk assessors must decide whether to maintain the standard assumption. A pilot study of formaldehyde is reported that was undertaken to demonstrate how expert scientific judgment can help guide a controversial risk assessment where pharmacokinetic data are considered inconclusive. Eight experts on pharmacokinetic data were selected by a formal procedure, and each was interviewed personally using a structured interview protocol. The results suggest that expert scientific opinion is polarized in this case, a situation that risk assessors can respond to with a range of risk characterizations considered biologically plausible by the experts. Convergence of expert opinion is likely in this case of several specific research strategies ar executed in a competent fashion. Elicitation of expert scientific judgment is a promising vehicle for evaluating the quality of pharmacokinetic data, expressing uncertainty in risk assessment, and fashioning a research agenda that offers possible forging of scientific consensus.

Ageism and Gender among Social Work and Criminal Justice Students

ERIC Educational Resources Information Center

Kane, Michael N.

2006-01-01

Undergraduate social work and criminal justice students completed 1 of 4 vignettes that were identical with the exception of the age and gender of the vignette's subject. In each vignette, the subject interacted with an opposite-sex 24-year-old waiter or waitress. Following each vignette, respondents answered 20 items relating to the age, gender,…

The Effects of Vignette Placement on Attitudes toward Supporting Family Members

ERIC Educational Resources Information Center

Lau, Charles Q.; Seltzer, Judith A.; Bianchi, Suzanne M.

2016-01-01

Vignettes are useful for measuring norms and beliefs, but little is known about how vignette placement affects responses to subsequent attitude questions. We investigate how the placement of a vignette about parents and adult children living together affects answers to subsequent questions about family obligations in a survey of the U.S.…

Using Vignettes To Build and Assess Teacher Understanding of Instructional Strategies

ERIC Educational Resources Information Center

Jeffries, Carolyn; Maeder, Dale W.

2005-01-01

In the last fifty years, the use of stories in education has included vignettes as an effective stimulus for discussion of real-life contexts and problems. However, vignettes have rarely been used as an assessment tool and there is no reported consensus on their definition and design. This article documents the use of vignettes as an effective…

Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education

ERIC Educational Resources Information Center

Benner, Patricia

2004-01-01

Three studies using the Dreyfus model of skill acquisition were conducted over a period of 21 years. Nurses with a range of experience and reported skillfulness were interviewed. Each study used nurses' narrative accounts of actual clinical situations. A subsample of participants were observed and interviewed at work. These studies extend the…

Principle-based ethics and nurses' attitudes towards artificial feeding.

PubMed

Day, L; Drought, T; Davis, A J

1995-02-01

Nurses often institute artificial feeding for patients who would otherwise starve. Recently, the courts in the United States have favoured withholding or withdrawing feedings from patients who currently refuse or previously gave some indication they would refuse artificial nutrition and hydration. This paper investigates under what circumstances nurses feel justified in withholding artificial nutrition and hydration. Structured interviews were conducted with 40 cancer care nurses from two sites, and 40 dementia care nurses from two sites. The interviews were based on two vignettes, one involving an alert patient with terminal cancer, the other a patient suffering end-stage Alzheimer's dementia, and were analysed for themes coinciding with principles of deontological ethics. Investigators found that autonomy, beneficence and non-maleficence most often guided nurses' decisions to withhold or implement artificial feeding.

Gender-dependence of substituted judgment on quality of life in patients with dementia

PubMed Central

2011-01-01

Background Substituted judgment asks the proxy to decide what the patient would have decided, had he or she been competent. It is unclear whether substituted judgment of the patient's quality of life can serve as a surrogate measure in patients with dementia. Methods 212 patients with dementia and their proxies were interviewed in their homes. Dementia syndrome was characterized with cognitive, non-cognitive and functional scales. Quality of life (QoL) was assessed with the QoL-AD. Results Substituted judgment of the patient's QoL was unrelated to dementia severity but also correlated with the proxie's own QoL (r = 0.356; p < 0.001). Gender-specific analysis reveals that for male proxies the most important variable is severity of patient's depression (r = -0.895; p = 0.001) while for female proxies it is the proxie's own QoL (r = 0.371; p < 0.001). Subjective burden correlates with the proxie's QoL in females (r = -0.282; p = 0.001) but not in males (r = -0.163, p = 0.161). Conclusion Substituted judgment of the patient's QoL does not correlate with dementia severity. Substituted judgment is subject to proxy-related variables in a gender-dependent fashion and therefore not suited to serve as an appropriate surrogate of the patients' quality of life. PMID:21961477

Treatment acceptability and preferences for managing severe health anxiety: Perceptions of internet-delivered cognitive behaviour therapy among primary care patients.

PubMed

Soucy, Joelle N; Hadjistavropoulos, Heather D

2017-12-01

While cognitive behaviour therapy (CBT) is an established treatment for health anxiety, there are barriers to service access. Internet-delivered cognitive behaviour therapy (ICBT) has demonstrated effectiveness and has the potential to improve access to treatment. Nevertheless, it is unknown how patients perceive ICBT relative to other interventions for health anxiety and what factors predict ICBT acceptability. This study investigated these questions. Primary care patients (N = 116) who reported elevated levels of health anxiety were presented three treatment vignettes that each described a different protocol for health anxiety (i.e., medication, CBT, ICBT). Acceptability and credibility of the treatments were assessed following the presentation of each vignette. Participants then ranked the three treatments and provided a rational for their preferences. The treatments were similarly rated as moderately acceptable. Relative to medication and ICBT, CBT was perceived as the most credible treatment for health anxiety. The highest preference ranks were for CBT and medication. Regression analyses indicated that lower computer anxiety, past medication use, and lower ratings of negative cognitions about difficulty coping with an illness significantly predicted greater ICBT acceptability. Health anxiety was not assessed with a diagnostic interview. Primary care patients were recruited through a Qualtrics panel. Patients did not have direct experience with treatment but learned about treatment options through vignettes. Medication and CBT are preferred over ICBT. If ICBT is to increase treatment access, methods of improving perceptions of this treatment option are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Creating a Novel Video Vignette Stroke Preparedness Outcome Measure Using a Community-Based Participatory Approach.

PubMed

Skolarus, Lesli E; Murphy, Jillian B; Dome, Mackenzie; Zimmerman, Marc A; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B

2015-07-01

Evaluating the efficacy of behavioral interventions for rare outcomes is a challenge. One such topic is stroke preparedness, defined as inteventions to increase stroke symptom recognition and behavioral intent to call 911. Current stroke preparedness intermediate outcome measures are centered on written vignettes or open-ended questions and have been shown to poorly reflect actual behavior. Given that stroke identification and action requires aural and visual processing, video vignettes may improve on current measures. This article discusses an approach for creating a novel stroke preparedness video vignette intermediate outcome measure within a community-based participatory research partnership. A total of 20 video vignettes were filmed of which 13 were unambiguous (stroke or not stroke) as determined by stroke experts and had test discrimination among community participants. Acceptable reliability, high satisfaction, and cultural relevance were found among the 14 community respondents. A community-based participatory approach was effective in creating a video vignette intermediate outcome. Future projects should consider obtaining expert and community feedback prior to filming all the video vignettes to improve the proportion of vignettes that are usable. While content validity and preliminary reliability were established, future studies are needed to confirm the reliability and establish construct validity. © 2014 Society for Public Health Education.

Creating a Novel Video Vignette Stroke Preparedness Outcome Measure using a Community Based Participatory Approach

PubMed Central

Skolarus, Lesli E.; Murphy, Jillian B.; Dome, Mackenzie; Zimmerman, Marc A.; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B.

2015-01-01

Evaluating the efficacy of behavioral interventions for rare outcomes is a challenge. One such topic is stroke preparedness, defined as inteventions to increase stroke symptom recognition and behavioral intent to call 911. Current stroke preparedness intermediate outcome measures are centered on written vignettes or open ended questions and have been shown to poorly reflect actual behavior. Given that stroke identification and action requires aural and visual processing, video vignettes may improve upon current measures. This article discusses an approach for creating a novel stroke preparedness video vignette intermediate outcome measure within a community based participatory research partnership. A total of 20 video vignettes were filmed of which 13 were unambiguous (stroke or not stroke) as determined by stroke experts and had test discrimination among community participants. Acceptable reliability, high satisfaction and cultural relevance were found among the 14 community respondents. A community based participatory approach was effective in creating a video vignette intermediate outcome. Future projects should consider obtaining expert and community feedback prior to filming all the video vignettes to improve the proportion of vignettes that are usable. While content validity and preliminary reliability were established, future studies are needed to confirm the reliability and establish construct validity. PMID:25367896

Slipping Anchor? Testing the Vignettes Approach to Identification and Correction of Reporting Heterogeneity

PubMed Central

d’Uva, Teresa Bago; Lindeboom, Maarten; O’Donnell, Owen; van Doorslaer, Eddy

2011-01-01

We propose tests of the two assumptions under which anchoring vignettes identify heterogeneity in reporting of categorical evaluations. Systematic variation in the perceived difference between any two vignette states is sufficient to reject vignette equivalence. Response consistency - the respondent uses the same response scale to evaluate the vignette and herself – is testable given sufficiently comprehensive objective indicators that independently identify response scales. Both assumptions are rejected for reporting of cognitive and physical functioning in a sample of older English individuals, although a weaker test resting on less stringent assumptions does not reject response consistency for cognition. PMID:22184479

Physician Bayesian updating from personal beliefs about the base rate and likelihood ratio.

PubMed

Rottman, Benjamin Margolin

2017-02-01

Whether humans can accurately make decisions in line with Bayes' rule has been one of the most important yet contentious topics in cognitive psychology. Though a number of paradigms have been used for studying Bayesian updating, rarely have subjects been allowed to use their own preexisting beliefs about the prior and the likelihood. A study is reported in which physicians judged the posttest probability of a diagnosis for a patient vignette after receiving a test result, and the physicians' posttest judgments were compared to the normative posttest calculated from their own beliefs in the sensitivity and false positive rate of the test (likelihood ratio) and prior probability of the diagnosis. On the one hand, the posttest judgments were strongly related to the physicians' beliefs about both the prior probability as well as the likelihood ratio, and the priors were used considerably more strongly than in previous research. On the other hand, both the prior and the likelihoods were still not used quite as much as they should have been, and there was evidence of other nonnormative aspects to the updating, such as updating independent of the likelihood beliefs. By focusing on how physicians use their own prior beliefs for Bayesian updating, this study provides insight into how well experts perform probabilistic inference in settings in which they rely upon their own prior beliefs rather than experimenter-provided cues. It suggests that there is reason to be optimistic about experts' abilities, but that there is still considerable need for improvement.

Working with Parents of Aggressive Children: Clinical Vignettes.

ERIC Educational Resources Information Center

Mordock, John B.

1988-01-01

Seven brief clinical vignettes are presented, illustrating principles of intervention with parents of aggressive children. The vignettes describe family relationships; parents' feelings toward counselors, especially anger; counseling techniques; actions taken by counselors; and outcomes of treatment. (JDD)

The use of vignettes to empower effective responses to attempted sexual assault.

PubMed

Allen, Kaylie T; Meadows, Elizabeth A

2017-01-01

Women assertively resisting sexual aggression have the best chances of avoiding completed rape. Especially with acquaintances, there are significant social and psychological barriers to resistance. Novel vignettes depicting acquaintance rape were designed to enhance self-efficacy, reduce unrealistic optimism, and empower assertive resistance. The data were collected using a Web-based survey of 449 female college students from multiple universities in August-October 2014. Between-subjects mixed-methods design. Participants were randomly assigned to read one of four vignettes and complete self-report measures of personal vulnerability, self-efficacy, and beliefs and intention about resistance. Although vignettes did not impact self-efficacy, one vignette enhanced perceived controllability and decreased unrealistic optimism. Women who read about completed acquaintance rape described intention to use physically assertive responses at double the rate of women reading about successful resistance. As low-cost, easily disseminated materials, vignettes about sexual assault may enhance campus prevention efforts.

The value of case-based teaching vignettes in clinical microbiology rounds.

PubMed

Spicer, Jennifer O; Kraft, Colleen S; Burd, Eileen M; Armstrong, Wendy S; Guarner, Jeannette

2014-03-01

To describe the implementation and evaluation of a case-based microbiology curriculum during daily microbiology rounds. Vignettes consist of short cases with images and questions that facilitate discussion among microbiologists, pathologists, infectious disease physicians, and trainees (residents and fellows). We performed a survey to assess the value of these vignettes to trainees. Motivation to come to rounds on time increased from 60% to 100%. Trainees attending rounds after implementation of the vignettes perceived the value of microbiology rounds to be significantly higher compared with those who attended rounds before implementation (P = .04). Pathology residents found that vignettes were helpful for retaining knowledge (8.3 of 10 points). The vignettes have enhanced the value of microbiology rounds by serving as a formalized curriculum exposing trainees from multiple specialties to various microbiology topics. Emphasis on interdisciplinary interactions between clinical and laboratory personnel was highlighted with this case-based curriculum.

Bench-marking effects in the blaming of professionals for incidents of aggression and assault.

PubMed

Carifio, J; Lanza, M

1994-01-01

This study compared all possible orders of responding to three vignettes describing incidents between a male patient and a female nurse in which the nurse is mildly assaulted, severely assaulted, or verbally abused by the patient (the control condition). Subjects were 32 female senior-year nursing students and 28 practicing nurses. It was found that response levels to a given vignette could predict a respondent's response to the other vignettes. Also, a significant "bench-marking" effect was found: if a subject responded to the mild assault vignette first, the subject's overall response pattern best fit the general nonlinear assignment-of-blame pattern observed, but if the subject responded to the severe assault or control vignette first, this vignette set a bench mark for responding from which the subject's subsequent responses did not deviate greatly, which slightly distorted the subject's V-shaped nonlinear response pattern.

Contracts, covenants and advance care planning: an empirical study of the moral obligations of patient and proxy.

PubMed

Fins, Joseph J; Maltby, Barbara S; Friedmann, Erika; Greene, Michele G; Norris, Kaye; Adelman, Ronald; Byock, Ira

2005-01-01

Previously we had speculated that the patient-proxy relationship existed on a contractual to covenantal continuum. In order to assess this hypothesis, and to better understand the moral obligations of the patient-proxy relationship, we surveyed 50 patient-proxy pairs as well as 52 individuals who had acted as proxies for someone who had died. Using structured vignettes representative of three distinct disease trajectories (cancer, acute stroke, and congestive heart failure), we assessed whether respondents believed that proxies should follow explicit instructions regarding life-sustaining therapy and act contractually or whether more discretionary or covenantal judgments were ethically permissible. Additional variables included the valence of initial patient instructions--for example, "to do nothing" or "to do everything"--as well as the quality of information available to the proxy. Responses were graded on a contractual to covenantal continuum using a modified Likert scale employing a prospectively scored survey instrument. Our data indicate that the patient-proxy relationship exists on a contractual to covenantal continuum and that variables such as disease trajectory, the clarity of prognosis, instructional valence, and the quality of patient instructions result in statistically significant differences in response. The use of interpretative or covenantal judgment was desired by patients and proxies when the prognosis was grim, even if initial instructions were to pursue more aggressive care. Nonetheless, there was a valence effect: patients and proxies intended that negative instructions to be left alone be heeded. These data suggest that the delegation of patient self-determination is morally complex. Advance care planning should take into account both the exercise of autonomy and the interpretative burdens assumed by the proxy. Patients and proxies think inductively and contextually. Neither group viewed deviation from patient instructions as a violation of the principal's autonomy. Instead of adhering to narrow notions of patient self-determination, respondents made nuanced and contextually informed moral judgments. These findings have implications for patient education as well as the legal norms that guide advance care planning.

Physicians' response to sexual dysfunction presented by a younger vs. An older adult.

PubMed

Gewirtz-Meydan, Ateret; Ayalon, Liat

2017-12-01

The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction presented by older vs. younger patients in terms of attributed diagnosis, etiology, proposed treatment and perceived prognosis. An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by the age of the patient (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an "old" vignette and 126 physicians received a "young" vignette. Even though both cases presented with a clear psychosocial etiology, the "older" vignette was more likely to be diagnosed with erectile dysfunction whereas the "younger" vignette was more likely to be diagnosed with performance anxiety. The "older" vignette's dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend testosterone replacement therapy (TRT) and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) as well as a referral to urology to the "older" vignette. In contrast, the "younger" vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the tendency to prescribe PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Opinions of the Dutch public on palliative sedation: a mixed-methods approach

PubMed Central

van der Kallen, Hilde TH; Raijmakers, Natasja JH; Rietjens, Judith AC; van der Male, Alex A; Bueving, Herman J; van Delden, Johannes JM; van der Heide, Agnes

2013-01-01

Background Palliative sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim To inform healthcare professionals about attitudes of the general public regarding palliative sedation. Design and setting A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing palliative sedation (response rate 78%); 16 participants were interviewed. Results In total, 22% of the responders indicated knowing the term ‘palliative sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient’s life (79%, P = 0.54). Conclusion Most of the general public accept the use of palliative sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what palliative sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options. PMID:24152482

Assessment of competence to complete advance directives: validation of a patient centred approach

PubMed Central

Fazel, Seena; Hope, Tony; Jacoby, Robin

1999-01-01

Objective To develop a patient centred approach for the assessment of competence to complete advance directives (“living wills”) of elderly people with cognitive impairment. Design Semistructured interviews. Setting Oxfordshire. Subjects 50 elderly volunteers living in the community, and 50 patients with dementia on first referral from primary care. Main outcome measures Psychometric properties of competence assessment. Results This patient centred approach for assessing competence to complete advance directives can discriminate between elderly persons living in the community and elderly patients with dementia. The procedure has good interrater (r=0.95) and test-retest (r=0.97) reliability. Validity was examined by relating this approach with a global assessment of competence to complete an advance directive made by two of us (both specialising in old age psychiatry). The data were also used to determine the best threshold score for discriminating between those competent and those incompetent to complete an advance directive. Conclusion A patient centred approach to assess competence to complete advance directives can be reliably and validly used in routine clinical practice. Key messagesAdvance directives could potentially be useful for patients with dementia as a means of extending their autonomy when they become incompetentCompetence to complete an advance directive involves understanding possible future clinical situationsVignettes presenting hypothetical medical problems were tested in 100 elderly people, and were found to validly and reliably discriminate between volunteers living in the community and patients with dementiaWe suggest that two clinical vignettes, each followed by a semistructured interview comprising 10 points, can aid in the assessment of competence to complete advance directives PMID:10024254

Mental health literacy in higher education students.

PubMed

Reavley, Nicola J; McCann, Terence V; Jorm, Anthony F

2012-02-01

With approximately 50% of young people aged 18-24 in tertiary education, these are potential settings for programmes to improve mental health literacy. A survey was carried out with students and staff of a tertiary education institution to investigate recognition of depression, help-seeking intentions, beliefs about interventions and stigmatizing attitudes. Students of an Australian metropolitan university (with staff as a comparison group) participated in a telephone interview. They answered questions relating to mental health literacy. Of the completed interviews, 774 (65%) were students and 422 (35%) were staff. Over 70% of students and staff were able to recognize depression in a vignette, with greater likelihood of recognition in students associated with older age, female gender, being born in Australia and a higher level of education. Over 80% of respondents said they would seek help if they had a problem similar to that of the vignette. However, rates of specific help-seeking intentions for students were relatively low, with only 26% nominating a general practitioner and only 10% nominating a student counsellor. Factors associated with stigmatizing attitudes included male gender, younger age, lower level of education, being born outside Australia and lack of recognition of depression. There is a need for mental health literacy interventions targeted at students, particularly those who are younger, male, born outside Australia and of a lower level of education. As rates of specific help-seeking intentions for students were relatively low, there is a need for further exploration of the barriers to help seeking from professional sources. © 2011 Blackwell Publishing Asia Pty Ltd.

How supportive supervision influences immunization session site practices: a quasi-experimental study in Odisha, India.

PubMed

Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Chauhan, Abhimanyu S; Anasuya, Anita; Som, Meena; Zodpey, Sanjay

2015-01-01

Routine immunization (RI) is a key child survival intervention. Ensuring acceptable standards of RI service delivery is critical for optimal outcomes. Accumulated evidences suggest that 'supportive supervision' improves the quality of health care services in general. During 2009-2010, the Government of Odisha and UNICEF jointly piloted this strategy in four districts to improve RI program outcomes. The present study aims to assess the effect of this strategy on improvement of skills and practices at immunization session sites. A quasi-experimental 'post-test only' study design was adopted to compare the opinion and practices of frontline health workers and their supervisors in four intervention districts (IDs) with two control districts (CDs). Altogether, we interviewed 111 supervisor-supervisee (health worker) pairs using semi-structured interview schedules and case vignettes. We also directly observed health workers' practices during immunization sessions at 111 sites. Data were analyzed with SPSS version 16.0. The mean knowledge score of supervisors in CDs was significantly higher than in intervention groups. Variegated responses were obtained on case vignettes. The control group performed better in solving certain hypothetically asked problems, whereas the intervention group scored better in others. Health workers in IDs gave a lower rating to their respective supervisors' knowledge, skill, and frequency of supervision. Logistics and vaccine availability were better in CDs. Notwithstanding other limitations, supportive supervision may not have independent effects on improving the quality of immunization services. Addressing systemic issues, such as the availability of essential logistics, supply chain management, timely indenting, and financial resources, could complement the supportive supervision strategy in improving immunization service delivery.

Opinions of the Dutch public on palliative sedation: a mixed-methods approach.

PubMed

van der Kallen, Hilde T H; Raijmakers, Natasja J H; Rietjens, Judith A C; van der Male, Alex A; Bueving, Herman J; van Delden, Johannes J M; van der Heide, Agnes

2013-10-01

Palliative sedation is defined as deliberately lowering a patient's consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. To inform healthcare professionals about attitudes of the general public regarding palliative sedation. design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing palliative sedation (response rate 78%); 16 participants were interviewed. In total, 22% of the responders indicated knowing the term 'palliative sedation'. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient's life (79%, P = 0.54). Most of the general public accept the use of palliative sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what palliative sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options.

Rape blame as a function of alcohol presence and resistance type.

PubMed

Sims, Calvin M; Noel, Nora E; Maisto, Stephen A

2007-12-01

Attributions of rape blame may be related to variables such as alcohol presence and resistance type used during a sexual assault. The current study sought to assess participants' attributions of responsibility for a sexual assault based on these two variables through the use of several written scenarios. Two hundred and thirteen male and female college students participated in the study. Results indicated that responsibility ratings given to the victim varied by the presence of alcohol but not by resistance type. If the female target had been drinking, she was judged as being more responsible for the assault than if she had not been drinking. However, how she resisted the assault did not affect ratings of her responsibility. Additionally, participant gender was found to not be an important factor for attributing blame to the woman target. Future research should focus on two important factors: 1) how participants' judgments of blame may change during actual alcohol administration and 2) how the use of video, rather than written vignettes, may produce stronger effects.

Moral anger, but not moral disgust, responds to intentionality.

PubMed

Russell, Pascale Sophie; Giner-Sorolla, Roger

2011-04-01

We propose that, when people judge moral situations, anger responds to the contextual cues of harm and intentionality. On the other hand, disgust responds uniquely to whether or not a bodily norm violation has occurred; its apparent response to harm and intent is entirely explained by the coactivation of anger. We manipulated intent, harm, and bodily norm violation (eating human flesh) within a vignette describing a scientific experiment. Participants then rated their anger, disgust, and moral judgment, as well as various appraisals. Anger responded independently of disgust to harm and intentionality, whereas disgust responded independently of anger only to whether or not the act violated the bodily norm of cannibalism. Theoretically relevant appraisals accounted for the effects of harm and intent on anger; however, appraisals of abnormality did not fully account for the effects of the manipulations on disgust. Our results show that anger and disgust are separately elicited by different cues in a moral situation. PsycINFO Database Record (c) 2011 APA, all rights reserved.

[Social reasoning of early adolescents and parents regarding parent-child conflicts].

PubMed

Utsumi, Shoka

2015-08-01

Few researches have delineated how adolescents and parents view conflict in familial settings in Japan. Seventh and eighth grade junior high school students (n = 63) and parents (n = 68) were asked to complete a questionnaire using four hypothetical stories to investigate their judgments and reasoning about parent-child situations. Vignettes described health management, household chores, and two situations involving personal choice (clothes and friends) situations. Participants responded differently to personal, prudential, and conventional conflict. Parental acceptance of the child's demands and discretion and the child's tendency to reject parental authority were significantly higher for personal than for conventional or prudential conflict, and for conventional than for prudential conflict. Children rejected parental authority more than adults rejected parental authority when the child's choice was central to the child's identity; on the other hand, children accepted parents' conventional demands more often than adults accepted parents' conventional demands. These results suggest that early adolescents assert their rights when they judge the situation to be in the personal domain.

Risks with older adults in acute care settings: UK occupational therapists' and physiotherapists' perceptions of risks associated with discharge and professional practice.

PubMed

Atwal, Anita; McIntyre, Anne; Wiggett, Claire

2012-06-01

Internationally, there is evidence that hospital discharge to home for older adults is a complex and challenging process that is dependent upon multidisciplinary team working. At the centre of the discharge process is the management of risk, which involves occupational therapists and other healthcare professionals managing perceived dangers and determining why some dangers are seen as presenting risks while others are not. This study did not aim to explore interprofessional differences but to ascertain a greater understanding of professionals' perceptions of risk in acute care settings. This qualitative study utilised 12 semi-structured interviews with seven occupational therapists and five physiotherapists in the United Kingdom (UK). During the interview, therapists were asked to read and answer questions on a validated vignette. The interview data were subjected to thematic content analysis and the vignettes to template analysis. Our research is one of the first studies to explore therapists' perceptions of risk with older adults in acute care settings. Our study has highlighted that perception of risk does have an impact on discharge decision-making and location. Therapists used negative terminology to refer to patients who wanted to take risks, which could be a reflection of the therapists' anxiety. Mental capacity, and patients' functioning and safety were key factors in risk decision-making with older adults. Our research has highlighted the potential value of multidisciplinary working to manage risk situations and the need for reflection and discussion regarding how persons who do not have capacity wishes are managed within acute care settings. There is a need to develop an interprofessional care pathway to guide clinicians through the risk decision-making process which needs to ensure that the client's opinions and wishes are taken into account throughout. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

The effect of sleep deprivation on vocal expression of emotion in adolescents and adults.

PubMed

McGlinchey, Eleanor L; Talbot, Lisa S; Chang, Keng-Hao; Kaplan, Katherine A; Dahl, Ronald E; Harvey, Allison G

2011-09-01

Investigate the impact of sleep deprivation on vocal expression of emotion. Within-group repeated measures analysis involving sleep deprivation and rested conditions. Experimental laboratory setting. Fifty-five healthy participants (24 females), including 38 adolescents aged 11-15 y and 17 adults aged 30-60 y. A multimethod approach was used to examine vocal expression of emotion in interviews conducted at 22:30 and 06:30. On that night, participants slept a maximum of 2 h. Interviews were analyzed for vocal expression of emotion via computerized text analysis, human rater judgments, and computerized acoustic properties. Computerized text analysis and human rater judgments indicated decreases in positive emotion in all participants at 06:30 relative to 22:30, and adolescents displayed a significantly greater decrease in positive emotion via computerized text analysis relative to adults. Increases in negative emotion were observed among all participants using human rater judgments. Results for the computerized acoustic properties indicated decreases in pitch, bark energy (intensity) in certain high frequency bands, and vocal sharpness (reduction in high frequency bands > 1000 Hz). These findings support the importance of sleep for healthy emotional functioning in adults, and further suggest that adolescents are differentially vulnerable to the emotional consequences of sleep deprivation.

In person versus Computer Screening for Intimate Partner Violence Among Pregnant Patients

PubMed Central

Dado, Diane; Schussler, Sara; Hawker, Lynn; Holland, Cynthia L.; Burke, Jessica G.; Cluss, Patricia A.

2012-01-01

Objective To compare in person versus computerized screening for intimate partner violence (IPV) in a hospital-based prenatal clinic and explore women’s assessment of the screening methods. Methods We compared patient IPV disclosures on a computerized questionnaire to audio-taped first obstetric visits with an obstetric care provider and performed semi-structured interviews with patient participants who reported experiencing IPV. Results Two-hundred and fifty patient participants and 52 provider participants were in the study. Ninety-one (36%) patients disclosed IPV either via computer or in person. Of those who disclosed IPV, 60 (66%) disclosed via both methods, but 31 (34%) disclosed IPV via only one of the two methods. Twenty-three women returned for interviews. They recommended using both types together. While computerized screening was felt to be non-judgmental and more anonymous, in person screening allowed for tailored questioning and more emotional connection with the provider. Conclusion Computerized screening allowed disclosure without fear of immediate judgment. In person screening allows more flexibility in wording of questions regarding IPV and opportunity for interpersonal rapport. Practice Implications Both computerized or self-completed screening and in person screening is recommended. Providers should address IPV using non-judgmental, descriptive language, include assessments for psychological IPV, and repeat screening in person, even if no patient disclosure occurs via computer. PMID:22770815

In person versus computer screening for intimate partner violence among pregnant patients.

PubMed

Chang, Judy C; Dado, Diane; Schussler, Sara; Hawker, Lynn; Holland, Cynthia L; Burke, Jessica G; Cluss, Patricia A

2012-09-01

To compare in person versus computerized screening for intimate partner violence (IPV) in a hospital-based prenatal clinic and explore women's assessment of the screening methods. We compared patient IPV disclosures on a computerized questionnaire to audio-taped first obstetric visits with an obstetric care provider and performed semi-structured interviews with patient participants who reported experiencing IPV. Two-hundred and fifty patient participants and 52 provider participants were in the study. Ninety-one (36%) patients disclosed IPV either via computer or in person. Of those who disclosed IPV, 60 (66%) disclosed via both methods, but 31 (34%) disclosed IPV via only one of the two methods. Twenty-three women returned for interviews. They recommended using both types together. While computerized screening was felt to be non-judgmental and more anonymous, in person screening allowed for tailored questioning and more emotional connection with the provider. Computerized screening allowed disclosure without fear of immediate judgment. In person screening allows more flexibility in wording of questions regarding IPV and opportunity for interpersonal rapport. Both computerized or self-completed screening and in person screening is recommended. Providers should address IPV using non-judgmental, descriptive language, include assessments for psychological IPV, and repeat screening in person, even if no patient disclosure occurs via computer. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Community beliefs about treatments and outcomes of mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

PubMed

Kermode, M; Bowen, K; Arole, S; Joag, K; Jorm, A F

2009-07-01

Mental health remains a neglected issue in most developing countries, especially in rural areas where access to effective mental health services is limited. The integration of mental health into primary health care is being promoted as a strategy to address this problem. Consequently, there is an urgent need to enhance mental health awareness among communities, and to provide mental health training for primary healthcare staff. In order to do this effectively, it is important to understand and take account of local views on mental health and illness. As such, a mental health literacy (MHL) assessment was undertaken in a poor, rural area of Maharashtra, India to inform the development of a mental health training programme. A cross-sectional MHL survey was undertaken in late 2007. Data were collected from 240 systematically sampled community members and 60 purposively sampled village health workers (VHWs) using an interviewer-administered questionnaire. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked to name the problems, and to identify the treatments and people that were most likely to be helpful (or otherwise), and the likely outcomes for people with such problems. Most participants recognized that the people in the vignettes were experiencing a mental health problem. 'Depression' was the most common label for the problems experienced in the depression vignette, and 'a mind/brain problem' was the most common label in the case of the psychosis vignette. Socio-economic interventions provided by family, friends and neighbours were considered to be most helpful. Local VHWs and doctors were also viewed as potentially helpful, but psychiatrists less so. Approximately half of the sample thought that dealing with the problem alone would be helpful. Special diets, tonics, appetite stimulants and sleeping pills were also strongly endorsed, but awareness of psychiatric medications was negligible. The findings from this study highlight the need to enhance MHL in this community. Additionally, there is a need to build the capacity of the primary healthcare staff, including the VHWs, so that they are equipped to provide an effective local response for people experiencing mental health problems.

Changing attitudes towards obesity - results from a survey experiment.

PubMed

Luck-Sikorski, C; Riedel-Heller, S G; Phelan, J C

2017-05-02

This experimental study in a population-based sample aimed to compare attitudes towards obesity following three different causal explanations for obesity (individual behavior, environmental factors, genetic factors). The data were derived from an online representative sample. A random subsample of n = 407 participants was included. Two independent variables were investigated: cause of obesity as described in the vignette and cause of obesity as perceived by the participant regardless of vignette. Quality features of the vignettes (accuracy and bias of the vignette) were introduced as moderators to regression models. Three stigma-related outcomes (negative attitudes, blame and social distance) served as dependent variables. Inaccuracy and bias was ascribed to the social environmental and genetic vignettes more often than to the individual cause vignette. Overall, participants preferred individual causes (72.6%). While personal beliefs did not differ between the genetic and environmental cause conditions (Chi 2  = 4.36, p = 0.113), both were different from the distribution seen in the individual cause vignette. Negative attitudes as well as blame were associated with the belief that individuals are responsible for obesity (b = 0.374, p = 0.003; 0.597, p < 0.001), but were not associated with vignette-manipulated causal explanation. The vignette presenting individual responsibility was associated with lower levels of social distance (b = -0.183, p = 0.043). After including perceived inaccuracy and bias as moderators, the individual responsibility vignette was associated with higher levels of blame (emphasis: b = 0.980, p = 0.010; bias: b = 0.778, p = 0.001) and the effect on social distance vanished. This study shows that media and public health campaigns may solidify beliefs that obesity is due to individual causes and consequently increase stigma when presenting individual behavior as a cause of obesity. Public health messages that emphasize the role of social environmental or genetic causes may be ineffective because of entrenched beliefs.

Instructional Vignettes in Publication and Journalism Ethics in Radiology Research: Assessment via a Survey of Radiology Trainees.

PubMed

Rosenkrantz, Andrew B; Ginocchio, Luke A

2016-07-01

The aim of the present study was to assess the potential usefulness of written instructional vignettes relating to publication and journalism ethics in radiology via a survey of radiology trainees. A literature review was conducted to guide the development of vignettes, each describing a scenario relating to an ethical issue in research and publication, with subsequent commentary on the underlying ethical issue and potential approaches to its handling. Radiology trainees at a single institution were surveyed regarding the vignettes' perceived usefulness. A total of 21 vignettes were prepared, addressing institutional review board and human subjects protection, authorship issues, usage of previous work, manuscript review, and other miscellaneous topics. Of the solicited trainees, 24.7% (16/65) completed the survey. On average among the vignettes, 94.0% of the participants found the vignette helpful; 19.9 received prior formal instruction on the issue during medical training; 40.0% received prior informal guidance from a research mentor; and 42.0% indicated that the issue had arisen in their own or a peer's prior research experience. The most common previously experienced specific issue was authorship order (93.8%). Free-text responses were largely favorable regarding the value of the vignettes, although also indicated numerous challenges in properly handling the ethical issues: impact of hierarchy, pressure to publish, internal politics, reluctance to conduct sensitive conversations with colleagues, and variability in journal and professional society policies. Radiology trainees overall found the vignettes helpful, addressing commonly encountered topics for which formal and informal guidance were otherwise lacking. The vignettes are publicly available through the Association of University Radiologists (AUR) website and may foster greater insights by investigators into ethical aspects of the publication and journalism process, thus contributing to higher quality radiology research. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Information quantity and quality affect the realistic accuracy of personality judgment.

PubMed

Letzring, Tera D; Wells, Shannon M; Funder, David C

2006-07-01

Triads of unacquainted college students interacted in 1 of 5 experimental conditions that manipulated information quantity (amount of information) and information quality (relevance of information to personality), and they then made judgments of each others' personalities. To determine accuracy, the authors compared the ratings of each judge to a broad-based accuracy criterion composed of personality ratings from 3 types of knowledgeable informants (the self, real-life acquaintances, and clinician-interviewers). Results supported the hypothesis that information quantity and quality would be positively related to objective knowledge about the targets and realistic accuracy. Interjudge consensus and self-other agreement followed a similar pattern. These findings are consistent with expectations based on models of the process of accurate judgment (D. C. Funder, 1995, 1999) and consensus (D. A. Kenny, 1994). Copyright 2006 APA, all rights reserved.

Vignettes: Implications for LIS Research

ERIC Educational Resources Information Center

Benedetti, Allison; Jackson, John; Luo, Lili

2018-01-01

Vignettes, brief descriptions of fictional characters and situations, serve as a tool to study people's lives, perceptions, beliefs, and attitudes about specific situations. Although not widely used in library and information science (LIS) research, vignettes can depersonalize responses to controversial situations or behavioral responses related…

Improving communication of breast cancer recurrence risk.

PubMed

Brewer, Noel T; Richman, Alice R; DeFrank, Jessica T; Reyna, Valerie F; Carey, Lisa A

2012-06-01

Doctors commonly use genomic testing for breast cancer recurrence risk. We sought to assess whether the standard genomic report provided to doctors is a good approach for communicating results to patients. During 2009-2010, we interviewed 133 patients with stages I or II, node-negative, hormone receptor-positive breast cancer and eligible for the Oncotype DX genomic test. In a randomized experiment, patients viewed six vignettes that presented hypothetical recurrence risk test results. Each vignette described a low, intermediate, or high chance of breast cancer recurrence in 10 years. Vignettes used one of five risk formats of increasing complexity that we derived from the standard report that accompanies the commercial assay or a sixth format that used an icon array. Among women who received the genomic recurrence risk test, 63% said their doctors showed them the standard report. The standard report format yielded among the most errors in identification of whether a result was low, intermediate, or high risk (i.e., the gist of the results), whereas a newly developed risk continuum format yielded the fewest errors (17% vs. 5%; OR 0.23; 95% CI 0.10-0.52). For high recurrence risk results presented in the standard format, women made errors 35% of the time. Women rated the standard report as one of the least understandable and least-liked formats, but they rated the risk continuum format as among the most understandable and most liked. Results differed little by health literacy, numeracy, prior receipt of genomic test results during clinical care, and actual genomic test results. The standard genomic recurrence risk report was more difficult for women to understand and interpret than the other formats. A less complex report, potentially including the risk continuum format, would be more effective in communicating test results to patients.

Development and validation of the social information processing application: a Web-based measure of social information processing patterns in elementary school-age boys.

PubMed

Kupersmidt, Janis B; Stelter, Rebecca; Dodge, Kenneth A

2011-12-01

The purpose of this study was to evaluate the psychometric properties of an audio computer-assisted self-interviewing Web-based software application called the Social Information Processing Application (SIP-AP) that was designed to assess social information processing skills in boys in 3rd through 5th grades. This study included a racially and ethnically diverse sample of 244 boys ages 8 through 12 (M = 9.4) from public elementary schools in 3 states. The SIP-AP includes 8 videotaped vignettes, filmed from the first-person perspective, that depict common misunderstandings among boys. Each vignette shows a negative outcome for the victim and ambiguous intent on the part of the perpetrator. Boys responded to 16 Web-based questions representing the 5 social information processing mechanisms, after viewing each vignette. Parents and teachers completed measures assessing boys' antisocial behavior. Confirmatory factor analyses revealed that a model positing the original 5 cognitive mechanisms fit the data well when the items representing prosocial cognitions were included on their own factor, creating a 6th factor. The internal consistencies for each of the 16 individual cognitions as well as for the 6 cognitive mechanism scales were excellent. Boys with elevated scores on 5 of the 6 cognitive mechanisms exhibited more antisocial behavior than boys whose scores were not elevated. These findings highlight the need for further research on the measurement of prosocial cognitions or cognitive strengths in boys in addition to assessing cognitive deficits. Findings suggest that the SIP-AP is a reliable and valid tool for use in future research of social information processing skills in boys.

Development and Validation of the Social Information Processing Application: A Web-Based Measure of Social Information Processing Patterns in Elementary School-Age Boys

PubMed Central

Kupersmidt, Janis B.; Stelter, Rebecca; Dodge, Kenneth A.

2013-01-01

The purpose of this study was to evaluate the psychometric properties of an audio computer-assisted self-interviewing Web-based software application called the Social Information Processing Application (SIP-AP) that was designed to assess social information processing skills in boys in 3rd through 5th grades. This study included a racially and ethnically diverse sample of 244 boys ages 8 through 12 (M = 9.4) from public elementary schools in 3 states. The SIP-AP includes 8 videotaped vignettes, filmed from the first-person perspective, that depict common misunderstandings among boys. Each vignette shows a negative outcome for the victim and ambiguous intent on the part of the perpetrator. Boys responded to 16 Web-based questions representing the 5 social information processing mechanisms, after viewing each vignette. Parents and teachers completed measures assessing boys’ antisocial behavior. Confirmatory factor analyses revealed that a model positing the original 5 cognitive mechanisms fit the data well when the items representing prosocial cognitions were included on their own factor, creating a 6th factor. The internal consistencies for each of the 16 individual cognitions as well as for the 6 cognitive mechanism scales were excellent. Boys with elevated scores on 5 of the 6 cognitive mechanisms exhibited more antisocial behavior than boys whose scores were not elevated. These findings highlight the need for further research on the measurement of prosocial cognitions or cognitive strengths in boys in addition to assessing cognitive deficits. Findings suggest that the SIP-AP is a reliable and valid tool for use in future research of social information processing skills in boys. PMID:21534693

The Power of the Right Vignette

ERIC Educational Resources Information Center

Darvin, Jacqueline

2017-01-01

Cultural Political Vignettes (CPVs) are hypothetical situations involving ethical or social dilemmas presented to students in the form of brief vignettes. They help students consider and discuss questions about ethics, society, and responsibility, and develop both skills (like critical thinking) and dispositions (like empathy) needed to be a…

First Equals Most Important? Order Effects in Vignette-Based Measurement

ERIC Educational Resources Information Center

Auspurg, Katrin; Jäckle, Annette

2017-01-01

To measure what determines people's attitudes, definitions, or decisions, surveys increasingly ask respondents to judge vignettes. A vignette typically describes a hypothetical situation or object as having various attributes (dimensions). In factorial surveys, the values (levels) of dimensions are experimentally varied, so that their impact on…

Using Vignettes to Tap Into Moral Reasoning in Public Health Policy: Practical Advice and Design Principles From a Study on Food Advertising to Children

PubMed Central

Taylor, Emily; Hoang, Sylvia; Cook, Brian

2014-01-01

In this article, we describe a process for designing and applying vignettes in public health policy research and practice. We developed this methodology for a study on moral reasoning underpinning policy debate on food advertising to children. Using vignettes prompted policy actors who were relatively entrenched in particular ways of speaking professionally about a controversial and ethically challenging issue to converse in a more authentic and reflective way. Vignettes hold benefits and complexities. They can focus attention on moral conflicts, draw out different types of evidence to support moral reasoning, and enable simultaneous consideration of real and ideal worlds. We suggest a process and recommendations on design features for crafting vignettes for public health policy. PMID:25121818

Using vignettes to tap into moral reasoning in public health policy: practical advice and design principles from a study on food advertising to children.

PubMed

Mah, Catherine L; Taylor, Emily; Hoang, Sylvia; Cook, Brian

2014-10-01

In this article, we describe a process for designing and applying vignettes in public health policy research and practice. We developed this methodology for a study on moral reasoning underpinning policy debate on food advertising to children. Using vignettes prompted policy actors who were relatively entrenched in particular ways of speaking professionally about a controversial and ethically challenging issue to converse in a more authentic and reflective way. Vignettes hold benefits and complexities. They can focus attention on moral conflicts, draw out different types of evidence to support moral reasoning, and enable simultaneous consideration of real and ideal worlds. We suggest a process and recommendations on design features for crafting vignettes for public health policy.

Putting Physical Activity While Experiencing Low Back Pain in Context: Balancing the Risks and Benefits.

PubMed

Darlow, Ben; Perry, Meredith; Dean, Sarah; Mathieson, Fiona; Baxter, G David; Dowell, Anthony

2016-02-01

To analyze attitudes and beliefs about movement and physical activity in people with low back pain (LBP) and compare these beliefs between people with acute and chronic LBP. Qualitative inductive analysis of data collected via face-to-face semistructured interviews. Interviews were audio-recorded and transcribed verbatim. Participants were purposively recruited from 1 region of New Zealand. Persons with LBP (N=23), consisting of individuals with acute LBP (<6wk; n=12) and chronic LBP (>3mo; n=11). Not applicable. Themes that emerged from participant interview transcripts using analysis based on Interpretative Description. Participants with acute and chronic LBP made judgments about physical activity and rest using the same conceptual model. Concerns about creating more pain, tissue damage, or impairment influenced the physical activity judgments of most participants with acute and chronic LBP. These perceived risks were balanced against the perceived benefits, the most important of which were psychological or social rather than physical. Judgments made by those with acute and chronic LBP were context dependent and influenced by the nature and duration of pain, the type of physical activity, the importance of the activity, and the participant's previous experience. Participants with acute pain who had not experienced back pain previously often expressed more uncertainty, whereas those with chronic LBP appeared to have developed cognitive rules that determined physical activity decisions. Exploring the perceived risks, benefits, and contextual factors that influence decisions about physical activity and rest may help clinicians to understand the behavior of patients with acute and chronic LBP. Clinicians may best support their patients to engage in physical activity by providing an informed assessment of risks and an explanation about the range of potential benefits. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Authority, Autonomy, and Deception: Evaluating the Legitimacy of Parental Authority and Adolescent Deceit.

PubMed

Gingo, Matthew; Roded, Alona D; Turiel, Elliot

2017-12-01

This research examined adolescents' judgments about lying to avoid parental control over different types of activities. Participants (N = 66, M age  = 16.38, 73% European American) were interviewed about hypothetical situations describing adolescents who defied parental directives and lied about their defiance. Judgments about the legitimacy of parents' directives and protagonists' deception differed by types of parent relationship with adolescents (mutual or unilateral). Directives were least accepted, and deception was most accepted, in the context of unilateral relationships. Judgments also differed by domain of the action (personal, prudential, or conventional). Participants were least accepting of parental directives, and most accepting of deception about personal activities. Findings indicate that adolescents value honesty and parental authority, but sometimes give priority to concerns with autonomy and mutuality. © 2017 The Authors. Journal of Research on Adolescence © 2017 Society for Research on Adolescence.

Obstetrician-gynaecologists' opinions about conscientious refusal of a request for abortion: results from a national vignette experiment.

PubMed

Rasinski, Kenneth A; Yoon, John D; Kalad, Youssef G; Curlin, Farr A

2011-12-01

Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee--whether the doctor referred and whether the doctor disclosed their objection to the abortion. 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Physicians indicated their approval for the vignette doctor's decision. Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor-patient relationship.

A Matrix for Processing Descriptive and Judgmental Data for Use with the Learning Area Sections of the "Evaluative Criteria," Sixth Edition.

ERIC Educational Resources Information Center

Pace, Vernon D.; Buser, Robert L.

1990-01-01

Presents a matrix that can be used by accreditation team members to gather, organize, analyze, and report descriptive and evaluative information about instructional support components, teacher observations/interviews, and curriculum evaluation. (DMM)

Comparing Vignette Instruction and Assessment Tasks to Classroom Observations and Reflections

ERIC Educational Resources Information Center

Jeffries, Carolyn; Maeder, Dale W.

2011-01-01

The growing body of research on the use of vignettes in teacher education courses suggests that vignette-based instruction and assessment tasks may represent a viable alternative to traditional forms of scaffolded instruction and reflective essays following classroom observations, thereby creating a bridge between college and K-12 classrooms for…

Using Anchoring Vignettes to Adjust Self-Reported Personality: A Comparison Between Countries

PubMed Central

Weiss, Selina; Roberts, Richard D.

2018-01-01

Data from self-report tools cannot be readily compared between cultures due to culturally specific ways of using a response scale. As such, anchoring vignettes have been proposed as a suitable methodology for correcting against this difference. We developed anchoring vignettes for the Big Five Inventory-44 (BFI-44) to supplement its Likert-type response options. Based on two samples (Rwanda: n = 423; Philippines: n = 143), we evaluated the psychometric properties of the measure both before and after applying the anchoring vignette adjustment. Results show that adjusted scores had better measurement properties, including improved reliability and a more orthogonal correlational structure, relative to scores based on the original Likert scale. Correlations of the Big Five Personality Factors with life satisfaction were essentially unchanged after the vignette-adjustment while correlations with counterproductive were noticeably lower. Overall, these changed findings suggest that the use of anchoring vignette methodology improves the cross-cultural comparability of self-reported personality, a finding of potential interest to the field of global workforce research and development as well as educational policymakers. PMID:29593621

Medical ethics on film: towards a reconstruction of the teaching of healthcare professionals.

PubMed

Volandes, Angelo

2007-11-01

The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient's perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions.

Factors influencing secondary care pharmacist and nurse independent prescribers' clinical reasoning: An interprofessional analysis.

PubMed

Abuzour, Aseel S; Lewis, Penny J; Tully, Mary P

2018-03-01

In the United Kingdom, pharmacist and nurse independent prescribers are responsible for both the clinical assessment of and prescribing for patients. Prescribing is a complex skill that entails the application of knowledge, skills, and clinical reasoning to arrive at a clinically appropriate decision. Decision-making is influenced and informed by many factors. This study, the first of its kind, explores what factors influence pharmacist and nurse independent prescribers during the process of clinical reasoning. A think-aloud methodology immediately followed by a semi-structured interview was conducted with 11 active nurse and 10 pharmacist independent prescribers working in secondary care. Each participant was presented with validated clinical vignettes for the think-aloud stage. Participants chose the clinical therapeutic areas for the vignettes, based on their self-perceived competencies. Data were audio-recorded, transcribed verbatim, and a constant-comparative approach was used for analysis. Influences on clinical reasoning were broadly categorised into themes: social interaction, intrinsic, and contextual factors. These themes showed that intrinsic, sociocultural, and contextual aspects heavily influenced the clinical reasoning processes of prescribers. For example, prescribers were aware of treatment pathways, but chose to refer patient cases to avoid making the final prescribing decision. Exploration of this behaviour in the interviews revealed that previous experience and attitudes such as confidence and cautiousness associated with responsibility were strong influencers within the decision-making process. In addition, strengthening the professional identity of prescribers could be achieved through collaborative work with interprofessional healthcare teams to orient their professional practice from within the profession. Findings from this study can be used to inform the education, training, and practice of independent prescribers to improve healthcare services by improving their professional and interprofessional development.

Addressing cultural diversity: the hepatitis B clinical specialist perspective.

PubMed

Wallace, Jack; Smith, Elizabeth; Hajarizadeh, Behzad; Richmond, Jacqueline; Lucke, Jayne

2017-08-31

Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will assist in addressing gaps in the clinical response to hepatitis B.

A qualitative study describing nursing home nurses sensemaking to detect medication order discrepancies.

PubMed

Vogelsmeier, Amy; Anderson, Ruth A; Anbari, Allison; Ganong, Lawrence; Farag, Amany; Niemeyer, MaryAnn

2017-08-04

Medication reconciliation is a safety practice to identify medication order discrepancies when patients' transitions between settings. In nursing homes, registered nurses (RNs) and licensed practical nurses (LPNs), each group with different education preparation and scope of practice responsibilities, perform medication reconciliation. However, little is known about how they differ in practice when making sense of medication orders to detect discrepancies. Therefore, the purpose of this study was to describe differences in RN and LPN sensemaking when detecting discrepancies. We used a qualitative methodology in a study of 13 RNs and 13 LPNs working in 12 Midwestern United States nursing homes. We used both conventional content analysis and directed content analysis methods to analyze semi-structured interviews. Four resident transfer vignettes embedded with medication order discrepancies guided the interviews. Participants were asked to describe their roles with medication reconciliation and their rationale for identifying medication order discrepancies within the vignettes as well as to share their experiences of performing medication reconciliation. The analysis approach was guided by Weick's Sensemaking theory. RNs provided explicit stories of identifying medication order discrepancies as well as examples of clinical reasoning to assure medication order appropriateness whereas LPNs described comparing medication lists. RNs and LPNs both acknowledged competing demands, but when performing medication reconciliation, RNs were more concerned about accuracy and safety, whereas LPNs were more concerned about time. Nursing home nurses, particularly RNs, are in an important position to identify discrepancies that could cause resident harm. Both RNs and LPNs are valuable assets to nursing home care and keeping residents safe, yet RNs offer a unique contribution to complex processes such as medication reconciliation. Nursing home leaders must acknowledge the differences in RN and LPN contributions and make certain nurses in the most qualified role are assigned to ensure residents remain safe.

Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.

PubMed

Tannenbaum, David; Doctor, Jason N; Persell, Stephen D; Friedberg, Mark W; Meeker, Daniella; Friesema, Elisha M; Goldstein, Noah J; Linder, Jeffrey A; Fox, Craig R

2015-03-01

Healthcare professionals are rapidly adopting electronic health records (EHRs). Within EHRs, seemingly innocuous menu design configurations can influence provider decisions for better or worse. The purpose of this study was to examine whether the grouping of menu items systematically affects prescribing practices among primary care providers. We surveyed 166 primary care providers in a research network of practices in the greater Chicago area, of whom 84 responded (51% response rate). Respondents and non-respondents were similar on all observable dimensions except that respondents were more likely to work in an academic setting. The questionnaire consisted of seven clinical vignettes. Each vignette described typical signs and symptoms for acute respiratory infections, and providers chose treatments from a menu of options. For each vignette, providers were randomly assigned to one of two menu partitions. For antibiotic-inappropriate vignettes, the treatment menu either listed over-the-counter (OTC) medications individually while grouping prescriptions together, or displayed the reverse partition. For antibiotic-appropriate vignettes, the treatment menu either listed narrow-spectrum antibiotics individually while grouping broad-spectrum antibiotics, or displayed the reverse partition. The main outcome was provider treatment choice. For antibiotic-inappropriate vignettes, we categorized responses as prescription drugs or OTC-only options. For antibiotic-appropriate vignettes, we categorized responses as broad- or narrow-spectrum antibiotics. Across vignettes, there was an 11.5 percentage point reduction in choosing aggressive treatment options (e.g., broad-spectrum antibiotics) when aggressive options were grouped compared to when those same options were listed individually (95% CI: 2.9 to 20.1%; p = .008). Provider treatment choice appears to be influenced by the grouping of menu options, suggesting that the layout of EHR order sets is not an arbitrary exercise. The careful crafting of EHR order sets can serve as an important opportunity to improve patient care without constraining physicians' ability to prescribe what they believe is best for their patients.

Using vignettes to study nurse practitioners' performance in suspected domestic violence situations.

PubMed

Gagan, M J

2000-01-01

Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.

Analogue patients' self-reported engagement and psychophysiological arousal in a video-vignettes design: Patients versus disease-naïve individuals.

PubMed

Visser, Leonie N C; Tollenaar, Marieke S; Bosch, Jos A; van Doornen, Lorenz J P; de Haes, Hanneke C J M; Smets, Ellen M A

2016-10-01

The ecological validity of video-vignettes design investigating patient-provider communication hinges on the engagement of analogue patients (APs) with the vignette. The present study aimed to compare engagement in two commonly utilized groups of APs, patients and disease-naïve individuals. Engagement was assessed by self-report and in the form of physiological arousal. Cancer patients (N=22) and disease-naïve individuals (N=24) were recruited as APs. APs completed the Video Engagement Scale after watching a vignette of a oncologic bad news consultation. Electrodermal and cardiovascular activity were assessed continuously during watching the vignette, and cortisol levels were assessed in four saliva samples. Patients reported higher engagement with the vignette than disease-naïve individuals (t=2.46, p<0.05) and showed a larger blood pressure response (systolic: F=5.87, p<0.01 and diastolic: F=4.00, p<0.05). However, these differences disappeared after adjusting for age. No group differences were found on other psychophysiological parameters. Our results suggest that patients and disease-naïve individuals are equally engaged when viewing video vignettes. When group differences were found, older age turned out to be a more prominent predictor of engagement. Researchers may consider other arguments besides APs' disease history when selecting an AP group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ageism and Intervention: What Social Work Students Believe about Treating People Differently Because of Age

ERIC Educational Resources Information Center

Kane, Michael

2004-01-01

BSW and MSW students randomly completed one of two vignettes that were identical with the exception of the age of the vignette's subject. Following the vignette, respondents responded to 16 bio-psycho-social assessment and intervention items relating to health, illness, aging, and death. The multivariate analysis of variance was significant…

Ageism and Intervention: What Social Work Students Believe about Treating People Differently because of Age

ERIC Educational Resources Information Center

Kane, Michael N.

2004-01-01

BSW and MSW students randomly completed one of two vignettes that were identical with the exception of the age of the vignette's subject. Following the vignette, respondents responded to 16 bio-psycho-social assessment and intervention items relating to health, illness, aging, and death. The multivariate analysis of variance was significant…

Effects of Race and Precipitating Event on Suicide versus Nonsuicide Death Classification in a College Sample

ERIC Educational Resources Information Center

Walker, Rheeda L.; Flowers, Kelci C.

2011-01-01

Race group differences in suicide death classification in a sample of 109 Black and White university students were examined. Participants were randomly assigned to read three vignettes for which the vignette subjects' race (only) varied. The vignettes each described a circumstance (terminal illness, academic failure, or relationship difficulties)…

Innovative Methods for Collecting and Analyzing Qualitative Data: Vignettes and Pre-Structured Cases.

ERIC Educational Resources Information Center

Miles, Matthew B.

Two innovative methods for collecting and analyzing qualitative data are vignettes and pre-structured cases. Vignettes are descriptions of situations or problems written by a professional, with a suggested outline and comments provided by a researcher. Advantages of this method are strength of impact of the written descriptions and efficiency of…

Studying medical communication with video vignettes: a randomized study on how variations in video-vignette introduction format and camera focus influence analogue patients' engagement.

PubMed

Visser, Leonie N C; Bol, Nadine; Hillen, Marij A; Verdam, Mathilde G E; de Haes, Hanneke C J M; van Weert, Julia C M; Smets, Ellen M A

2018-01-19

Video vignettes are used to test the effects of physicians' communication on patient outcomes. Methodological choices in video-vignette development may have far-stretching consequences for participants' engagement with the video, and thus the ecological validity of this design. To supplement the scant evidence in this field, this study tested how variations in video-vignette introduction format and camera focus influence participants' engagement with a video vignette showing a bad news consultation. Introduction format (A = audiovisual vs. B = written) and camera focus (1 = the physician only, 2 = the physician and the patient at neutral moments alternately, 3 = the physician and the patient at emotional moments alternately) were varied in a randomized 2 × 3 between-subjects design. One hundred eighty-one students were randomly assigned to watch one of the six resulting video-vignette conditions as so-called analogue patients, i.e., they were instructed to imagine themselves being in the video patient's situation. Four dimensions of self-reported engagement were assessed retrospectively. Emotional engagement was additionally measured by recording participants' electrodermal and cardiovascular activity continuously while watching. Analyses of variance were used to test the effects of introduction format, camera focus and their interaction. The audiovisual introduction induced a stronger blood pressure response during watching the introduction (p = 0.048, [Formula: see text]= 0.05) and the consultation part of the vignette (p = 0.051, [Formula: see text]= 0.05), when compared to the written introduction. With respect to camera focus, results revealed that the variant focusing on the patient at emotional moments evoked a higher level of electrodermal activity (p = 0.003, [Formula: see text]= 0.06), when compared to the other two variants. Furthermore, an interaction effect was shown on self-reported emotional engagement (p = 0.045, [Formula: see text]= 0.04): the physician-only variant resulted in lower emotional engagement if the vignette was preceded by the audiovisual introduction. No effects were shown on the other dimensions of self-reported engagement. Our findings imply that using an audiovisual introduction combined with alternating camera focus depicting patient's emotions results in the highest levels of emotional engagement in analogue patients. This evidence can inform methodological decisions during the development of video vignettes, and thereby enhance the ecological validity of future video-vignettes studies.

Evaluating the construct of triage acuity against a set of reference vignettes developed via modified Delphi method.

PubMed

Twomey, Michèle; Wallis, Lee A; Myers, Jonathan E

2014-07-01

To evaluate the construct of triage acuity as measured by the South African Triage Scale (SATS) against a set of reference vignettes. A modified Delphi method was used to develop a set of reference vignettes. Delphi participants completed a 2-round consensus-building process, and independently assigned triage acuity ratings to 100 written vignettes unaware of the ratings given by others. Triage acuity ratings were summarised for all vignettes, and only those that reached 80% consensus during round 2 were included in the reference set. Triage ratings for the reference vignettes given by two independent experts using the SATS were compared with the ratings given by the international Delphi panel. Measures of sensitivity, specificity, associated percentages for over-triage/under-triage were used to evaluate the construct of triage acuity (as measured by the SATS) by examining the association between the ratings by the two experts and the international panel. On completion of the Delphi process, 42 of the 100 vignettes reached 80% consensus on their acuity rating and made up the reference set. On average, over all acuity levels, sensitivity was 74% (CI 64% to 82%), specificity 92% (CI 87% to 94%), under-triage occurred 14% (CI 8% to 23%) and over-triage 12% (CI 8% to 23%) of the time. The results of this study provide an alternative to evaluating triage scales against the construct of acuity as measured with the SATS. This method of using 80% consensus vignettes may, however, systematically bias the validity estimate towards better performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Survey of recognition and treatment of at-risk mental state by Japanese psychiatrists.

PubMed

Tsujino, Naohisa; Tagata, Hiromi; Baba, Yoko; Kojima, Akiko; Yamaguchi, Taiju; Katagiri, Naoyuki; Nemoto, Takahiro; Mizuno, Masafumi

2018-02-27

The importance of early intervention in psychiatry is widely recognized among psychiatrists. However, it is unknown whether precise knowledge of at-risk mental state has been disseminated. With this survey, we aimed to reveal how Japanese psychiatrists diagnose patients with at-risk mental state and prescribe treatment strategies for them. Using fictional case vignettes, we conducted a questionnaire survey of psychiatrists (n = 1399) who worked in Tokyo. We mailed study documents to all eligible participants in November 2015 with a requested return date in December. Two hundred and sixty (19.3%) psychiatrists responded to the survey. Their correct diagnosis rates for the patients in the at-risk mental state vignettes were low (14.6% for the vignette describing at-risk mental state with attenuated positive symptom syndrome; 13.1% for the vignette describing at-risk mental state with brief intermittent psychotic syndrome). Many psychiatrists selected pharmacotherapy and antipsychotics to treat patients in the at-risk mental state vignettes. The psychiatrists who correctly diagnosed patients in the at-risk mental state vignettes had significantly fewer years of clinical psychiatric experience than did those who diagnosed them as having a non-at-risk mental state (12.5 years vs 22.7 years for the vignette describing at-risk mental state with attenuated positive symptom syndrome, P < 0.01; 14.3 years vs 22.2 years for the vignette describing at-risk mental state with brief intermittent psychotic syndrome, P < 0.01). This study suggests that precise knowledge of at-risk mental state has not been disseminated among Japanese psychiatrists. © 2018 The Authors. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology.

Genital Responses to Rape Vignettes Among Young Men: The Influence of Mood and Directed Attention.

PubMed

Lalumière, Martin L; Fairweather, Annabree; Harris, Grant T; Suschinsky, Kelly D; Seto, Michael C

2017-04-01

Although it is clear that men with a history of sexual assaults against women produce higher relative genital responses to rape vignettes in the laboratory than do men without such a history, it remains unclear what aspects of the vignettes are eliciting these responses, and whether the genital responses are affected by situational factors. The antisocial tendencies hypothesis states that many men are inhibited by cues of violence, suffering, and coercion in rape vignettes, but other men, particularly antisocial and sexually aggressive men, are not so inhibited. In this study, we investigated whether the hypothesized inhibition to rape vignettes among nonoffenders could be affected by manipulation of mood and directed attention. A total of 48 young men were exposed to audio-recorded vignettes describing mutually consenting and nonviolent sexual interactions, mutually consenting and violent sexual interactions, nonconsenting and violent sexual interactions, and nonsexual and nonviolent social interactions (within-subjects). Participants were randomly assigned to a mood manipulation designed to induce a happy, neutral, or sad mood (between-subjects). All were asked to pay attention to either sex words or violent words while listening to the vignettes (within-subjects). As is typically observed, genital responses were lower (inhibited) when vignettes included cues of violence or nonconsent. Both happy and sad mood inductions reduced this inhibition, so that men induced into a happy or sad mood showed greater relative responding to cues of violence or nonconsent compared with men in a neutral mood. The attention manipulation had no significant effect. Results suggest that genital responses to rape cues can be situationally influenced, but not necessarily as predicted by the antisocial tendencies hypothesis.

Help-seeking beliefs for mental disorders among medical and nursing students.

PubMed

Picco, Louisa; Seow, Esmond; Chua, Boon Yiang; Mahendran, Rathi; Verma, Swapna; Xie, Huiting; Wang, Jia; Chong, Siow Ann; Subramaniam, Mythily

2018-05-09

The current study aimed to investigate beliefs about help-seeking, treatment options and expected outcomes for people with alcohol abuse, dementia, depression, obsessive-compulsive disorder and schizophrenia, using a vignette-based approach, among a sample of nursing and medical students. This was a cross-sectional online study among medical and nursing students (n = 1002) who were randomly assigned 1 of 5 vignettes. Questions were asked about whom could best help the person in the vignette, the likely helpfulness of a broad range of interventions, and the likely outcome for the person in the vignette with and without appropriate help. A total of 45.1% of students recommended seeing a psychiatrist, which was the most common source of help reported for all 5 vignettes. Help-seeking preferences were significantly associated with age, academic year and vignette type. Respondents rated seeing a psychiatrist as the most helpful intervention (92.4%) and dealing with the problem on their own as the most harmful (68.1%). Then, 81.5% of students indicated that the condition of the person in the vignette would worsen if appropriate help was not sought. Medical and nursing students most commonly recommended seeking help from a psychiatrist for mental health-related problems, where help-seeking preferences were associated with various age, academic year and vignette type. As these students will be the future medical and nursing workforce, they need to be equipped with the skills and ability to recognize signs and symptoms of mental illness, to aid timely and appropriate treatment for people with mental illness. © 2018 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

Medical ethics on film: towards a reconstruction of the teaching of healthcare professionals

PubMed Central

Volandes, Angelo

2007-01-01

The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient's perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions. PMID:17971475

Measuring individual differences in responses to date-rape vignettes using latent variable models.

PubMed

Tuliao, Antover P; Hoffman, Lesa; McChargue, Dennis E

2017-01-01

Vignette methodology can be a flexible and powerful way to examine individual differences in response to dangerous real-life scenarios. However, most studies underutilize the usefulness of such methodology by analyzing only one outcome, which limits the ability to track event-related changes (e.g., vacillation in risk perception). The current study was designed to illustrate the dynamic influence of risk perception on exit point from a date-rape vignette. Our primary goal was to provide an illustrative example of how to use latent variable models for vignette methodology, including latent growth curve modeling with piecewise slopes, as well as latent variable measurement models. Through the combination of a step-by-step exposition in this text and corresponding model syntax available electronically, we detail an alternative statistical "blueprint" to enhance future violence research efforts using vignette methodology. Aggr. Behav. 43:60-73, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

"I Have Just Understood It from the Story …": Using Vignettes in Educational Research to Investigate Cultural Tolerance

ERIC Educational Resources Information Center

Al Sadi, Fatma H.; Basit, Tehmina N.

2017-01-01

The vignettes approach has emerged as a popular tool in quantitative and qualitative research. It has proven to be particularly effective in measuring sensitive topics. This paper focuses on the construction and validation process of questionnaire-based vignettes, which were used as an instrument to examine Omani secondary school girls' cultural…

New vignettes for the experimental manipulation of injury cause in prospective mild traumatic brain injury research.

PubMed

Sullivan, Karen A; Edmed, Shannon L

2016-01-01

This study developed standardized vignettes that depict a mild traumatic brain injury (TBI) from one of several causes and subjected them to formal expert review. A base vignette was developed using the World Health Organization operational criteria for mild TBI. Eight specific causes (e.g. sport vs assault) were examined. A convenience sample of mild TBI experts with a discipline background of Neuropsychology from North America, Australasia and Europe (n = 21) used an online survey to evaluate the vignettes and rated the role of cause on outcome. The vignette suite was rated as fitting the mild TBI WHO operational diagnostic criteria at least moderately well. When compared to other factors, cause was not rated as significantly contributing to outcome. When evaluated in isolation, approximately half of the sample rated cause as important or very important and at least two of three clinical outcomes were associated with a different cause. The vignettes may be useful in experimental mild TBI research. They enable the injury parameters to be controlled so that the effects of cause can be isolated and examined empirically. Such studies should advance understanding of the role of this factor in mild TBI outcome.

Interpretive Responses in Reading History and Biology: An Exploratory Study

ERIC Educational Resources Information Center

Fareed, Ahmed A.

1971-01-01

Explores the interpretive processes of 12 sixth-grade pupils, using the recorded interview technique. Concludes that readers use the processes of reproduction, inquiry, emotional reaction, rational judgment, appreciation, association, and illumination, and that the nature of the reading material influences the types of interpretive responses. (VJ)

The Effect of Jail Reform Policies on Guard/Management Relations.

ERIC Educational Resources Information Center

Pogrebin, Mark

1987-01-01

Interviewed 60 jail corrections officers in four types of jails to examine views about working relations and judgments of institutional policy. Respondents reported feeling unappreciated by superiors and powerless in relation to inmates. Officers were caught between administration demands for safety and recently acquired rights of inmates. (NB)

Perceptions of Learning among Swiss Watch Managers

ERIC Educational Resources Information Center

Tajeddini, Kayhan

2009-01-01

Purpose: This paper aims to explore managers' perceptions of learning within a sample of Swiss watch firms. Design/methodology/approach: A purposeful (judgmental) stratified sampling method was employed, where in-depth interviews with 13 marketing managers and owners were carried out over a three-month period. Meaning units (MUs) were abstracted,…

Perceptions of Audio Computer-Assisted Self-Interviewing (ACASI) among Women in an HIV-Positive Prevention Program

PubMed Central

Estes, Larissa J.; Lloyd, Linda E.; Teti, Michelle; Raja, Sheela; Bowleg, Lisa; Allgood, Kristi L.; Glick, Nancy

2010-01-01

Background Audio Computer-Assisted Self Interviewing (ACASI) has improved the reliability and accuracy of self-reported HIV health and risk behavior data, yet few studies account for how participants experience the data collection process. Methodology/Principal Findings This exploratory qualitative analysis aimed to better understand the experience and implications of using ACASI among HIV-positive women participating in sexual risk reduction interventions in Chicago (n = 12) and Philadelphia (n = 18). Strategies of Grounded Theory were used to explore participants' ACASI experiences. Conclusion/Significance Key themes we identified included themes that could be attributed to the ACASI and other methods of data collection (e.g., paper-based self-administered questionnaire or face-to-face interviews). The key themes were usability; privacy and honesty; socially desirable responses and avoiding judgment; and unintentional discomfort resulting from recalling risky behavior using the ACASI. Despite both positive and negative findings about the ACASI experience, we conclude that ACASI is in general an appropriate method for collecting sensitive data about HIV/AIDS risk behaviors among HIV-positive women because it seemed to ensure privacy in the study population allowing for more honest responses, minimize socially desirable responses, and help participants avoid actual or perceived judgment. PMID:20161771

Teaching psychiatry in a new medical school: a multimedia approach.

PubMed

Baskett, S J

1978-12-01

As a developing department in a new medical school, we were able to improve our curriculum by using a multimedia approach to teaching psychiatry. We relied heavily on a programmed self-instructional text with videotaped clinical examples (PLS), learning objectives, formal classroom presentations, small group discussions, self-assessment exercises, an affective approach to the patient-doctor relationship using role-playing and videotaped patient vignettes, and finally live patient interviews. We believe we have been able to present the widely agreed upon content in the basic science years, using a wide variety of teaching materials and technics which maintain the interest of most students.

Are medical students assigning proper global assessment of functioning scores?

PubMed

Warsi, Mustafa K; Sattar, S Pirzada; Din, Amad U; Petty, Frederick; Padala, Prasad R

2007-01-01

This article seeks to determine whether medical students can estimate the appropriate score for the Global Assessment of Functioning (GAF) compared with psychiatry residents and staff psychiatrists. The authors hypothesized that medical students' estimations of GAF scores for patients in clinical vignettes would differ from those assessed by the psychiatry residents and staff psychiatrists. The authors designed a cross-sectional confidential survey of medical students, psychiatry residents, and staff psychiatrists. Consenting participants were asked to provide demographic information and then complete the accompanying questionnaire after reading two vignettes. One of the vignettes described a depressed patient and the other a psychotic patient. The subjects were asked to estimate the GAF scores for the patients in both vignettes. Then the subjects were given the GAF scoring guide to review and were asked to re-assess their initial GAF scores for the patients in the vignettes. Medical students assigned much higher GAF scores for the patient in the vignette with less severe symptoms than the psychiatry residents and staff psychiatrists. The GAF scores of all three groups for the patient in the vignette with more severe symptoms were comparable. The ability of medical students to assign proper GAF scores needs to be studied further. Our study suggests that current 1-month rotations in psychiatry, without specific training on assigning GAF scores, may not provide medical students with enough information to assess GAF scores accurately. This might need to be addressed in psychiatry clerkships.

Stability in the metamemory realism of eyewitness confidence judgments.

PubMed

Buratti, Sandra; Allwood, Carl Martin; Johansson, Marcus

2014-02-01

The stability of eyewitness confidence judgments over time in regard to their reported memory and accuracy of these judgments is of interest in forensic contexts because witnesses are often interviewed many times. The present study investigated the stability of the confidence judgments of memory reports of a witnessed event and of the accuracy of these judgments over three occasions, each separated by 1 week. Three age groups were studied: younger children (8-9 years), older children (10-11 years), and adults (19-31 years). A total of 93 participants viewed a short film clip and were asked to answer directed two-alternative forced-choice questions about the film clip and to confidence judge each answer. Different questions about details in the film clip were used on each of the three test occasions. Confidence as such did not exhibit stability over time on an individual basis. However, the difference between confidence and proportion correct did exhibit stability across time, in terms of both over/underconfidence and calibration. With respect to age, the adults and older children exhibited more stability than the younger children for calibration. Furthermore, some support for instability was found with respect to the difference between the average confidence level for correct and incorrect answers (slope). Unexpectedly, however, the younger children's slope was found to be more stable than the adults. Compared to the previous research, the present study's use of more advanced statistical methods provides a more nuanced understanding of the stability of confidence judgments in the eyewitness reports of children and adults.

The relative contribution of patient, provider and organizational influences to the appropriate diagnosis and management of diabetes mellitus.

PubMed

Marceau, Lisa; McKinlay, John; Shackelton, Rebecca; Link, Carol

2011-12-01

To estimate the relative contribution of patient attributes, provider characteristics and organizational features of the doctors' workplace to the diagnosis and management of diabetes. In a factorial experimental design doctors (n = 192) viewed clinically authentic vignettes of 'patients' presenting with identical signs and symptoms. Doctor subjects were primary care doctors stratified according to gender and level of experience. During an in-person interview scheduled between real patients, doctors were asked how they would diagnosis and manage the vignette 'patients' in clinical practice. This study considered the relative contribution of patient, doctor and organizational factors. Taken together patient attributes explained only 4.4% of the variability in diabetes diagnosis. Doctor factors explained only 2.0%. The vast majority of the explained variance in diabetes diagnosis was due to organizational factors (14.3%). Relative contributions combined (patient, provider, organizational factors) explained only 20% of the total variance. Attempts to reduce health care variations usually focus on the education/activation of patients, or increased training of doctors. Our findings suggest that shifting quality improvement efforts to the area which contributes most to the creation and amplification of variations (organizational influences) may produce better results in terms of reduced variations in health care associated with diabetes. © 2010 Blackwell Publishing Ltd.

The impact of risk management practice upon the implementation of recovery-oriented care in community mental health services: a qualitative investigation.

PubMed

Holley, Jessica; Chambers, Mary; Gillard, Steven

2016-08-01

Recovery-oriented care has become guiding principle for mental health policies and practice in the UK and elsewhere. However, a pre-existing culture of risk management practice may impact upon the provision of recovery-oriented mental health services. To explore how risk management practice impacts upon the implementation of recovery-oriented care within community mental health services. Semi-structured interviews using vignettes were conducted with eight mental health worker and service user dyads. Grounded theory techniques were used to develop explanatory themes. Four themes arose: (1) recovery and positive risk taking; (2) competing frameworks of practice; (3) a hybrid of risk and recovery; (4) real-life recovery in the context of risk. In abstract responses to the vignettes, mental health workers described how they would use a positive-risk taking approach in support of recovery. In practice, this was restricted by a risk-averse culture embedded within services. Mental health workers set conditions with which service users complied to gain some responsibility for recovery. A lack of strategic guidance at policy level and lack of support and guidance at practice level may result in resistance to implementing ROC in the context of RMP. Recommendations are made for policy, training and future research.

Making Judgments: How Blame Mediates the Influence of Rape Myth Acceptance in Police Response to Sexual Assault.

PubMed

Venema, Rachel M

2016-08-01

As research continues to describe negative experiences and high case attrition within sexual assault cases reported to the police, it is important to better understand the role of first-responding police officers. This study surveyed a sample of sworn police officers ( N = 174) from one department in a midsized city in the Great Lakes region to examine the effect of individual police officer characteristics, rape myth acceptance (RMA), attributions of blame, and case characteristics from a hypothetical vignette, on officer perceptions of a "good" case and behavioral intentions. Results found that although RMA predicts both perceptions of the case and behavioral intentions to respond in ways indicative of perceived seriousness, RMA is mediated by attributions of suspect blame. Victim alcohol use was found to decrease an officer's likelihood of responding more vigorously, showing less likelihood of calling a detective or arresting the suspect, if identified. Future research should begin to connect not only case characteristics but also individual police officer characteristics, attitudes, and attributions of blame, with real case outcomes, in addition to hypothetical scenarios.

Imaging first impressions: distinct neural processing of verbal and nonverbal social information.

PubMed

Kuzmanovic, Bojana; Bente, Gary; von Cramon, D Yves; Schilbach, Leonhard; Tittgemeyer, Marc; Vogeley, Kai

2012-03-01

First impressions profoundly influence our attitudes and behavior toward others. However, little is known about whether and to what degree the cognitive processes that underlie impression formation depend on the domain of the available information about the target person. To investigate the neural bases of the influence of verbal as compared to nonverbal information on interpersonal judgments, we identified brain regions where the BOLD signal parametrically increased with increasing strength of evaluation based on either short text vignettes or mimic and gestural behavior. While for verbal stimuli the increasing strength of subjective evaluation was correlated with increased neural activation of precuneus and posterior cingulate cortex (PC/PCC), a similar effect was observed for nonverbal stimuli in the amygdala. These findings support the assumption that qualitatively different cognitive operations underlie person evaluation depending upon the stimulus domain: while the processing of nonverbal person information may be more strongly associated with affective processing as indexed by recruitment of the amygdala, verbal person information engaged the PC/PCC that has been related to social inferential processing. Copyright © 2011 Elsevier Inc. All rights reserved.

The Influence of Plaintiff’s Body Weight on Judgments of Responsibility: The Role of Weight Bias

PubMed Central

White, Darrell E.; Wott, Carissa B.; Carels, Robert A.

2014-01-01

Problem The current study investigated the influence of a plaintiff’s weight and the location of an accident on a simulated jury’s perceptions of plaintiff’s personal responsibility for an accident. Methods Participants were 185 lean and overweight male and female adults (mean self-reported body mass index: 24.87 ± 5.45) who read one of three vignettes describing an accident that occurred while leaving one of three different establishments (fast food burger restaurant; fitness gym; department store) while viewing one of two silhouettes of the alleged plaintiff (a lean female; an obese female). Results Participants were significantly more likely to report the plaintiff’s weight entered into their perceptions of personal responsibility when they viewed the overweight plaintiff compared to the thin plaintiff. As respondent’s self-reported weight bias increased, participants were more likely to hold the plaintiff responsible and more likely to blame plaintiff characteristics for the accident. Conclusion The weight of a plaintiff may affect juror perceptions of personal responsibility particularly if the juror possesses self-reported weight bias. PMID:25434916

Observer perceptions of pain in children with cognitive impairments: vignette development and validation.

PubMed

Genik, Lara M; McMurtry, C Meghan; Breau, Lynn M

2015-01-01

Develop vignettes depicting different pain types in verbal and nonverbal children with cognitive impairments that could help examine pain assessment and management decisions of secondary caregivers, and conduct initial convergent and divergent validity analyses. For six vignettes, 76 undergraduate students (38 females, mean age = 19.55) rated (0-10): pain intensity, difficulty rating pain intensity, need for medical attention and need for other attention (e.g., physical comfort). Ratings significantly varied by pain source (e.g., headache was rated more painful than injections). Verbal ability did not impact ratings. Vignettes could serve as an alternative method to study pain decisions by caregivers of children with cognitive impairments when ethical barriers limit more naturalistic research.

Another missed opportunity? Recognition of alcohol use problems by mental health providers.

PubMed

Freimuth, Marilyn

2008-09-01

Alcohol use problems (AUPs) are prevalent among people seeking psychotherapy. Despite mandates from managed care companies to routinely screen for AUPs, little is known about the screening practices of providers or their ability to identify AUPs based on presenting symptoms. Participants (N = 117) read two case vignettes and suggested initial diagnoses and questions they would ask in order to clarify a diagnosis. Participants were more likely to ask about substance use and diagnose an AUP when the vignette contained explicit reference to the client's substance use as compared to a vignette where the signs of an AUP were more subtle. In both vignettes, a mental health problem was a more likely diagnosis than an AUP. Neither participant attributes nor personal or professional experiences with AUPs reliably shaped responses to the vignettes. The findings are discussed in light of their implications for future research and improved training in addictions for mental health providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Online Interactive Video Vignettes (IVVs)

NASA Astrophysics Data System (ADS)

Laws, Priscilla

2016-03-01

Interest in on-line learning is increasing rapidly. A few years ago members of the LivePhoto Physics Group1 received collaborative NSF Grants2 to create short, single-topic, on-line activities that invite introductory physics students to make individual predictions about a phenomenon and test them though video observations or analysis. Each Vignette is designed for web delivery as: (1) an ungraded homework assignment or (2) an exercise to prepare for a class or tutorial session. Sample IVVs are available at the ComPadre website http://www.compadre.org/ivv/. Portions of Vignettes on mechanics topics including Projectile Motion, Circular Motion, the Bullet-Block phenomenon, and Newton's Third Law will be presented. Those attending this talk will be asked to guess what predictions students are likely to make about phenomena in various IVVs. These predictions can be compared to those made by students who completed Vignettes. Finally, research on the impact of Vignettes on student learning and attitudes will be discussed. Co-PI Robert Teese, Rochester Institute of Technology.

Learning Happens: 30 Video Vignettes of Babies and Toddlers Learning School Readiness Skills through Everyday Interactions. [DVD and Guide

ERIC Educational Resources Information Center

Lerner, Claire; Parlakian, Rebecca

2007-01-01

This DVD (duration: 1 hour 53 seconds) features 30 video vignettes that show parents and children--aged birth to 3 years--interacting during everyday play and routines. These vignettes, some in English and some in Spanish, are designed to be tools for professionals to use both in direct work with families and for training other early child…

The Genomic Revolution and Beliefs about Essential Racial Differences: A Backdoor to Eugenics?

PubMed Central

Phelan, Jo C.; Link, Bruce G.; Feldman, Naumi M.

2014-01-01

Could the explosion of genetic research in recent decades affect our conceptions of race? In Backdoor to Eugenics, Duster argues that reports of specific racial differences in genetic bases of disease, in part because they are presented as objective facts whose social implications are not readily apparent, may heighten public belief in more pervasive racial differences. We tested this hypothesis with a multi-method study. A content analysis showed that news articles discussing racial differences in genetic bases of disease increased significantly between 1985 and 2008 and were significantly less likely than non–health-related articles about race and genetics to discuss social implications. A survey experiment conducted with a nationally representative sample of 559 adults found that a news-story vignette reporting a specific racial difference in genetic risk for heart attacks (the Backdoor Vignette) produced significantly greater belief in essential racial differences than did a vignette portraying race as a social construction or a no-vignette condition. The Backdoor Vignette produced beliefs in essential racial differences that were virtually identical to those produced by a vignette portraying race as a genetic reality. These results suggest that an unintended consequence of the genomic revolution may be the reinvigoration of age-old beliefs in essential racial differences. PMID:24855321

Use of antipsychotic blood levels in clinician decision making: A cross-over study using clinical vignettes of patients with schizophrenia.

PubMed

Savitz, Adam; Melkote, Rama; Riley, Ralph; Pobre, Maria A; McQuarrie, Kelly; Williamson, David; Banderas, Benjamin

2018-05-19

The cause of treatment failure of antipsychotic medications is often difficult to determine in patients with schizophrenia. Evaluation of antipsychotic blood levels (ABLs) may aid clinicians in determining the cause of antipsychotic failure. The Clinical Assessment of the Schizophrenia Patient (CASP) was developed to evaluate clinical decision making during outpatient visits. The CASP assesses changes in medications, psychosocial treatments, and acute interventions along with factors influencing clinical decision making. Nine vignettes representative of clinical situations in patients with schizophrenia were created in two versions (one with ABLs, one without ABLs). The CASP was used to evaluate clinical decisions using the vignettes. Thirty-four clinicians participated in the study. In 8 out of 9 vignettes, most clinicians (at least 89.7%) made a different clinical decision with ABLs compared to without ABLs. In assessing the usefulness of ABLs, a majority (60.7%-85.7%, depending on the vignette) of clinicians responded that ABLs changed their clinical decision for 8 vignettes. Most clinicians (79%-93%) responded that they were more confident in their decisions with ABL information. This study demonstrated that ABLs have the potential to influence clinical decision making in the treatment of patients with schizophrenia. Copyright © 2018. Published by Elsevier B.V.

Using clinical vignettes to assess doctors' and medical students' ability to identify sociocultural factors affecting health and health care.

PubMed

Hudelson, Patricia; Perron, N Junod; Perneger, Thomas

2011-01-01

Methods are needed for assessing clinicians' cultural knowledge frameworks. We used a mail survey containing four short clinical vignettes to explore respondents' ability to identify sociocultural factors affecting health and health care. Participants included 299 physicians working at the University Hospitals of Geneva, 156 private physicians, and all 134 local medical students in their clinical years. Twenty-one sociocultural "domains" were identified through inductive coding of responses. For each vignette, we obtained the sum of codes as a measure of the respondent's awareness of sociocultural factors that might affect care in this particular situation. As internal consistency was reasonably high (0.68), we computed a single total score as the sum of responses given to all four vignettes. Reponses correlated with factors that might be expected to impact clinicians' awareness of sociocultural factors affecting care. Medical students, females, respondents who had received cultural competence training, those with greater interest in caring for immigrant patients, and those with high self-assessed skills at exploring psychosocial and migration-related issues scored higher on the vignettes. Brief clinical vignettes appear to be a relevant and feasible method for exploring physicians' knowledge of social and cultural factors affecting health and health care.

Referring patients to specialists: A structured vignette survey of Australian and British GPs

PubMed Central

Jiwa, Moyez; Gordon, Michael; Arnet, Hayley; Ee, Hooi; Bulsara, Max; Colwell, Brigitte

2008-01-01

Background In Australia and in the United Kingdom (UK) access to specialists is sanctioned by General Practitioners (GPs). It is important to understand how practitioners determine which patients warrant referral. Methods A self-administered structured vignette postal survey of General Practitioners in Western Australia and the United Kingdom. Sixty-four vignettes describing patients with colorectal symptoms were constructed encompassing six clinical details. Nine vignettes, chosen at random, were presented to each individual. Respondents were asked if they would refer the patient to a specialist and how urgently. Logistic regression and parametric tests were used to analyse the data Results We received 260 completed questionnaires. 58% of 'cancer vignettes' were selected for 'urgent' referral. 1632/2367 or 69% of all vignettes were selected for referral. After adjusting for clustering the model suggests that 38.4% of the variability is explained by all the clinical variables as well as the age and experience of the respondents. 1012 or 42.8 % of vignettes were referred 'urgently'. After adjusting for clustering the data suggests that 31.3 % of the variability is explained by the model. The age of the respondents, the location of the practice and all the clinical variables were significant in the decision to refer urgently. Conclusion GPs' referral decisions for patients with lower bowel symptoms are similar in the two countries. We question the wisdom of streaming referrals from primary care without a strong evidence base and an effective intervention for implementing guidelines. We conclude that implementation must take into account the profile of patients but also the characteristics of GPs and referral policies. PMID:18194578

Asking for work adjustments or initiating behavioural changes - what makes a 'problematic co-worker' score Brownie points? An experimental study on the reactions towards colleagues with a personality disorder.

PubMed

Muschalla, Beate; Fay, Doris; Seemann, Anne

2016-10-01

People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues' reactions towards a problematic worker dependent on the returning person's reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.

Portraying mental illness and drug addiction as treatable health conditions: effects of a randomized experiment on stigma and discrimination.

PubMed

McGinty, Emma E; Goldman, Howard H; Pescosolido, Bernice; Barry, Colleen L

2015-02-01

Despite significant advances in treatment, stigma and discrimination toward persons with mental illness and drug addiction have remained constant in past decades. Prior work suggests that portraying other stigmatized health conditions (i.e., HIV/AIDS) as treatable can improve public attitudes toward those affected. Our study compared the effects of vignettes portraying persons with untreated and symptomatic versus successfully treated and asymptomatic mental illness and drug addiction on several dimensions of public attitudes about these conditions. We conducted a survey-embedded randomized experiment using a national sample (N = 3940) from an online panel. Respondents were randomly assigned to read one of ten vignettes. Vignette one was a control vignette, vignettes 2-5 portrayed individuals with untreated schizophrenia, depression, prescription pain medication addiction and heroin addiction, and vignettes 6-10 portrayed successfully treated individuals with the same conditions. After reading the randomly assigned vignette, respondents answered questions about their attitudes related to mental illness or drug addiction. Portrayals of untreated and symptomatic schizophrenia, depression, and heroin addiction heightened negative public attitudes toward persons with mental illness and drug addiction. In contrast, portrayals of successfully treated schizophrenia, prescription painkiller addiction, and heroin addiction led to less desire for social distance, greater belief in the effectiveness of treatment, and less willingness to discriminate against persons with these conditions. Portrayal of persons with successfully treated mental illness and drug addiction is a promising strategy for reducing stigma and discrimination toward persons with these conditions and improving public perceptions of treatment effectiveness. Copyright © 2014 Elsevier Ltd. All rights reserved.

Functional assessment of the elderly. A comparison of standard instruments with clinical judgment.

PubMed

Pinholt, E M; Kroenke, K; Hanley, J F; Kussman, M J; Twyman, P L; Carpenter, J L

1987-03-01

Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable through early intervention.

Nursing home nurses' and community-dwelling older adults' reported knowledge, attitudes, and behavior toward antibiotic use.

PubMed

Kistler, Christine E; Beeber, Anna; Becker-Dreps, Sylvia; Ward, Kimberly; Meade, Megan; Ross, Brittany; Sloane, Philip D

2017-01-01

Antibiotic overuse causes antibiotic resistance, one of the most important threats to human health. Older adults, particularly those in nursing homes, often receive antibiotics when they are not indicated. To understand knowledge, attitudes, and behaviors of nursing home (NH) nurses and community-dwelling older adults towards antibiotic use, especially in clinical situations consistent with antibiotic overuse, we conducted a mixed-method survey in two NHs and one Family Medicine clinic in North Carolina, among English-speaking nurses and community-dwelling, cognitively intact adults aged 65 years or older. Based on the Knowledge-Attitude-Practice model, the survey assessed knowledge, attitudes, and behavior towards antibiotic use, including three vignettes designed to elicit possible antibiotic overuse: asymptomatic bacteriuria (ASB), a viral upper respiratory illness (URI), and a wound from a fall. Of 31 NH nurses and 66 community-dwelling older adults, 70% reported knowledge of the dangers of taking antibiotics. Nurses more often reported evidence-based attitudes towards antibiotics than older adults, except 39% agreed with the statement "by the time I am sick enough to go to the doctor with a cold, I expect an antibiotic", while only 28% of older adults agreed with it. A majority of nurses did not see the need for antibiotics in any of the three vignettes: 77% for the ASB vignette, 87% for the URI vignette, and 97% for the wound vignette. Among older adults, 50% did not perceive a need for antibiotics in the ASB vignette, 58% in the URI vignette, and 74% in the wound vignette. While a substantial minority had no knowledge of the dangers of antibiotic use, non-evidence-based attitudes towards antibiotics, and behaviors indicating inappropriate management of suspected infections, most NH nurses and community-dwelling older adults know the harms of antibiotic use and demonstrate evidence-based attitudes and behaviors. However, more work is needed to improve the knowledge, attitudes and behaviors that may contribute to antibiotic overuse.

French Swiss physicians' attitude toward palliative sedation: Influence of prognosis and type of suffering.

PubMed

Beauverd, M; Bernard, M; Currat, T; Ducret, S; Foley, R A; Borasio, G D; Blondeau, D; Dumont, S

2014-10-01

Palliative sedation is a last resort medical act aimed at relieving intolerable suffering induced by intractable symptoms in patients at the end-of-life. This act is generally accepted as being medically indicated under certain circumstances. A controversy remains in the literature as to its ethical validity. There is a certain vagueness in the literature regarding the legitimacy of palliative sedation in cases of non-physical refractory symptoms, especially "existential suffering." This pilot study aims to measure the influence of two independent variables (short/long prognosis and physical/existential suffering) on the physicians' attitudes toward palliative sedation (dependent variable). We used a 2 × 2 experimental design as described by Blondeau et al. Four clinical vignettes were developed (vignette 1: short prognosis/existential suffering; vignette 2: long prognosis/existential suffering; vignette 3: short prognosis/physical suffering; vignette 4: long prognosis/physical suffering). Each vignette presented a terminally ill patient with a summary description of his physical and psychological condition, medication, and family situation. The respondents' attitude towards sedation was assessed with a six-point Likert scale. A total of 240 vignettes were sent to selected Swiss physicians. 74 vignettes were completed (36%). The means scores for attitudes were 2.62 ± 2.06 (v1), 1.88 ± 1.54 (v2), 4.54 ± 1.67 (v3), and 4.75 ± 1.71 (v4). General linear model analyses indicated that only the type of suffering had a significant impact on the attitude towards sedation (F = 33.92, df = 1, p = 0.000). Significance of the results: The French Swiss physicians' attitude toward palliative sedation is more favorable in case of physical suffering than in existential suffering. These results are in line with those found in the study of Blondeau et al. with Canadian physicians and will be discussed in light of the arguments given by physicians to explain their decisions.

Children's Eyewitness Memory for Multiple Real-Life Events

ERIC Educational Resources Information Center

Odegard, Timothy N.; Cooper, Crystal M.; Lampinen, James M.; Reyna, Valerie F.; Brainerd, Charles J.

2009-01-01

The present research examined the influence of prior knowledge on children's free recall, cued recall, recognition memory, and source memory judgments for a series of similar real-life events. Forty children (5-12 years old) attended 4 thematic birthday parties and were later interviewed about the events that transpired during the parties using…

Teacher Judgments of Competence of Male Junior High School Students.

ERIC Educational Resources Information Center

Fisher, Lawrence

Junior High School (JHS) teachers were interviewed to determine their criteria for competent and incompetent student behavior in school and their verbatim statements were adapted into questionnaire format. Two hundred and eleven male students were rated on competence in 15 classrooms by their teachers and a series of factor analytic procedures…

What Students Want You to Know: Promoting Achievement in Postsecondary Students with Anxiety Disorders

ERIC Educational Resources Information Center

Sokal, Laura; Desjardins, Nicole

2016-01-01

Eight Canadian postsecondary students who had been diagnosed with anxiety disorders were interviewed to determine their perceptions of the supports and barriers they experienced at university. Qualitative analysis revealed four themes related to student needs: self-determination; shame, guilt, and judgment; control; and trust. Students provided…

Berkeley Doctoral Students Appraise Their Academic Programs.

ERIC Educational Resources Information Center

Heiss, Ann M.

1967-01-01

This study was designed to obtain the judgment of doctoral students about the quality and character of their experiences in graduate study, and to identify stress stages in the degree process. An analysis was made of over 2,300 responses to a survey questionnaire and 100 interviews with doctoral students at the University of California at…

Assessment of the Influence of Demographic and Professional Characteristics on Health Care Providers' Pain Management Decisions Using Virtual Humans.

PubMed

Boissoneault, Jeff; Mundt, Jennifer M; Bartley, Emily J; Wandner, Laura D; Hirsh, Adam T; Robinson, Michael E

2016-05-01

Disparities in health care associated with patients' gender, race, and age are well documented. Previous studies using virtual human (VH) technology have demonstrated that provider characteristics may play an important role in pain management decisions. However, these studies have largely emphasized group differences. The aims of this study were to examine dentists' and physicians' use of VH characteristics when making clinical judgments (i.e., cue use) and to identify provider characteristics associated with the magnitude of the impact of these cues (β-weights). Providers (N=152; 76 physicians, 76 dentists) viewed video vignettes of VH patients varying in gender (male/female), race (white/black), and age (younger/older). Participants rated VH patients' pain intensity and unpleasantness and then rated their own likelihood of administering non-opioid and opioid analgesics. Compared to physicians, dentists had significantly lower β-weights associated with VH age cues for all ratings (p<0.001; d>0.69). These effects varied by provider race and gender. For pain intensity, professional differences were present only among non-white providers. White providers had greater β-weights than non-white providers for pain unpleasantness but only among men. Provider differences regarding the use of VH age cues in non-opioid analgesic administration were present among all providers except non-white males. These findings highlight the interaction of patient and provider factors in driving clinical decision making. Although profession was related to use of VH age cues in pain-related clinical judgments, this relationship was modified by providers' personal characteristics. Additional research is needed to understand what aspects of professional training or practice may account for differences between physicians and dentists and what forms of continuing education may help to mitigate the disparities.

Audit of admission to medical school: II--Shortlisting and interviews.

PubMed Central

McManus, I C; Richards, P

1984-01-01

Analysis of shortlisting of applicants for interview at St Mary's Hospital Medical School showed that factor analysis could reduce the selection criteria to three independent scales--"academic ability," "interests," and "community service"--all of which contributed to the interview decision. Early applicants scored more highly on all three factors but were still at a greater advantage in selection for interview than would have been predicted. The dean's judgment of priority for interview from the UCCA form was found to predict a candidate's chance of acceptance at other medical schools besides St Mary's. Analysis of interviewing showed high correlations among interviewers in their assessments, although there was evidence of influence by the chairmen. Factor analysis showed three major factors--academic suitability, non-academic suitability, and health--of which non academic suitability was the major determinant of interview success. Non academic suitability was related to personality (high extraversion and low psychoticism) and to the choices made on the UCCA form. The system of admission interviews enabled greater emphasis to be put on broader interests and achievements than if selection had been on the basis of UCCA application form alone. PMID:6437522

Are inspectors' assessments reliable? Ratings of NHS acute hospital trust services in England.

PubMed

Boyd, Alan; Addicott, Rachael; Robertson, Ruth; Ross, Shilpa; Walshe, Kieran

2017-01-01

The credibility of a regulator could be threatened if stakeholders perceive that assessments of performance made by its inspectors are unreliable. Yet there is little published research on the reliability of inspectors' assessments of health care organizations' services. Objectives We investigated the inter-rater reliability of assessments made by inspectors inspecting acute hospitals in England during the piloting of a new regulatory model implemented by the Care Quality Commission (CQC) during 2013 and 2014. Multi-professional teams of inspectors rated service provision on a four-point scale for each of five domains: safety; effectiveness; caring; responsiveness; and leadership. Methods In an online survey, we asked individual inspectors to assign a domain and a rating to each of 10 vignettes of service information extracted from CQC inspection reports. We used these data to simulate the ratings that might be produced by teams of inspectors. We also observed inspection teams in action, and interviewed inspectors and staff from hospitals that had been inspected. Results Levels of agreement varied substantially from vignette to vignette. Characteristics such as professional background explained only a very small part of the variation. Overall, agreement was higher on ratings than on domains, and for groups of inspectors compared with individual inspectors. A number of potential causes of disagreement were identified, such as differences regarding the weight that should be given to contextual factors and general uncertainty about interpreting the rating and domain categories. Conclusion Groups of inspectors produced more reliable assessments than individual inspectors, and there is evidence to support the utility of appropriate discussions between inspectors in improving reliability. The reliability of domain allocations was lower than for ratings. It is important to define categories and rating levels clearly, and to train inspectors in their use. Further research is needed to replicate these results now that the model has been fully implemented, and to understand better the impact that inspector uncertainty and disagreement may have on published CQC ratings.

Using short vignettes to disentangle perceived capability from motivation: a test using walking and resistance training behaviors.

PubMed

Rhodes, Ryan E; Williams, David M; Mistry, Chetan D

2016-07-01

Self-efficacy is arguably the strongest correlate of physical activity, yet some researchers suggest this is because the construct confounds ability with motivation. We examine a more circumscribed construct, called perceived capability (PC), meant to measure ability but not motivation and propose that the construct will not be related to unskilled physical activities but may be linked to skilled behaviors. The purpose of this paper was to examine whether a PC construct can be stripped of motivation using a vignette approach in both walking and resistance training behaviors. Participants were a random sample of 248 university students, who were then randomly assigned to either answer resistance training or walking behavior questions. Both groups completed a PC measure and reasons for their answer before and after reading a vignette that clarified the phrasing of capability to a literal use of the term. PC was significantly (p < .01) higher post- compared to pre-vignette and the differences were greater (p < .01) for walking than for resistance training. PC had significantly (p < .01) smaller correlations with intention and self-reported behavior post-disambiguation, which resulted in a null relationship with walking but a small correlation with resistance training behavior. When PC was combined with intention to predict behavior, however, there was no significant (p > .05) difference in the amount of variance explained pre- to post-vignette. Thought listing showed that participants did not report capability barriers to walking and over half of the sample construed capability as motivation/other priorities pre-vignette. The findings support use of a vignette approach for researchers who wish to disentangle the assessment of PC from motivation while creating no overall loss in explained variance of physical activity.

The physiological correlates of children's emotions in contexts of moral transgression.

PubMed

Malti, Tina; Colasante, Tyler; Zuffianò, Antonio; de Bruine, Marieke

2016-02-01

Heightened attention to sociomoral conflicts and arousal at the prospect of committing moral transgressions are thought to increase the likelihood of negatively valenced moral emotions (NVMEs; e.g., guilt) in children. Here, we tested this biphasic model of moral emotions with a psychophysiological framework. For a series of vignettes depicting moral transgressions, 5- and 8-year-olds (N=138) were asked to anticipate their emotions as hypothetical victimizers. Their responses were coded for the presence and intensity of NVMEs. In addition, their heart rate (HR) was calculated for three intervals of interest: a baseline period, the presentation of vignettes, and the anticipation of emotions following vignettes. We used multilevel modeling to examine how change in children's HR across these intervals related to the intensity of their NVMEs. Those who experienced greater HR deceleration from baseline to vignettes and greater acceleration from vignettes to anticipated emotions reported more intense NVMEs. We discuss the potential attention- and arousal-related processes behind children's physiological reactivity and anticipated emotions in contexts of moral transgression. Copyright © 2015 Elsevier Inc. All rights reserved.

Temporo-parietal junction activity in theory-of-mind tasks: falseness, beliefs, or attention.

PubMed

Aichhorn, Markus; Perner, Josef; Weiss, Benjamin; Kronbichler, Martin; Staffen, Wolfgang; Ladurner, Gunther

2009-06-01

By combining the false belief (FB) and photo (PH) vignettes to identify theory-of-mind areas with the false sign (FS) vignettes, we re-establish the functional asymmetry between the left and right temporo-parietal junction (TPJ). The right TPJ (TPJ-R) is specially sensitive to processing belief information, whereas the left TPJ (TPJ-L) is equally responsible for FBs as well as FSs. Measuring BOLD at two time points in each vignette, at the time the FB-inducing information (or lack of information) is presented and at the time the test question is processed, made clear that the FB is processed spontaneously as soon as the relevant information is presented and not on demand for answering the question in contrast to extant behavioral data. Finally, a fourth, true belief vignette (TB) required teleological reasoning, that is, prediction of a rational action without any doubts being raised about the adequacy of the actor's information about reality. Activation by this vignette supported claims that the TPJ-R is activated by TBs as well as FBs.

Mammographers’ Perception of Women’s Breast Cancer Risk

PubMed Central

Egger, Joseph R.; Cutter, Gary R.; Carney, Patricia A.; Taplin, Stephen H.; Barlow, William E.; Hendrick, R. Edward; D’Orsi, Carl J.; Fosse, Jessica S.; Abraham, Linn; Elmore, Joann G.

2011-01-01

Objective To understand mammographers’ perception of individual women’s breast cancer risk. Materials and Methods Radiologists interpreting screening mammography examinations completed a mailed survey consisting of questions pertaining to demographic and clinical practice characteristics, as well as 2 vignettes describing different risk profiles of women. Respondents were asked to estimate the probability of a breast cancer diagnosis in the next 5 years for each vignette. Vignette responses were plotted against mean recall rates in actual clinical practice. Results The survey was returned by 77% of eligible radiologists. Ninety-three percent of radiologists overestimated risk in the vignette involving a 70-year-old woman; 96% overestimated risk in the vignette involving a 41-year-old woman. Radiologists who more accurately estimated breast cancer risk were younger, worked full-time, were affiliated with an academic medical center, had fellowship training, had fewer than 10 years experience interpreting mammograms, and worked more than 40% of the time in breast imaging. However, only age was statistically significant. No association was found between radiologists’ risk estimate and their recall rate. Conclusion U.S. radiologists have a heightened perception of breast cancer risk. PMID:15951455

Dietary Supplement Polypharmacy: An Unrecognized Public Health Problem?

PubMed Central

Gryzlak, Brian M.; Zimmerman, M. Bridget; Wallace, Robert B.

2010-01-01

Excessive and inappropriate use of medications, or ‘polypharmacy’, has been recognized as a public health problem. In addition, there is growing use of dietary supplements in the United States; however, little is known about the patterns of supplement use. Recent reports in the literature of cases of excessive or inappropriate use of herbal dietary supplements leading to the term ‘polyherbacy’. The clinical vignettes described in this article highlight the need for further research on the nature and extent of multiple and inappropriate dietary supplement use or ‘dietary supplement polypharmacy’. Clinical interviewing and population surveys both address this issue in complementary ways, and provide a further understanding of dietary supplement use patterns. PMID:18955288

Using the HEADSSS guide to teach students diagnostic skills in adolescent health Views from students participating in interprofessional courses.

PubMed

Parisi, Vanessa; De Stadelhofen, Léo Meyer; Péchère, Benoit; Steimer, Sylvain; De Watteville, Aude; Haller, Dagmar M; Navarro, Carol; Szynalski-Morel, Murielle; Meynard, Anne

Over the past few years, an interprofessional team of lecturers in Geneva has developed courses entitled « adolescent health and development ». These courses are open to students in medicine, nursing and nutrition, as well as to other interested health professionals. Using vignettes, students who participated in the courses present their thoughts on the use of the HEADSSS interview guide in the diagnostic approach with adolescents. These optional courses provide an opportunity to explore infrequently taught domains of the curriculum in a creative way. They give students the chance to develop common practice skills providing the basis for improved inter-professional collaborations in the future.

What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform.

PubMed

Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto

2015-02-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. © The Author(s) 2014.

What Would It Take? Stakeholders’ Views and Preferences for Implementing a Health Care Manager Program in Community Mental Health Clinics Under Health Care Reform

PubMed Central

Cabassa, Leopoldo J.; Gomes, Arminda P.; Lewis-Fernández, Roberto

2015-01-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders’ recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. PMID:25542194

The role of emotion regulation in situational empathy-related responding and prosocial behaviour in the presence of negative affect.

PubMed

Hein, Sascha; Röder, Mandy; Fingerle, Michael

2016-12-15

Empathy and prosocial behaviour are crucial factors for children's positive social adjustment. Contemporary models of empathy highlight the capacity to regulate vicariously experienced emotions as a precursor to empathy-related responses (e.g., prosocial behaviour). The goal of this study was to examine the role of emotion regulation (ER) in situational empathy-related responding and prosocial behaviour. A sample of 157 children (76 boys and 81 girls; M age = 9.94 years) participated in a two-tiered interview procedure that utilised vignettes to assess empathy and prosocial behaviour. Between both phases of the interview, a negative affect was induced to investigate the influence of ER on the change between the two phases. Results from a latent change model showed that ER strategies positively predicted change scores, that is, children with higher abilities to regulate emotions showed a higher increase in empathy and prosocial behaviour. Implications for the promotion of social-emotional learning in school are discussed. © 2016 International Union of Psychological Science.

Adolescent judgments and reasoning about the failure to include peers with social disabilities.

PubMed

Bottema-Beutel, Kristen; Li, Zhushan

2015-06-01

Adolescents with autism spectrum disorder often do not have access to crucial peer social activities. This study examines how typically developing adolescents evaluate decisions not to include a peer based on disability status, and the justifications they apply to these decisions. A clinical interview methodology was used to elicit judgments and justifications across four contexts. We found adolescents are more likely to judge the failure to include as acceptable in personal as compared to public contexts. Using logistic regression, we found that adolescents are more likely to provide moral justifications as to why failure to include is acceptable in a classroom as compared to home, lab group, and soccer practice contexts. Implications for intervention are also discussed.

In the Orchard: Farm Worker Children's Moral and Environmental Reasoning

ERIC Educational Resources Information Center

Severson, Rachel L.; Kahn, Peter H., Jr.

2010-01-01

In this study, farm worker children (N = 40) in 2nd and 5th grade were interviewed about (a) their conceptions and judgments of pesticide exposure and (b) their reasoning about the moral standing of nature. First, results showed that all participants negatively judged pesticide exposure based on moral obligatory criteria. Yet, most children…

Students' Misconceptions in Interpreting Center and Variability of Data Represented via Histograms and Stem-and-Leaf Plots

ERIC Educational Resources Information Center

Cooper, Linda L.; Shore, Felice S.

2008-01-01

This paper identifies and discusses misconceptions that students have in making judgments of center and variability when data are presented graphically. An assessment addressing interpreting center and variability in histograms and stem-and-leaf plots was administered to, and follow-up interviews were conducted with, undergraduates enrolled in…

Mothers' Judgments of Students with Emotional Disturbance and Social Maladjustment/Conduct Disorder: Comparisons of Target Students and Siblings

ERIC Educational Resources Information Center

Easler, Ray C., Jr.; Medway, Frederic J.

2004-01-01

In response to United States special education law requirements, this study attempted to differentiate emotionally disturbed and socially maladjusted students using parent ratings on the FACES III and a newly developed interview measure of primarily internalizing and externalizing behaviors. Forty mothers of students in special education and 40…

The Cognitive Developmental Approach to "Epistemology" and Its Relation to Logical and Moral Stages.

ERIC Educational Resources Information Center

Broughton, John

This paper presents a cross-sectional investigation of adolescents' and young adults' reflective epistemological development. Three groups of 8 subjects (4 male and female) ages 10, 14, and 18 were given Piagetian tasks, the Kohlberg moral judgment questionnaire, and an epistemology interview covering such concepts as knowledge, thought, feeling,…

Multifactor Screener in the 2000 National Health Interview Survey Cancer Control Supplement: Definition of Acceptable Dietary Data Values

Cancer.gov

We used the U.S. Department of Agriculture's (USDA) 1994-96 Continuing Survey of Food Intakes of Individuals (CSFII) data on reported intakes over two days of 24-hour recall to make judgments about reasonable frequencies of consumption that were reported on a per day basis.

The Evolution of Children's Mental Addition.

ERIC Educational Resources Information Center

Ashcraft, Mark H.; Hamann, Mary Sue

Students in grades 1, 4, 7, and 10 were tested in a two-part investigation of simple and complex mental addition (with college students as a reference point). One session involved a normal reaction time task in which children made true/false judgments about a series of addition examples. The other session involved a verbal protocol interview, the…

Anchoring Vignettes in the Health and Retirement Study: How Do Medical Professionals and Disability Recipients Characterize the Severity of Work Limitations?

PubMed Central

Heiland, Frank; Yin, Na

2015-01-01

Purpose Recent studies report systematic differences in how individuals categorize the severity of identical health and work limitation vignettes. We investigate how health professionals and disability recipients characterize the severity of work limitations and whether their reporting patterns are robust to demographic, education, and health characteristics. We use the results to illustrate the potential impact of reporting heterogeneity on the distribution of work disability estimated from self-reported categorical health and disability data. Method Nationally representative data on anchoring disability vignettes from the 2004 Health and Retirement Study (HRS) are used to investigate how respondents with an occupation background in health and Social Security disability beneficiaries categorize work limitation vignettes. Using pain, cardiovascular health, and depression vignettes, we estimate generalized ordered probit models (N = 2,660 individuals or 39,681 person-vignette observations) that allow the severity thresholds to vary by respondent characteristics. Results We find that health professionals (excluding nurses) and disability recipients tend to classify identical work limitations as more severe compared to non-health professional non-disabled respondents. For disability recipients, the differences are most pronounced and particularly visible in the tails of the work limitations distribution. For health professionals, we observe smaller differences, affecting primarily the classification of mildly and moderately severe work limitations. The patterns for health professionals (excluding nurses) are robust to demographics, education, and health conditions. The greater likelihood of viewing the vignette person as more severely work limited observed among disability recipients is mostly explained by the fact that these respondents also tend to be in poorer health which itself predicts a more inclusive scale. Conclusions Knowledge of reporting scales from health professionals and disabled individuals can benefit researchers in a broad range of applications in health and disability research. They may be useful as reference scales to evaluate disability survey data. Such knowledge may be beneficial when studying disability programs. Given the increasing availability of anchoring vignette data in surveys, this is a promising area for future evaluation research. PMID:25966316

The Differential Diagnosis of Pulmonary Blastomycosis Using Case Vignettes: A Wisconsin Network for Health Research (WiNHR) Study

PubMed Central

Baumgardner, Dennis J.; Temte, Jonathan L.; Gutowski, Erin; Agger, William A.; Bailey, Howard; Burmester, James K.; Banerjee, Indrani

2012-01-01

Purpose Pulmonary blastomycosis is an uncommon but serious fungal infection endemic in Wisconsin. Clinician awareness of the protean presentations of this disease may reduce diagnostic delay. This study addressed the diagnostic accuracy of physicians responding to case vignettes of pulmonary blastomycosis and the primary care differential diagnosis of this disease. Methods Eight pulmonary blastomycosis cases were developed from case files. From these, 2 vignettes were randomly selected and mailed to primary care physicians in the Wisconsin Network for Health Research. Respondents were asked to list the 3 most likely diagnoses for each case. Results Respondents listed Blastomycosis as the most likely diagnosis for 37/227 (16%) case vignettes, and 1 of the 3 most likely diagnoses for 43/227 (19%). When vignettes included patient activity in counties with an annual incidence rate of blastomycosis greater than 2/100,000, compared to counties with lower incidence rates, diagnosis was more accurate (28/61 [46%] vs 15/166 [9%]; P < 0.001). Physicians with practice locations in counties with annual blastomycosis incidence rates >2/100,000 listed blastomycosis more commonly than physicians from other counties (16/36 [44%] vs 27/177 [15%]; P < 0.001). This difference in accurate diagnosis remained significant in a multivariate model of practice demographics. Based on responses to the vignettes, pneumonia, cancer, non-infectious pulmonary disease, and tuberculosis emerged as the most-frequently noted diagnosis in the differential diagnosis of blastomycosis. Conclusion Blastomycosis was not listed as 1 of 3 primary diagnoses in a majority of cases when Wisconsin primary care physicians considered case vignettes of actual pulmonary blastomycosis cases. Diagnosis was more accurate if the patient vignette listed exposure to a higher incidence county, or if the physician practiced in a higher incidence county. In Wisconsin, failure to include blastomycosis in the differential diagnoses of illnesses associated with a wide variety of pulmonary symptoms suspected to represent infectious or non-infectious pulmonary, cardiac, or neoplastic disease, regardless of geographic exposure, could result in excess morbidity or mortality. PMID:21560560

Understanding how patients perceive physician wellness and its links to patient care: A qualitative study

PubMed Central

Dixit, Jaya; Yiu, Verna

2018-01-01

Despite increased interest in physician wellness, little is known about patients’ views on the topic. We explore patients’ perceptions of physician wellness and how it links to patient care. This exploratory, qualitative study employed semi-structured interviews with a convenience sample of 20 patients from outpatient care settings in a western Canadian city. Using inductive thematic analysis, interview transcripts were independently coded by two authors and then discussed to ensure consensus and to abstract into higher-level themes. Three overarching premises were identified. First, patients notice cues that they interpret as signs of physician wellness. These include overt indicators, such as a physician’s demeanor or physical appearance, along with a general impression about a physician’s wellness. Second, patients form judgments based on what they notice, and these judgments affect patients’ views about their care; feelings, such as trust, in their interactions with physicians; and actions, such as following care plans. Third, participants perceive a bi-directional link between physician wellness and patient care. Physician wellness impacts patient care, but physician wellness is also impacted by the care they provide and the challenges they face within the healthcare system. Patients’ judgments regarding physician wellness may have important impacts on the doctor-patient relationship. Furthermore, patients appear to have a nuanced understanding about how physicians’ work may put physicians at risk for being unwell. Patients may be powerful allies in supporting physician wellness initiatives focused on the shared responsibility of individual physicians, the medical profession, and healthcare organizations. PMID:29763443

Neuropsychological Correlates of Capacity Determinations in Alzheimer’s Disease: Implications for Assessment

PubMed Central

Palmer, Barton W.; Ryan, Kerry A.; Kim, H. Myra; Karlawish, Jason H.; Appelbaum, Paul S.; Kim, Scott Y. H.

2011-01-01

Objectives To explore the neuropsychological correlates of the capacity to consent to research and to appoint a research proxy among persons with Alzheimer’s disease. Design, Setting, and Participants Interview study of 77 persons with Alzheimer’s disease recruited through an Alzheimer’s disease research center and a memory disorder clinic. Measurements The capacity to consent to two research scenarios (a drug randomized clinical trial and a neurosurgical clinical trial) and the capacity to appoint a research proxy were determined by five experienced consultation psychiatrists who rendered categorical judgments based on videotaped interviews of the MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) and the Capacity to Appoint a Proxy Assessment (CAPA). Mattis Dementia Rating Scale-2 (DRS-2) was used to assess neuropsychological functioning. Results The capacity to appoint a proxy and to consent to the drug randomized clinical trial, as determined by a majority or greater opinion of the 5-psychiatrist panel, were predicted by Conceptualization and Initiation/Perseveration subscales whereas the capacity to consent to a neurosurgical randomized clinical trial was predicted by the Memory subscale. Furthermore, the more lenient individual psychiatrists’ judgments were predicted by the Conceptualization subscale whereas the stricter psychiatrists’ judgments were predicted by the Memory subscale. Conclusions How experienced psychiatrists view Alzheimer’s patients’ capacity for consenting to research and for appointing a proxy may be related to the patients’ conceptualization and memory functioning. More explicit and standardized guidance on the role of short term memory in capacity determinations may be useful. PMID:23498384

Age and excuses for forgetting: self-handicapping versus damage-control strategies.

PubMed

Erber, J T; Prager, I G

2000-01-01

Either before or after being interviewed for a volunteer position, a young or old protagonist (i.e., target) gave an excuse for forgetting. Study participants (i.e., perceivers) had a higher opinion of the target's memory, were more confident in the target's capability of performing memory-related tasks, and attributed the target's memory failures more to bad luck when the excuse was given after (damage-control strategy) rather than before (self-handicapping strategy) the interview. Moreover, the excuse given before the interview had no significant effect on perceivers' judgments when compared with data from an earlier study in which the target gave no excuse for forgetting. The present findings suggest that a damage-control strategy can ameliorate negative capability impressions.

Self-other agreement of personality judgments in job interviews: exploring the effects of trait, gender, age and social desirability.

PubMed

Nederström, Mikael; Salmela-Aro, Katariina

2014-10-01

The article investigated agreement between self-reports and stranger ratings of personality. A sample of 139 real-life job applicants was interviewed by expert psychologists upon entrance to the assessment center. The applicants provided self-descriptions on 15 personality factors, and the psychologists rated the same traits of each target based on their impressions in the interview. The results demonstrated that professional judges can reach a substantial self-other agreement (SOA) on several traits even when the targets are strangers, and that the trait being judged, the target's gender, age and social desirability have an effect on the level of agreement. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Physician styles of patient management as a potential source of disparities: cluster analysis from a factorial experiment.

PubMed

Lutfey, Karen E; Gerstenberger, Eric; McKinlay, John B

2013-06-01

To identify styles of physician decision making (as opposed to singular clinical actions) and to analyze their association with variations in the management of a vignette presentation of coronary heart disease (CHD). Primary data were collected from primary care physicians in North and South Carolina. In a balanced factorial experimental design, primary care physicians viewed one of 16 (2(4)) video vignette presentations of CHD and provided detailed information about how they would manage the case. 256 MD primary care physicians were interviewed face-to-face in North and South Carolina. We identify three clusters depicting unique styles of CHD management that are robust to controls for physician (gender and level of experience) and patient characteristics (age, gender, socioeconomic status, and race) as well as key organizational features of physicians' work settings. Physicians in Cluster 1 "Cardiac" (N = 92) were more likely to focus on cardiac issues compared with their counterparts; physicians in Cluster 2 "Talkers" (N = 93) were more likely to give advice and take additional medical history; whereas physicians in Cluster 3 "Minimalists" (N = 71) were less likely than their counterparts to take action on any of the types of management behavior. Variations in styles of decision making, which encompass multiple outcome variables and extend beyond individual-level demographic predictors, may add to our understanding of disparities in health quality and outcomes. © Health Research and Educational Trust.

Patterns of stigma toward schizophrenia among the general population: a latent profile analysis.

PubMed

Loch, Alexandre A; Wang, Yuan-Pang; Guarniero, Francisco B; Lawson, Fabio L; Hengartner, Michael P; Rössler, Wulf; Gattaz, Wagner F

2014-09-01

Our purpose was to assess stigma toward schizophrenia in a representative sample of the Brazilian general population. The sample consisted of 1015 individuals interviewed by telephone. A vignette describing someone with schizophrenia was read, and four stigma aspects regarding this hypothetical individual were assessed: stereotypes, restrictions, perceived prejudice and social distance. Latent profile analysis searched for stigma profiles among the sample. Multinomial logistic regression was used to find correlates of each class. Four stigma profiles were found; 'no stigma' individuals (n = 251) mostly displayed positive opinions. 'Labelers' (n = 222) scored high on social distance; they more often had familial contact with mental illness and more often labeled the vignette's disorder as schizophrenia. 'Discriminators', the group with the majority of individuals (n = 302), showed high levels of stigmatizing beliefs in all dimensions; discriminators were significantly older. 'Unobtrusive stigma' individuals (n = 240) seemed to demonstrate uncertainty or low commitment since they mostly answered items with the middle/impartial option. Some findings from the international literature were replicated; however, familial contact increased stigma, possibly denoting a locally modulated determinant. Hereby, our study also adds important cross-cultural data by showing that stigma toward schizophrenia is high in a Latin-American setting. We highlight the importance of analyzing the general population as a heterogeneous group, aiming to better elaborate anti-stigma campaigns. © The Author(s) 2013.

Influences on the perception of elder financial abuse among older adults in Southern California.

PubMed

Knight, Bob G; Kim, Seungyoun; Rastegar, Sarah; Jones, Scott; Jump, Victoria; Wong, Serena

2016-01-01

Under-reporting of elder financial abuse is partly due to failure of those around the victim to perceive the financial mistreatment as abuse. This study explored the effect of victim and perceiver factors on perception of elder financial abuse in the context of Routine Activity Theory (RAT). 488 older adults in Ventura County (CA) were surveyed about financial abuse using vignette method. In the study's Vignette 1, the amount of money taken, the type of frailty, and the relationship of perpetrator and victim were manipulated. In Vignette 2, the victim's age and relationship of perpetrator and victim were manipulated. Respondents' demographics (age, gender, education, and ethnicity) were collected. Logistic regression analyses revealed that children of the victim were least likely to be seen as committing abuse in both vignettes. In Vignette 1, there was an interaction of gender of respondent and the amount of money taken. In Vignette 2, non-Whites were less likely to perceive the signing over of the house as financial abuse. Respondents endorsed the concept of a special court with expertize in elder abuse as a way to increase the likelihood that they would report. Even though most financial abuse is perpetrated by family members, older adults are less likely to perceive a financial situation as abuse when it involves a child of the victim, thus making reporting and prevention less likely. The support for a specialty Elder Abuse Court (EAC) suggests that some reluctance to report is based on misgivings about punishing the perpetrator.

Model Minority Stereotype: Influence on Perceived Mental Health Needs of Asian Americans.

PubMed

Cheng, Alice W; Chang, Janet; O'Brien, Janine; Budgazad, Marc S; Tsai, Jack

2017-06-01

This study examined the influence of the model minority stereotype on the perceived mental health functioning of Asian Americans. It was hypothesized that college students would perceive Asian Americans as having fewer mental health problems and clinical symptoms than Whites due to the model minority stereotype. Four hundred and twenty-five undergraduate students from a predominately White college campus in the American northeast were randomly exposed to one of four conditions: (1) a clinical vignette describing a White college student suffering from adjustment disorder; (2) the same vignette describing an Asian American college student; (3) a newspaper article describing a success story of Whites and the White clinical vignette; (4) the same newspaper article and clinical vignette describing an Asian American. Following exposure to one of the conditions, participants completed a memory recall task and measures of colorblindness, attitudes towards Asian Americans, attitudes towards out-group members, and perceived mental health functioning. Participants exposed to the vignettes primed with the positive/model minority stereotype perceived the target regardless of race/ethnicity as having better mental health functioning and less clinical symptoms than the condition without the stereotype. Additionally, the stereotype primer was found to be a modest predictor for the perception of mental health functioning in Asian American vignettes. Results shed light on the impact of the model minority stereotype on the misperception of Asian Americans' mental health status, contributing to the invisibility or neglect of this minority group's mental health needs.

Negotiated dying: a grounded theory of how nurses shape withdrawal of treatment in hospital critical care units.

PubMed

Long-Sutehall, Tracy; Willis, Helen; Palmer, Rachel; Ugboma, Debra; Addington-Hall, Julia; Coombs, Maureen

2011-12-01

The process of withdrawal of treatment in critical care environments has created ethical and moral dilemmas in relation to end of life care in the UK and elsewhere. Common within this discourse is the differing demands made on health professionals as they strive to provide care for the dying patient and family members. Despite reports that withdrawal of treatment is a source of tension between those nurses and doctors involved in the process, the role of the nurse in facilitating withdrawal of treatment has received relatively little attention. To illustrate how differing dying trajectories impact on decision-making underpinning withdrawal of treatment processes, and what nurses do to shape withdrawal of treatment. Qualitative methods of enquiry using clinical vignettes and applying Charmaz's grounded theory method. Single audio-recorded qualitative interviews with thirteen critical care nurses from four intensive care specialities: cardiac; general; neurological and renal were carried out. Interviews were facilitated by an end-of-life vignette developed with clinical collaborators. Across critical care areas four key dying trajectories were identified. These trajectories were shaped by contested boundaries associated with delayed or stalled decision-making around how withdrawal of treatment should proceed. Nurses provided end of life care (including collaborative and action-oriented skills) to shape the dying trajectory of patients so as to satisfy the wishes of the patient and family, and their own professional aims. Differing views as to when withdrawal of treatment should commence and how it should be operationalised appeared to be underpinned by the requirements of the role that health professionals fulfil, with doctors focusing on making withdrawal of treatment decisions, and nurse's being tasked with operationalising the processes that constitute it. Multidisciplinary teams need a 'shared' understanding of each other's roles, responsibilities, aims, and motivations when planning and implementing the dying trajectory of withdrawal of treatment. 2011 Elsevier Ltd. All rights reserved.

Association of unconscious race and social class bias with vignette-based clinical assessments by medical students.

PubMed

Haider, Adil H; Sexton, Janel; Sriram, N; Cooper, Lisa A; Efron, David T; Swoboda, Sandra; Villegas, Cassandra V; Haut, Elliott R; Bonds, Morgan; Pronovost, Peter J; Lipsett, Pamela A; Freischlag, Julie A; Cornwell, Edward E

2011-09-07

Studies involving physicians suggest that unconscious bias may be related to clinical decision making and may predict poor patient-physician interaction. The presence of unconscious race and social class bias and its association with clinical assessments or decision making among medical students is unknown. To estimate unconscious race and social class bias among first-year medical students and investigate its relationship with assessments made during clinical vignettes. A secure Web-based survey was administered to 211 medical students entering classes at Johns Hopkins School of Medicine, Baltimore, Maryland, in August 2009 and August 2010. The survey included the Implicit Association Test (IAT) to assess unconscious preferences, direct questions regarding students' explicit race and social class preferences, and 8 clinical assessment vignettes focused on pain assessment, informed consent, patient reliability, and patient trust. Adjusting for student demographics, multiple logistic regression was used to determine whether responses to the vignettes were associated with unconscious race or social class preferences. Association of scores on an established IAT for race and a novel IAT for social class with vignette responses. Among the 202 students who completed the survey, IAT responses were consistent with an implicit preference toward white persons among 140 students (69%, 95% CI, 61%-75%). Responses were consistent with a preference toward those in the upper class among 174 students (86%, 95% CI, 80%-90%). Assessments generally did not vary by patient race or occupation, and multivariable analyses for all vignettes found no significant relationship between implicit biases and clinical assessments. Regression coefficient for the association between pain assessment and race IAT scores was -0.49 (95% CI, -1.00 to 0.03) and for social class, the coefficient was -0.04 (95% CI, -0.50 to 0.41). Adjusted odds ratios for other vignettes ranged from 0.69 to 3.03 per unit change in IAT score, but none were statistically significant. Analysis stratified by vignette patient race or class status yielded similarly negative results. Tests for interactions between patient race or class status and student IAT D scores in predicting clinical assessments were not statistically significant. The majority of first-year medical students at a single school had IAT scores consistent with implicit preference for white persons and possibly for those in the upper class. However, overall vignette-based clinical assessments were not associated with patient race or occupation, and no association existed between implicit preferences and the assessments.

Association of Unconscious Race and Social Class Bias With Vignette-Based Clinical Assessments by Medical Students

PubMed Central

Haider, Adil H.; Sexton, Janel; Sriram, N.; Cooper, Lisa A.; Efron, David T.; Swoboda, Sandra; Villegas, Cassandra V.; Haut, Elliott R.; Bonds, Morgan; Pronovost, Peter J.; Lipsett, Pamela A.; Freischlag, Julie A.; Cornwell, Edward E.

2012-01-01

Context Studies involving physicians suggest that unconscious bias may be related to clinical decision making and may predict poor patient-physician interaction. The presence of unconscious race and social class bias and its association with clinical assessments or decision making among medical students is unknown. Objective To estimate unconscious race and social class bias among first-year medical students and investigate its relationship with assessments made during clinical vignettes. Design, Setting, and Participants A secure Web-based survey was administered to 211 medical students entering classes at Johns Hopkins School of Medicine, Baltimore, Maryland, in August 2009 and August 2010. The survey included the Implicit Association Test (IAT) to assess unconscious preferences, direct questions regarding students’ explicit race and social class preferences, and 8 clinical assessment vignettes focused on pain assessment, informed consent, patient reliability, and patient trust. Adjusting for student demographics, multiple logistic regression was used to determine whether responses to the vignettes were associated with unconscious race or social class preferences. Main Outcome Measures Association of scores on an established IAT for race and a novel IAT for social class with vignette responses. Results Among the 202 students who completed the survey, IAT responses were consistent with an implicit preference toward white persons among 140 students (69%, 95% CI, 61%–75%). Responses were consistent with a preference toward those in the upper class among 174 students (86%, 95% CI, 80%–90%). Assessments generally did not vary by patient race or occupation, and multivariable analyses for all vignettes found no significant relationship between implicit biases and clinical assessments. Regression coefficient for the association between pain assessment and race IAT scores was −0.49 (95% CI, −1.00 to 0.03) and for social class, the coefficient was −0.04 (95% CI, −0.50 to 0.41). Adjusted odds ratios for other vignettes ranged from 0.69 to 3.03 per unit change in IAT score, but none were statistically significant. Analysis stratified by vignette patient race or class status yielded similarly negative results. Tests for interactions between patient race or class status and student IAT D scores in predicting clinical assessments were not statistically significant. Conclusions The majority of first-year medical students at a single school had IAT scores consistent with implicit preference for white persons and possibly for those in the upper class. However, overall vignette-based clinical assessments were not associated with patient race or occupation, and no association existed between implicit preferences and the assessments. PMID:21900134

Moral Judgment in Children: Their Responses to Children's Literature Examined Against Piaget's Stages of Moral Development.

ERIC Educational Resources Information Center

Weiger, Myra

Three stories were presented via audiovisual media to each of three classes in grade two, three classes in grade four, and three in grade six. Children were interviewed individually after the presentations and were asked which misdemeanor in the stories was naughtiest, whether the punishment was fair, what punishment would be fair, and why.…

In Their Own Words: Critical Thinking in Artists' Diaries and Interviews

ERIC Educational Resources Information Center

Green, Gaye

2006-01-01

It is not uncommon for art educators to always justify that artmaking is a serious endeavor that requires thought and reasoned judgment. Always, they also find themselves worried that arts will be reduced or eliminated when districts announce that cuts are needed to balance the budget or provide more room for the basics. These are problems often…

Support for self-management of cardiovascular disease by people with learning disabilities.

PubMed

Young, Anita F; Naji, Simon; Kroll, Thilo

2012-08-01

Cardiovascular disease (CVD) is the second most common cause of death among people with learning disabilities (LD), and lifestyle has been linked to risk factors. With a shift towards illness prevention and self-management support, it is important to know how people with LD can be involved in this process. To elicit the perceptions of people with LD, carers and health professionals regarding supported self-management of CVD. A qualitative approach used in-depth semi-structured interviews based on vignettes with accompanying pictures. Fourteen people with LD, 11 carers/care staff and 11 health professionals were recruited and interviewed. Thematic framework analysis was used to analyse interview data. In total, 11 men and 25 women were interviewed. All respondents contributed views of self-management with a wide range of opinions expressed within each participant group. Four key themes encompassed: strategies for self-management; understanding the prerequisites for self-management support; preferred supporters and challenges for self-management implementation. Facilitated service user involvement in self-management decision making was highly valued in all groups. Service users wished for co-ordinated incremental support from across agencies and individuals. People with LD can be effectively consulted regarding health management and their views can inform service development. Promoting joined-up support across health and social care and families will require investment in resources, education and dismantling of professional barriers.

Young Children’s Affective Responses to Another’s Distress: Dynamic and Physiological Features

PubMed Central

Fink, Elian; Heathers, James A. J.; de Rosnay, Marc

2015-01-01

Two descriptive studies set out a new approach for exploring the dynamic features of children’s affective responses (sadness and interest-worry) to another’s distress. In two samples (N study1 = 75; N study2 = 114), Kindergarten children were shown a video-vignette depicting another child in distress and the temporal pattern of spontaneous expressions were examined across the unfolding vignette. Results showed, in both study 1 and 2, that sadness and interest-worry had distinct patterns of elicitation across the events of the vignette narrative and there was little co-occurrence of these affects within a given child. Temporal heart rate changes (study 2) were closely aligned to the events of the vignette and, furthermore, affective responses corresponded to distinctive physiological response profiles. The implications of distinct temporal patterns of elicitation for the meaning of sadness and interest-worry are discussed within the framework of emotion regulation and empathy. PMID:25874952

A biopsychosocial vignette for case conceptualization in dementia (VIG-Dem): development and pilot study.

PubMed

Spector, Aimee; Hebditch, Molly; Stoner, Charlotte R; Gibbor, Luke

2016-09-01

The ability to identify biological, social, and psychological issues for people with dementia is an important skill for healthcare professionals. Therefore, valid and reliable measures are needed to assess this ability. This study involves the development of a vignette style measure to capture the extent to which health professionals use "Biopsychosocial" thinking in dementia care (VIG-Dem), based on the framework of the model developed by Spector and Orrell (2010). The development process consisted of Phase 1: Developing and refining the vignettes; Phase 2: Field testing (N = 9), and Phase 3: A pilot study to assess reliability and validity (N = 131). The VIG-Dem, consisting of two vignettes with open-ended questions and a standardized scoring scheme, was developed. Evidence for the good inter-rater reliability, convergent validity, and test-retest reliability were established. The VIG-Dem has good psychometric properties and may provide a useful tool in dementia care research and practice.

Pursuing Excellence: The Power of Selection Science to Provide Meaningful Data and Enhance Efficiency in Selecting Surgical Trainees.

PubMed

Gardner, Aimee K; Dunkin, Brian J

2018-05-01

As current screening methods for selecting surgical trainees are receiving increasing scrutiny, development of a more efficient and effective selection system is needed. We describe the process of creating an evidence-based selection system and examine its impact on screening efficiency, faculty perceptions, and improving representation of underrepresented minorities. The program partnered with an expert in organizational science to identify fellowship position requirements and associated competencies. Situational judgment tests, personality profiles, structured interviews, and technical skills assessments were used to measure these competencies. The situational judgment test and personality profiles were administered online and used to identify candidates to invite for on-site structured interviews and skills testing. A final rank list was created based on all data points and their respective importance. All faculty completed follow-up surveys regarding their perceptions of the process. Candidate demographic and experience data were pulled from the application website. Fifty-five of 72 applicants met eligibility requirements and were invited to take the online assessment, with 50 (91%) completing it. Average time to complete was 42 ± 12 minutes. Eighteen applicants (35%) were invited for on-site structured interviews and skills testing-a greater than 50% reduction in number of invites compared to prior years. Time estimates reveal that the process will result in a time savings of 68% for future iterations, compared to traditional methodologies. Fellowship faculty (N = 5) agreed on the value and efficiency of the process. Underrepresented minority candidates increased from an initial 70% to 92% being invited for an interview and ranked using the new screening tools. Applying selection science to the process of choosing surgical trainees is feasible, efficient, and well-received by faculty for making selection decisions.

Dealing with Uncertainty and Accounting for Social Value Judgments in Assessments of Orphan Drugs: Evidence from Four European Countries.

PubMed

Nicod, Elena; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Kanavos, Panos

To better understand the reasons for differences in reimbursement decisions for orphan drugs in four European countries that were not readily apparent from health technology assessment (HTA) reports and operating procedures. Semistructured interviews with representatives of HTA bodies in England, Scotland, Sweden, and France were conducted. An interview topic guide was developed on the basis of findings from a systematic comparison of HTA decisions for 10 orphan drugs. Qualitative thematic data analysis was applied to the interview transcripts using the framework approach. Eight representatives from the four HTA bodies were interviewed between March and June 2015. Evidentiary requirements and approaches to dealing with imperfect or incomplete evidence were explored, including trial design and duration, study population and subgroups, comparators, and end points. Interviewees agreed that decisions regarding orphan drugs are made in a context of lower quality evidence, and the threshold of acceptable uncertainty varied by country. Some countries imposed higher evidentiary standards for greater clinical claims, which may be more challenging for orphan diseases. The acceptability of surrogate end points was not consistent across countries nor were the validation requirements. The most common social value judgments identified related to innovation, disease severity, and unmet need. Differences were seen in the way these concepts were defined and accounted for across countries. Although agreement was seen in evidentiary requirements or preferences, there were subtle differences in the circumstances in which uncertain evidence may be considered acceptable, possibly explaining differences in HTA recommendations across countries. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

'I Got it off my Chest': An Examination of how Research Participation Improved the Mental Health of Women Engaging in Transactional Sex.

PubMed

Felsher, Marisa; Wiehe, Sarah E; Gunn, Jayleen K L; Roth, Alexis M

2018-02-01

Ecologic momentary assessment (EMA) is a form of close-ended diary writing. While it has been shown that participating in a study that incorporates EMA improves mental health of participants, no study to date has examined the pathways through which benefits may occur. For 4-weeks, twice-daily EMAs and weekly interviews captured mood, daily activities and HIV risk behavior of 25 women who engage in transactional sex. Qualitative analysis of exit interviews was performed to examine how participation impacted women's mental health. The majority of participants felt that EMAs heightened awareness of emotions and behavior. Most reported experiencing catharsis from the interviews; specifically, from having a non-judgmental, trusting listener. Participants felt responsible for completing tasks, a sense of accomplishment for completing the study, and altruism. This study demonstrates there are direct benefits associated with participation in an EMA and interview study.

Vitalistic thinking in adults.

PubMed

Wilson, Stuart

2013-11-01

Vitalistic thinking has traditionally been associated with reasoning about biological phenomena. The current research aimed to investigate a broader range of vitalistic thinking than previously studied. Esoteric notions of 'energy' are frequently used by individuals when making causal attributions for strange occurrences, and previous literature has linked such thinking with paranormal, magical, and superstitious beliefs. Two experiments are described that aim to investigate whether adults are vitalistic when asked to make causal judgments, and whether this can be predicted by thinking styles and prior paranormal belief. Experiment 1 asked participants to rate three causal options (one of which was vitalistic) for six vignettes. Scores on one dimension of paranormal belief (New Age Philosophy) and analytical thinking significantly predicted vitalism, but scores on intuitive thinking and Traditional Paranormal Beliefs did not. Experiment 2 extended the findings by asking participants to generate their own causal responses. Again, paranormal belief was found to be the best predictor of vitalism, but this time Traditional Paranormal Beliefs were associated with vitalistic responses whilst both intuitive and analytical thinking were unable to significantly predict classification. Results challenge previous findings, suggesting that vitalistic thinking may operate differently when applied to everyday causal reasoning. © 2012 The British Psychological Society.

Priming unconscious racial stereotypes about adolescent offenders.

PubMed

Graham, Sandra; Lowery, Brian S

2004-10-01

Two studies examined unconscious racial stereotypes of decision makers in the juvenile justice system. Police officers (Experiment 1) and juvenile probation officers (Experiment 2) were subliminally exposed to words related to the category Black or to words neutral with respect to race. In a presumably unrelated task, officers read 2 vignettes about a hypothetical adolescent who allegedly committed either a property crime (shoplifting from a convenience store) or an interpersonal crime (assaulting a peer). The race of the offender was left unstated and the scenarios were ambiguous about the causes of the crime. Respondents rated the hypothetical offender on a number of traits (e.g., hostility and immaturity) and made judgments about culpability, expected recidivism, and deserved punishment. They also completed a self-report measure of conscious attitudes about race. As hypothesized, officers in the racial prime condition reported more negative trait ratings, greater culpability, and expected recidivism, and they endorsed harsher punishment than did officers in the neutral condition. The effects of the racial primes were not moderated by consciously held attitudes about African Americans. The implications of the findings for racial disparity in the juvenile justice system and for changing unconscious stereotypes were discussed.

Online processing of moral transgressions: ERP evidence for spontaneous evaluation

PubMed Central

Kunkel, Angelika; Mackenzie, Ian G.; Filik, Ruth

2015-01-01

Experimental studies using fictional moral dilemmas indicate that both automatic emotional processes and controlled cognitive processes contribute to moral judgments. However, not much is known about how people process socio-normative violations that are more common to their everyday life nor the time-course of these processes. Thus, we recorded participants’ electrical brain activity while they were reading vignettes that either contained morally acceptable vs unacceptable information or text materials that contained information which was either consistent or inconsistent with their general world knowledge. A first event-related brain potential (ERP) positivity peaking at ∼200 ms after critical word onset (P200) was larger when this word involved a socio-normative or knowledge-based violation. Subsequently, knowledge-inconsistent words triggered a larger centroparietal ERP negativity at ∼320 ms (N400), indicating an influence on meaning construction. In contrast, a larger ERP positivity (larger late positivity), which also started at ∼320 ms after critical word onset, was elicited by morally unacceptable compared with acceptable words. We take this ERP positivity to reflect an implicit evaluative (good–bad) categorization process that is engaged during the online processing of moral transgressions. PMID:25556210

Juror Decision-making in Death Penalty Sentencing when Presented with Defendant's History of Child Abuse or Neglect.

PubMed

Bell Holleran, Lisa L; Vaughan, Tyler J; Vandiver, Donna M

2016-11-01

Previous studies have found aggravating, mitigating, and null effects of defendant histories of abuse and neglect on punishment preferences in capital sentencing. Perceiving these defendants as more dangerous, jurors may be more likely to favor the death penalty when such evidence is presented. This is counter to the intuition that abuse or neglect reduces culpability, and therefore mitigates the severity of punishment. We investigated the effect of defendant childhood physical abuse, sexual abuse, or neglect on the probability of a prospective juror preferring the death penalty in an between-subject experimental design. Using vignettes and two large samples (students and jurors), defendant histories were found to mitigate the probability that the hypothetical defendant received the death penalty, with sexual abuse having the most salient effect. Further, the effects were conditioned by preference for the death penalty - larger mitigating effects were observed among individuals who favor the death penalty. These findings suggest that initial judgments of abuse and neglect are related to juror leniency, and further research on the interaction of jury instructions and defendant histories is needed. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Decision rules for GHB (γ-hydroxybutyric acid) detoxification: a vignette study.

PubMed

Kamal, Rama M; van Iwaarden, Sjacco; Dijkstra, Boukje A G; de Jong, Cornelis A J

2014-02-01

GHB dependent patients can suffer from a severe and sometimes life-threatening withdrawal syndrome. Therefore, most of the patients are treated within inpatient settings. However, some prefers an outpatient approach to treatment. The aim of this study was to develop decision rules for addiction physicians to determine whether an outpatient or inpatient setting should be chosen for a safe GHB detoxification. A prospective vignette study was performed. Forty addiction medicine specialists from various treatment settings and residents of the Addiction Medicine postgraduate Master training were asked to contribute vignettes of GHB dependent patients. A focus group of 15 psychiatrists and addiction medicine specialists was asked to recommend an outpatient or inpatient setting for GHB detoxification treatment per vignette. Finally, five addiction medicine specialists, experts in GHB dependence treatment in the Netherlands, assessed the bio-psychosocial reasons for the choices of the focus group and formulated the recommended criteria. Based on the bio-psychosocial state of twenty vignette patients, addiction physicians and psychiatrists established the criteria and conditions recommended for the indication of an outpatient GHB detoxification. Intensity of addiction (GHB dose ≤32 g/d and frequency of abuse ≤2 h) was stated as the primary criterion in determining the setting as well as the complexity of the psychiatric comorbid disorders. The importance of a stable support system was emphasised. The vignette study resulted in a set of criteria with which addiction medicine specialists can make a weighted decision as to an outpatient or inpatient setting for GHB detoxification. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Genetic Literacy and Patient Perceptions of IBD Testing Utility and Disease Control: A Randomized Vignette Study of Genetic Testing

PubMed Central

Hooker, Gillian W.; Peay, Holly; Erby, Lori; Bayless, Theodore; Biesecker, Barbara B.; Roter, Debra L.

2014-01-01

Background Findings from inflammatory bowel disease (IBD) genome-wide association studies are being translated clinically into prognostic and diagnostic indicators of disease. Yet, patient perception and understanding of these tests and their applicability to providing risk information is unclear. The goal of this study was to determine, using hypothetical scenarios, whether patients with IBD perceive genetic testing to be useful for risk assessment, whether genetic test results impact perceived control, and whether low genetic literacy may be a barrier to patient understanding of these tests. Methods Two hundred fifty seven patients with IBD from the Johns Hopkins gastroenterology clinics were randomized to receive a vignette depicting either a genetic testing scenario or a standard blood testing scenario. Participants were asked questions about the vignette and responses were compared between groups. Results Perceptions of test utility for risk assessment were higher among participants responding to the genetic vignette (P < 0.001). There were no significant differences in perceptions of control over IBD after hypothetical testing between vignettes (P = 0.24). Participant responses were modified by genetic literacy, measured using a scale developed for this study. Participants randomized to the genetic vignette who scored higher on the genetic literacy scale perceived greater utility of testing for risk assessment (P = 0.008) and more control after testing (P = 0.02). Conclusions Patients with IBD perceive utility in genetic testing for providing information relevant to family members, and this appreciation is promoted by genetic literacy. Low genetic literacy among patients poses a potential threat to effective translation of genetic and genomic tests. PMID:24691112

[Health status identification and their relationship with socieconomics and geographic characteristics: a population survey analysis in México].

PubMed

Vargas-Palacios, Armando; Gutiérrez, Juan Pablo; Carreón-Rodríguez, Víctor

2006-01-01

To estimate the effectiveness of using standardized health vignettes to adjust self-reported health taking into account household and community variables to correct for systematic bias. The national health survey "Evaluación del Desempeño 2002" (Mexican component of the World Health Survey) was used. This survey analyzed subject's health perception based on their responses to hypothetical questions referring to third parties in the vignettes within eight domains. Variations in responses were attributed to socio-demographic, socioeconomic, community, differences of the subjects. To assess those variations, an index for each domain was constructed and used as a variable in a series of linear regression models to estimate the relation between health perceptions, self-reported health, socioeconomic and socio-demographic characteristics. The health perception index derived from the vignettes showed a positive, logarithmic correlation with household expenditure for each health domain, after controlling for socio-demographic, health and community characteristics. No relationship was found between the health status described in the vignettes and self-reported health status. In no case was the explanatory power above 10%. The low explanatory power of the models, and the lack of correlation between self reported health status and the health perception index, suggest that the variability in the vignettes responses cannot be explained by differences in self-reported health status or socioeconomic and socio-demographic characteristics. These results from Mexico suggest that vignette-based methods to correct for systematic variability in perception of own health status are of limited efficacy and reinforce the importance of collecting objective measures of health status in health surveys.

Attitudes of pediatric intensive care unit physicians towards the use of cognitive aids: a qualitative study.

PubMed

Weiss, Matthew J; Kramer, Chelsea; Tremblay, Sébastien; Côté, Luc

2016-05-21

Cognitive aids are increasingly recommended in clinical practice, yet little is known about the attitudes of physicians towards these tools. We employed a qualitative, descriptive design to explore physician attitudes towards cognitive aids in pediatric intensive care units (PICUs). Semi-structured interviews elicited the opinions of a convenience sample of practicing PICU physicians towards the use of cognitive aids. We analyzed interview data for thematic content to examine the three factors of intention to use cognitive aids as defined by the Theory of Planned Behavior (TPB), attitudes, social norms, and perceived control. Analysis of 14 interviews suggested that in the PICU setting, cognitive aids are widely used. Discovered themes related to their use touched on all three TPB factors of intention and included: aids are perceived to improve team communication; aids may improve patient safety; aids may hinder clinician judgment; physicians may resist implementation if it occurs prior to demonstration of benefit; effective adoption requires cognitive aids to be integrated into local workplace culture; and implementation should take physician concerns into account. Our sample of PICU physicians were open to cognitive aids in their practice, as long as such aids preserve the primacy of clinical judgment, focus on team communication, demonstrate effectiveness through preliminary testing, and are designed and implemented with the local culture and work environment in mind. Future knowledge translation efforts to implement cognitive aids would benefit from consideration of these issues.

“Dude, You’re Such a Slut!” Barriers and Facilitators of Sexual Communication Among Young Gay Men and Their Best Friends

PubMed Central

McDavitt, Bryce; Mutchler, Matt G.

2014-01-01

Conversations with friends are a crucial source of information about sexuality for young gay men, and a key way that sexual health norms are shared during emerging adulthood. However, friends can only provide this support if they are able to talk openly about sexuality. We explored this issue through qualitative interviews with an ethnically diverse sample of young gay men and their best friends. Using theories of sexual scripts, stigma, and emerging adulthood, we examined how conversations about sex could be obstructed or facilitated by several key factors, including judgmentalism, comfort/discomfort, and receptivity. Gay male friends sometimes spoke about unprotected sex in judgmental ways (e.g., calling a friend “slut” or “whore” for having sex without condoms). In some cases, this language could be used playfully, while in others it had the effect of shaming a friend and obstructing further communication about sexual risk. Female friends were rarely openly judgmental, but often felt uncomfortable talking about gay male sexuality, which could render this topic taboo. Sexual communication was facilitated most effectively when friends encouraged it through humor or supportive questioning. Drawing on these findings, we show how judgmentalism and discomfort may generate sexual scripts with contradictory norms, and potentially obstruct support from friends around sexual exploration during a period of life when it may be most developmentally important. PMID:25419044

9. Historic American Buildings Survey VIGNETTE FROM PLAN OF THE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Historic American Buildings Survey VIGNETTE FROM PLAN OF THE CITY OF BALTIMORE... BY T. H. POPPLETON...ENGRAVED BY J. H. CONE...CORRECT TO 1852 - Aged Women's Home, 1400 West Lexington Street, Baltimore, Independent City, MD

An experimental study exploring the impact of vignette gender on the quality of university students' mental health first aid for peers with symptoms of depression.

PubMed

Davies, E Bethan; Wardlaw, John; Morriss, Richard; Glazebrook, Cris

2016-02-25

University students have high rates of depression, and friends are often the most commonly-used source of support for emotional distress in this population. This study aimed to explore students' ability to provide effective support for their peers with depressive symptoms and the factors influencing the quality of their mental health first aid (MHFA) skills, including students' gender, course of study, and gender of student experiencing depression. Via an online survey, students at two British universities (N = 483) were quasi-randomly allocated to view a video vignette of either a male or female student depicting symptoms of depression. An open-ended question probed MHFA actions they would take to help the vignette character, which were rated using a standardised scoring scheme based on MHFA guidelines. Students reported low MHFA scores (mean 2.89, out of possible 12). The most commonly reported action was provision of support and information, but only eight (1.6%) students stated an intention to assess risk of harm. Those studying clinically non-relevant degrees with limited mental health content reported poorer MHFA (p = <0.001) and were less confident about their ability to support a friend with depression (p = 0.04). There was no main effect of vignette gender, but within the group of students on non-relevant courses the male vignette received significantly poorer MHFA than the female vignette (p = 0.02). A significant three-way interaction found that male participants studying non-relevant degrees who viewed a male vignette had poorer MHFA compared to females studying non-relevant degrees who viewed the female vignette (p = 0.005). Most students lack the necessary MHFA skills to support friends suffering from symptoms of depression, or to help them get appropriate support and prevent risk of harm. Students on courses which do not include mental health related content are particularly ill-equipped to support male students, with male students receiving the poorest quality MHFA from fellow male students on these courses. MHFA training has the potential to improve outcomes for students with depression, and could have a valuable role in reducing the excess risk of harm seen in male students.

Adding a second surprise question triggers general practitioners to increase the thoroughness of palliative care planning: results of a pilot RCT with cage vignettes.

PubMed

Weijers, F; Veldhoven, C; Verhagen, C; Vissers, K; Engels, Y

2018-04-19

In our aging society, palliative care should be a standard component of health care. However, currently it is only provided to a small proportion of patients, mostly to those with cancer, and restricted to the terminal phase. Many general practitioners (GPs) say that one of their most significant challenges is to assess the right moment to start anticipatory palliative care. The "Surprise Question" (SQ1: "Would I be surprised if this patient were to die in the next 12 months"?), if answered with "no", is an easy tool to apply in identifying patients in need of palliative care. However, this tool has a low specificity. Therefore, the aim of our pilot study was to determine if adding a second, more specific "Surprise Question" (SQ2: "Would I be surprised if this patient is still alive after 12 months"?) in case SQ1 is answered in the negative, prompts GPs to plan for anticipatory palliative care. By randomization, 28 GPs in the south-eastern part of the Netherlands were allocated to three different groups. They all received a questionnaire with four vignettes, respectively representing patients with advanced organ failure (A), end stage cancer (B), frailty (C), and recently diagnosed cancer (D). GPs in the first group did not receive additional information, the second group received SQ1 after each vignette, and the third group received SQ1 and SQ2 after each vignette. We rated their answers based on essential components of palliative care (here called RADIANT score). GPs in group 3 gave higher RADIANT scores to those vignettes in which they would be surprised if the patients were still alive after 12 months. In all groups, vignette B had the highest mean RADIANT score, followed by vignettes A and C, and the lowest on vignette D. Seventy-one percent of GPs in groups 2 and 3 considered SQ1 a helpful tool, and 75% considered SQ2 helpful. This innovative pilot study indicates that the majority of GPs think SQ2 is a helpful additional tool. The combination of the two "Surprise Questions" encourages GPs to make more specific plans for anticipatory palliative care.

Effect of a legal prime on clinician's assessment of suicide risk.

PubMed

Berman, Noah Chase; Sullivan, Alexandra; Wilhelm, Sabine; Cohen, I Glenn

2016-01-01

The present study evaluates how liability influences mental health clinicians' assessment of suicide risk. In this online vignette-based experiment, clinicians (N = 268) were either primed with a legal standard prior to a case vignette or presented the case vignette alone. Clinicians then rated the patient's likelihood of suicide and need for hospitalization. Results indicated that trainees provided significantly lower ratings of suicide risk following presentation of the legal standard, but this was not associated with hospitalization endorsement. Results have training and legal implications for improving the accuracy of suicide risk assessment in both trainees and licensed professionals.

Rape Myths, Rape Scripts, and Common Rape Experiences of College Women: Differences in Perceptions of Women Who Have Been Raped.

PubMed

Hockett, Jericho M; Saucier, Donald A; Badke, Caitlyn

2016-03-01

Rape is prevalent at colleges. Although research suggests commonalities across many college women's rape experiences (e.g., perpetrators using multiple coercive strategies), vignettes used to assess rape perceptions often reflect false beliefs. Two studies varying a perpetrator's coercive tactics examine rape perceptions using vignettes reflecting rape myths, rape scripts, or many college women's common rape experiences. Participants perceive a woman who was raped more positively in vignettes reflecting common rape experiences versus those reflecting rape myths or scripts. Theoretical, educational, and research implications are discussed. © The Author(s) 2015.

Machinima and Video-Based Soft-Skills Training for Frontline Healthcare Workers.

PubMed

Conkey, Curtis A; Bowers, Clint; Cannon-Bowers, Janis; Sanchez, Alicia

2013-02-01

Multimedia training methods have traditionally relied heavily on video-based technologies, and significant research has shown these to be very effective training tools. However, production of video is time and resource intensive. Machinima technologies are based on videogaming technology. Machinima technology allows videogame technology to be manipulated into unique scenarios based on entertainment or training and practice applications. Machinima is the converting of these unique scenarios into video vignettes that tell a story. These vignettes can be interconnected with branching points in much the same way that education videos are interconnected as vignettes between decision points. This study addressed the effectiveness of machinima-based soft-skills education using avatar actors versus the traditional video teaching application using human actors in the training of frontline healthcare workers. This research also investigated the difference between presence reactions when using avatar actor-produced video vignettes as compared with human actor-produced video vignettes. Results indicated that the difference in training and/or practice effectiveness is statistically insignificant for presence, interactivity, quality, and the skill of assertiveness. The skill of active listening presented a mixed result indicating the need for careful attention to detail in situations where body language and facial expressions are critical to communication. This study demonstrates that a significant opportunity exists for the exploitation of avatar actors in video-based instruction.

Perceived impact of socially anxious behaviors on individuals' lives in Western and East Asian countries.

PubMed

Rapee, Ronald M; Kim, Jinkwan; Wang, Jianping; Liu, Xinghua; Hofmann, Stefan G; Chen, Junwen; Oh, Kyung Ya; Bögels, Susan M; Arman, Soroor; Heinrichs, Nina; Alden, Lynn E

2011-09-01

The current study compared the predicted social and career impact of socially withdrawn and reticent behaviors among participants from Western and East Asian countries. Three hundred sixty-one college students from 5 Western countries and 455 students from 3 East Asian countries read hypothetical vignettes describing socially withdrawn and shy behaviors versus socially outgoing and confident behaviors. Participants then answered questions following each vignette indicating the extent to which they would expect the subject of the vignette to be socially liked and to succeed in their career. Participants also completed measures of their own social anxiety and quality of life. The results indicated significant vignette-by-country interactions in that the difference in perceived social and career impact between shy and outgoing vignettes was smaller among participants from East Asian countries than from Western countries. In addition, significant negative correlations were shown between personal level of shyness and experienced quality of life for participants from both groups of countries, but the size of this relationship was greater for participants from Western than East Asian countries. The results point to the more negative impact of withdrawn and socially reticent behaviors for people from Western countries relative to those from East Asia. Copyright © 2011. Published by Elsevier Ltd.

Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals.

PubMed

Foster, L W; McLellan, L J; Rybicki, L A; Dabney, J; Welsh, E; Bolwell, B J

2006-01-01

BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.

Treating Women Drug Abusers: Action Therapy and Trauma Assessment

PubMed Central

Uhler, Ann S.; Parker, Olga V.

2002-01-01

The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors believe the use of unassisted clinical judgment for trauma assessment in first interviews may drive patients away by probing for painful information that clients are not yet ready to confront or divulge. PMID:18567963

Treating women drug abusers: action therapy and trauma assessment.

PubMed

Uhler, Ann S; Parker, Olga V

2002-07-01

The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors believe the use of unassisted clinical judgment for trauma assessment in first interviews may drive patients away by probing for painful information that clients are not yet ready to confront or divulge.

Meanings and implications of acceptability judgements for wilderness use impacts

Treesearch

Amy F. Hoss; Mark W. Brunson

2000-01-01

While the concept of “acceptability” is central to the Limits of Acceptable Change (LAC) framework, there is inadequate understanding of how “acceptability” is judged and how unacceptable conditions affect visitor experiences. To address this knowledge gap, visitors to nine wilderness areas were interviewed. Judgments of social and environmental conditions fell into...

Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice.

PubMed

Elzakkers, Isis F F M; Danner, Unna N; Grisso, Thomas; Hoek, Hans W; van Elburg, Annemarie A

Informed consent requires adequate mental capacity to consent to treatment. Mental capacity (MC) to consent to treatment refers to the ability to make medical decisions. MC is assessed in a general psychiatric interview, but this clinical assessment is known to overestimate mental capacity in patients and the inter rater reliability is low. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) has emerged as the gold standard to assess mental capacity to consent to treatment. The MacCAT-T is a semi-structured interview designed to aid clinicians in this assessment and has shown good inter rater reliability in patients with schizophrenia and other mental disorders, but has hardly been studied in patients with anorexia nervosa. Patients with anorexia nervosa (AN) regularly avoid treatment, even when severely ill and discussion includes assessing MC to consent to treatment. The aim of this study is to compare clinical judgment and the MacCAT-T in evaluating MC in patients with AN which in turn may influence use of the MacCAT-T in daily practice. In a sample of 70 consecutively referred severely ill patients with AN with a mean BMI of 15.5 kg/m 2 and a mean duration of illness of 8.6 years, clinical assessment of MC by experienced psychiatrists and the outcome of the MacCAT-T interview were compared. Agreement (κ-value) was calculated. Agreement between clinical assessment and outcome of the MacCAT-T was questionable (κ 0.23). Unlike in other psychiatric populations, clinicians judged a high proportion of patients with AN as having diminished MC. The MacCAT-T can be useful in assessing MC in AN when used in addition to clinical judgment to aid clinicians in complex cases. Why clinicians judge a relatively high proportion of patients with AN as having diminished MC, in contrast to lower proportions in other psychiatric disorders, is an area in need of further research. Copyright © 2018 Elsevier Ltd. All rights reserved.

Agreement among health care professionals in diagnosing case Vignette-based surgical site infections.

PubMed

Lepelletier, Didier; Ravaud, Philippe; Baron, Gabriel; Lucet, Jean-Christophe

2012-01-01

To assess agreement in diagnosing surgical site infection (SSI) among healthcare professionals involved in SSI surveillance. Case-vignette study done in 2009 in 140 healthcare professionals from seven specialties (20 in each specialty, Anesthesiologists, Surgeons, Public health specialists, Infection control physicians, Infection control nurses, Infectious diseases specialists, Microbiologists) in 29 University and 36 non-University hospitals in France. We developed 40 case-vignettes based on cardiac and gastrointestinal surgery patients with suspected SSI. Each participant scored six randomly assigned case-vignettes before and after reading the SSI definition on an online secure relational database. The intraclass correlation coefficient (ICC) was used to assess agreement regarding SSI diagnosis on a seven-point Likert scale and the kappa coefficient to assess agreement for superficial or deep SSI on a three-point scale. Based on a consensus, SSI was present in 21 of 40 vignettes (52.5%). Intraspecialty agreement for SSI diagnosis ranged across specialties from 0.15 (95% confidence interval, 0.00-0.59) (anesthesiologists and infection control nurses) to 0.73 (0.32-0.90) (infectious diseases specialists). Reading the SSI definition improved agreement in the specialties with poor initial agreement. Intraspecialty agreement for superficial or deep SSI ranged from 0.10 (-0.19-0.38) to 0.54 (0.25-0.83) (surgeons) and increased after reading the SSI definition only among the infection control nurses from 0.10 (-0.19-0.38) to 0.41 (-0.09-0.72). Interspecialty agreement for SSI diagnosis was 0.36 (0.22-0.54) and increased to 0.47 (0.31-0.64) after reading the SSI definition. Among healthcare professionals evaluating case-vignettes for possible surgical site infection, there was large disagreement in diagnosis that varied both between and within specialties.

Analyze This! Thematic Analysis: Hostility, Attribution of Intent, and Interpersonal Perception Bias.

PubMed

Karadenizova, Zhana; Dahle, Klaus-Peter

2017-11-01

Research suggests that aggressive individuals exhibit a strong tendency to attribute hostile intent to the behavior of others when confronted with an ambiguous social situation. The vignettes method has become a standard procedure to assess hostile attributions. Vignettes represent incomplete ambiguous social stories, in which the subjects experience a negative outcome and are asked to attribute intent to the provocateur's action. This article explores the ways in which subjects perceive ambiguous social situations and other people's intentions, their tendency to refer negative outcome to oneself, and the components defining hostility in the interpersonal relationships. The sample consisted of male adolescent violent offenders ( N = 45) recruited from the Social Therapy Department of the German correctional facility for juvenile offenders in Berlin. All offenders were incarcerated for a violent or sexual crime and were currently undergoing individual and group psychotherapy. The five hypothetical vignettes used in this study were originally designed to assess hostile attributions in both institutional and noninstitutional social situations. Participants' responses were analyzed using thematic analysis. Thematic analysis revealed three key themes regarding the social perception-positive, negative, and neutral-and two themes regarding the components of hostility-provocateur-related personality features and relationship type. Although the vignettes were originally developed to detect hostility-prone perception bias, they seem to be able to reveal a wider set of different attributions of intent, both positive and negative. Thus, vignettes are not limited to assessment of hostility specifically. They much rather seem to be a measure which is sensitive to diverse attributions of intent in general. The diagnostic qualities of the vignettes, their area of application, limitations of the study, and future perspective are discussed.

Community-based participatory research: a new approach to engaging community members to rapidly call 911 for stroke.

PubMed

Skolarus, Lesli E; Zimmerman, Marc A; Murphy, Jillian; Brown, Devin L; Kerber, Kevin A; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B

2011-07-01

Acute stroke treatments are underutilized primarily because of delayed hospital arrival. Using a community-based participatory research approach, we explored stroke self-efficacy, knowledge, and perceptions of stroke among a predominately African American population in Flint, Michigan. In March 2010, a survey was administered to youth and adults after religious services at 3 churches and during 1 church health day. The survey consisted of vignettes (12 stroke, 4 nonstroke) to assess knowledge of stroke warning signs and behavioral intent to call 911. The survey also assessed stroke self-efficacy, personal knowledge of someone who had experienced a stroke, personal history of stroke, and barriers to calling 911. Linear regression models explored the association of stroke self-efficacy with behavioral intent to call 911 among adults. Two hundred forty-two adults and 90 youths completed the survey. Ninety-two percent of adults and 90% of youth respondents were African American. Responding to 12 stroke vignettes, adults would call 911 in 72% (SD, 0.26) of the vignettes, whereas youths would call 911 in 54% of vignettes (SD, 0.29; P<0.001). Adults correctly identified stroke in 51% (SD, 0.32) of the stroke vignettes and youth correctly identified stroke in 46% (SD, 0.28) of the stroke vignettes (P=0.28). Stroke self-efficacy predicted behavioral intent to call 911 (P=0.046). In addition to knowledge of stroke warning signs, behavioral interventions to increase both stroke self-efficacy and behavioral intent may be useful for helping people make appropriate 911 calls for stroke. A community-based participatory research approach may be effective in reducing stroke disparities.

Anchoring Vignettes in EQ-5D-5L Questionnaire: Validation of a New Instrument.

PubMed

Azzolina, Danila; Minto, Clara; Boschetto, Stefania; Martinato, Matteo; Bauce, Barbara; Iliceto, Sabino; Gregori, Dario

2017-01-01

Health Related Quality of Life (HRQoL) is an indicator of patient's physical, psychological and social life. HRQoL is influenced by experience, beliefs, perceptions and expectations, and measures subjective perspective of the patient himself. EQ-5D-5L and SF-12 questionnaires are validated instruments useful to measure HRQoL, increasingly administered in electronic formats. The main purpose is to evaluate the feasibility of anchoring vignettes for the EQ-5D-5L questionnaire, with the aim to improve intergroup comparability of responses among different subjects. A comparison with SF-12 questionnaire is carried out. This is a cross-sectional study conducted at the ambulatories of cardiology of the University Hospital of Padova, in Italy. Thirty-eight subjects with a diagnosis of cardiovascular disease or at risk of cardiovascular disease were enrolled. A factorial analysis has been performed to assess the convergent validity of EQ-5D-5L questionnaire compared to Sf-12. Moreover, a compound Hierarchical Ordered Probit (Chopit) model has been estimated to evaluate if the questionnaire form affects the subjective evaluation process in order to compare EQ-5D-5L with and without vignettes. Correlation and factor analysis demonstrate that EQ_5D questionnaire is coherent with SF-12 in paper format. Chopit model estimation shows that questionnaire format does not affect the subjective question interpretation. Moreover, in a parametric model including vignettes, education attainment, disease severity, and gender are predictors of HRQoL status. The EQ-5D including vignettes in electronic format seems to be a valid tool to measure HRQoL as compared to EQ-5D without vignettes in paper format and to SF-12 questionnaire.

The Mentor Teacher Casebook.

ERIC Educational Resources Information Center

Shulman, Judith H., Ed.; Colbert, Joel A., Ed.

This casebook, developed in collaboration with 22 mentor teachers in the Los Angeles (California) Unified School District, provides illustrative vignettes, written by the mentor teachers themselves, of their work with first-year teachers. The vignettes describe the circumstances of each event, its consequences, and the ongoing thoughts and…

Attitudes toward Posthumous Harvesting and Reproduction

ERIC Educational Resources Information Center

Hans, Jason D.

2008-01-01

Attitudes toward posthumous harvesting of reproductive material and beliefs about medical professionals' obligation to assist were examined using a multiple segment factorial vignette survey design with 407 randomly selected respondents from a southern state. Attitudes and beliefs were primarily shaped by the vignette couple's marital status,…

Vignettes in College Developmental Classes.

ERIC Educational Resources Information Center

Valeri-Gold, Maria T.

1994-01-01

Discusses providing developmental learners with the opportunity to hear and respond to vignettes (short, descriptive literary sketches such as those in "The House on Mango Street"). Notes that the activity allowed students to experiment with another writing style and to use figurative language in a creative way. (RS)

Borderline personality disorder in men: A literature review and illustrative case vignettes.

PubMed

Bayes, Adam; Parker, Gordon

2017-11-01

The aim is to review the salient literature on borderline personality disorder (BPD) in men and link those findings with case vignettes. We provide a literature review and then report case examples of those who met DSM and clinical BPD criteria, and consider the extent to which the small male sub-set corresponded developmentally and phenomenologically with prototypic BPD in women. The review considered phenomenological, epidemiological, biological and developmental BPD factors, finding BPD men evidence elevated substance abuse, and 'externalising' patterns of behavior, antisocial personality traits, violent self-harm and interpersonal aggression, whereas women display more 'internalising' strategies. The five male vignettes enriched the literature review providing support for gender differences reported in our review. The literature and case vignette findings should assist clinicians in recognising that BPD in men may not be as rare as generally viewed, and which may reflect BPD being commonly viewed as weighted to women and being misdiagnosed as an antisocial personality disorder (ASPD) in men. Copyright © 2017 Elsevier B.V. All rights reserved.

Staff Member Reactions to Same-Gender, Resident-to-Resident Sexual Behavior Within Long-Term Care Facilities.

PubMed

Ahrendt, Andrew; Sprankle, Eric; Kuka, Alex; McPherson, Keagan

2017-01-01

The current study assesses ageism and heterosexism relating to older adult sexual activity within long-term care facilities. To assess caregiver reactions, 153 residential care facility staff members read one of three vignettes. Each vignette described a scenario in which a staff member walks in on two residents (male/female, male/male, or female/female) engaging in sexual activity. Although no main effects were discovered for vignette type, exploratory analyses revealed that the facility where participants were employed was significantly related to their ratings of approval. Furthermore, an interaction effect between vignette and facility types was also discovered for caregivers' approval of sexual activity among residents. Additionally, a strong overall approval rating of older adult sexuality was reported by staff members. The results of this study warrant that further research is necessary regarding older adults' perception of caregiver bias, as well as further investigation of caregivers' perceptions of older adults' sexual activity.

Genes and plays: bringing ELSI issues to life.

PubMed

Rothenberg, Karen H; Bush, Lynn W

2012-02-01

Ethical complexities surround the promise of genomic technology and the power of genetic information as they alter conceptions of identity and dynamics within personal and professional relationships. Creative approaches such as dramatic vignettes offer a unique analytical stage for imagining the bioethical past and future. Dramatic narratives can bring to life images of differing perspectives and values when experiencing innovations in medicine. Although the scientific landscape shifts, concerns expressed in theatre from 50 years ago parallel many contemporary ELSI (ethical, legal, and social implications) issues, highlighting the ongoing struggle to appreciate the impact of emerging genetic technologies on relationships. To illuminate these enduring concerns, we explore how perceptions and relationships have influenced-and been influenced by-genetics as portrayed through dramatic vignettes. We build on the legacy of using case vignettes as a clinical teaching modality, and believe similar value exists within the research ethics domain. The selection of dialogue discussed encompasses abbreviated excerpts from two existing and one original vignette that we staged at the ELSI 2011 Congress and various academic and health institutions.

Effortful versus automatic emotional processing in schizophrenia: Insights from a face-vignette task.

PubMed

Patrick, Regan E; Rastogi, Anuj; Christensen, Bruce K

2015-01-01

Adaptive emotional responding relies on dual automatic and effortful processing streams. Dual-stream models of schizophrenia (SCZ) posit a selective deficit in neural circuits that govern goal-directed, effortful processes versus reactive, automatic processes. This imbalance suggests that when patients are confronted with competing automatic and effortful emotional response cues, they will exhibit diminished effortful responding and intact, possibly elevated, automatic responding compared to controls. This prediction was evaluated using a modified version of the face-vignette task (FVT). Participants viewed emotional faces (automatic response cue) paired with vignettes (effortful response cue) that signalled a different emotion category and were instructed to discriminate the manifest emotion. Patients made less vignette and more face responses than controls. However, the relationship between group and FVT responding was moderated by IQ and reading comprehension ability. These results replicate and extend previous research and provide tentative support for abnormal conflict resolution between automatic and effortful emotional processing predicted by dual-stream models of SCZ.

Talking with consumers about energy reductions: recommendations from a motivational interviewing perspective

PubMed Central

Klonek, Florian E.; Kauffeld, Simone

2015-01-01

Reduction of energy costs has become a concern for many organizations. First, we review energy-saving studies in organizations in which consumers showed resistance to change their behavior. Second, we relate resistance to change to the psycholinguistic construct “sustain talk” that describes verbal arguments against behavior change (e.g., “Work processes have priority here”). Third, we argue how Motivational Interviewing (MI)—an interaction-approach to facilitate behavior change—might be helpful in dealing with this behavior. We transfer MI to interactions about energy-savings in organizations and demonstrate how qualification in MI for energy managers may affect these interactions. Therefore, we present three short case scenarios (i.e., video vignettes) that demonstrate socio-interactional mechanisms underlying energy-relevant decisions and behaviors. Consumer' verbal responses are graphed as one single time-variant index of readiness versus resistance (R-index) in order to illustrate interactional dynamics. In sum, we combine theoretical and empirical perspectives from multiple disciplines and discuss an innovative socio-interaction approach that may facilitate energy-efficient behavior in organizations. PMID:25821440

Multimedia storytelling

NASA Astrophysics Data System (ADS)

Linder, C. A.; Wilbert, M.; Holmes, R. M.

2010-12-01

Multimedia video presentations, which integrate still photographs with video clips, audio interviews, ambient sounds, and music, are an effective and engaging way to tell science stories. In July 2009, Linder joined professors and undergraduates on an expedition to the Kolyma River in northeastern Siberia. This IPY science project, called The Polaris Project (http://www.thepolarisproject.org), is an undergraduate research experience where students and faculty work together to increase our understanding of climate change impacts, including thawing permafrost, in this remote corner of the world. During the summer field season, Linder conducted dozens of interviews, captured over 20,000 still photographs and hours of ambient audio and video clips. Following the 2009 expedition, Linder blended this massive archive of visual and audio information into a 10-minute overview video and five student vignettes. In 2010, Linder again traveled to Siberia as part of the Polaris Project, this time mentoring an environmental journalism student who will lead the production of a video about the 2010 field season. Using examples from the Polaris productions, we will present tips, tools, and techniques for creating compelling multimedia science stories.

How do we keep our residents safe? An educational intervention.

PubMed

Wasser, Tobias D

2015-02-01

Recent evidence suggests that 25-64 % of psychiatry residents are the victims of assault by patients; only a minority, however, feel they receive adequate safety and violence training during residency. To address this disparity, the author designed, implemented, and assessed the effectiveness of a brief educational intervention focused on improving the residents' ability to recognize violence risk and increase attention to safety in the psychiatric interview. The subjects were 13 second-year psychiatry residents. Effectiveness was evaluated via the assessment of the residents' written responses describing their first clinical intervention after hearing a case vignette of a potentially violent patient (before and 1 month following the intervention). Responses were evaluated for any evidence of concerns for safety. The number of residents citing safety concerns increased (38 to 92 %), as did the level of sophistication in their proposed interventions. A brief educational intervention focused on violence risk and interview safety may be effective in increasing residents' attention to safety concerns in their clinical care, and further work will be beneficial to confirm and expand upon these findings.

An assessment of the shared-decision model in parents of children with acute otitis media.

PubMed

Merenstein, Dan; Diener-West, Marie; Krist, Alex; Pinneger, Matthew; Cooper, Lisa A

2005-12-01

Medicine is shifting from a doctor-centered approach to a model entailing more shared decision-making. Many organizations now recommend a shared-decision approach to treating children with acute otitis media (AOM). Our primary objectives in this study were to assess (1) which style of decision-making on the physician's part would most effectively reduce parents' proclivity to use antibiotics for treatment of their child's AOM and (2) parental satisfaction with different doctor-patient decision-making styles. We conducted a cross-sectional survey to examine how parents respond to doctor-patient communication styles in 3 clinical vignettes that presented 2 versions of a shared-decision model (SDM) and 1 paternalistic model. Parents were randomly assigned to receive 1 of 3 vignettes. The main predictor variable was the vignette assignment, and the main outcomes were (1) parent proclivity to use antibiotics and (2) parent ratings of care by the physician in the vignette. Using logistic regression, we adjusted for caregivers' age, gender, income, knowledge of antibiotics, decision-making preference, confidence in physician, and length of relationship with personal physician. Four hundred sixty-six parents met inclusion criteria, with a response rate of 94%. General characteristics were similar across vignette assignment groups. Parents who received the paternalistic-model vignettes were more likely to say that they would use antibiotics than those who received the SDM vignettes (odds ratio: 4.9; 95% confidence interval: 2.3-10.6). This result remained statistically significant after adjustment for potential confounders. In addition, parents in the shared-decision groups were more satisfied (93% and 84%) than those in the paternalistic-model group (76%). To our knowledge, this is the first study to examine parent interest, acceptance, and satisfaction with the SDM. Our findings suggest that shared decision-making for AOM may lead to less antibiotic usage and higher levels of parental satisfaction. Although more studies are needed to examine how best to incorporate parents in the SDM, our study serves as an example of the potential benefit of this approach in pediatric medicine.

‘It’s my home and your work’: the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities

PubMed Central

Hellzen, Ove; Haugenes, Marit; Østby, May

2018-01-01

ABSTRACT Purpose: Examining everyday challenges in the interactions between people with intellectual disabilities and their staff, as seen from the user’s perspective, is an important perspective in health care research. Involving people with intellectual disabilities as so-called co-researchers is a relatively unexplored research strategy. In this paper, co-researchers participated in all the steps of the research process, from planning to reporting, in addition to the written reporting of the findings. The aim of this study was to explore how people with intellectual disabilities experienced a filmed vignette of an everyday situation. Method: Based on audio-recorded and transcribed individual and focus-group interviews with people with intellectual disabilities, performed by co-researchers with intellectual disabilities together with researchers, qualitative content analysis was used. Results: The analysis reveals three themes: “being emotionally touched”, “being aware of the other”, and “being unclear”. Conclusions: The results are discussed in light of normalization and participation in society with independence and one’s own decision-making. Regarding the care of people with intellectual disabilities, the main finding is the need to focus not only on greater involvement of this population in their own daily lives, but also to teach self-determination skills. Another finding is the importance of involving people with intellectual impairment as co-researchers. PMID:29733261

Does knowing that a suicide was "rational" influence grief?

PubMed

Brazda, Geoffrey F; Range, Lillian M; Remley, Theodore P; White, Carolyn C

2018-03-15

Counseling professionals and graduate students (N = 117) recruited online read a randomly assigned one-paragraph vignette about either a non-rational or rational suicide involving an imaginary loved one. Then, they completed the Grief Experiences Questionnaire (GEQ) about how they would feel. The non-rational suicide group expected significantly more search for explanation than the rational suicide group, but were not significantly different on the other six GEQ subscales. All participants expected few distressing reactions to either vignette, suggesting a one-paragraph vignette may not be sufficient to induce the kind of grief many experience when a loved one dies by suicide.

Psychosis or Faith? Clinicians' Assessment of Religious Beliefs

ERIC Educational Resources Information Center

O'Connor, Shawn; Vandenberg, Brian

2005-01-01

This study investigated mental health professionals' assessment of the pathognomonic significance of religious beliefs. A total of 110 participants reviewed 3 vignettes depicting individuals possessing the religious beliefs associated with Catholicism, Mormonism, and Nation of Islam. The religious beliefs of the individuals in the vignettes were…

The Use of Vignettes to Empower Effective Responses to Attempted Sexual Assault

ERIC Educational Resources Information Center

Allen, Kaylie T.; Meadows, Elizabeth A.

2017-01-01

Objective: Women assertively resisting sexual aggression have the best chances of avoiding completed rape. Especially with acquaintances, there are significant social and psychological barriers to resistance. Novel vignettes depicting acquaintance rape were designed to enhance self-efficacy, reduce unrealistic optimism, and empower assertive…

Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes.

PubMed

Peabody, John W; DeMaria, Lisa; Smith, Owen; Hoth, Angela; Dragoti, Edmond; Luck, Jeff

2017-09-27

A significant determinant of population health outcomes is the quality of care provided for noncommunicable diseases, obstetric, and pediatric care. We present results on clinical practice quality in these areas as measured among nearly 4,000 providers working at more than 1,000 facilities in 6 Eastern European and Central Asian countries. This study was conducted between March 2011 and April 2013 in Albania, Armenia, Georgia, Kazakhstan, Kirov Province in Russia, and Tajikistan. Using a probability proportional-to-size sampling technique, based on number of hospital beds, we randomly selected within each country 42 hospitals and their associated primary health care clinics. Physicians and midwives within each clinical area of interest were randomly selected from each hospital and clinic and asked how they would care for simulated patients using Clinical Performance and Value (CPV) vignettes. Facility administrators were also asked to complete a facility survey to collect structural measures of quality. CPV vignettes were scored on a scale of 0% to 100% for each provider. We used descriptive statistics and t tests to identify significant differences in CPV scores between hospitals and clinics and rural vs. urban facilities, and ANOVA to identify significant differences in CPV scores across countries. We found that quality of care, as concurrently measured by performance on CPV vignettes, was generally poor and widely variable within and between countries. Providers in Kirov Province, Russia, had the highest overall performance, with an average score of 70.8%, while providers in Albania and Tajikistan had the lowest average score, each at 50.8%. The CPV vignettes with the lowest scores were for multiple noncommunicable disease risk factors and birth asphyxia. A considerable proportion (11%) of providers performed well on the CPV vignettes, regardless of country, facility, or structural resources available to them. Countries of Eastern Europe and Central Asia are challenged by poor performance as measured by clinical care vignettes, but there is potential for provision of high-quality care by a sizable proportion of providers. Large-scale assessments of quality of care have been hampered by the lack of effective measurement tools that provide generalizable and reliable results across diverse economic, cultural, and social settings. The feasibility of quality measurement using CPV vignettes in these 6 countries and the ability to combine results with individual feedback could significantly enhance strategies to improve quality of care, and ultimately population health. © Peabody et al.

The Watcher and the Watched: Social Judgments about Privacy in a Public Place

NASA Astrophysics Data System (ADS)

Friedman, Batya; Kahn, Peter H.; Hagman, Jennifer; Severson, Rachel L.; Gill, Brian

Digitally capturing and displaying real-time images of people in public places raises concerns for individual privacy. Applying the principles of Value Sensitive Design, we conducted two studies of people's social judgments about this topic. In Study I, 750 people were surveyed as they walked through a public plaza that was being captured by a HDTV camera and displayed in real-time in the office of a building overlooking the plaza. In Study II, 120 individuals were interviewed about the same topic. Moreover, Study II controlled for whether the participant was a direct stakeholder of the technology (inside the office watching people on the HDTV large-plasma display window) or an indirect stakeholder (being watched in the public venue). Taking both studies together, results (showed the following): (a) the majority of participants upheld some modicum of privacy in public; (b) people's privacy judgments were not a one-dimensional construct, but often involved considerations based on physical harm, psychological well-being, and informed consent; and (c) more women than men expressed concerns about the installation, and, unlike the men, equally brought forward their concerns, whether they were The Watcher or The Watched.

Enhancing nature of science understanding, reflective judgment, and argumentation through socioscientific issues

NASA Astrophysics Data System (ADS)

Callahan, Brendan E.

There is a distinct divide between theory and practice in American science education. Research indicates that a constructivist philosophy, in which students construct their own knowledge, is conductive to learning, while in many cases teachers continue to present science in a more traditional manner. This study sought to explore possible relationships between a socioscientific issues based curriculum and three outcome variables: nature of science understanding, reflective judgment, and argumentation skill. Both quantitative and qualitative methods were used to examine both whole class differences as well as individual differences between the beginning and end of a semester of high school Biology I. Results indicated that the socioscientific issues based curriculum did not produce statistically significant changes over the course of one semester. However, the treatment group scored better on all three instruments than the comparison group. The small sample size may have contributed to the inability to find statistical significance in this study. The qualitative interviews did indicate that some students provided more sophisticated views on nature of science and reflective judgment, and were able to provide slightly more complex argumentation structures. Theoretical implications regarding the use of explicit use of socioscientific issues in the classroom are presented.

NATO Standardization and Licensing Policy - Exploratory Phase. Volume 2. Main Report

DTIC Science & Technology

1976-11-30

issued under this section, every person who engages in the business of manufacturing, exporting, or importing arms, ammunition, or implements of... Wiliiam C. Pettijohn, Consultant Arthur Tyler Port, Consultant George M. Sr.ead, Jr. and Hoagland, MacLachlan & Co., Inc., Subcontractor 8...support in obtaining interviews with busy officials. The views and judgments expressed in this report are those of the authors and do not

Validation of social skills of adolescent males in an interview conversation with a previously unknown adult.

PubMed

Spence, S H

1981-01-01

Seventy convicted young male offenders were videotaped during a 5-min standardized interview with a previously unknown adult. In order to determine the social validity of the behavioral components of social interaction for this population, measures of 13 behaviors were obtained from the tapes. These measures were then correlated with ratings of friendliness, social anxiety, social skills performance, and employability made by four independent adult judges from the same tapes. It was found that measures of eye contact and verbal initiations were correlated significantly with all four criterion rating scales. The frequencies of smiling and speech dysfluencies were both significantly correlated with ratings of friendliness and employability. The amount spoken was found to be a significant predictor of social skills performance whereas the frequency of head movements influenced judgments of social anxiety. The latency of response was negatively correlated with social skills and employability ratings and the frequency of question-asking and interruptions correlated significantly with friendliness, social skills, and employability ratings. Finally, the levels of gestures, gross body movements, and attention feedback responses were not found to influence judgments on any of the criterion scales. The implications of the study for selection of targets for social skills training for adolescent male offenders are discussed.

Validation of social skills of adolescent males in an interview conversation with a previously unknown adult.

PubMed Central

Spence, S H

1981-01-01

Seventy convicted young male offenders were videotaped during a 5-min standardized interview with a previously unknown adult. In order to determine the social validity of the behavioral components of social interaction for this population, measures of 13 behaviors were obtained from the tapes. These measures were then correlated with ratings of friendliness, social anxiety, social skills performance, and employability made by four independent adult judges from the same tapes. It was found that measures of eye contact and verbal initiations were correlated significantly with all four criterion rating scales. The frequencies of smiling and speech dysfluencies were both significantly correlated with ratings of friendliness and employability. The amount spoken was found to be a significant predictor of social skills performance whereas the frequency of head movements influenced judgments of social anxiety. The latency of response was negatively correlated with social skills and employability ratings and the frequency of question-asking and interruptions correlated significantly with friendliness, social skills, and employability ratings. Finally, the levels of gestures, gross body movements, and attention feedback responses were not found to influence judgments on any of the criterion scales. The implications of the study for selection of targets for social skills training for adolescent male offenders are discussed. PMID:7287599

Interactive Learning: Vignettes from America's Most Wired Campuses.

ERIC Educational Resources Information Center

Brown, David G., Ed.

This book presents a collection of best practices in using instructional technology from 42 college campuses. In 93 brief, informal, and practical vignettes, professors show how they transformed courses with technology, discuss how the technology affects teaching and learning, and distill important lessons learned. The book is divided into two…

"Doing School": Cross Cultural Encounters

ERIC Educational Resources Information Center

Edwards, Viv

2015-01-01

In this paper, a series of vignettes is used to explore important current challenges in TESOL. These vignettes are drawn from many different settings, including Bengali-, Pahari- and Chinese-speaking children in UK primary schools, speakers of Aboriginal English in Australia and Chinese teachers of English on courses in Higher Education. A number…

Children's Beliefs about Parental Expectations for Emotional-Expressive Behavior Management.

ERIC Educational Resources Information Center

Saarni, Carolyn

The focus in the present study was on children's expectancies about how parents would respond to their children's genuine emotional-expressive displays, as sampled across seven different vignettes about parent-child interaction. The vignettes consisted of schematic cartoons and a verbal narrative. They contained "emotional displays" of…

Vignettes of Ambiguity

ERIC Educational Resources Information Center

Gotz, Ignacio L.

2010-01-01

This article is an exploration of ambiguity as it appears in various guises in philosophical, social, political, and educational situations. Among these situations is the experience of exile. The exploration is conducted by means of literary anecdotes and real-life instances, hence the use of vignettes. The suggestion is made that ambiguity can be…

An Attributional Analysis of Personal and Interpersonal Motivation for Collaborative Projects

ERIC Educational Resources Information Center

Peterson, Sarah E.; Schreiber, James B.

2006-01-01

Attribution theory provides a framework for examining personal and interpersonal motivation for collaborative projects. Undergraduates were asked to read vignettes concerning student dyads engaged in collaborative projects. The vignettes systematically varied on outcome of the project, student self-ability, student self-effort, partner ability,…

Teachers' Perceptions of Bullying among Youth

ERIC Educational Resources Information Center

Bell, Karen J. S.; Willis, W. Grant

2016-01-01

A series of 48 vignettes of bullying was constructed by crossing (a) four kinds of social contact (physical aggression, verbal aggression, relational aggression, and non-aggression) with (b) male and female bullies, (c) male and female and victims, and (d) reaction of the victim (aggressive, passive, and no reaction). Teachers rated vignettes for…

Whiteness in the Academy: Using Vignettes to Move beyond Safe Silences

ERIC Educational Resources Information Center

Behm Cross, Stephanie

2017-01-01

This point of departure presents the writings of a White, female teacher educator's experiences in the academy. Through the use of vignettes, the author discusses how four recent experiences--and her writing about those experiences--reveal the insidiousness of silence and Whiteness in the academy.

A comparison of three developmental stage scoring systems.

PubMed

Dawson, Theo Linda

2002-01-01

In social psychological research the stage metaphor has fallen into disfavor due to concerns about bias, reliability, and validity. To address some of these issues, I employ a multidimensional partial credit analysis comparing moral judgment interviews scored with the Standard Issue Scoring System (SISS) (Colby and Kohlberg, 1987b), evaluative reasoning interviews scored with the Good Life Scoring System (GLSS) (Armon, 1984b), and Good Education interviews scored with the Hierarchical Complexity Scoring System (HCSS) (Commons, Danaher, Miller, and Dawson, 2000). A total of 209 participants between the ages of 5 and 86 were interviewed. The multidimensional model reveals that even though the scoring systems rely upon different criteria and the data were collected using different methods and scored by different teams of raters, the SISS, GLSS, and HCSS all appear to measure the same latent variable. The HCSS exhibits more internal consistency than the SISS and GLSS, and solves some methodological problems introduced by the content dependency of the SISS and GLSS. These results and their implications are elaborated.

Latino Immigrant Men's Perceptions of Depression and Attitudes toward Help Seeking

ERIC Educational Resources Information Center

Cabassa, Leopoldo J.

2007-01-01

Perceptions of depression, attitudes toward depression treatments, help-seeking preferences, and perceived barriers to care were examined in a sample of 56 Latino immigrant men recruited from a primary health care clinic. Each participant was presented a vignette depicting an individual with major depression. Men described the vignette as a…

Case-Based Pedagogy Using Student-Generated Vignettes: A Pre-Service Intercultural Awareness Tool

ERIC Educational Resources Information Center

Cournoyer, Amy

2010-01-01

This qualitative study investigated the effectiveness of case-based pedagogy as an instructional tool aimed at increasing cultural awareness and competence in the preparation of 18 pre-service and in-service students enrolled in an Intercultural Education course. Each participant generated a vignette based on an instructional challenge identified…

Therapist Directiveness and Client Reactance in the Administration of Homework in Therapy with College Students

ERIC Educational Resources Information Center

Branagan, William Tyler; Swanbrow Becker, Martin A.

2018-01-01

The present study used an analog design with three vignettes portraying homework administrations at three levels of therapist directiveness (low, medium, and high) and the Therapeutic Reactance Scale to measure participant reactance. Participants (N = 436) read the vignettes and completed the Homework Completion Scale (HCS), Counseling…

Using Anchoring Vignettes to Assess Group Differences in General Self-Rated Health

ERIC Educational Resources Information Center

Grol-Prokopczyk, Hanna; Freese, Jeremy; Hauser, Robert M.

2011-01-01

This article addresses a potentially serious problem with the widely used self-rated health (SRH) survey item: that different groups have systematically different ways of using the item's response categories. Analyses based on unadjusted SRH may thus yield misleading results. The authors evaluate anchoring vignettes as a possible solution to this…

Validation of Assessment Vignettes and Scoring Rubric of Multicultural and International Competency in Faculty Teaching

ERIC Educational Resources Information Center

Henderson, Sheila J.; Horton, Ruth A.; Saito, Paul K.; Shorter-Gooden, Kumea

2016-01-01

The purpose of this research was to develop a new tool for assessing multicultural and international competency in faculty teaching through vignette scenarios of university classroom critical incidents--across disciplines of clinical and forensics psychology, business, and education. Construct and content validity of the initial draft vignettes…

Does Major Matter? Considering the Implications of Collecting Vignette Data from Our Students

ERIC Educational Resources Information Center

Collett, Jessica L.; Childs, Ellen

2009-01-01

Social psychologists in both sociology and psychology commonly use vignettes to gauge how people might respond in a given situation. Research subjects in such studies, like those in other experiments, are often undergraduates, surveyed or recruited in classes. While there has been significant attention to the generalizability of students'…

Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

ERIC Educational Resources Information Center

Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

2014-01-01

With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

Clinical Vignettes Improve Performance in Anatomy Practical Assessment

ERIC Educational Resources Information Center

Ikah, December S. K.; Finn, Gabrielle M.; Swamy, Meenakshi; White, Pamela M.; McLachlan, John C.

2015-01-01

Although medical curricula now adopt an integrated teaching approach, this is not adequately reflected in assessment of anatomy knowledge and skills. In this study, we aimed to explore the impact of the addition of clinical vignette to item stems on students' performance in anatomy practical examinations. In this study, 129 undergraduate medical…

An Exploratory Study of Digital Video Editing as a Tool for Teacher Preparation

ERIC Educational Resources Information Center

Calandra, Brendan; Gurvitch, Rachel; Lund, Jacalyn

2008-01-01

The authors' purpose was to examine teacher candidates' perspectives of successful teaching through personalized video vignettes. Furthermore, the authors were interested in how participants' written reflections might change as a result of creating these vignettes. This research used mixed-methods within the context of an exploratory multi-case…

The Use of Vignettes in Participatory Research with Young Children

ERIC Educational Resources Information Center

Palaiologou, Ioanna

2017-01-01

Participatory advocacy in research has brought new ways of thinking and researching young children's lives. Although some such methods in research are more successful than others, it is the process of involving children and their voices that matter most. Thus, this paper examines to what extent the vignette method facilitates participatory…

Using Vignettes as Self-Reflexivity in Narrative Research of Problematised History Pedagogy

ERIC Educational Resources Information Center

Hunter, Philippa

2012-01-01

This article focuses on the use of vignettes as an emergent dimension of narrative research writing. The author draws on doctoral research that problematised history curriculum and pedagogy with pre-service teachers in the context of secondary teacher education in New Zealand. Pedagogic crossings of history education sites, and negotiation of…

Case Vignettes of School Psychologists' Consultations Involving Hispanic Youth

ERIC Educational Resources Information Center

Ramirez, Sylvia Z.; Smith, Kenneth A.

2007-01-01

Despite the recognized importance of multicultural issues in school consultation, there has been a paucity of research in the area, especially regarding Hispanic issues. The purpose of this exploratory study was to investigate how school consultation was adapted in cases involving Hispanic youth. The anonymous case vignettes were provided by 49…

Knowledge as a Contingency Factor: Achieving Coordination in Interorganizational Systems

DTIC Science & Technology

2010-09-01

Problem...............................70 b. Vignette 2: Terrorism Threat to an International Event Held in a Archipelagic Environment...72 c. Vignette 3: Containing a Pandemic in a Archipelagic Environment...Operations (NEO) and disaster relief operations), and they also agree that there is no doctrine or procedures written to help them achieve successful

The New Friends Vignettes: Measuring Parental Psychological Control that Confers Risk for Anxious Adjustment in Preschoolers

ERIC Educational Resources Information Center

McShane, Kelly E.; Hastings, Paul D.

2009-01-01

This investigation examined the links between preschoolers' internalizing problems and anxiety-related social difficulties and two aspects of maternal and paternal psychological control: overprotection and critical control. Some 115 mothers and 92 fathers completed the New Friends Vignettes (NFV), a new measure of psychological control and…

Doing History: Investigating with Children in Elementary and Middle Schools.

ERIC Educational Resources Information Center

Levstik, Linda S.; Barton, Keith C.

This book draws on classroom experience to provide models of instructionally sound, thoughtful, and thought-provoking history teaching for students from a wide variety of backgrounds. Most chapters begin with a classroom vignette showing a community of inquiry as students are actively engaged in their history education. Each vignette offers a…

Alcohol's Effects on Women's Risk Detection in a Date-Rape Vignette

ERIC Educational Resources Information Center

Loiselle, Marci; Fuqua, Wayne R.

2007-01-01

Researchers have established that alcohol is a risk factor for date rape for both victims and perpetrators. Objective: The authors tried to experimentally address the link between alcohol consumption and women's risk detection abilities in a risky sexual vignette. Participants: The authors recruited 42 women from undergraduate classrooms at a…

Audience and Witnessing: Research into Dramatherapy using Vignettes and aMSN Messenger

ERIC Educational Resources Information Center

Jones, Phil

2008-01-01

This article describes the process of research undertaken to examine therapists' responses to the concept of the core processes of change in dramatherapy. The research uses a combination of vignette description and analysis using aMSN messenger. The article describes the theoretical underpinning and rationale to the approach, and the…

Child Protection Decision Making: A Factorial Analysis Using Case Vignettes

ERIC Educational Resources Information Center

Stokes, Jacqueline; Schmidt, Glen

2012-01-01

This study explored decision making by child protection social workers in the province of British Columbia, Canada. A factorial survey method was used in which case vignettes were constructed by randomly assigning a number of key characteristics associated with decision making in child protection. Child protection social workers (n = 118) assessed…

Children's Use and Knowledge of Display Rules for Anger following Hypothetical Vignettes versus following Live Peer Interaction.

ERIC Educational Resources Information Center

Parker, Elizabeth H.; Hubbard, Julie A.; Ramsden, Sally R.; Relyea, Nicole; Dearing, Karen F.; Smithmyer, Catherine M.; Schimmel, Kelly D.

2001-01-01

Examined correspondence between second-graders' use and knowledge of anger display rules. Found that children's responses were moderately related across two contexts. Following live interactions, compared to hypothetical vignettes, children reported feeling and expressing less anger, intending to hide their anger more, and dissembling their anger…

Framing effect debiasing in medical decision making.

PubMed

Almashat, Sammy; Ayotte, Brian; Edelstein, Barry; Margrett, Jennifer

2008-04-01

Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts. The present study investigated the effects of a debiasing procedure designed to prevent the framing effect for young adults who made decisions based on hypothetical medical decision-making vignettes. The debiasing technique involved participants listing advantages and disadvantages of each treatment prior to making a choice. One hundred and two undergraduate students read a set of three medical treatment vignettes that presented information in terms of different outcome probabilities under either debiasing or control conditions. The framing effect was demonstrated by the control group in two of the three vignettes. The debiasing group successfully avoided the framing effect for both of these vignettes. These results further support previous findings of the framing effect as well as an effective debiasing technique. This study improved upon previous framing debiasing studies by including a control group and personal medical scenarios, as well as demonstrating debiasing in a framing condition in which the framing effect was demonstrated without a debiasing procedure. The findings suggest a relatively simple manipulation may circumvent the use of decision-making heuristics in patients.

The Effect of Perceived Child Anxiety Status on Parental Latency to Intervene with Anxious and Non-Anxious Youth

PubMed Central

Aschenbrand, Sasha G.; Kendall, Philip C.

2012-01-01

Objective Examined the effect of perceived child anxiety status on parental latency to intervene with anxious and non-anxious youth. Method Parents (68) of anxiety-disordered (PAD) and non-anxiety-disordered (56: PNAD) children participated. Participants listened and responded to an audio vignette of a parent-child interaction: half were told the child was anxious and half were given a neutral description. Participants completed measures of anxiety and emotional responding before and after the audio vignette, and signaled when the mother on the vignette should accommodate the child. Results Whereas PNAD responded significantly faster when provided with neutral information about the child than when told the child was anxious, PAD did not differ in response latency. However, PAD exhibited a significant increase in state anxiety and negative affect and a decrease in positive affect after the vignette, whereas PNAD did not. Conclusions Results suggest that PNAD are more flexible and adaptable in their parenting behavior than PAD and that the greater anxiety and emotional lability of PAD may influence their parenting. Suggestions for research are discussed. PMID:22309473

Knowledge of ghostwriting and financial conflicts-of-interest reduces the perceived credibility of biomedical research

PubMed Central

2011-01-01

Background While the impact of conflicts-of-interest (COI) is of increasing concern in academic medicine, there is little research on the reaction of practicing clinicians to the disclosure of such conflicts. We developed two research vignettes presenting a fictional antidepressant medication study, one in which the principal investigator had no COI and another in which there were multiple COI disclosed. We confirmed the face validity of the COI vignette through consultation with experts. Hospital-based clinicians were randomly assigned to read one of these two vignettes and then administered a credibility scale. Findings Perceived credibility ratings were much lower in the COI group, with a difference of 11.00 points (31.42%) on the credibility scale total as calculated through the Mann-Whitney U test (95% CI = 6.99 - 15.00, p < .001). Clinicians in the COI group were also less likely to recommend the antidepressant medication discussed in the vignette (Odds Ratio = 0.163, 95% CI = .03 = 0.875). Conclusions In this study, increased disclosure of COI resulted in lower credibility ratings. PMID:21281504

Aggressive and nonaggressive children's moral judgments and moral emotion attributions in situations involving retaliation and unprovoked aggression.

PubMed

Gasser, Luciano; Malti, Tina; Gutzwiller-Helfenfinger, Eveline

2012-01-01

The authors investigated 7- and 9-year-old children's moral understanding of retaliation as compared to unprovoked aggression with regard to their aggressive behavior status. Based on peer ratings, 48 children were selected as overtly aggressive and 91 as nonaggressive. Their moral understanding of retaliation and unprovoked aggression was assessed by an interview including questions about their moral judgments and emotion attributions. Aggressive children judged retaliations as less serious than did nonaggressive children. They also referred less often to the harmful consequences of retaliation and were more likely to excuse the retaliation because of the provocation. In unprovoked aggressive situations younger aggressive children, compared with the younger nonaggressive children, attributed more happiness to transgressors, more anger to victims, and less sadness to transgressors and victims. The results are discussed in terms of previous research on aggressive children's moral understanding of retaliation and unprovoked aggression.

Metacognition, risk behavior, and risk outcomes: the role of perceived intelligence and perceived knowledge.

PubMed

Jaccard, James; Dodge, Tonya; Guilamo-Ramos, Vincent

2005-03-01

The present study explores 2 key variables in social metacognition: perceived intelligence and perceived levels of knowledge about a specific content domain. The former represents a judgment of one's knowledge at an abstract level, whereas the latter represents a judgment of one's knowledge in a specific content domain. Data from interviews of approximately 8,411 female adolescents from a national sample were analyzed in a 2-wave panel design with a year between assessments. Higher levels of perceived intelligence at Wave 1 were associated with a lower probability of the occurrence of a pregnancy over the ensuing year independent of actual IQ, self-esteem, and academic aspirations. Higher levels of perceived knowledge about the accurate use of birth control were associated with a higher probability of the occurrence of a pregnancy independent of actual knowledge about accurate use, perceived intelligence, self-esteem, and academic aspirations.

Weaving together peer assessment, audios and medical vignettes in teaching medical terms.

PubMed

Allibaih, Mohammad; Khan, Lateef M

2015-12-06

The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning.

Scaling up the evaluation of psychotherapy: evaluating motivational interviewing fidelity via statistical text classification

PubMed Central

2014-01-01

Background Behavioral interventions such as psychotherapy are leading, evidence-based practices for a variety of problems (e.g., substance abuse), but the evaluation of provider fidelity to behavioral interventions is limited by the need for human judgment. The current study evaluated the accuracy of statistical text classification in replicating human-based judgments of provider fidelity in one specific psychotherapy—motivational interviewing (MI). Method Participants (n = 148) came from five previously conducted randomized trials and were either primary care patients at a safety-net hospital or university students. To be eligible for the original studies, participants met criteria for either problematic drug or alcohol use. All participants received a type of brief motivational interview, an evidence-based intervention for alcohol and substance use disorders. The Motivational Interviewing Skills Code is a standard measure of MI provider fidelity based on human ratings that was used to evaluate all therapy sessions. A text classification approach called a labeled topic model was used to learn associations between human-based fidelity ratings and MI session transcripts. It was then used to generate codes for new sessions. The primary comparison was the accuracy of model-based codes with human-based codes. Results Receiver operating characteristic (ROC) analyses of model-based codes showed reasonably strong sensitivity and specificity with those from human raters (range of area under ROC curve (AUC) scores: 0.62 – 0.81; average AUC: 0.72). Agreement with human raters was evaluated based on talk turns as well as code tallies for an entire session. Generated codes had higher reliability with human codes for session tallies and also varied strongly by individual code. Conclusion To scale up the evaluation of behavioral interventions, technological solutions will be required. The current study demonstrated preliminary, encouraging findings regarding the utility of statistical text classification in bridging this methodological gap. PMID:24758152

Layered stigma among health-care and social service providers toward key affected populations in Jamaica and The Bahamas.

PubMed

Rogers, S J; Tureski, K; Cushnie, A; Brown, A; Bailey, A; Palmer, Q

2014-01-01

While considerable research has documented stigma toward key populations affected by HIV and AIDS - men who have sex with men (MSM), sex workers (SWs) - it provided limited empirical evidence on the presence of layered stigma among health-care professionals providing services for these populations. C-Change conducted a survey among 332 staff of health-care and social service agencies in Jamaica and The Bahamas to understand the levels of stigma toward people living with HIV (PLHIV), including MSM and SWs and factors associated with stigma. While most health-care professionals responding to the survey said that PLHIV, MSM, and SWs deserved quality care, they expressed high levels of blame and negative judgments, especially toward MSM and SWs. Across a stigma assessment involving eight vignette characters, the highest levels of stigma were expressed toward PLHIV who were also MSM or SWs, followed by PLHIV, MSM, and SWs. Differences were assessed by gender, country, type of staff, type of agency, and exposure to relevant training. Findings indicate higher reported stigma among nonclinical vs. clinical staff, staff who worked in general vs. MSM/SW-friendly health facilities, and among untrained vs. training staff. This implies the need for targeted staff capacity strengthening as well as improved facility environments that are MSM/SW-friendly.

Sex differences in mate preferences revisited: do people know what they initially desire in a romantic partner?

PubMed

Eastwick, Paul W; Finkel, Eli J

2008-02-01

In paradigms in which participants state their ideal romantic-partner preferences or examine vignettes and photographs, men value physical attractiveness more than women do, and women value earning prospects more than men do. Yet it remains unclear if these preferences remain sex differentiated in predicting desire for real-life potential partners (i.e., individuals whom one has actually met). In the present study, the authors explored this possibility using speed dating and longitudinal follow-up procedures. Replicating previous research, participants exhibited traditional sex differences when stating the importance of physical attractiveness and earning prospects in an ideal partner and ideal speed date. However, data revealed no sex differences in the associations between participants' romantic interest in real-life potential partners (met during and outside of speed dating) and the attractiveness and earning prospects of those partners. Furthermore, participants' ideal preferences, assessed before the speed-dating event, failed to predict what inspired their actual desire at the event. Results are discussed within the context of R. E. Nisbett and T. D. Wilson's (1977) seminal article: Even regarding such a consequential aspect of mental life as romantic-partner preferences, people may lack introspective awareness of what influences their judgments and behavior. (c) 2008 APA, all rights reserved

Online processing of moral transgressions: ERP evidence for spontaneous evaluation.

PubMed

Leuthold, Hartmut; Kunkel, Angelika; Mackenzie, Ian G; Filik, Ruth

2015-08-01

Experimental studies using fictional moral dilemmas indicate that both automatic emotional processes and controlled cognitive processes contribute to moral judgments. However, not much is known about how people process socio-normative violations that are more common to their everyday life nor the time-course of these processes. Thus, we recorded participants' electrical brain activity while they were reading vignettes that either contained morally acceptable vs unacceptable information or text materials that contained information which was either consistent or inconsistent with their general world knowledge. A first event-related brain potential (ERP) positivity peaking at ∼200 ms after critical word onset (P200) was larger when this word involved a socio-normative or knowledge-based violation. Subsequently, knowledge-inconsistent words triggered a larger centroparietal ERP negativity at ∼320 ms (N400), indicating an influence on meaning construction. In contrast, a larger ERP positivity (larger late positivity), which also started at ∼320 ms after critical word onset, was elicited by morally unacceptable compared with acceptable words. We take this ERP positivity to reflect an implicit evaluative (good-bad) categorization process that is engaged during the online processing of moral transgressions. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Passing the Rod: Similarities between Parents' and Children's Orientations toward Physical Punishment.

ERIC Educational Resources Information Center

Holden, George W.; And Others

This study examined the correspondence between parents' and children's orientations toward the use of physical punishment. A series of vignettes concerning child misbehavior was shown to children and their parents. Subjects were asked to assess the likelihood of their responding to the situation shown by spanking the child in the vignette.…

Cross-Country Heterogeneity in Students' Reporting Behavior: The Use of the Anchoring Vignette Method

ERIC Educational Resources Information Center

Vonkova, Hana; Zamarro, Gema; Hitt, Collin

2018-01-01

Self-reports are an indispensable source of information in education research but they are often affected by heterogeneity in reporting behavior. Failing to correct for this heterogeneity can lead to invalid comparisons across groups. The researchers use the parametric anchoring vignette method to correct for cross-country incomparability of…

The Factorial Survey: Design Selection and its Impact on Reliability and Internal Validity

ERIC Educational Resources Information Center

Dülmer, Hermann

2016-01-01

The factorial survey is an experimental design consisting of varying situations (vignettes) that have to be judged by respondents. For more complex research questions, it quickly becomes impossible for an individual respondent to judge all vignettes. To overcome this problem, random designs are recommended most of the time, whereas quota designs…

3-D Computer Animation vs. Live-Action Video: Differences in Viewers' Response to Instructional Vignettes

ERIC Educational Resources Information Center

Smith, Dennie; McLaughlin, Tim; Brown, Irving

2012-01-01

This study explored computer animation vignettes as a replacement for live-action video scenarios of classroom behavior situations previously used as an instructional resource in teacher education courses in classroom management strategies. The focus of the research was to determine if the embedded behavioral information perceived in a live-action…

Sharing Practices, but What Is the Story? Exploring Award-Winning Teachers' Conceptions of Teaching

ERIC Educational Resources Information Center

Gan Joo Seng, Mark; Geertsema, Johan

2018-01-01

This paper critically considers the attempt by a research-intensive university in Asia to draw on and make public the practices of teaching award winners in different disciplines through the use of narrative vignettes. More specifically, this paper examines what the vignettes suggest about the connection between award-winning teachers' conceptions…

In Our Voices: Latino Students on Higher Education. (Videotape and Discussion Guide.)

ERIC Educational Resources Information Center

Intercultural Development Research Association, San Antonio, TX.

This 40-minute video presents 10 vignettes about Latino young people reflecting on important issues as they move from high school to college and into civic engagement as leaders in their communities. The vignettes are based on composite life experiences of Latino students. The script, lyrics, and music are original compositions of Los Inocentes…

Values in Action: The Meaning of Executive Vignettes. Technical Report 28.

ERIC Educational Resources Information Center

Lombardo, Michael M.

This technical report contains executive vignettes collected during a research project involving 400 executives in 8 organizations. It analyzes individual stories and categorizes them into four broad themes: (1) how things work politically in an organization; (2) how people are treated; (3) how one gets ahead; and (4) the proper role of an…

Psychometric Properties of Virtual Reality Vignette Performance Measures: A Novel Approach for Assessing Adolescents' Social Competency Skills

ERIC Educational Resources Information Center

Paschall, Mallie J.; Fishbein, Diana H.; Hubal, Robert C.; Eldreth, Diana

2005-01-01

This study examined the psychometric properties of performance measures for three novel, interactive virtual reality vignette exercises developed to assess social competency skills of at-risk adolescents. Performance data were collected from 117 African-American male 15-17 year olds. Data for 18 performance measures were obtained, based on…

Endorsement of Couples Counseling in a Domestic Violence Case as a Function of Training

ERIC Educational Resources Information Center

Bapat, Mona; Tracey, Terence

2009-01-01

Reactions of students in helping professions to domestic violence were examined with respect to whether or not the students had any training in domestic violence. One hundred, four students read one of two vignettes describing a domestic violence case and responded to statements related to treatment options. The vignettes differed only in…

Values in School Science: Some Practical Materials and Suggestions. Third Edition.

ERIC Educational Resources Information Center

Brinckerhoff, Richard F.

The collection of vignettes in this book provide science teachers with a multitude of source materials and useful alternatives for incorporation into their curricula and teaching. Teachers may select topics as brief issues for casual reflection or as a means for promoting deeper investigation and analysis. Most of the vignettes can be extended and…

Sixth Graders' Conflict Resolution in Role Plays with a Peer, Parent, and Teacher

ERIC Educational Resources Information Center

Borbely, Christina J.; Graber, Julia A.; Nichols, Tracy; Brooks-Gunn, Jeanne; Botvin, Gilbert J.

2005-01-01

This study used conflict resolution role play vignettes and self-report surveys of 450 New York City 6th graders to examine associations between adolescents' conflict resolution efficacy and social skills. Vignettes covered 3 social contexts, conflict with a peer (disagreement over activities), with a parent (raise in allowance), and with a…

College students' perceptions of peers with autism spectrum disorder.

PubMed

Matthews, Nicole L; Ly, Agnes R; Goldberg, Wendy A

2015-01-01

Little is known about peer attitudes toward college students with autism spectrum disorder (ASD). Affective, behavioral, and cognitive attitudes toward vignette characters displaying behaviors characteristic of ASD were examined among 224 four-year university students who were randomly assigned to one of three labeling conditions for the primary vignette characters: high functioning autism (HFA), typical college student, or no label. Students in the HFA label condition reported more positive behavioral and cognitive attitudes toward the vignette characters than students in the no label condition. Male students and students with lower scores on the Broad Autism Phenotype Questionnaire reported more positive attitudes across study conditions. These experimental results suggest that knowledge of a diagnosis might improve attitudes toward college students with ASD.

Nursing diagnoses determined by first year students: a vignette study.

PubMed

Hakverdioğlu Yönt, Gülendam; Korhan, Esra Akın; Erdemir, Firdevs; Müller-Staub, Maria

2014-02-01

The study aimed to determine the ability of first year students in identifying nursing diagnoses. In a descriptive evaluation study, an expert-validated vignette containing 18 nursing diagnoses was used. The students determined 15 nursing diagnoses. The highest percentages of diagnoses identified were disturbed sleep pattern and nutrition imbalance. Students also considered medical diagnoses as nursing diagnoses: hypertension and tachycardia. Despite the fact that students were only at the end of their first semester and had limited clinical experience, they successfully identified the majority of nursing diagnoses. Patient case study vignettes are recommended for education. To foster students' knowledge and experience, it is also suggested that evaluating nursing diagnoses in clinical practicals becomes a requirement. © 2013 NANDA International, Inc.

[Structure and characteristics of technical support that psychiatric social workers of prefectural governments provide for municipalities].

PubMed

Okada, Takashi

2017-01-01

Objectives　The support to municipalities by prefectural governments has become necessary in the fields of mental health and welfare. Therefore, psychiatric social workers (PSW) ordered from the prefectural governor has been providing technical support (TS) that promote community activities of the municipality and improve staff support for persons with mental disabilities. The purpose of this study was to identify empirical structure and characteristics of TS that PSW provide for municipality staff.Method　Semi-structured interviews were conducted with seven certified PSW randomly selected from the membership list of the National Psychiatric Social Worker Organization. Inclusion criteria required participants to have more than 10 years of experience at the prefectural government and experience providing TS in the last five years. Interviews focused on two situations: a casework and a project related to mental health. Interview data were analyzed using a qualitative content method, setting a framework for the consultation process.Results　The analysis included five categories < > and 15 subcategories [ ], which consisted of 37 concepts. In category with municipalities consisted of [complementary relationship] and [partnership]. The category included two subcategories, [analyze/judgment from the conditions spread in front of] and [analyze/judgment be the accumulated skills and knowledge in person]. In category , six policies were considered as important, including [problem solving and promoting action], [fostering person centered care perspective], [promoting the understanding of residents], [provide psychological support to the staff], [clarify responsibility as the municipal officials], and [coordinate to improve the environment]. Category consisted of both [support indirectly] and [support cooperatively]. The last category, included three subcategories, [lead to the maintenance and improvement of the system], [have the staff pleasure/contribute to the community], and [consider whether it can be applied to other regions]. The results showed that the characteristics of TS had a consultation function, and the support function utilized complementarity and collaboration between prefecture and municipality providing services to residents.Conclusion　This study has clarified the characteristics of TS, which have not been clarified in previous research. We should accumulate the knowledge and establish a method for spreading through various regions.

Perceptions about traditional and novel methods to learn about postoperative pain management: a qualitative study.

PubMed

Ingadottir, Brynja; Blondal, Katrin; Jaarsma, Tiny; Thylen, Ingela

2016-11-01

The aim of this study was to explore the perceptions of surgical patients about traditional and novel methods to learn about postoperative pain management. Patient education is an important part of postoperative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice. A qualitative design with a vignette and semi-structured interviews used for data collection. A purposeful sample of 13 postsurgical patients, who had been discharged from hospital, was recruited during 2013-2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about postoperative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach. Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualized the factors affecting patients' perceptions: (1) 'Trusting the source', sub-categorized into 'Being familiar with the method' and 'Having own prejudgments'; and (2) 'Being motivated to learn' sub-categorized into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'. To implement successfully novel educational methods into postoperative care, healthcare professionals need to be aware of the factors influencing patients' perceptions about how to learn, such as trust and motivation. © 2016 John Wiley & Sons Ltd.

Does the COPD assessment test (CAT(TM)) questionnaire produce similar results when self- or interviewer administered?

PubMed

Agusti, A; Soler-Cataluña, J J; Molina, J; Morejon, E; Garcia-Losa, M; Roset, M; Badia, X

2015-10-01

The COPD assessment test (CAT) is a questionnaire that assesses the impact of chronic obstructive pulmonary disease (COPD) on health status, but some patients have difficulties filling it up by themselves. We examined whether the mode of administration of the Spanish version of CAT (self vs. interviewer) influences its scores and/or psychometric properties. Observational, prospective study in 49 Spanish centers that includes clinically stable COPD patients (n = 153) and patients hospitalized because of an exacerbation (ECOPD; n = 224). The CAT was self-administered (CAT-SA) or administered by an interviewer (CAT-IA) based on the investigator judgment of the patient's capacity. To assess convergent validity, the Saint George's Respiratory Disease Questionnaire (SGRQ) and the London Chest Activity of Daily Living (LCADL) instrument were also administered. Psychometric properties were compared across modes of administration. A total of 118 patients (31 %) completed the CAT-SA and 259 (69 %) CAT-IA. Multiple regression analysis showed that mode of administration did not affect CAT scores. The CAT showed excellent psychometric properties in both modes of administration. Internal consistency coefficients (Cronbach's alpha) were high (0.86 for CAT-SA and 0.85 for CAT-IA) as was test-retest reliability (intraclass correlation coefficients of 0.83 for CAT-SA and CAT-IA). Correlations with SGRQ and LCADL were moderate to strong both in CAT-SA and CAT-IA, indicating good convergent validity. Similar results were observed when testing longitudinal validity. The mode of administration does not influence CAT scores or its psychometric properties. Hence, both modes of administration can be used in clinical practice depending on the physician judgment of patient's capacity.

Is it a Case of "Work-Anxiety" When Patients Report Bad Workplace Characteristics and Low Work Ability?

PubMed

Muschalla, Beate

2017-03-01

Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients' work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians' judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments.

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

PubMed

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

Unconscious race and class bias: its association with decision making by trauma and acute care surgeons.

PubMed

Haider, Adil H; Schneider, Eric B; Sriram, N; Dossick, Deborah S; Scott, Valerie K; Swoboda, Sandra M; Losonczy, Lia; Haut, Elliott R; Efron, David T; Pronovost, Peter J; Freischlag, Julie A; Lipsett, Pamela A; Cornwell, Edward E; MacKenzie, Ellen J; Cooper, Lisa A

2014-09-01

Recent studies have found that unconscious biases may influence physicians' clinical decision making. The objective of our study was to determine, using clinical vignettes, if unconscious race and class biases exist specifically among trauma/acute care surgeons and, if so, whether those biases impact surgeons' clinical decision making. A prospective Web-based survey was administered to active members of the Eastern Association for the Surgery of Trauma. Participants completed nine clinical vignettes, each with three trauma/acute care surgery management questions. Race Implicit Association Test (IAT) and social class IAT assessments were completed by each participant. Multivariable, ordered logistic regression analysis was then used to determine whether implicit biases reflected on the IAT tests were associated with vignette responses. In total, 248 members of the Eastern Association for the Surgery of Trauma participated. Of these, 79% explicitly stated that they had no race preferences and 55% stated they had no social class preferences. However, 73.5% of the participants had IAT scores demonstrating an unconscious preference toward white persons; 90.7% demonstrated an implicit preference toward upper social class persons. Only 2 of 27 vignette-based clinical decisions were associated with patient race or social class on univariate analyses. Multivariable analyses revealed no relationship between IAT scores and vignette-based clinical assessments. Unconscious preferences for white and upper-class persons are prevalent among trauma and acute care surgeons. In this study, these biases were not statistically significantly associated with clinical decision making. Further study of the factors that may prevent implicit biases from influencing patient management is warranted. Epidemiologic study, level II.

Using Vignettes to Compare the Quality of Clinical Care Variation in Economically Divergent Countries

PubMed Central

Peabody, John W; Tozija, Fimka; Muñoz, Jorge A; Nordyke, Robert J; Luck, Jeff

2004-01-01

Objective To determine whether clinical vignettes can measure variations in the quality of clinical care in two economically divergent countries. Data Source/Study Setting Primary data collected between February 1997 and February 1998 at two Veterans Affairs facilities in the United States and four government-run outpatient facilities in Macedonia. Study Design Randomly selected, eligible Macedonian and U.S. physicians (>97 percent participation rate) completed vignettes for four common outpatient conditions. Responses were judged against a master list of explicit quality criteria and scored as percent correct. Data Collection/ Extraction An ANOVA model and two-tailed t-tests were used to compare overall scores by case, study site, and country. Principal Findings The mean score for U.S. physicians was 67 percent (+/−11 percent) compared to 48 percent (+/−11 percent) for Macedonian physicians. The quality of clinical practice, which emphasizes basic skills, varied greatly in both sites, but more so in Macedonia. However, the top Macedonian physicians in all sites approached or—in one case—exceeded the median score in the U.S. sites. Conclusions Vignettes are a useful method for making cross-national comparisons of the quality of care provided in very different settings. The vignette measurements revealed that some physicians in Macedonia performed at a standard comparable to that of their counterparts in the United States, despite the disparity of the two health systems. We infer that in poorer countries, policy that promotes improvements in the quality of clinical practice—not just structural inputs—could lead to rapid improvements in health. PMID:15544639

Do Consultation Psychiatrists, Forensic Psychiatrists, Psychiatry Trainees, and Health Care Lawyers Differ in Opinion on Gray Area Decision-Making Capacity Cases? A Vignette-Based Survey.

PubMed

Armontrout, James; Gitlin, David; Gutheil, Thomas

2016-01-01

Previous research in the area of medical decision-making capacity has demonstrated relatively poor agreement between experienced evaluators in "gray area" cases. We performed a survey to determine the level of agreement about gray area decision-making capacity case scenarios within and between individuals of different professional backgrounds. Participants received a survey consisting of 3 complicated decision-making capacity vignettes with an accompanying "yes/no" question regarding capacity and a certainty scale for each vignette. Participants were identified from mailing lists of professional organizations and local hospitals. We received responses from psychiatry trainees, consultation-liaison psychiatrists, forensic psychiatrists, and lawyers with experience in health care law. Results were analyzed using SPSS. Across the 3 vignettes, the percentage agreeing that the individual described had capacity to refuse medical treatment ranged between 35% and 40% for trainees, 33% and 67% for consult psychiatrists, 41% and 76% for forensic psychiatrists, and 40% and 83% for health care lawyers. Only question 2 reached significance between-group differences (Pearson χ(2) = 11.473, p < 0.01). Across vignettes, trainees were less likely to consider patients to have capacity for decision-making than were forensic psychiatrists and lawyers. As found in previous research, agreement among experienced evaluators appears generally low in gray area capacity cases. It is noteworthy that individuals of different professional backgrounds at times offer divergent between-group opinions on capacity. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Variations in Identification of Healthcare-Associated Infections

PubMed Central

Keller, Sara C.; Linkin, Darren R.; Fishman, Neil O.; Lautenbach, Ebbing

2014-01-01

OBJECTIVE Little is known about whether those performing healthcare-associated infection (HAI) surveillance vary in their interpretations of HAI definitions developed by the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN). Our primary objective was to characterize variations in these interpretations using clinical vignettes. We also describe predictors of variation in responses. DESIGN Cross-sectional study. SETTING United States. PARTICIPANTS A sample of US-based members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. METHODS Respondents assessed whether each of 6 clinical vignettes met criteria for an NHSN-defined HAI. Individual- and institutional-level data were also gathered. RESULTS Surveys were distributed to 143 SHEA Research Network members from 126 hospitals. In total, 113 responses were obtained, representing at least 61 unique hospitals (30 respondents did not identify a hospital); 79.2% (84 of 106 nonmissing responses) were infection preventionists, and 79.4% (81 of 102 nonmissing responses) worked at academic hospitals. Among the 6 vignettes, the proportion of respondents correctly characterizing the vignettes was as low as 27.3%. Combining all 6 vignettes, the mean percentage of correct responses was 61.1% (95% confidence interval, 57.7%–63.8%). Percentage of correct responses was associated with presence of a clinical background (ie, nursing or physician degrees) but not with hospital size or infection prevention and control department characteristics. CONCLUSIONS Substantial heterogeneity exists in the application of HAI definitions in this survey of infection preventionists and hospital epidemiologists. Our data suggest a need to better clarify these definitions, especially when comparing HAI rates across institutions. PMID:23739071

Weaving together peer assessment, audios and medical vignettes in teaching medical terms

PubMed Central

Khan, Lateef M.

2015-01-01

Objectives The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. Methods The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. Results The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. Conclusions The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning. PMID:26637986

Conceptions of mental illness: attitudes of mental health professionals and the general public.

PubMed

Stuber, Jennifer P; Rocha, Anita; Christian, Ann; Link, Bruce G

2014-04-01

The authors compared attitudes of the U.S. general public and of mental health professionals about the competence and perceived dangerousness of people with mental health problems and the desire for social distance from them. Factors related to negative attitudes and the desire for social distance also were examined. Vignettes describing individuals meeting DSM-IV criteria for major depression and schizophrenia were included in the 2006 General Social Survey (GSS) and a 2009 study of mental health professionals, and responses were descriptively compared (GSS, N=397 responses to depression vignette, N=373 responses to schizophrenia vignette; 731 mental health professionals responded to both vignettes). Regression analyses examined whether demographic and provider characteristics were associated with perceptions of less competence and perceived dangerousness of the vignette character and with respondents' desire for social distance. Compared with the American public, mental health professionals had significantly more positive attitudes toward people with mental health problems. However, some providers' conceptions about the dangerousness of people with schizophrenia and provider desire for social distance from clients in work and personal situations were concerning. Younger age, self-identifying as non-Hispanic white, being female, having at least a four-year college degree, being familiar with mental illness, and certain job titles and more years of experience in the mental health field were predictive of more positive conceptions. Although mental health professionals held more positive attitudes than the general public about people with mental health problems, strong stereotypes persisted in both groups, especially concerning schizophrenia. This study identified several demographic and provider characteristics that can inform intervention strategies in both groups.

Factors Influencing Labeling Nonconsensual Sex as Sexual Assault.

PubMed

Yndo, Monica C; Zawacki, Tina

2017-03-01

The current study examined the effects of physical attractiveness and sexual interest cues on men's sexual perceptions of women and whether increases in sexual perceptions of a woman would lead to decreases in labeling of subsequent nonconsensual sex as sexual assault. Two hundred thirty-three male college students ( M age = 19.17, SD = 1.22) read a vignette describing a hypothetical social interaction between a man and a woman; within the vignette, the female character's physical attractiveness (attractive vs. less attractive) and the degree to which the female character behaved interested in the male character (uninterested vs. ambiguous) were manipulated. The vignette ends with the male character physically forcing sexual intercourse with the female character. After reading the vignette, participants' labeling of the nonconsensual sex as sexual assault was addressed. Participants' perceptions of the female character's sexual interest in the male character prior to the nonconsensual sex was assessed as a dependent variable during stopping points in the vignette, prior to sexual assault. Both physical attractiveness and interest cues had a significant positive influence on men's perception of the female character as sexually interested. In addition, perceptions of sexual interest had a direct negative effect on sexual assault labeling. These results indicate that increases in physical attractiveness and interest cues increase perceptions of sexual interest, in turn decreasing the labeling of nonconsensual sex as sexual assault. This experimental research contributes to the literature on misperception of sexual interest and sexual assault labeling. These findings provide implications for intervention programs and for forensic issues related to sexual assault.

Editorial, Forum and Book Reviews

NASA Astrophysics Data System (ADS)

Caulfield, H. J.

1983-12-01

In his usual delightful fashion, Professor Richard Feynman recently recounted stories, insights, and observations from his life in science during a one hour interview on U.S. public television. All of what he said was enjoyable, but I think he erred in at least one judgment. He expressed disdain for organizations that form committees to determine who is worthy of an honor. With due deference to his insight, let me offer my own analysis in support of another view.

Clouding the Judgment of Domestic Violence Law: Victim Blaming by Institutional Stakeholders in Cambodia

PubMed Central

Brickell, Katherine

2015-01-01

This article examines victims’ purported complicity in the judicial failures of domestic violence law to protect them in Cambodia. It is based on 3 years (2012-2014) of research in Siem Reap and Pursat Provinces on the everyday politics of the 2005 “Law on the Prevention of Domestic Violence and the Protection of the Victims” (DV Law). The project questioned why investments in DV Law are faltering and took a multi-stakeholder approach to do so. In addition to 40 interviews with female domestic violence victims, the research included 50 interviews with legal and health professionals, NGO workers, low- and high-ranking police officers, religious figures, and local government authority leaders who each have an occupational investment in the implementation and enforcement of DV Law. Forming the backbone of the article, the findings from this latter sample reveal how women are construed not only as barriers “clouding the judgment of law” but also as actors denying the agency of institutional stakeholders (and law itself) to bring perpetrators to account. The findings suggest that DV Law has the potential to entrench, rather than diminish, an environment of victim blaming. In turn, the article signals the importance of research on, and better professional support of, intermediaries who (discursively) administrate the relationship between DV Law and the victims/citizens it seeks to protect. PMID:26076978

Implementing Primary Social and Emotional Aspects of Learning (SEAL) Small Group Interventions: Recommendations for Practitioners

ERIC Educational Resources Information Center

Lendrum, Ann; Humphrey, Neil; Kalambouka, Afroditi; Wigelsworth, Michael

2009-01-01

This article presents an extended vignette describing a good practice model for implementing SEAL small group work at "Mellington Primary", a fictional school. The vignette/model was developed from in-depth case studies at five primary schools in the north-west of England during a national evaluation of primary SEAL by the authors. The…

Teacher Perceptions of Classroom Interventions for Children with ADHD: A Cross-Cultural Comparison of Teachers in the United States and New Zealand

ERIC Educational Resources Information Center

Curtis, David F.; Pisecco, Stewart; Hamilton, Richard J.; Moore, Dennis W.

2006-01-01

This investigation compared United States and New Zealand teachers' perceptions of classroom interventions for attention deficit hyperactivity disorder (ADHD). Participants read one of six vignettes describing a child with symptoms representative of ADHD. The number and type of symptoms were consistent across all vignettes. Next, teachers read a…

Evidence of More Immanent Justice Responding in Adults than Children: A Challenge to Traditional Developmental Theories

ERIC Educational Resources Information Center

Raman, Lakshmi; Winer, Gerald A.

2004-01-01

Three studies investigated developmental changes in immanent justice responding by asking participants to respond to vignettes in which a person's bad behaviour was followed by a negative consequence. Study 1 consisted of 152 sixth graders and 128 college students and presented participants with a vignette that examined the notion of bad people…

The Treatment of Anorexia Nervosa in a General Hospital: A Case Vignette of a Multi-Disciplinary General Hospital-Based Approach.

ERIC Educational Resources Information Center

Kronenberg, J.; And Others

1994-01-01

Describes anorexia nervosa as condition variable in etiology and resistant to treatment, which may lead to mortality in 5% of treated cases. Notes that efforts have been made for treating disorder in nonstigmatizing medical units outside psychiatric hospitals. Describes, through presentation of short case vignette, advantages of treating…

Cultural and Political Vignettes in the English Classroom: Problem-Posing, Problem-Solving, and the Imagination

ERIC Educational Resources Information Center

Darvin, Jacqueline

2009-01-01

One way to merge imagination with problem-posing and problem-solving in the English classroom is by asking students to respond to "cultural and political vignettes" (CPVs). CPVs are cultural and political situations that are presented to students so that they can practice the creative and essential decision-making skills that they will need to use…

Do Social Work Students Assess and Address Economic Barriers to Clients Implementing Agreed Tasks?

ERIC Educational Resources Information Center

Eamon, Mary Keegan; Zhang, Sai-jun

2006-01-01

Identical vignettes except for a sentence describing a client's economic resources were randomly assigned to 129 MSW students. The vignettes described a social worker who agreed with a client's decision to relocate her residence as a partial solution to a presenting problem but did not assess or address economic barriers to the client's…

Preschoolers' Problem-Solving in Sexually Abusive and Non-Sexual Situations.

ERIC Educational Resources Information Center

Grober, Jacqueline S.; And Others

This study examined the relation of social situation variables and children's gender to children's social problem solving ability in potentially unsafe situations. A total of 62 preschoolers (mean age 4.4 years) were shown a series of four vignettes. In two vignettes, an adult or a child asked a second child to cross a street. In two other…

Using Video Vignettes of Historical Episodes for Promoting Pre-Service Teachers' Ideas about the Nature of Science

ERIC Educational Resources Information Center

Cakmakci, Gultekin

2017-01-01

This study used video vignettes of historical episodes from documentary films as a context and instructional tool to promote pre-service science teachers' (PSTs) conceptions of the nature of science (NOS). The participants received explicit-reflective NOS instruction, and were introduced to techniques to be able to use scenes from documentary…

Temporo-Parietal Junction Activity in Theory-of-Mind Tasks: Falseness, Beliefs, or Attention

ERIC Educational Resources Information Center

Aichhorn, Markus; Perner, Josef; Weiss, Benjamin; Kronbichler, Martin; Staffen, Wolfgang; Ladurner, Gunther

2009-01-01

By combining the false belief (FB) and photo (PH) vignettes to identify theory-of-mind areas with the false sign (FS) vignettes, we re-establish the functional asymmetry between the left and right temporo-parietal junction (TPJ). The right TPJ (TPJ-R) is specially sensitive to processing belief information, whereas the left TPJ (TPJ-L) is equally…

Tune in to Your Rights...A Guide for Teenagers about TURNING OFF Sexual Harassment.

ERIC Educational Resources Information Center

Morris, Barbra; And Others

Targeted to secondary school students, this booklet discusses sexual harassment. The booklet opens with a vignette about a teenage girl who is harassed by a fellow student and several shorter vignettes describing various types of sexual harassment. Sexual harassment is defined, and nine forms of harassment are listed. The right to a life and an…

The Career Success/Personal Failure Phenomenon as Perceived in Others: Comparing Vignettes of Male and Female Managers.

ERIC Educational Resources Information Center

Westman, Mina; Etzion, Dalia

1990-01-01

Reactions to 4 versions of a vignette describing a successful manager were obtained from 233 management students, including 50 executives in an extension course. Career success was perceived as a major cause of personal failure. The personal price paid by successful people was perceived differently depending on gender and marital status. (SK)

The Causal Attributions of Teaching Staff towards Children with Intellectual Disabilities: A Comparison of "Vignettes" Depicting Challenging Behaviour with "Real" Incidents of Challenging Behaviour

ERIC Educational Resources Information Center

Lucas, Victoria L.; Collins, Suzanne; Langdon, Peter E.

2009-01-01

Background: We examined whether staff attributions, emotions and helping behaviours in reaction to "real" incidents of challenging behaviour (CB) exhibited by children with intellectual disabilities were different from reactions to "vignettes". We also examined whether these reactions are congruent with that predicted by attribution theory.…

Web-based multimedia vignettes in advanced community pharmacy practice experiences.

PubMed

Flowers, Schwanda K; Vanderbush, Ross E; Hastings, Jan K; West, Donna

2010-04-12

To evaluate the effectiveness of Web-based multimedia vignettes on complex drug administration techniques to augment the training of pharmacy students in advanced community pharmacy practice experiences. During the orientation for a community APPE, students were randomly assigned to either a study group or control group After they began their APPE, students in the study group were given an Internet address to access multimedia vignettes which they were required to watch to augment their training and standardize their counseling of patients in the use of inhalers and ear and eye drops. A 12-item questionnaire was administered to students in both groups at the orientation and again on the last day of the APPE to evaluate their knowledge of counseling patients in the use of inhalers and ear and eye drops. The control group did not experience any improvement in their counseling knowledge of the research topics during their month-long experience. Students in the intervention group scored higher on their postintervention test than students in the control group (p < 0.001). Student learning outcomes from experiential training can be improved through the use of Web-based multimedia instructional vignettes.

Ethical considerations in aesthetic rhinoplasty: a survey, critical analysis, and review.

PubMed

Karimi, Kian; McKneally, Martin F; Adamson, Peter A

2012-11-01

Although the practice of medicine is built on a foundation of ethics, science, and common sense, the increasing complexity of medical interventions, social interactions, and societal norms of behavior challenges the ethical practice of aesthetic surgeons. We report a survey of the opinions, practices, and attitudes of experienced and novice facial plastic surgeons. The survey consisted of 15 clinical vignettes addressing ethical quandaries in aesthetic rhinoplasty. The vignettes are based on the experience and observations of the senior author (P.A.A.) over nearly 30 years of practice and teaching. Fellowship directors and facial plastic surgery fellows of the American Academy of Facial Plastic and Reconstructive Surgery were surveyed anonymously. Five of the 15 vignettes demonstrated significant differences between the responses of the fellowship directors and the fellows. No single vignette had a unanimous consensus in either group. Aesthetic rhinoplasty surgeons encounter ethical issues that should be reflected on by both experienced and inexperienced facial plastic surgeons, preferably before being faced with them in practice. We present a practical approach to ethical issues in clinical practice. Our survey can also be used as a stimulus for further discussion and teaching.

A Novel Scenario-Based Interview Tool to Evaluate Nontechnical Skills and Competencies in Global Health Delivery.

PubMed

Wroe, Emily B; McBain, Ryan K; Michaelis, Annie; Dunbar, Elizabeth L; Hirschhorn, Lisa R; Cancedda, Corrado

2017-08-01

Despite rapid growth in the number of physicians and academic institutions entering the field of global health, there are few tools that inform global health curricula and assess physician readiness for this field. To address this gap, we describe the development and pilot testing of a new tool to assess nontechnical competencies and values in global health. Competencies assessed include systems-based practice, interpersonal and cross-cultural communication, professionalism and self-care, patient care, mentoring, teaching, management, and personal motivation and experience. The Global Health Delivery Competency Assessment Tool presents 15 case vignettes and open-ended questions related to situations a global health practitioner might encounter, and grades the quality of responses on a 6-point ordinal scale. We interviewed 17 of 18 possible global health residents (94%), matched with 17 residents not training in global health, for a total of 34 interviews. A second reviewer independently scored recordings of 13 interviews for reliability. Pilot testing indicated a high degree of discriminant validity, as measured by the instrument's ability to distinguish between residents who were and were not enrolled in a global health program ( P  < .001). It also demonstrated acceptable consistency, as assessed by interrater reliability (κ = 0.53), with a range of item-level agreement from 84%-96%. The tool has potential applicability to a variety of academic and programmatic activities, including evaluation of candidates for global health positions and evaluating the success of training programs in equipping practitioners for entry into this field.

Relationship between feeding practices and weanling diarrhoea in northeast Thailand.

PubMed

Cao, X; Rawalai, K; Thompson, A J; Hartel, G; Thompson, S; Paterson, J H; Chusilp, K

2000-09-01

Diarrhoea is a major public health problem in Thailand. During November 1998-January 1999, a cross-sectional survey and a nested qualitative study were conducted to understand the relationship between feeding practices and weanling diarrhoea, and to describe the related local beliefs and practices in a subdistrict of northeast Thailand. A cluster-sampling method was used for selecting 156 weanlings aged 3-24 months. A structured interview was conducted with the main caregivers of these weanlings. The questionnaire used for the interview included items about feeding practices and diarrhoea-history of the weanlings in 2 months prior to the interview. Seven focus-group discussions with an opportunistic sample of the caregivers were held in the villages. A series of vignettes and unstructured questions were used for eliciting the local beliefs about weanling diarrhoea and its causes. Thirty-six (23%) of the 156 weanlings had diarrhoea in 2 months prior to the interview. The factors that were significantly related to reported weanling diarrhoea included consumption of unboiled water by weanlings (OR = 10, p = 0.03), not covering perishable foods (OR = 3, p = 0.02), and washing feeding utensils of weanlings without dishwashing detergent (OR = 3.1, p = 0.02), 'Su' and 'tongsia'--two common local terms--were used for describing different types of weanling diarrhoea. Many caregivers considered 'su' a natural occurrence in a child's development. The results suggest that some poor feeding practices may contribute to the higher risk of weanling diarrhoea in northeast Thailand. Some local beliefs about weanling diarrhoea may mask the true causes, and mislead messages about its prevention.

Decision Makers' Allocation of Home-Care Therapy Services: A Process Map

PubMed Central

Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

2013-01-01

ABSTRACT Purpose: To explore decision-making processes currently used in allocating occupational and physical therapy services in home care for complex long-stay clients in Ontario. Method: An exploratory study using key-informant interviews and client vignettes was conducted with home-care decision makers (case managers and directors) from four home-care regions in Ontario. The interview data were analyzed using the framework analysis method. Results: The decision-making process for allocating therapy services has four stages: intake, assessment, referral to service provider, and reassessment. There are variations in the management processes deployed at each stage. The major variation is in the process of determining the volume of therapy services across home-care regions, primarily as a result of financial constraints affecting the home-care programme. Government funding methods and methods of information sharing also significantly affect home-care therapy allocation. Conclusion: Financial constraints in home care are the primary contextual factor affecting allocation of therapy services across home-care regions. Given the inflation of health care costs, new models of funding and service delivery need to be developed to ensure that the right person receives the right care before deteriorating and requiring more costly long-term care. PMID:24403672

The role of gender and sexual relations for young people in identity construction and youth suicide.

PubMed

Gilchrist, Heidi; Sullivan, Gerard

2006-01-01

The suicide rate among young people in Australia has caused considerable concern and been the focus of research and intervention. Issues related to sexuality and gender can be the source of conflict for young people within their communities, and have been implicated in suicide attempts. This paper examines the cultural context of youth suicide, and asks how youth suicide may be related to emerging sexual identity, which all young people must negotiate through the customs, discourse and taboos of their society. In particular, it focuses on the situation of young heterosexual women. The findings are based on interviews with 41 young people, parents and youth service providers regarding youth suicide. Interviews were semi-structured and open-ended, and conducted in a suburban community. They included the use of scenarios or vignettes. Finding, suggest that traditional constructions of gender remain widespread, and that these are often disadvantageous to both young women and young men. Parents may be unaware that they have little control over, or even knowledge about, their teenagers' behaviour. Young people are more inclined to confide in their friends, who may not be equipped to deal with crises.

Characteristics of effective professional development for early career science teachers

NASA Astrophysics Data System (ADS)

Simon, Shirley; Campbell, Sandra; Johnson, Sally; Stylianidou, Fani

2011-04-01

The research reported here set out to investigate the features in schools and science departments that were seen as effective in contributing to the continuing professional development (CPD) of early career science teachers. Ten schools took part in the study, selected on the basis of their reputation for having effective CPD practices. To gain different perspectives from within the organisations we conducted interviews with senior members of staff, heads of science departments and early career teachers. A thematic analysis of the interviews is presented, drawing on findings from across the 10 schools, and exemplified in more detail by a vignette to show specific features of effective CPD practice. The study has revealed a wealth of practice across the 10 schools, which included a focus on broadening experience beyond the classroom, having an open, sharing, non-threatening culture and systemic procedures for mentoring and support that involved ring-fenced budgets. The schools also deployed staff judiciously in critical roles that model practice and motivate early career science teachers. Early career teachers were concerned primarily with their overall development as teachers, though some science specific examples such as observing practical work and sessions to address subject knowledge were seen as important.

'She gave it her best shot right away': patient experiences of biomedical and patient-centered communication.

PubMed

Swenson, Sara L; Zettler, Patti; Lo, Bernard

2006-05-01

Medical educators and researchers recommend a patient-centered interviewing style, but little empirical data exists regarding what aspects of physician communication patients like and why. We investigated patient responses to videotaped doctor-patient vignettes to ascertain what they liked about patient-centered and biomedical communication. We conducted semi-structured interviews with 230 adult medicine patients who viewed videotapes depicting both patient-centered and biomedical physician communication styles. We used a mixed methods approach to derive a "ground-up" framework of patient communication preferences. Respondents who preferred different communication styles articulated different sets of values, important physician behaviors, and physician-patient role expectations. Participants who preferred the patient-centered physician (69%) liked that she worked with and respected patients and explored what the patient wanted. Participants who preferred the biomedical physician (31%) liked that she prevented harm, demonstrated medical authority, and delivered information clearly. Patients like (and dislike) patient-centered communication for thoughtful, considered reasons that appear grounded in their values and expectations about physicians, patients, and the clinical encounter. Better understanding the diversity of patient communication preferences may lead to more effective and individualized care.

Theoretical Approaches to Enhancing Motivation for Adherence to Antidepressant Medications.

PubMed

Hamrin, Vanya; Sinclair, Vaughn G; Gardner, Virginia

2017-04-01

Adherence to antidepressants is a major challenge in our health care system, with a high percentage of patients discontinuing their medications within six months. The purpose of this position paper is to discuss theoretical frameworks that address the psychological beliefs, benefits and barriers and feelings of autonomy that affect a person's willingness and motivation to take anti-depressant medications within a therapeutic relationship with a nurse practitioner. Three theoretical frameworks were selected to highlight particular perspectives relevant to enhancing patient motivation for medication adherence. The Self-Regulation Model, Health Belief Model, and Self-Determination Theory combined with motivational interviewing all offer guidance on strategies for improving adherence to antidepressants. The Self-Regulation Model underscores the importance of illness representations that prompt considering patient perceptions of depression that affect adherence. The Health Belief Model focuses on cost-benefit considerations that affect patient's adherence, along with perceived control. Finally, Self-Determination Theory combined with motivational interviewing offers strategies that enhance autonomy and optimize collaboration and motivation for adherence. These three theoretical models are applied to a vignette for a patient who is having difficulty with adherence to antidepressant medication. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical reasoning skills in final-year dental students: A qualitative cross-curricula comparison.

PubMed

Nafea, E T; Dennick, R

2018-05-01

The aim of this research was to explore the perceptions of undergraduate dental students regarding clinical reasoning skills and also discover the influences of different curriculum designs on the acquisition of these skills by students. Eighteen final-year students from three different dental schools with varied curricula and cultures participated in the current research. The research used qualitative methodology. The study took place in 2013-2014. Interviews captured the participants' own understanding of clinical reasoning and its acquisition plus they "talked through" a clinical problem using a "think-aloud" technique. Thematic analysis was used to analyse the transcripts of the recorded interviews. Results obtained were related to curriculum structure. Unfamiliarity with the term clinical reasoning was common in students. Students from different schools used different strategies to reason when discussing clinical vignettes. Clinical reasoning process was dominated by pattern recognition. Students' behaviours seemed to be influenced by cultural factors. This research contributes to a greater understanding of how students learn, understand and apply dental clinical reasoning which will improve educational practices in the future. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Recall and dating of psychiatric symptoms. Test-retest reliability of time-related symptom questions in a standardized psychiatric interview.

PubMed

Wittchen, H U; Burke, J D; Semler, G; Pfister, H; Von Cranach, M; Zaudig, M

1989-05-01

The advent of more explicit diagnostic criteria and the growing interest in "lifetime" rates of mental disorders has made imperative an accurate determination of time-related diagnostic criteria. We used data from two independent test-retest studies of the Diagnostic Interview Schedule (DIS) and the Composite International Diagnostic Interview (CIDI) to study the reliability of different time-related questions in these fully standardized diagnostic interviews. With two exceptions (anxiety disorders and alcohol-related questions), the test-retest reliability of most time-related questions in both interviews was judged to be satisfactorily high. Furthermore, the validity of time-related questions in the DIS (age at symptom onset, duration and frequency of illness episodes) was examined by comparing them with detailed "consensus" ratings done independently by different clinicians for 207 former psychiatric inpatients. A surprisingly high concordance was found for former psychotic patients except for those still severely disturbed at the follow-up investigation. Some severe restrictions were also found for nonpsychotic disorders with regard to judgment of the age at onset of phobias, panic attacks, and depression. For a more valid assessment of time-related symptom information, the use of specific memory aids is suggested.

Perceived risk as a barrier to appropriate diagnosis of irritable bowel syndrome.

PubMed

Ahn, Eunmi; Son, Ki Young; Shin, Dong Wook; Han, Min Kyu; Lee, Hyejin; An, Ah Reum; Kim, Eun Ho; Cho, BeLong

2014-12-28

To evaluate perceived risk, diagnostic testing, and acceptance of a diagnosis of irritable bowel syndrome (IBS) among the Korean laypersons. We designed a conceptual framework to evaluate the health-seeking behavior of subjects based on a knowledge, attitude, and practice model. We developed a vignette-based questionnaire about IBS based on a literature review and focused group interviews. The vignette described a 40-year-old woman who meets the Rome III criteria for IBS without red-flag signs. It was followed by questions about demographic characteristics, health behaviors, IBS symptoms, risk perception, perceived need for diagnostic tests, and acceptance of a positive diagnosis of IBS. We planned a nationwide survey targeting laypersons without IBS and between the ages of 20 and 69 years. Survey participants were selected by quota sampling stratified by gender, age, and nationwide location. A multivariate logistic model was constructed based on literature reviews, univariate analysis, and a stepwise selection method to investigate correlations between the perceived risk, need for diagnostic tests, and acceptance of a positive diagnosis. Of 2354 eligible households, 1000 subjects completed the survey and 983 subjects were analyzed, excluding those who met symptom criteria for IBS. After reading the IBS vignette, the majority of subjects (86.8%) responded that the patient was at increased risk of severe disease. The most frequent concern was colon cancer (59.8%), followed by surgical condition (51.5%). Most subjects responded the patient needs diagnostic tests (97.2%). Colonoscopy was the most commonly required test (79.5%). Less than half of the respondents requested a stool examination (45.0%), blood test (40.7%), abdominal ultrasound (36.0%), or computed tomography (20.2%). The subjects who felt increased risk were more likely to see a need for colonoscopy [adjusted odds ratio (aOR) = 2.10, 95%CI: 1.38-3.18]. When asked about the positive diagnosis, the most frequent response was that "the patient would not be reassured" (65.7%). The increased risk perception group was less likely to be reassured by a positive diagnosis of IBS, compared to the other respondents (aOR = 0.52, 95%CI: 0.34-0.78). For IBS diagnosis, increased risk perception is a possible barrier to the appropriate use of diagnostic tests and to the patient's acceptance of a positive diagnosis.

Development of a meta-algorithm for guiding primary care encounters for patients with multimorbidity using evidence-based and case-based guideline development methodology.

PubMed

Muche-Borowski, Cathleen; Lühmann, Dagmar; Schäfer, Ingmar; Mundt, Rebekka; Wagner, Hans-Otto; Scherer, Martin

2017-06-22

The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures. Primary care. The meta-algorithm was developed in six steps:1. Designing 10 case vignettes of patients with multimorbidity (common, epidemiologically confirmed disease patterns and/or particularly challenging health care needs) in a multidisciplinary workshop.2. Based on the main diagnoses, a systematic guideline synopsis of evidence-based and consensus-based clinical practice guidelines was prepared. The recommendations were prioritised according to the clinical and psychosocial characteristics of the case vignettes.3. Case vignettes along with the respective guideline recommendations were validated and specifically commented on by an external panel of practicing general practitioners (GPs).4. Guideline recommendations and experts' opinions were summarised as case specific management recommendations (N-of-one guidelines).5. Healthcare preferences of patients with multimorbidity were elicited from a systematic literature review and supplemented with information from qualitative interviews.6. All N-of-one guidelines were analysed using pattern recognition to identify common decision nodes and care elements. These elements were put together to form a generic meta-algorithm. The resulting meta-algorithm reflects the logic of a GP's encounter of a patient with multimorbidity regarding decision-making situations, communication needs and priorities. It can be filled with the complex problems of individual patients and hereby offer guidance to the practitioner. Contrary to simple, symptom-oriented algorithms, the meta-algorithm illustrates a superordinate process that permanently keeps the entire patient in view. The meta-algorithm represents the back bone of the multimorbidity guideline of the German College of General Practitioners and Family Physicians. This article presents solely the development phase; the meta-algorithm needs to be piloted before it can be implemented. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

On the Complexity of Digital Video Cameras in/as Research: Perspectives and Agencements

ERIC Educational Resources Information Center

Bangou, Francis

2014-01-01

The goal of this article is to consider the potential for digital video cameras to produce as part of a research agencement. Our reflection will be guided by the current literature on the use of video recordings in research, as well as by the rhizoanalysis of two vignettes. The first of these vignettes is associated with a short video clip shot by…

Explicit-Reflective Teaching Nature of Science as Embedded within the Science Topic: Interactive Historical Vignettes Technique

ERIC Educational Resources Information Center

Nur, Erdogan Melek; Fitnat, Koseoglu

2015-01-01

It is obvious that more extensive work is needed in developing historical materials that address nature of science (NOS) concepts that will be implemented by teachers. Owing to the importance of meeting this need, research problem of this study is to design historical vignettes focused on the concept of chemical equilibrium which lies at the heart…

Promoting Student-Centered Learning Using iPads in a Grade 1 Classroom: Using the Digital Didactic Framework to Deconstruct Instruction

ERIC Educational Resources Information Center

Woloshyn, Vera Ella; Bajovic, Mira; Worden, Melissa Maney

2017-01-01

In this qualitative case study, we provide a series of vignettes illustrating a Grade 1 teacher's experiences integrating iPad technology into her instruction over a school year. We use the digital didactic model to deconstruct these vignettes and draw upon the teacher's reflections to gain further insights about her instructional experiences…

The Influence of Length of Marriage and Fidelity Status on Perception of Marital Rape

ERIC Educational Resources Information Center

Munge, Bethany A.; Pomerantz, Andrew M.; Pettibone, Jonathan C.; Falconer, Jameca W.

2007-01-01

To what extent does the length of the marriage or the wife's faithfulness to the husband influence the perception of responsibility or trauma in marital rape? In the current study, each participant was presented with one of four marital rape vignettes. The vignettes varied only in the length of the marriage (3 years or 15 years) and the fidelity…

Variations in GPs' decisions to investigate suspected lung cancer: a factorial experiment using multimedia vignettes.

PubMed

Sheringham, Jessica; Sequeira, Rachel; Myles, Jonathan; Hamilton, William; McDonnell, Joe; Offman, Judith; Duffy, Stephen; Raine, Rosalind

2017-06-01

Lung cancer survival is low and comparatively poor in the UK. Patients with symptoms suggestive of lung cancer commonly consult primary care, but it is unclear how general practitioners (GPs) distinguish which patients require further investigation. This study examined how patients' clinical and sociodemographic characteristics influence GPs' decisions to initiate lung cancer investigations. A factorial experiment was conducted among a national sample of 227 English GPs using vignettes presented as simulated consultations. A multimedia-interactive website simulated key features of consultations using actors ('patients'). GP participants made management decisions online for six 'patients', whose sociodemographic characteristics systematically varied across three levels of cancer risk. In low-risk vignettes, investigation (ie, chest X-ray ordered, computerised tomography scan or respiratory consultant referral) was not indicated; in medium-risk vignettes, investigation could be appropriate; in high-risk vignettes, investigation was definitely indicated. Each 'patient' had two lung cancer-related symptoms: one volunteered and another elicited if GPs asked. Variations in investigation likelihood were examined using multilevel logistic regression. GPs decided to investigate lung cancer in 74% (1000/1348) of vignettes. Investigation likelihood did not increase with cancer risk. Investigations were more likely when GPs requested information on symptoms that 'patients' had but did not volunteer (adjusted OR (AOR)=3.18; 95% CI 2.27 to 4.70). However, GPs omitted to seek this information in 42% (570/1348) of cases. GPs were less likely to investigate older than younger 'patients' (AOR=0.52; 95% CI 0.39 to 0.7) and black 'patients' than white (AOR=0.68; 95% CI 0.48 to 0.95). GPs were not more likely to investigate 'patients' with high-risk than low-risk cancer symptoms. Furthermore, they did not investigate everyone with the same symptoms equally. Insufficient data gathering could be responsible for missed opportunities in diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Comparison of work and time estimates by chiropractic physicians with those of medical and osteopathic providers.

PubMed

Hess, J A; Mootz, R D

1999-06-01

Resource-based relative value scales (RBRVS) have become a standard method for identifying costs and determining reimbursement for physician services. Development of RBRVS systems and methods are reviewed, and the RBRVS concept of physician "work" is defined. Results of work and time inputs from chiropractic physicians are compared with those reported by osteopathic and medical specialties. Last, implications for reimbursement of chiropractic fee services are discussed. Total work, intraservice work, and time inputs for clinical vignettes reported by chiropractic, osteopathic, and medical physicians are compared. Data for chiropractic work and time reports were drawn from a national random sample of chiropractors conducted as part of a 1997 workers' compensation chiropractic fee schedule development project. Medical and osteopathic inputs were drawn from RBRVS research conducted at Harvard University under a federal contract reported in 1990. Both data sets used the same or similar clinical vignettes and similar methods. Comparisons of work and time inputs are made for clinical vignettes to assess whether work reported by chiropractors is of similar magnitude and variability as work reported by other specialties. Chiropractic inputs for vignettes related to evaluation and management services are similar to those reported by medical specialists and osteopathic physicians. The range of variation between chiropractic work input and other specialties is of similar magnitude to that within other specialties. Chiropractors report greater work input for radiologic interpretation and lower work input for manipulation services. Chiropractors seem to perform similar total "work" for evaluation and management services as other specialties. No basis exists for excluding chiropractors from using evaluation and management codes for reimbursement purposes on grounds of dissimilar physician time or work estimates. Greater work input by chiropractors in radiology interpretation may be related to a greater importance placed on findings in care planning. Consistently higher reports for osteopathic work input on manipulation are likely attributable to differences in reference vignettes used in the respective populations. Research with a common reference vignette used for manipulation providers is recommended, as is development of a single generic approach to coding for manipulation services.

Operating room clinicians' ratings of workload: a vignette simulation study.

PubMed

Wallston, Kenneth A; Slagle, Jason M; Speroff, Ted; Nwosu, Sam; Crimin, Kimberly; Feurer, Irene D; Boettcher, Brent; Weinger, Matthew B

2014-06-01

Increased clinician workload is associated with medical errors and patient harm. The Quality and Workload Assessment Tool (QWAT) measures anticipated (pre-case) and perceived (post-case) clinical workload during actual surgical procedures using ratings of individual and team case difficulty from every operating room (OR) team member. The purpose of this study was to examine the QWAT ratings of OR clinicians who were not present in the OR but who read vignettes compiled from actual case documentation to assess interrater reliability and agreement with ratings made by clinicians involved in the actual cases. Thirty-six OR clinicians (13 anesthesia providers, 11 surgeons, and 12 nurses) used the QWAT to rate 6 cases varying from easy to moderately difficult based on actual ratings made by clinicians involved with the cases. Cases were presented and rated in random order. Before rating anticipated individual and team difficulty, the raters read prepared clinical vignettes containing case synopses and much of the same written case information that was available to the actual clinicians before the onset of each case. Then, before rating perceived individual and team difficulty, they read part 2 of the vignette consisting of detailed role-specific intraoperative data regarding the anesthetic and surgical course, unusual events, and other relevant contextual factors. Surgeons had higher interrater reliability on the QWAT than did OR nurses or anesthesia providers. For the anticipated individual and team workload ratings, there were no statistically significant differences between the actual ratings and the ratings obtained from the vignettes. There were differences for the 3 provider types in perceived individual workload for the median difficulty cases and in the perceived team workload for the median and more difficult cases. The case difficulty items on the QWAT seem to be sufficiently reliable and valid to be used in other studies of anticipated and perceived clinical workload of surgeons. Perhaps because of the limitations of the clinical documentation shown to anesthesia providers and OR nurses in the current vignette study, more evidence needs to be gathered to demonstrate the criterion-related validity of the QWAT difficulty items for assessing the workload of nonsurgeon OR clinicians.

Impact of advance directives and a health care proxy on doctors' decisions: a randomized trial.

PubMed

Escher, Monica; Perneger, Thomas V; Rudaz, Sandrine; Dayer, Pierre; Perrier, Arnaud

2014-01-01

Advance directives or proxy designations are widely recommended, but how they affect doctors' decision making is not well known. The aim of this study was to quantify the influence of advance directives and proxy opinions on doctors' decisions. We mailed to all the generalists and internists in French-speaking Switzerland (N = 1962) three vignettes describing difficult decisions involving incapacitated patients. In each case, the advance directive requested that further care be withheld. One vignette tested the impact of a written advance directive vs. a proxy. Another compared the impact of a handwritten directive vs. a formalized document. The third vignette compared the impact of a family member vs. a doctor as a proxy. Each vignette was prepared in three or four versions, including a control version in which no directive or proxy was present. Vignettes were randomly allocated to respondents. We used logistic regression to predict the decision to forgo a medical intervention. Compared with the control condition, the odds of forgoing a medical intervention were increased by the written advance directive (odds ratio [OR] 7.3; P < 0.001), the proxy (OR 7.9; P < 0.001), and the combination of the two (OR 35.7; P < 0.001). The handwritten directive had the same impact (OR 13.3) as the formalized directive (OR 13.8). The effect of proxy opinion was slightly stronger when provided by a doctor (OR 11.3) rather than by family (OR 7.8). Advance directives and proxy opinions are equally effective in influencing doctors' decisions, but having both has the strongest effect. The format of the advance directive and the identity of the proxy have little influence on decisions. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Community Based Participatory Research: A New approach to engaging community members to rapidly call 911 for Stroke

PubMed Central

Skolarus, Lesli E.; Zimmerman, Marc A.; Murphy, Jillian; Brown, Devin L.; Kerber, Kevin A.; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B.

2014-01-01

Background and Purpose Acute stroke treatments are underutilized primarily due to delayed hospital arrival. Using a community based participatory research approach, we explored stroke self-efficacy, knowledge and perceptions of stroke among a predominately African American population in Flint, Michigan. Methods In March 2010, a survey was administered to youth and adults after religious services at three churches and one church health day. The survey consisted of vignettes (12 stroke, 4 non-stroke) to assess knowledge of stroke warning signs and behavioral intent to call 911. The survey also assessed stroke self-efficacy, personal knowledge of someone who had had a stroke, personal history of stroke and barriers to calling 911. Linear regression models explored the association of stroke self-efficacy with behavioral intent to call 911 among adults. Results Two hundred forty two adults and 90 youth completed the survey. Ninety two percent of adults and 90% of youth respondents were African American. Responding to 12 stroke vignettes, adults would call 911 in 72% (sd=0.26) of the vignettes while youth would call 911 in 54% (sd=0.29) (p<0.001). Adults correctly identified stroke in 51% (sd=0.32) of the stroke vignettes and youth in 46% (sd=0.28) of the stroke vignettes (p=0.28). Stroke self-efficacy predicted behavioral intent to call 911 (p=0.046). Conclusion In addition to knowledge of stroke warning signs, behavioral interventions to increase both stroke self-efficacy and behavioral intent may be useful for helping people make appropriate 911 calls for stroke. A community based participatory research approach may be effective in reducing stroke disparities. PMID:21617148

Perception of Physical Child Abuse Among Parents and Professionals in a French Emergency Department.

PubMed

Bailhache, Marion; Alioum, Ahmadou; Salmi, Louis-Rachid

2017-04-01

France has not prohibited all forms of corporal punishment, and the point at which an act is regarded as physical abuse is not clearly determined. The aim of our study was to compare perception of a caregiver's violent behavior toward his child by professionals and parents in an emergency department and determine characteristics associated with that perception. A cross-sectional study was conducted from November 2013 to October 2014 in the emergency department of the pediatric university hospital in Bordeaux, France. An anonymous self-administered questionnaire, including vignettes describing hypothetical situations of violent interaction between a parent and child, and items related to sociodemographic and family characteristics, was administered to professionals and parents. Vignettes included varying child's age and behavior, frequency of caregiver's behavior, hitting with/without an object, and targeted child's body part. Violent behavior was restricted to hitting for reasons of feasibility. Respondents were asked to rate the acceptability of situations on a 100-mm visual analog scale. Analyses were multivariate mixed Poisson regressions. A total of 1,001 participants assessed the vignettes. Participants were predominantly females (64%), married or living with a partner (87%), with a median age of 34 years. Professionals assessed vignettes as acceptable significantly more than parents (mean rating 2.8 times higher; p < .001). For both professionals and parents, all vignette characteristics were significantly associated with acceptability. Parents who had a child below 1 year old, those who had visited an emergency department many times in the past year, and those who had fewer children were less tolerant. Such findings indicate the need for additional research to better appreciate consequences and severity of violent behavior toward children, and the need to educate parents and professionals.

Evidence of the preferential use of disease prototypes over case exemplars among early year one medical students prior to and following diagnostic training.

PubMed

Papa, Frank J; Li, Feiming

2015-12-01

Two core dual processing theory (DPT) System I constructs (Exemplars and Prototypes) were used to: 1) formulate a training exercise designed to improve diagnostic performance in year one medical students, and 2) explore whether any observed performance improvements were associated with preferential use of exemplars or prototypes. With IRB approval, 117 year one medical students participated in an acute chest pain diagnostic training exercise. A pre- and post-training test containing the same 27 case vignettes was used to determine if the subjects' diagnostic performance improved via training in both exemplars and prototypes. Exemplar and Prototype theory was also used to generate a unique typicality estimate for each case vignette. Because these estimates produce different performance predictions, differences in the subjects' observed performance would make it possible to infer whether subjects were preferentially using Exemplars or Prototypes. Pre- vs. post-training comparison revealed a significant performance improvement; t=14.04, p<0.001, Cohen's d=1.32. Pre-training, paired t-testing demonstrated that performance against the most typical vignettes>mid typical vignettes: t=4.94, p<0.001; and mid typical>least typical: t=5.16, p<0.001. Post-training, paired t-testing again demonstrated that performance against the most typical vignettes>mid typical: t=2.94, p<0.01; and mid typical>least typical: t=6.64, p<0.001. These findings are more consistent with the performance predictions generated via Prototype theory than Exemplar theory. DPT is useful in designing and evaluating the utility of new approaches to diagnostic training, and, investigating the cognitive factors driving diagnostic capabilities among early medical students.

Conceptions of Mental Illness: Attitudes of Mental Health Professionals and the General Public

PubMed Central

Stuber, Jennifer P.; Rocha, Anita; Christian, Ann; Link, Bruce G.

2014-01-01

Objectives The authors compared attitudes of the U.S. general public and of mental health professionals about the competence and perceived dangerousness of people with mental health problems and the desire for social distance from them. Factors related to negative attitudes and the desire for social distance also were examined. Methods Vignettes describing individuals meeting DSM-IV criteria for major depression and schizophrenia were included in the 2006 General Social Survey (GSS) and a 2009 study of mental health professionals, and responses were descriptively compared (GSS, N=397 responses to depression vignette, N=373 responses to schizophrenia vignette; 731 mental health professionals responded to both vignettes). Regression analyses examined whether demographic and provider characteristics were associated with perceptions of less competence and perceived dangerousness of the vignette character and with respondents’ desire for social distance. Results Compared with the American public, mental health professionals had significantly more positive attitudes toward people with mental health problems. However, some providers’ conceptions about the dangerousness of people with schizophrenia and provider desire for social distance from clients in work and personal situations were concerning. Younger age, self-identifying as non-Hispanic white, being female, having at least a four-year college degree, being familiar with mental illness, and certain job titles and more years of experience in the mental health field were predictive of more positive conceptions. Conclusions Although mental health professionals held more positive attitudes than the general public about people with mental health problems, strong stereotypes persisted in both groups, especially concerning schizophrenia. This study identified several demographic and provider characteristics that can inform intervention strategies in both groups. PMID:24430508

Effect of clinical vignettes on senior medical students' opinions of climate change.

PubMed

Prasad, Vinay; Thistlethwaite, William; Dale, William

2011-06-01

The consequences of climate change directly threaten human health. Some have argued that, as such, doctors have a special duty to solve climate change. Despite such recommendations, to our knowledge, there has been no previous work documenting physician attitudes on climate change, or the stability of those opinions. We invited 523 fourth-year medical students to a survey asking their opinion on climate change and their opinion regarding one of two fictional medical vignettes. In the vignettes, which are analogous to the climate change issue, students decide whether to discontinue a drug that may be adversely affecting laboratory values. In the climate change question, students are asked whether the United States should take efforts to discontinue the use of fossil fuels. Students are randomized to the order in which they receive the questions. Ninety-five percent (95% CI 89.1%-100%) of students initially asked about climate change feel the United States should take steps to curb carbon dioxide emissions, while only 73% (95% CI 57.5%-89.2%) of students respond similarly if first given an analogous patient vignette. Conversely, in all cases where a fictional medical vignette follows the climate change question, students are more likely to cease using a potentially harmful agent (66% CI 53.5%-71.8% vs. 52% CI 43.3%-67.1%). Our results suggest that student physician attitudes to climate change are mutable. Priming students into "medical mode" may alter their opinions on the scientific merit of nonmedical issues, and may be a vestige of a hidden medical curriculum. Further studies should explore the interrelationship between other sociopolitical beliefs and medical decision making.

Silence That Can Be Dangerous: A Vignette Study to Assess Healthcare Professionals’ Likelihood of Speaking up about Safety Concerns

PubMed Central

Schwappach, David L. B.; Gehring, Katrin

2014-01-01

Purpose To investigate the likelihood of speaking up about patient safety in oncology and to clarify the effect of clinical and situational context factors on the likelihood of voicing concerns. Patients and Methods 1013 nurses and doctors in oncology rated four clinical vignettes describing coworkers’ errors and rule violations in a self-administered factorial survey (65% response rate). Multiple regression analysis was used to model the likelihood of speaking up as outcome of vignette attributes, responder’s evaluations of the situation and personal characteristics. Results Respondents reported a high likelihood of speaking up about patient safety but the variation between and within types of errors and rule violations was substantial. Staff without managerial function provided significantly higher levels of decision difficulty and discomfort to speak up. Based on the information presented in the vignettes, 74%−96% would speak up towards a supervisor failing to check a prescription, 45%−81% would point a coworker to a missed hand disinfection, 82%−94% would speak up towards nurses who violate a safety rule in medication preparation, and 59%−92% would question a doctor violating a safety rule in lumbar puncture. Several vignette attributes predicted the likelihood of speaking up. Perceived potential harm, anticipated discomfort, and decision difficulty were significant predictors of the likelihood of speaking up. Conclusions Clinicians’ willingness to speak up about patient safety is considerably affected by contextual factors. Physicians and nurses without managerial function report substantial discomfort with speaking up. Oncology departments should provide staff with clear guidance and trainings on when and how to voice safety concerns. PMID:25116338

Mental health literacy survey of non-mental health professionals in six general hospitals in Hunan Province of China

PubMed Central

Wu, Qiuxia

2017-01-01

Background Mental illness has brought great economic burden related to misdiagnosis by non-mental health professionals in general hospitals. The aim of this study was to explore non-mental health professionals’ conceptions related to the identification of mental illness and perceived treatments, first aid and prognosis. Methods In 2014–2015, we presented 1123 non-mental health professionals from six general hospitals in Hunan Province with one of three vignettes describing a person with schizophrenia, depression, or generalized anxiety disorder. Identification rates, beliefs about various interventions, best methods, and the prognosis with or without treatment were measured. Results Less than 60% of the non-mental health professionals could identify the mental disorders correctly. Psychiatrists and psychologists were considered to be the people who would be most helpful in all vignettes. Over 70% of participants identified the correct medication for each vignette. Participants gave higher ratings to lifestyle interventions than to psychological and medical interventions, especially in the depression and generalized anxiety disorder vignettes. For the question about how the person could best be helped, about half of the participants rated listening or talking with the person more highly than accompanying the person to professional help or encouraging the person to visit a psychiatrist or psychologist. Participants believed that, with professional help, the people in the vignettes would fully recover but that problems would probably reoccur and that, without professional help, the people described would get worse. Conclusions The beliefs that non-mental health professionals hold about mental disorders are inadequate to provide appropriate help. There is an urgent need for mental health education campaigns to improve non-mental health professionals’ mental health knowledge in mainland China in order to provide better support for mental health service users. PMID:28678848

Mental health literacy survey of non-mental health professionals in six general hospitals in Hunan Province of China.

PubMed

Wu, Qiuxia; Luo, Xiaoyang; Chen, Shubao; Qi, Chang; Long, Jiang; Xiong, Yifan; Liao, Yanhui; Liu, Tieqiao

2017-01-01

Mental illness has brought great economic burden related to misdiagnosis by non-mental health professionals in general hospitals. The aim of this study was to explore non-mental health professionals' conceptions related to the identification of mental illness and perceived treatments, first aid and prognosis. In 2014-2015, we presented 1123 non-mental health professionals from six general hospitals in Hunan Province with one of three vignettes describing a person with schizophrenia, depression, or generalized anxiety disorder. Identification rates, beliefs about various interventions, best methods, and the prognosis with or without treatment were measured. Less than 60% of the non-mental health professionals could identify the mental disorders correctly. Psychiatrists and psychologists were considered to be the people who would be most helpful in all vignettes. Over 70% of participants identified the correct medication for each vignette. Participants gave higher ratings to lifestyle interventions than to psychological and medical interventions, especially in the depression and generalized anxiety disorder vignettes. For the question about how the person could best be helped, about half of the participants rated listening or talking with the person more highly than accompanying the person to professional help or encouraging the person to visit a psychiatrist or psychologist. Participants believed that, with professional help, the people in the vignettes would fully recover but that problems would probably reoccur and that, without professional help, the people described would get worse. The beliefs that non-mental health professionals hold about mental disorders are inadequate to provide appropriate help. There is an urgent need for mental health education campaigns to improve non-mental health professionals' mental health knowledge in mainland China in order to provide better support for mental health service users.

Beliefs About Help Seeking for Mental Disorders: Findings From a Mental Health Literacy Study in Singapore.

PubMed

Picco, Louisa; Abdin, Edimansyah; Chong, Siow Ann; Pang, Shirlene; Vaingankar, Janhavi A; Sagayadevan, Vathsala; Kwok, Kian Woon; Subramaniam, Mythily

2016-11-01

This study investigated beliefs about help seeking, treatment options, and expected outcomes for alcohol abuse, dementia, depression, obsessive-compulsive disorder (OCD), and schizophrenia, by using a vignette-based approach. The Mind Matters study was a comprehensive, population-based, cross-sectional survey conducted among Singapore residents (N=3,006) ages 18 to 65 to establish the level of mental health literacy. Questions were asked about whom the person in the vignette should seek help from, the likely helpfulness of a broad range of interventions, and the likely outcome for the person in the vignette with and without appropriate help. "Talk to family or friends" was the most common source of help recommended for alcohol abuse (30.1%), depression (54.2%), and schizophrenia (21.5%), and "see a doctor or general practitioner" was the most recommended for dementia (53.8%) and OCD (26.8%). Help-seeking preferences were significantly associated with age, gender, ethnicity, and income and with having a personal experience of or knowing someone with a mental disorder similar to that described in the vignette. Respondents rated seeing a psychiatrist as the most helpful intervention (88.4%) and dealing with the problem on his or her own as the most harmful (64.6%). Most respondents (79.3%) indicated that the condition of the person in the vignette would worsen if appropriate help was not sought. Most respondents recommended seeking help for mental disorders from informal sources, such as family and friends. Targeted intervention strategies to improve mental health literacy related to help seeking, treatment beliefs, and effectiveness of evidence-based treatments are needed in Singapore.

International variation in adherence to referral guidelines for suspected cancer: a secondary analysis of survey data.

PubMed

Nicholson, Brian D; Mant, David; Neal, Richard D; Hart, Nigel; Hamilton, Willie; Shinkins, Bethany; Rubin, Greg; Rose, Peter W

2016-02-01

Variation in cancer survival persists between comparable nations and appears to be due, in part, to primary care practitioners (PCPs) having different thresholds for acting definitively in response to cancer-related symptoms. To explore whether cancer guidelines, and adherence to them, differ between jurisdictions and impacts on PCPs' propensity to take definitive action on cancer-related symptoms. A secondary analysis of survey data from six countries (10 jurisdictions) participating in the International Cancer Benchmarking Partnership. PCPs' responses to five clinical vignettes presenting symptoms and signs of lung (n = 2), colorectal (n = 2), and ovarian cancer (n = 1) were compared with investigation and referral recommendations in cancer guidelines. Nine jurisdictions had guidelines covering the two colorectal vignettes. For the lung vignettes, although eight jurisdictions had guidelines for the first, the second was covered by a Swedish guideline alone. Only the UK and Denmark had an ovarian cancer guideline. Survey responses of 2795 PCPs (crude response rate: 12%) were analysed. Guideline adherence ranged from 20-82%. UK adherence was lower than other jurisdictions for the lung vignette covered by the guidance (47% versus 58%; P <0.01) but similar (45% versus 46%) or higher (67% versus 38%; P <0.01) for the two colorectal vignettes. PCPs took definitive action least often when a guideline recommended a non-definitive action or made no recommendation. UK PCPs adhered to recommendations for definitive action less than their counterparts (P <0.01). There wasno association between jurisdictional guideline adherence and 1-year survival. Cancer guideline content is variable between similarly developed nations and poor guideline adherence does not explain differential survival. Guidelines that fail to cover high-risk presentations or that recommend non-definitive action may reduce definitive diagnostic action. © British Journal of General Practice 2016.

Cultural influences on stigmatization of problem gambling: East Asian and Caucasian canadians.

PubMed

Dhillon, Jasmin; Horch, Jenny D; Hodgins, David C

2011-12-01

Cultural influences on problem gambling stigma were examined using a between subject vignette study design. Students of East Asian (n = 64) and Caucasian (n = 50) ancestry recruited from a Canadian University rated a vignette describing either an East Asian problem gambler or a Caucasian problem gambler on a measure of attitudinal social distance. In accordance with the hypothesis, a factorial ANOVA revealed that East Asian Canadians stigmatize problem gambling more than Caucasian Canadians. Moreover, East Asian participants stigmatized the East Asian individual described in the vignette more than they did the Caucasian individual. Individuals with gambling problems were generally not perceived as being dangerous. However, participants who perceived problem gambling as a dangerous condition wanted more social distance than those who did not perceive individuals with a gambling problem as dangerous.

Influence of Social Class Perceptions on Attributions among Mental Health Practitioners

PubMed Central

Thomposon, Mindi; Diestelmann, Jacob; Cole, Odessa; Keller, Abiola; Minami, Takuya

2018-01-01

Objective A vignette-based study assessed the influence of social class attributions toward a hypothetical client’s difficulty. Method 188 licensed mental health professionals who were recruited through professional listservs completed an online survey after reviewing one of two versions of a vignette describing a hypothetical client that varied based on social class cues. Results As expected, this sample of licensed mental health practitioners detected social class differences based on the descriptors of the hypothetical client across the two vignettes. These perceived social class differences, however, did not impact participants’ attributions toward the client for causing or solving her problems, level of GAF score ascribed to the client, or willingness to work with the client. Conclusions There was no evidence that participants differentially ascribed attributions based on social class. Implications and directions for future research are provided. PMID:24499284

Medical student abuse: perceptions and experience.

PubMed

Bourgeois, J A; Kay, J; Rudisill, J R; Bienenfeld, D; Gillig, P; Klykylo, W M; Markert, R J

1993-07-01

A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10-item attitude assessment about abusive behaviour were administered to the first- and fourth-year medical students at a mid-west US university medical school. The first- and fourth-year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth-year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.

A proposal for overcoming problems in teaching interviewing skills to medical students.

PubMed

Benbassat, Jochanan; Baumal, Reuben

2009-08-01

The objective of this paper is to draw attention to four features that distinguish the pedagogy of patient interviewing from the teaching of other clinical skills: (a) students are not naïve to the skill to be learned, (b) they encounter role models with a wide variability in interviewing styles, (c) clinical teachers are not usually specialists in the behavioral sciences, including patient interviewing, and (d) the validity of the methods used for assessment of interviewing skills is uncertain. We propose to adjust the teaching of patient interviewing to these features by (a) gaining an insight into the students' views and using these views as a point of departure for discussions of patient interviewing; (b) helping students to understand why different clinicians use different communication styles; (c) providing the clinical tutors with additional training that will help them function as both specialists who share their expertise with the students and facilitators of small-group learning; and (d) using assessment methods that encourage joint deliberation by the learner and the examiner, rather than a judgmental right-wrong dualism by the examiner alone. The teaching approach that we suggest is consistent with current theories of adult learning, and it occurs in an egalitarian rather than a hierarchical environment. Hopefully, students will also adopt such egalitarian attitudes toward patients, thereby reducing the tendency to a paternalistic communication style.

How College Students' Conceptions of Newton's Second and Third Laws Change through Watching Interactive Video Vignettes: A Mixed Methods Study

ERIC Educational Resources Information Center

Engelman, Jonathan

2016-01-01

Changing student conceptions in physics is a difficult process and has been a topic of research for many years. The purpose of this study was to understand what prompted students to change or not change their incorrect conceptions of Newtons Second or Third Laws in response to an intervention, Interactive Video Vignettes (IVVs), designed to…

Training Requirements for Visualizing Time and Space at Company and Platoon Level

DTIC Science & Technology

2007-09-01

vignettes. Participants were given approximately 20 minutes to develop a concept of operations, using whiteboards or butcher paper as necessary (see Figure...was conducted based on workshops with active and retired military personnel (n = 50). The CTA used a representative scenario and supporting...throughout this research effort including design of the scenario and vignettes used in the workshops, participation in and facilitation of the workshops

School Superintendents' Perceptions of Ethically Just Responses to a Teacher Sexting Vignette: Severity of Administrator Response, Superintendent Personality, and Offender Gender and Race

ERIC Educational Resources Information Center

Adams, Michael W.

2012-01-01

This study focused on the perceived ethics of the decisions superintendents make in response to a situation with a teacher that was value-laden, potentially volatile, and potentially affected by the teachers' gender or ethnicity. Superintendents (N = 123) each read one of 12 versions of a vignette depicting a sexting incident between a…

All framing effects are not created equal: Low convergent validity between two classic measurements of framing

PubMed Central

Zhen, Shanshan; Yu, Rongjun

2016-01-01

Human risk-taking attitudes can be influenced by two logically equivalent but descriptively different frames, termed the framing effect. The classic hypothetical vignette-based task (Asian disease problem) and a recently developed reward-based gambling task have been widely used to assess individual differences in the framing effect. Previous studies treat framing bias as a stable trait that has genetic basis. However, these two paradigms differ in terms of task domain (loss vs. gain) and task context (vignette-based vs. reward-based) and the convergent validity of these measurements remains unknown. Here, we developed a vignette-based task and a gambling task in both gain and loss domains and tested correlations of the framing effect among these tasks in 159 young adults. Our results revealed no significant correlation between the vignette-based task in the loss domain and the gambling task in the gain domain, indicating low convergent validity. The current findings raise the question of how to measure the framing effect precisely, especially in individual difference studies using large samples and expensive neuroscience methods. Our results suggest that the framing effect is influenced by both task domain and task context and future research should be cautious about the operationalization of the framing effect. PMID:27436680

All framing effects are not created equal: Low convergent validity between two classic measurements of framing.

PubMed

Zhen, Shanshan; Yu, Rongjun

2016-07-20

Human risk-taking attitudes can be influenced by two logically equivalent but descriptively different frames, termed the framing effect. The classic hypothetical vignette-based task (Asian disease problem) and a recently developed reward-based gambling task have been widely used to assess individual differences in the framing effect. Previous studies treat framing bias as a stable trait that has genetic basis. However, these two paradigms differ in terms of task domain (loss vs. gain) and task context (vignette-based vs. reward-based) and the convergent validity of these measurements remains unknown. Here, we developed a vignette-based task and a gambling task in both gain and loss domains and tested correlations of the framing effect among these tasks in 159 young adults. Our results revealed no significant correlation between the vignette-based task in the loss domain and the gambling task in the gain domain, indicating low convergent validity. The current findings raise the question of how to measure the framing effect precisely, especially in individual difference studies using large samples and expensive neuroscience methods. Our results suggest that the framing effect is influenced by both task domain and task context and future research should be cautious about the operationalization of the framing effect.