Browsing by Subject "Communication"
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Item Open Access A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder.(The Journal of pediatrics, 2020-07) Dawson, Geraldine; Sun, Jessica M; Baker, Jennifer; Carpenter, Kimberly; Compton, Scott; Deaver, Megan; Franz, Lauren; Heilbron, Nicole; Herold, Brianna; Horrigan, Joseph; Howard, Jill; Kosinski, Andrzej; Major, Samantha; Murias, Michael; Page, Kristin; Prasad, Vinod K; Sabatos-DeVito, Maura; Sanfilippo, Fred; Sikich, Linmarie; Simmons, Ryan; Song, Allen; Vermeer, Saritha; Waters-Pick, Barbara; Troy, Jesse; Kurtzberg, JoanneObjective
To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD).Study design
This prospective, randomized, placebo-controlled, double-blind study included 180 children with ASD, aged 2-7 years, who received a single intravenous autologous (n = 56) or allogeneic (n = 63) CB infusion vs placebo (n = 61) and were evaluated at 6 months postinfusion.Results
CB infusion was safe and well tolerated. Analysis of the entire sample showed no evidence that CB was associated with improvements in the primary outcome, social communication (Vineland Adaptive Behavior Scales-3 [VABS-3] Socialization Domain), or the secondary outcomes, autism symptoms (Pervasive Developmental Disorder Behavior Inventory) and vocabulary (Expressive One-Word Picture Vocabulary Test). There was also no overall evidence of differential effects by type of CB infused. In a subanalysis of children without intellectual disability (ID), allogeneic, but not autologous, CB was associated with improvement in a larger percentage of children on the clinician-rated Clinical Global Impression-Improvement scale, but the OR for improvement was not significant. Children without ID treated with CB showed significant improvements in communication skills (VABS-3 Communication Domain), and exploratory measures including attention to toys and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic power.Conclusions
Overall, a single infusion of CB was not associated with improved socialization skills or reduced autism symptoms. More research is warranted to determine whether CB infusion is an effective treatment for some children with ASD.Item Open Access An organizational framework for effective conservation organizations(Biological Conservation, 2022-03-01) Jiménez, I; Basurto, XThere is a scarcity of studies on how to design conservation organizations to improve biodiversity outcomes. We use information from four conservation organizations (African Parks, Australian Wildlife Conservancy, Mauritian Wildlife Foundation, and Rewilding Argentina) to update and describe an organizational framework for effective conservation organizations. This framework includes (1) clear and shared proactive vision inspired by innovative on-site senior leadership; (2) high contextuality based on shared leadership, on-the-ground administrative autonomy, and practice-based learning; (3) outstanding and well-communicated conservation outcomes; (4) linkages across-scales to access varied types of resources (i.e. political, social and economic); and (5) long-term financial viability. All these attributes form a dynamic and self-reinforcing “virtuous cycle,” with each attribute being both cause and effect at different moments in time, though the whole process is jump-started by on-site senior leaders. We believe that our framework can help to identify key questions that will facilitate the design and assessment of private and public conservation organizations towards improved effectiveness.Item Open Access Assessing Key Stakeholders' Knowledge, Needs, and Preferences for Head and Neck Cancer Survivorship Care Plans.(Journal of cancer education : the official journal of the American Association for Cancer Education, 2019-06) Zullig, Leah L; Ramos, Katherine; Berkowitz, Callie; Miller, Julie J; Dolor, Rowena J; Koontz, Bridget F; Yousuf Zafar, S; Hutch Allen, D; Tenhover, Jennifer A; Bosworth, Hayden BCancer survivorship care plans (SCPs) are endorsed to support quality care for cancer survivors, but uptake is slow. We assessed knowledge, needs, and preferences for SCP content and delivery from a wide variety of stakeholders. We focused SCP content for head and neck cancer as it is a disease prone to long-term side effects requiring management from multiple providers. We conducted telephone-based, qualitative interviews. We purposively sampled head and neck cancer survivors (n = 4), primary care physicians in the community (n = 5), and providers affiliated with a large academic medical center (n = 5) who treat head and neck cancer, cancer specialists (n = 6), and nurse practitioners/supportive care staff (n = 5). Interviews were recorded, transcribed, and analyzed using direct content analysis. Few participants reported personal experience with SCPs, but most supported the concept. Several key themes emerged: (1) perceived ambiguity regarding roles and responsibilities for SCPs, (2) a need to tailor the content and language based on the intended recipient, (3) documentation process should be as automated and streamlined as possible, (4) concerns about using the SCP to coordinate with outside providers, and (5) that SCPs would have added value as a "living document." We also report SCP-related issues that are unique to serving patients diagnosed with head and neck cancer. Effort is needed to tailor SCPs for different recipients and optimize their potential for successful implementation, impact on care outcomes, and sustainability. Many cancer survivors may not receive a SCP as part of routine care. Survivors could engage their health care team by requesting a SCP.Item Open Access Bridging the integration gap between patient-generated blood glucose data and electronic health records.(Journal of the American Medical Informatics Association : JAMIA, 2019-07) Lewinski, Allison A; Drake, Connor; Shaw, Ryan J; Jackson, George L; Bosworth, Hayden B; Oakes, Megan; Gonzales, Sarah; Jelesoff, Nicole E; Crowley, Matthew JTelemedicine can facilitate population health management by extending the reach of providers to efficiently care for high-risk, high-utilization populations. However, for telemedicine to be maximally useful, data collected using telemedicine technologies must be reliable and readily available to healthcare providers. To address current gaps in integration of patient-generated health data into the electronic health record (EHR), we examined 2 patient-facing platforms, Epic MyChart and Apple HealthKit, both of which facilitated the uploading of blood glucose data into the EHR as part of a diabetes telemedicine intervention. All patients were offered use of the MyChart platform; we subsequently invited a purposive sample of patients who used the MyChart platform effectively (n = 5) to also use the Apple HealthKit platform. Patients reported both platforms helped with diabetes self-management, and providers appreciated the convenience of the processes for obtaining patient data. Providers stated that the EHR data presentation format for Apple HealthKit was challenging to interpret; however, they also valued the greater perceived accuracy the Apple HealthKit data. Our findings indicate that patient-facing platforms can feasibly facilitate transmission of patient-generated health data into the EHR and support telemedicine-based care.Item Open Access Can metaphors and analogies improve communication with seriously ill patients?(J Palliat Med, 2010-03) Casarett, David; Pickard, Amy; Fishman, Jessica M; Alexander, Stewart C; Arnold, Robert M; Pollak, Kathryn I; Tulsky, James AOBJECTIVE: It is not known how often physicians use metaphors and analogies, or whether they improve patients' perceptions of their physicians' ability to communicate effectively. Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated with better patient ratings of their physicians' communication skills. DESIGN: Cross-sectional observational study of audio-recorded conversations between patients and physicians. SETTING: Three outpatient oncology practices. PATIENTS: Ninety-four patients with advanced cancer and 52 physicians. INTERVENTION: None. MAIN OUTCOME MEASURES: Conversations were reviewed and coded for the presence of metaphors and analogies. Patients also completed a 6-item rating of their physician's ability to communicate. RESULTS: In a sample of 101 conversations, coders identified 193 metaphors and 75 analogies. Metaphors appeared in approximately twice as many conversations as analogies did (65/101, 64% versus 31/101, 31%; sign test p < 0.001). Conversations also contained more metaphors than analogies (mean 1.6, range 0-11 versus mean 0.6, range 0-5; sign rank test p < 0.001). Physicians who used more metaphors elicited better patient ratings of communication (rho = 0.27; p = 0.006), as did physicians who used more analogies (Spearman rho = 0.34; p < 0.001). CONCLUSIONS: The use of metaphors and analogies may enhance physicians' ability to communicate.Item Open Access “Chinese Whispers”? The “China” that Disappears from Lossy Communications(2021) Cao, XuenanIn 1949, Bell Lab mathematician Claude Shannon modeled telephone communication by assigning statistic regularity to the rather irregular usage of human language. His lab mate Warren Weaver took a step further, putting the novel Alice in Wonderland through a translation machine in pursuit of a unified form of intercultural communication. Amidst the ideological polarities of the Cold War, this rationalist pursuit was idealistic. Yet today it still guides the scholarly approach to intercultural communication. This approach to data analysis poses a problem: the corporate sector simply has far superior systems of aggregating data and manipulating information, while individual academics would either have to ally with the world’s most popular social media or be forever trapped in isolation and by deficits. My work, on the contrary, focuses on the advantages of studying deficits. It questions why and how details are deliberately stripped out, why and how experience is transformed into algorithmic power, all for creating the impression of mere “data.”
This dissertation has two main objectives, one inwardly focused, the other outwardly oriented: first, to create a dialogue between literary studies and media studies through discussions of informational loss; second, to shift the narrow focus of North American and German media theory by drawing broadly on the material history of literature, media, and art from modern and contemporary China. China studies, a field born out of Cold War contexts in the West, have thus far developed under the growing pressure to track the particularities of this cultural other like China, without paying much attention to what documents are doing to a history rife with deliberately omitted information. This dissertation rectifies this mistreatment of lost details. Targeting communication scholar Marshall McLuhan’s provocation that “the medium is the message,” we may say that what is missing is the message; preserving what is missing in a cultural other end up making us not see China at all.
How do we approach objects that are opaque and always disappearing from view? This study locates this issue at the intersection of media theory and literary theory through reviewing key historical moments in both fields: this study examines the archival compression of the historical figure and the corpus called “Lu Xun” (1881-1936) to rethink the destructive role of print media in constructing Chinese modernity; returns to the industrial production of “books to lose” in the Great Leap Forward (1958-1960) to rethink the inevitable, functional bias of preservation in historiography; reviews the 1980s’ indulgence in a kind of “information fetishism” to reveal that opacity, too, can be a political ideal; and evaluates the claim of China’s 5G and AI “authoritarian networks” to expose the problematic metaphors of informatics. Each of the four chapters draws on literary and artistic texts, including Lu Xun’s untranslated essays (chapter 1), Yan Lianke’s fictional historiographies (chapter 2), Liu Cixin’s politicized science fiction (chapter 3), and emerging media arts in China (chapter 4). Referring to what tends to be hidden by acts of collecting, what becomes opaque, and what gets erased when the technological context is neglected, I borrow the term “lossy” from computer science. This term circumvents the notion of history based on static archives and their imaginary solidity. Interweaving two distinct threads of exposition (media studies and literature), this dissertation provides a multi-fold narrative about history, politics, and China.
Item Open Access Communication and education about asthma in rural and urban schools.(Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association, 2006-07) Hillemeier, Marianne M; Gusic, Maryellen; Bai, YuObjective
To assess the quality of communication and education about asthma in Pennsylvania public schools.Methods
Survey of a stratified random sample of school nurses in rural and urban Pennsylvania public schools (n = 996) concerning communication with school nurses about asthma by physicians and parents, nurses' perceived obstacles to asthma management at school, and utilization of and need for education about asthma.Results
A total of 757 surveys were received (response rate 76%). Thirty-nine percent of school nurses rated their communication with physicians about asthma as either poor or very poor. Urban nurses were significantly more likely to report poor/very poor physician communication (P = .09). Fifty-two percent of the nurses overall (43% rural, 56% urban) also cited lack of communication with parents as an important obstacle to asthma management. Forty-nine percent of school nurses (43% rural, 52% urban) reported attending an asthma education program during the previous year, and 75% (83% rural, 71% urban) expressed interest in additional education. Education about asthma was provided for classroom teachers in 54% of schools (56% rural, 54% urban) and provided for students in 58% of schools (54% rural, 60% urban).Conclusions
These findings document need for improvement in communication about children's asthma between school nurses and physicians. Although communication appears better in rural relative to urban schools, it is a salient issue in both settings. Study findings also indicate the need for expanded professional education opportunities for school nurses and improved access to appropriate curricular materials for school staff, parents, and students.Item Open Access Communication practices in physician decision-making for an unstable critically ill patient with end-stage cancer.(J Palliat Med, 2010-08) Mohan, Deepika; Alexander, Stewart C; Garrigues, Sarah K; Arnold, Robert M; Barnato, Amber EBACKGROUND: Shared decision-making has become the standard of care for most medical treatments. However, little is known about physician communication practices in the decision making for unstable critically ill patients with known end-stage disease. OBJECTIVE: To describe communication practices of physicians making treatment decisions for unstable critically ill patients with end-stage cancer, using the framework of shared decision-making. DESIGN: Analysis of audiotaped encounters between physicians and a standardized patient, in a high-fidelity simulation scenario, to identify best practice communication behaviors. The simulation depicted a 78-year-old man with metastatic gastric cancer, life-threatening hypoxia, and stable preferences to avoid intensive care unit (ICU) admission and intubation. Blinded coders assessed the encounters for verbal communication behaviors associated with handling emotions and discussion of end-of-life goals. We calculated a score for skill at handling emotions (0-6) and at discussing end of life goals (0-16). SUBJECTS: Twenty-seven hospital-based physicians. RESULTS: Independent variables included physician demographics and communication behaviors. We used treatment decisions (ICU admission and initiation of palliation) as a proxy for accurate identification of patient preferences. Eight physicians admitted the patient to the ICU, and 16 initiated palliation. Physicians varied, but on average demonstrated low skill at handling emotions (mean, 0.7) and moderate skill at discussing end-of-life goals (mean, 7.4). We found that skill at discussing end-of-life goals was associated with initiation of palliation (p = 0.04). CONCLUSIONS: It is possible to analyze the decision making of physicians managing unstable critically ill patients with end-stage cancer using the framework of shared decision-making.Item Open Access Communication: Weakening the critical dynamical slowing down of models with SALR interactions.(The Journal of chemical physics, 2022-11) Zheng, Mingyuan; Tarzia, Marco; Charbonneau, PatrickIn systems with frustration, the critical slowing down of the dynamics severely impedes the numerical study of phase transitions for even the simplest of lattice models. In order to help sidestep the gelation-like sluggishness, a clearer understanding of the underlying physics is needed. Here, we first obtain generic insight into that phenomenon by studying one-dimensional and Bethe lattice versions of a schematic frustrated model, the axial next-nearest neighbor Ising (ANNNI) model. Based on these findings, we formulate two cluster algorithms that speed up the simulations of the ANNNI model on a 2D square lattice. Although these schemes do not eliminate the critical slowing own, speed-ups of factors up to 40 are achieved in some regimes.Item Open Access Communicative Structure and the Emergence of Armed Conflict(2008-04-22) Warren, Timothy CamberThe goal of this dissertation is to provide a logically coherent and empirically grounded account of the relationships between collective communication, collective loyalties, and collective violence. Drawing on research from an array of disciplines, ranging from psychology to economics and sociology, I develop a new theoretical framework that I term "communicative structuralism." The central claim of this framework is that the communicative processes upon which the formation of collective identities and loyalties are based are structurally constrained in systematic ways. More specifically, it claims that public communicative structures, those which transmit synchronized messages and thus generate joint awareness of those messages amongst a collective audience, are central to the development of national, sub-national, and transnational symbolic allegiances because they create communities of shared experience and thereby generate symbolic touchstones which allow individuals to feel connected to a seemingly unified moral community. To test this theory, I collect data on the structural properties of the most prominent public communicative structures in the contemporary state system - those constituted by the mass media networks of newspapers, radios, and televisions - in 177 countries for the period 1945 - 1999. I then use this data to test the implications of the theory at two separate levels of analysis: (1) at the individual level the theory is tested using cross-national survey data on media exposure and state allegiance from over 30,000 respondents in 38 countries, and (2) at the state level the theory is tested using cross-national time-series data on civil conflict, identity fragmentation, and regime stability. I each case, the central finding is that mass media structures are fundamentally involved in generating the conditions for the formation of collective audiences (that is, audiences which are composed of members who are jointly aware of themselves as a collective). The dissertation demonstrates that such collective audiences, when constituted on a national scale by dense public communicative structures (i.e. mass media), make individuals more inclined to feel affective attachments to their country, and reduce the propensity to sociopolitical fragmentation thereby lessening the risk of large-scale civil conflict. In making this demonstration, the dissertation attempts to triangulate through the use of a wide variety of quantitative techniques, including multilevel hierarchical linear models, structural equation models, non-parametric tests of predictive accuracy, Bayesian model averaging, social network analysis, and agent-based computational simulations. I also ground the analysis in careful qualitative process-tracing of the disintegration of the Yugoslavian federation.Item Open Access Conceptualizing trust in community-academic research partnerships using concept mapping approach: A multi-CTSA study.(Evaluation and program planning, 2018-02) Dave, Gaurav; Frerichs, Leah; Jones, Jennifer; Kim, Mimi; Schaal, Jennifer; Vassar, Stefanie; Varma, Deepthi; Striley, Catherine; Ruktanonchai, Corrine; Black, Adina; Hankins, Jennifer; Lovelady, Nakita; Cene, Crystal; Green, Melissa; Young, Tiffany; Tiwari, Shristi; Cheney, Ann; Cottler, Linda; Sullivan, Greer; Brown, Arleen; Burke, Jessica; Corbie-Smith, GiselleObjectives
Collaborations between communities, healthcare practices and academic institutions are a strategy to address health disparities. Trust is critical in the development and maintaining of effective collaborations. The aim of this pilot study was to engage stakeholders in defining determinants of trust in community academic research partnerships and to develop a framework for measuring trust.Methods
The study was conducted by five collaborating National Institute of Health' Clinical and Translational Sciences Awardees. We used concept mapping to engage three stakeholders: community members, healthcare providers and academicians. We conducted hierarchical cluster analysis to assess the determinants of trust in community-academic research partnerships.Results
A total of 186 participants provided input generating 2,172 items that were consolidated into 125 unique items. A five cluster solution was defined: authentic, effective and transparent communication; mutually respectful and reciprocal relationships; sustainability; committed partnerships; and, communication, credibility and methodology to anticipate and resolve problems.Conclusion
Results from this study contribute to an increasing empirical body of work to better understand and improve the underlying factors that contribute to building and sustaining trust in community academic research partnerships.Item Open Access Correcting Misinformation on Firearms Injuries.(JAMA network open, 2022-12) Cook, Philip J; Parker, Susan TItem Open Access Countering misinformation via WhatsApp: Preliminary evidence from the COVID-19 pandemic in Zimbabwe.(PloS one, 2020-01) Bowles, Jeremy; Larreguy, Horacio; Liu, ShelleyWe examine how information from trusted social media sources can shape knowledge and behavior when misinformation and mistrust are widespread. In the context of the COVID-19 pandemic in Zimbabwe, we partnered with a trusted civil society organization to randomize the timing of the dissemination of messages aimed at targeting misinformation about the virus to 27,000 newsletter WhatsApp subscribers. We examine how exposure to these messages affects individuals' beliefs about how to deal with the virus and preventative behavior. In a survey of 864 survey respondents, we find a 0.26σ increase in knowledge about COVID-19 as measured by responses to factual questions. Through a list experiment embedded in the survey, we further find that potentially harmful behavior-not abiding by lockdown guidelines-decreased by 30 percentage points. The results show that social media messaging from trusted sources may have substantively large effects not only on individuals' knowledge but also ultimately on related behavior.Item Open Access Decision-Making With Potentially Biased Advisors(2011-04-18) Kupiec, KevinWith the world full of situations in which information that is potentially useful to decision-making is dispersed among various individuals, research into how this information can be efficiently shared has been the focus of a large body of research in recent years. Intuitively, it seems that even the most self-interested agents would benefit from sharing at least some of their private information, and by considering the sender-receiver game, the simplest Bayesian game with communication, it is possible to examine this belief. Previous research has studied the sender-receiver game in detail in order to characterize the associated equilibrium and determine properties of optimal decision-making strategies. However, a key assumption among current literature is that both players know the preference divergence between the sender and receiver, but this is not always true. In order to close the gap in research that currently exists, this paper examines the sender-receiver game when the preference divergence is unknown to the receiver, but in a situation when commitment to a mechanism is possible. The results reveal that any optimal mechanism maximizing the expected utility of the receiver must take a rather simple form in which he chooses the sender's favorite action in general, but if the recommendation is above or below a certain threshold, the decision rule becomes independent of the information. The results have many real-world implications and suggest that when commitment is possible, even when the receiver doesn't know how great the preference divergence is, expected utilities, a priori, can be increased. The analysis also suggests that disclosure of preferences by the sender may actually decrease expected outcomes.Item Open Access Defining heparin resistance: communication from the ISTH SSC Subcommittee of Perioperative and Critical Care Thrombosis and Hemostasis.(Journal of thrombosis and haemostasis : JTH, 2023-12) Levy, Jerrold H; Sniecinski, Roman M; Rocca, Bianca; Ghadimi, Kamrouz; Douketis, James; Frere, Corinne; Helms, Julie; Iba, Toshiaki; Koster, Andreas; Lech, Tara K; Maier, Cheryl L; Neal, Mathew D; Scarlestscu, Ecatarina; Spyropoulos, Alex; Steiner, Marie E; Tafur, Alfonso J; Tanaka, Kenichi A; Connors, Jean MThe term heparin resistance (HR) is used by clinicians without specific criteria. We performed a literature search and surveyed our SSC membership to better define the term when applied to medical and intensive care unit patients. The most common heparin dosing strategy reported in the literature (53%) and by survey respondents (80.4%) was the use of weight-based dosing. Heparin monitoring results were similar based on the proportion of publications and respondents that reported the use of anti-Xa and activated partial thromboplastin time. The most common literature definition of HR was >35 000 U/d, but no consensus was reported among survey respondents regarding weight-based and the total dose of heparin when determining resistance. Respondent consensus on treating HR included antithrombin supplementation, direct thrombin inhibitors, or administering more heparin as the strategies available for treating HR. A range of definitions for HR exist. Given the common use of heparin weight-based dosing, future publications employing the term HR should include weight-based definitions, monitoring assay, and target level used. Further work is needed to develop a consensus for defining HR.Item Open Access Differences in the early cognitive development of children and great apes.(Dev Psychobiol, 2014-04) Wobber, Victoria; Herrmann, Esther; Hare, Brian; Wrangham, Richard; Tomasello, MichaelThere is very little research comparing great ape and human cognition developmentally. In the current studies we compared a cross-sectional sample of 2- to 4-year-old human children (n=48) with a large sample of chimpanzees and bonobos in the same age range (n=42, hereafter: apes) on a broad array of cognitive tasks. We then followed a group of juvenile apes (n=44) longitudinally over 3 years to track their cognitive development in greater detail. In skills of physical cognition (space, causality, quantities), children and apes performed comparably at 2 years of age, but by 4 years of age children were more advanced (whereas apes stayed at their 2-year-old performance levels). In skills of social cognition (communication, social learning, theory of mind), children out-performed apes already at 2 years, and increased this difference even more by 4 years. Patterns of development differed more between children and apes in the social domain than the physical domain, with support for these patterns present in both the cross-sectional and longitudinal ape data sets. These results indicate key differences in the pattern and pace of cognitive development between humans and other apes, particularly in the early emergence of specific social cognitive capacities in humans.Item Metadata only Diffusion of surgical technology. An exploratory study.(J Health Econ, 1986-03) Sloan, FA; Valvona, J; Perrin, JM; Adamache, KWThe study presents an empirical analysis of the diffusion patterns of five surgical procedures. Roles of payer mix, regulatory policies, physician diffusion, competition among hospitals, and various hospital characteristics such as size and the spread of technologies are examined. The principal data base is a time series cross-section of 521 hospitals based on discharge abstracts sent to the Commission on Professional and Hospital Activities. Results on the whole are consistent with a framework used to study innovations in other contexts in which the decisions of whether to innovate and timing depend on anticipated streams of returns and cost. Innovation tends to be more likely to occur in markets in which the more generous payers predominate. But the marginal effects of payer mix are small compared to effects of location and hospital characteristics, such as size and teaching status. Hospital rate-setting sometimes retarded diffusion. Certificate of need programs did not.Item Open Access Diminished, Enduring, and Emergent Diversity Policy Concerns in an Evolving Media Environment(INTERNATIONAL JOURNAL OF COMMUNICATION, 2011-01-01) Napoli, Philip MItem Open Access Duty Hours on Surgery Clerkship: From Compliance Nightmare to Leadership and Professional Development Opportunity.(Journal of surgical education, 2023-06) Mikulski, Matthew F; Terzo, Madison; Jacquez, Zachary; Beckerman, Ziv; Brown, Kimberly MObjective
To evaluate the impact of an innovative leadership development initiative in the core surgery clerkship that addressed duty hours compliance and time-off requests.Design
A combination of deductive and inductive analysis of medical student reflections written after rotating on Acute Care Surgery over 2 academic years (2019-2020 and 2020-2021) was performed. Reflections were part of criteria to receive honors and a prompt was given to discuss their experience in creating their own call schedules. We utilized a combined deductive and inductive process to identify predominant themes within the reflections. Once established, we quantitatively identified frequency and density of themes cited, along with qualitative analysis to determine barriers and lessons learned.Setting
Dell Seton Medical Center, Dell Medical School at The University of Texas at Austin, a tertiary academic facility.Participants
There were 96 students who rotated on Acute Care Surgery during the study period, 64 (66.7%) of whom completed the reflection piece.Results
We identified 10 predominant themes through the combined deductive and inductive processes. Barriers were cited by most students (n = 58, 91%), with communication being the most commonly discussed theme when cited with a mean 1.96 references per student. Learned leadership skills included: communication, independence, teamwork, negotiating skills, reflection of best practices by residents, and realizing the importance of duty hours.Conclusions
Transferring duty hour scheduling responsibilities to medical students resulted in multiple professional development opportunities while decreasing administrative burden and improving adherence to duty hour requirements. This approach requires further validation, but may be considered at other institutions seeking to improve the leadership and communication skills of its students, while improving adherence to duty hour restrictions.Item Open Access Embodied Attention: Learning from the Wisdom of the Desert and Saint Augustine in an Age of Distraction(2014) Davelaar, Kathryn AnnThroughout the life of the Church, certain habits have been cultivated to shape the identity of its community and deepen our communion with God. We see in the writings of the Desert Fathers that attentiveness is one habit that people of faith have taken care to cultivate to better connect with God. Contemporary of the Desert Fathers, Saint Augustine, also speaks to attentiveness and its relation to time. What both the Desert writers and Augustine understand is that our ability to connect with God depends on our ability to be attentive in the present moment.
This thesis will argue that an embodied, present attentiveness is foundational to a relationship with God; furthermore, given the patterns of attention developed around Wireless Mobile Devices (i.e. smartphones) and the strong pull on its users for their constant interaction, I argue that the practices created around these devices do in fact hinder one's ability to connect with God, despite their other potential for good. The thesis employs qualitative research in the form of literature reviews. First, drawing from the practices of the Desert Fathers and Augustine's understanding of the relationship between time, memory, and knowledge of God, I make a case for the discipline of embodied attentiveness to the present moment as foundational to our relationship with God. I then draw from current psychological, sociological and anthropological insights to model how the current technological landscape places particular pressures on an embodied present attentiveness, with specific focus on the Wireless Mobile Device (WMD), commonly known as the smartphone. Finally, I place in conversation the findings from these reviews; leading to an assessment on the patterns technology creates around attentiveness.
People are becoming increasingly aware and concerned that the Internet and Wireless Mobile Devices are not neutral mediums and consistent exposure (and use) of these mediums is affecting us. We will see in this thesis that not only are habits of communication shifting, but also we are literally being rewired as our neural pathways are firing into uncharted territory. While psychological, sociological, and philosophical assessments of communication technologies and the self are critical to understand various implications on attentiveness, the goal of this thesis is to articulate the practices that the use of Wireless Mobile Devices cultivates regarding attentiveness through a theological lens.
As we begin to understand the concerns of the Saints who have gone before us, combined with understanding the shifting landscape of technology as it pertains to attentiveness, we can imagine why it is that the Church ought to be concerned with the continued cultivation of the discipline of attentiveness. Rather than simply "sounding the alarm" that technology is detrimental to our spiritual formation, however, this thesis will attempt to help the Church have a more nuanced understanding of why social media inhibits our ability to be attentive, as it examines to what end (telos) our attention is being drawn. After developing a more robust understanding of why a present, embodied attentiveness is foundational to our relationship with God, we will be able to enter into conversations regarding social media that are nuanced beyond it having "positive" and "negative" effects.