scholarly journals Second-order problem solving: Nurses’ perspectives on learning from near misses

Author(s):  
Yi Yang ◽  
Huaping Liu ◽  
Gwen D. Sherwood
BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026737
Author(s):  
Arie Bijl ◽  
Kees Ahaus ◽  
Gwenny Ruël ◽  
Paul Gemmel ◽  
Bert Meijboom

ObjectivesTo investigate the relationship between lean adoption and problem-solving behaviour in nursing teams, and to explore the practices of lean leaders on nursing wards to reveal how they can stimulate second-order problem-solving within their teams.DesignA mixed-methods retrospective multiple case study using semistructured interviews. Interview data were used to assess the level of lean maturity (based on a customised validated instrument) and the level of second-order problem-solving (based on scenarios). Within-case and cross-case analyses were employed to identify lean leadership practices.Setting14 nursing teams, with different levels of lean maturity, in a Dutch hospital.ParticipantsThree members of each nursing team were interviewed: the team leader, one nurse from the ward’s core team for the lean-based quality improvement programme and one nurse outside the core team.InterventionsThe nursing teams were in various phases of a lean-based quality improvement programme: ‘The Productive Ward – Releasing Time to Care’.ResultsA strongly significant positive relationship between lean maturity and second-order problem-solving was found: β=0.68, R2=0.46, p<0.001. Further, the results indicated a potential strengthening effect of lean leadership on this relationship. Seven lean leadership practices emerged from the data collected in a nursing ward setting: (1) convincing and setting an example; (2) unlocking individual and team potential; (3) solving problems systematically; (4) enthusing, actively participating and visualising; (5) developing self-managing teams; (6) sensing, as orchestrator, what is needed for change; and (7) listening, sharing information and appreciating. These practices have a strong link with transformational leadership.ConclusionsAs lean matures, nursing teams reach a higher level of second-order problem-solving. In later stages, lean leaders increasingly relinquish responsibility by developing self-managing teams.


10.36850/e4 ◽  
2021 ◽  
Author(s):  
Wendy Ross ◽  
Frédéric Vallée-Tourangeau

Insight problems are sometimes designed to encourage an incorrect and misleading interpretation that veils a simple answer. The socks problem is one such problem: Given black socks and brown socks in a drawer mixed in a ratio of four to five, how many socks will you have to take out to make sure that you have a pair of the same color? The ratio information is misleading since, with only two colors, pulling three socks will guarantee a matching pair. Recently, offered a distinction between first- and second-order problem-solving: The former proceeds with and through a physical model of the problem, while the latter proceeds in the absence of such interactions with the world, in other words on the basis of mental processes alone. Vallée-Tourangeau and March also proposed a thought experiment, suggesting that the ratio information in the socks problem might be quickly abandoned in a first-order environment, that is, one where participants observe the results of drawing socks out of a bag rather than imagining themselves doing so. We tested this prediction by randomly allocating participants to a low- (second-order) or high- (first-order) interactivity condition. Marginally more participants announced the correct answer within a 5-minute period in the high than in the low condition, although the difference was not significant. Detailed analysis of the video recording revealed the challenges of operationalizing a second-order condition, as participants engaged in dialogical interactions with the experimenter. In addition, the manner in which the high-interactivity condition was designed appeared to encourage the physical reification of the misleading ratio, thus anchoring that information more firmly rather than defusing it through interactivity. We close the paper with some reflections on wide, or systemic, cognition in experimental research on creative problem-solving.


1983 ◽  
Vol 53 (3) ◽  
pp. 775-778 ◽  
Author(s):  
Richard W. Millard ◽  
Ian M. Evans

A sample of 12 clinical psychologists and 12 graduate students in clinical psychology performed an analogue task to investigate decision processes with respect to the judged salience of criteria for social validity. Six child cases were considered by all; each card contained information describing a dangerous behavior, information accompanied by an explicit normative refererence, the same information without a normative reference, or unrelated filler comments. Non-parametric analyses indicated that subjects consistently evaluated information about dangerous behavior as being more serious than any other concern; dangerousness was ranked first 94.4% of the time. Subjects did not distinguish between information with explicit normative referents and the same information without any such referents. Students and clinicians did not differ in their response to these categories of information. The results demonstrate the application of a fixed-order problem-solving method to study the clinical-decision process and suggest the importance of criteria for social validity in this sequence.


Author(s):  
Joa˜o Pessoa ◽  
Nuno Fonseca ◽  
C. Guedes Soares

The paper presents an investigation of the slowly varying second order drift forces on a floating body of simple geometry. The body is axis-symmetric about the vertical axis, like a vertical cylinder with a rounded bottom and a ratio of diameter to draft of 3.25. The hydrodynamic problem is solved with a second order boundary element method. The second order problem is due to interactions between pairs of incident harmonic waves with different frequencies, therefore the calculations are carried out for several difference frequencies with the mean frequency covering the whole frequency range of interest. Results include the surge drift force and pitch drift moment. The results are presented in several stages in order to assess the influence of different phenomena contributing to the global second order responses. Firstly the body is restrained and secondly it is free to move at the wave frequency. The second order results include the contribution associated with quadratic products of first order quantities, the total second order force, and the contribution associated to the free surface forcing.


Author(s):  
Charles Monroy ◽  
Yann Giorgiutti ◽  
Xiao-Bo Chen

The influence of current in sea-keeping problems is felt not only for first order quantities such as wave run-ups in front of the structure, but also mainly for second order quantities. In particular, the wave drift damping (which is expressed as the derivative of drift force with respect to the current) is of special interest for mooring systems. The interaction effects of a double-body steady flow on wave diffraction-radiation is studied through a decomposition of the time-harmonic potential into linear and interaction components. A boundary integral method is used to solve the first order problem. Ultimately, a far-field method is proposed to get access to second order drift forces.


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