scholarly journals The epistemic roles of clinical expertise: An empirical study of how Swedish healthcare professionals understand proven experience

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252160
Author(s):  
Barry Dewitt ◽  
Johannes Persson ◽  
Lena Wahlberg ◽  
Annika Wallin
Keyword(s):  
Three Dimensions ◽  
Healthcare Personnel ◽  
Simple Random Sample ◽  
Clinical Expertise ◽  
Body Of Knowledge ◽  
Data Dimensionality Reduction ◽  
Confirmatory Factor ◽  
Competent Person ◽  
Survey Responses ◽  
Based Medicine

Clinical expertise has since 1891 a Swedish counterpart in proven experience. This study aims to increase our understanding of clinicians’ views of their professional expertise, both as a source or body of knowledge and as a skill or quality. We examine how Swedish healthcare personnel view their expertise as captured by the (legally and culturally relevant) Swedish concept of “proven experience,” through a survey administered to a simple random sample of Swedish physicians and nurses (2018, n = 560). This study is the first empirical attempt to analyse the notion of proven experience as it is understood by Swedish physicians and nurses. Using statistical techniques for data dimensionality reduction (confirmatory factor analysis and multidimensional scaling), the study provides evidence that the proven experience concept is multidimensional and that a model consisting of three dimensions–for brevity referred to as “test/evidence”, “practice”, and “being an experienced/competent person”–describes the survey responses well. In addition, our results cannot corroborate the widely held assumption in evidence-based medicine that an important component of clinical expertise consists of experience of patients’ preferences.

Psychometric Definition of Rorschach Determinant Component Structure

1998 ◽  
Vol 14 (2) ◽  
pp. 116-123 ◽  
Author(s):  
Raymond M. Costello
Keyword(s):  
Lower Order ◽  
Three Dimensions ◽  
Comprehensive System ◽  
Empirical Examination ◽  
Component Structure ◽  
Exner's Comprehensive System ◽  
Factor Analytic ◽  
Confirmatory Factor ◽  
Components Analysis ◽  
Definition Of

This is an empirical examination of Experienced Stimulation (es) and Experience Actual (EA) from Exner's Comprehensive System (CS) for Rorschach's Test, spurred by Kleiger's theoretical critique. Principal components analysis, Cronbach's α, and inter-item correlational analyses were used to test whether 13 determinants used to code Rorschach responses (M, FM, m, CF+C, YF+Y, C'F+C', TF+T, VF+V, FC, FC', FV, FY, FT) are best represented as a one, two, or more-dimensional construct. The 13 determinants appear to reflect three dimensions, a “lower order” sensori-motor dimension (m + CF+C + YF+Y + C'F+C' + TF+T + VF+V) with a suggested label of Modified Experienced Stimulation (MES), a “higher order” sensori-motor dimension (FM + FV + FY + FT) with a suggested label of Modified Experience Potential (MEP), and a third sensori-motor dimension (M+FC+FC') for which the label of Modified Experience Actual (MEA) is suggested. These findings are consistent with Kleiger's arguments and could lead to a refinement of CS constructs by aggregating determinants along lines more theoretically congruous and more internally consistent. A RAMONA model with parameters specified was presented for replication attempts which use confirmatory factor analytic techniques.

Perceived Realism of Television Medical Dramas and Perceptions About Physicians

2011 ◽  
Vol 23 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Hyunyi Cho ◽  
Kari Wilson ◽  
Jounghwa Choi
Keyword(s):  
College Students ◽  
Three Dimensions ◽  
Hierarchical Regression ◽  
Regression Analyses ◽  
Factor Analyses ◽  
Confirmatory Factor Analyses ◽  
Perceived Realism ◽  
Medical Dramas ◽  
Confirmatory Factor ◽  
Different Dimensions

This study investigated whether and how dimensions of perceived realism of television medical dramas are linked to perceptions of physicians. The three dimensions of perceived realism were considered: plausibility, typicality, and narrative consistency. Data from a survey of college students were examined with confirmatory factor analyses and hierarchical regression analyses. Across the three dramas (ER, Grey’s Anatomy, and House), narrative consistency predicted positive perceptions about physicians. Perceived plausibility and typicality of the medical dramas showed no significant association with perceptions about physicians. These results illustrate the importance of distinguishing different dimensions of perceived realism and the importance of narrative consistency in influencing social beliefs.

scholarly journals Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisanne S. Welink ◽  
Kaatje Van Roy ◽  
Roger A. M. J. Damoiseaux ◽  
Hilde A. Suijker ◽  
Peter Pype ◽  
...  
Keyword(s):  
Decision Making ◽  
General Practice ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Stimulated Recall ◽  
Previous Discussion ◽  
Based Medicine ◽  
Stimulated Recall Interviews ◽  
Gp Training

Abstract Background Evidence-based medicine (EBM) in general practice involves applying a complex combination of best-available evidence, the patient’s preferences and the general practitioner’s (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other’s consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other’s EBM behaviour through observation, and by identifying aspects that influence their recognition. Methods We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner’s consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner’s actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other’s considerations well with those who did not, we developed a model describing the aspects that influence the observer’s recognition of an actor’s EBM behaviour. Results Overall, there was moderate similarity between an actor’s EBM behaviour and the observer’s recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role. Conclusions GP trainees and supervisors do not fully recognise EBM behaviour through observing each other’s consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decision-making is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines.

DECONSTRUCTING LAWSON AND SAMSON’S CONCEPT OF INNOVATION CAPABILITY: A CRITICAL ASSESSMENT AND A REFINEMENT

2019 ◽  
Vol 23 (06) ◽  
pp. 1950053 ◽  
Author(s):  
ARMAND DJOUMESSI ◽  
SHU-LING CHEN ◽  
STEPHEN CAHOON
Keyword(s):  
Factor Analysis ◽  
Dynamic Capabilities ◽  
Innovation Management ◽  
Empirical Studies ◽  
Capabilities Approach ◽  
Three Dimensions ◽  
Innovation Capability ◽  
Maritime Industry ◽  
Firm Level ◽  
Confirmatory Factor

For almost 20 years, research on firm level innovation have relied upon [Lawson and Samson (2001). Developing innovation capability in organisations: A dynamic capabilities approach. International Journal of Innovation Management, 5(3), 377–400] concept of innovation capability (IC). Of note, these authors stated that this concept needs to be ‘refined, validated and tested using other research methods’ [Lawson and Samson (2001). Developing innovation capability in organisations: A dynamic capabilities approach. International Journal of Innovation Management, 5(3), 377–400], p. 396. To date, empirical studies heeding this call have been challenging to find. By researchers relying on this untested concept, they risk not attaining comprehensive insights into the firm level mechanisms underpinning the transformation idea and knowledge into innovations. This paper proposes a rethinking of the IC concept. The analysis is based on survey data of 69 firms involved in the Australian maritime industry using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The results suggest that the IC concept might be refined from seven dimensions, initially conceptualised, to three dimensions. The three dimensions are renamed as institutionalising innovation, implementing innovation and stimulating innovation.

scholarly journals The Relationship between Creative Capabilities and Cultural Intelligence: Field Study of Amman’s Five-Star Hotels

2015 ◽  
Vol 10 (12) ◽  
pp. 103 ◽  
Author(s):  
Ayad F. Altememi ◽  
Imad A. Hassouneh ◽  
Shaker Jarallah Alkshali
Keyword(s):  
Field Study ◽  
Cultural Intelligence ◽  
Positive Relationship ◽  
Three Dimensions ◽  
Simple Random Sample ◽  
Significant Positive Relationship ◽  
Independent Variable ◽  
And Behavior ◽  
The Relationship ◽  
The City

This study aims to identify the relationship between the creative capabilities of workers in 5-star hotels in the city of Amman and their cultural intelligence. In its measurement of the creative capabilities as an independent variable, the study adopted a scale consisting of three dimensions, namely: fluency, flexibility and originality. Whereas it relied in measuring the cultural intelligence as a dependent variable, on a scale consisting of three dimensions, namely: knowledge (cognition), motivation and behavior. The study was conducted on a sample of (258) workers currently working in these hotels. The required particulars for this study were collected through a specially prepared questionnaire for this purpose after having reviewed multi previous studies. The sample was distributed according to the simple random sample mechanism. The study revealed that there is a significant positive relationship between the dimensions of creative capabilities of workers in such hotels and their cultural intelligence. The study also included a set of recommendations and mechanisms that can be applied by the managements of these hotels to tackle some aspects of the dimensions constituting the cultural intelligence of workers.

Evidence-Based Decision-Making (Part 1): Origins and Evolution in the Health Sciences

2009 ◽  
Vol 24 (4) ◽  
pp. 298-305 ◽  
Author(s):  
David A. Bradt
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based Medicine ◽  
Strategic Decision ◽  
Systematic Research ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Strength Of Evidence ◽  
Based Medicine ◽  
Evidence Based Decision Making

AbstractEvidence is defined as data on which a judgment or conclusion may be based. In the early 1990s, medical clinicians pioneered evidence-based decision-making. The discipline emerged as the use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine required the integration of individual clinical expertise with the best available, external clinical evidence from systematic research and the patient's unique values and circumstances. In this context, evidence acquired a hierarchy of strength based upon the method of data acquisition.Subsequently, evidence-based decision-making expanded throughout the allied health field. In public health, and particularly for populations in crisis, three major data-gathering tools now dominate: (1) rapid health assessments; (2) population based surveys; and (3) disease surveillance. Unfortunately, the strength of evidence obtained by these tools is not easily measured by the grading scales of evidence-based medicine. This is complicated by the many purposes for which evidence can be applied in public health—strategic decision-making, program implementation, monitoring, and evaluation. Different applications have different requirements for strength of evidence as well as different time frames for decision-making. Given the challenges of integrating data from multiple sources that are collected by different methods, public health experts have defined best available evidence as the use of all available sources used to provide relevant inputs for decision-making.

scholarly journals PSYCHOMETRIC EVALUATION OF THE TURKISH VERSION OF THE COVID-19 INDUCED ANXIETY SCALE AND PROTECTIVE BEHAVIORS TOWARDS COVID-19 SCALE

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Hikmet Yazıcı ◽  
Fatma Altun ◽  
Cansu Tosun ◽  
Münevver Özdemir ◽  
Yasemin Karsantık
Keyword(s):  
Factor Analysis ◽  
Psychometric Evaluation ◽  
Study Data ◽  
Anxiety Scale ◽  
Three Dimensions ◽  
Protective Behaviors ◽  
Factor Analyses ◽  
Confirmatory Factor Analyses ◽  
Confirmatory Factor ◽  
Turkish Language

The purpose of the present study was to adapt COVID-19 Induced Anxiety Scale (CIAS) and Protective Behaviors towards COVID-19 Scale (PBCS) into Turkish language, and to investigate their psychometric properties. 593 adults participated in the study. Data were collected through CIAS and PBCS as well as The Fear of COVID-19 Scale (FCS). Cronbach alpha (α) and McDonald’s Omega (ω) coefficients were utilized for reliability of the Turkish forms of the scales, and validity of the scales was tested with exploratory factor analysis, confirmatory factor analysis and criterion validity. The analysis showed that α and ω reliability coefficients of both scales were over .70. The results of exploratory and confirmatory factor analyses revealed that CIAS had a single factor structure while PBCS had three dimensions as indicated in original forms of the scales. Significant and positive relationships were also found between the scores obtained from CIAS and PBCS and fear scores. To conclude, Turkish forms of CIAS and PBCS were proved to be valid and reliable tools to measure severity of COVID-19 induced anxiety through CIAS and individuals’ protective behaviors towards COVID-19 through PBCS.

scholarly journals Development Instruments Through Confirmatory Factor Analysis (CFA) in Appropriate Intensity Assessment

2017 ◽  
Vol 12 (1) ◽  
pp. 13-19
Author(s):  
Ari Saptono
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Three Dimensions ◽  
Likelihood Method ◽  
Test Results ◽  
Validity And Reliability ◽  
Measurement Instruments ◽  
School Students ◽  
Multi Stage ◽  
Confirmatory Factor

The research aims to develop the valid and reliable measurement instruments of entrepreneurship intention in vocational secondary school students. Multi stage random sampling was used as the technique to determine sample (300 respondents). The research method used research and development with confirmatory factor analysis (CFA). Result of confirmatory factor analysis (CFA) at the second order with robust maximum likelihood method shows that valid and reliable instrument with the acquisition value of loading factor is more than 0.5 (> 0,5) and a significance value of t is more than 1,96 (> 1,96). Reliability test results shows that the value of the combined construct reliability (CR) of 0.97and a variance value extract (VE) to 0.52 is greater than the limit of acceptance CR ? 0.70 and VE ? 0.50. The conclusion of the measurement instruments of entrepreneurship intention with three dimensions and 31 items met the standards of validity and reliability in accordance with the instrument development process.

Delineating Three Dimensions of E-Government Success

2015 ◽  
pp. 135-157 ◽  
Author(s):  
Alexandru V. Roman
Keyword(s):  
Technology Adoption ◽  
Communication Technologies ◽  
Three Dimensions ◽  
Information Communication Technologies ◽  
Historical Evolution ◽  
Information Communication ◽  
The Public ◽  
Body Of Knowledge ◽  
Long Run ◽  
Complex Process

This chapter draws upon the historical evolution of e-government and at the extant body of knowledge in order to delineate the dimensions that are critical for the success of the use of Information Communication Technologies (ICTs) for purposes of governance. Evaluating the impacts of technology adoption in the public sector is an intrinsically complex process. However, given that currently governmental spending on ICT projects rivals and at times even surpasses allocations for capital developments, the need for an evaluative framework becomes rather obvious. Based on multiple scholarly accounts and practical examples, this chapter suggests that the success of e-government should be examined along three chief dimensions: security, functionality, and transformation. All three vectors are highly interdependent, and it can be argued that the success of e-government in the long run is not possible if significant shortcomings are observed along any one of the three aspects.

DSS for Health Emergency Response

2011 ◽  
Vol 1 (2) ◽  
pp. 39-56 ◽  
Author(s):  
Dimitris Oikonomou ◽  
Vassilis Moulianitis ◽  
Dimitris Lekkas ◽  
Panayiotis Koutsabasis
Keyword(s):  
Emergency Response ◽  
User Interfaces ◽  
Healthcare Personnel ◽  
Call Centre ◽  
Dynamic Information ◽  
Ambulance Personnel ◽  
Web Based ◽  
Decision Making Processes ◽  
Public Emergency ◽  
Based Medicine

This paper presents the design approach and architecture of a Decision Support System (DSS) for the Hellenic Centre for Emergency Health Care (EKAB, http://www.ekab.gr). The DSS supports the cooperation and decision-making processes at the EKAB call centre concerning the effective activation and allocation of appropriate resources mainly: ambulances, healthcare personnel and other public emergency resources like fire fighting and police. The DSS is a geographic web-based mash-up that builds on top of existing information systems and databases, and collects, aggregates, records, and presents various types of dynamic information about medical incidents in real time, promoting evidence-based medicine. The system provides a number of user interfaces (web-based and mobile) for call centre operators, radio centre operators, ambulance personnel, and administration. A contextual approach was necessary for the design of the system based on various related methods. Field observation of the current ways of work at EKAB sites, design, and development of data resources and user interfaces were conducted.

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