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1.
Am J Obstet Gynecol MFM ; : 101424, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38992742

RESUMO

BACKGROUND: An institutional standardized, nurse-initiated protocol was implemented to improve the recognition of and response to perinatal hypertensive emergency. OBJECTIVE(S): The primary aim was to evaluate if the rate of guideline-based treatment of perinatal hypertensive emergency improved with implementation of the protocol. STUDY DESIGN: This quality improvement initiative was developed by a multidisciplinary team and consisted of clinician and nursing education and the implementation of a standardized, nurse-initiated severe hypertension protocol. The project took place in three phases: pre-implementation (July 2020-October 2020), implementation (November 2020-June 2021), and sustainment (July 2021-May 2022). The primary aim was to increase guideline-based treatment of hypertensive emergency among pregnant and postpartum persons. Guideline-based treatment was defined as repeat blood pressure within 30 minutes of severe hypertension to diagnose hypertensive emergency, antihypertensive medication administration within 30 minutes of diagnosis, and appropriately timed repeat blood pressure following treatment. Process measures included time to confirm the diagnosis, initiate the protocol, antihypertensive medication administration, repeat blood pressure after antihypertensive medication administration, and administration of a secondary dose as appropriate. Balancing measures included maternal intensive care unit admission, clinically significant maternal hypotension, fetal demise, neonatal birthweight, and Apgar <7 at 5 minutes. Data were evaluated using between-subjects statistics and a run chart was developed to assess relationship between the protocol and changes in guideline-based treatment over time. RESULTS: Overall, 503 hypertensive emergency encounters were identified during the project period (98 [20%] pre-implementation, 172 [34%] implementation, 233 [46%] sustainment). There were higher rates of persons with chronic hypertension and who self-identified as non-Hispanic Black race in the sustainment phase compared to the other phases. Guideline-based treatment increased from 18.4% pre-implementation to 75.1% in sustainment (p<0.001). Each component of guideline-based treatment also improved significantly from pre-implementation to sustainment (p<0.001). No episodes of clinically significant maternal hypotension occurred in any phase. There were four maternal intensive care unit admissions and three fetal demises during the initiative; none were related to hypertensive emergency. CONCLUSION(S): The nurse-initiated protocol for treatment of hypertensive emergency significantly increased guideline-based treatment of perinatal hypertensive emergency, reduced time to diagnose and treat hypertensive emergency, and increased the number of patients receiving treatment when indicated. This protocol was pragmatic, utilizing resources already available on obstetric units. Use of similar protocols may be considered at institutions providing obstetric care to improve recognition of and response to hypertensive emergency which may decrease maternal and neonatal morbidity and mortality related to hypertensive emergency.

2.
Neurobiol Learn Mem ; 213: 107958, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38971460

RESUMO

Procedural learning is the acquisition of motor and non-motor skills through a gradual process that increases with practice. Impairments in procedural learning have been consistently demonstrated in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. Considering that noninvasive brain stimulation modulates brain activity and boosts neuroplastic mechanisms, we reviewed the effects of coupling transcranial direct current stimulation (tDCS) with training methods for motor and non-motor procedural learning to explore tDCS potential use as a tool for enhancing implicit learning in healthy and clinical populations. The review covers tDCS effects over i. motor procedural learning, from basic to complex activities; ii. non-motor procedural learning; iii. procedural rehabilitation in several clinical populations. We conclude that targeting the primary motor cortex and prefrontal areas seems the most promising for motor and non-motor procedural learning, respectively. For procedural rehabilitation, the use of tDCS is yet at an early stage but some effectiveness has been reported for implicit motor and memory learning. Still, systematic comparisons of stimulation parameters and target areas are recommended for maximising the effectiveness of tDCS and its robustness for procedural rehabilitation.

3.
Artigo em Inglês | MEDLINE | ID: mdl-39004269

RESUMO

OBJECTIVE: Industry payments, as sources of revenue and prestige, may contribute to gender implicit bias. We examined industry payments to cardiothoracic (CT) surgeons to determine differences with respect to gender while accounting for practice focus and experience. METHODS: Payments to CT surgeons from 2014, 2016, 2018, 2020, and 2022 were abstracted from the CMS Open Payment database. Data was restricted to individual payments over $1000 and the following payment criteria: consulting fees; compensation for services other than consulting; honoraria; education; compensation for serving as faculty or as a speaker for a non-accredited and noncertified continuing education program; and grant. Physician profiles were queried for gender, practice type, and year of last fellowship completion. Descriptive statistics were reported based on these factors. RESULTS: In 2014, 509 CT surgeons (497 male and 12 female) received meaningful industry payments. Male surgeons received $10,471,192 (99.3%) with median payment of $6,500 and mean of $21,069 while females received $70,310 (0.7%) with median of $3,500 and mean of $5,859. In 2022, 674 CT surgeons (613 male and 61 female) received industry payments, with men receiving $10,967,855 (92.4%) with a median payment of $6,611 and mean of $17,892 and women receiving $905,431(7.6%) with a median payment of $6,000 and mean of $14,843. CONCLUSIONS: Industry payments to women increased from 2014 to 2022 as the proportion of women in practice rose. Industry support of women, with increases in compensation and roles as speakers, consultants, and educators, offers a potential strategy to combat implicit bias within CT surgery.

4.
Artigo em Inglês | MEDLINE | ID: mdl-39004344

RESUMO

We present the case of a 23-year-old man with a complex psychiatric history who was transferred from a community hospital for management of agitation and severe thrombocytopenia. Experts in consultation-liaison psychiatry deconstruct the consultation question in this case. The importance of addressing superficial and hidden aspects of a consultation are reviewed via the concepts of explicit, implicit, and tacit consultation questions.

5.
Philos Trans A Math Phys Eng Sci ; 382(2277): 20230295, 2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39005012

RESUMO

This study examines a class of time-dependent constitutive equations used to describe viscoelastic materials under creep in solid mechanics. In nonlinear elasticity, the strain response to the applied stress is expressed via an implicit graph allowing multi-valued functions. For coercive and maximal monotone graphs, the existence of a solution to the quasi-static viscoelastic problem is proven by applying the Browder-Minty fixed point theorem. Moreover, for quasi-linear viscoelastic problems, the solution is constructed as a semi-analytic formula. The inverse viscoelastic problem is represented by identification of a design variable from non-smooth measurements. A non-empty set of optimal variables is obtained based on the compactness argument by applying Tikhonov regularization in the space of bounded measures and deformations. Furthermore, an illustrative example is given for the inverse problem of isotropic kernel identification. This article is part of the theme issue 'Non-smooth variational problems with applications in mechanics'.

6.
Psychol Health ; : 1-23, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38946132

RESUMO

OBJECTIVE: In high-income countries, people with low socio-economic status (SES) engage in less leisure-time physical activity (PA) than those with higher SES. Beyond a materialistic account of this difference, the role of motivational precursors-among which attitudes are emblematic-remains poorly understood, particularly when it comes to dissociating the automatic vs. deliberative components of attitudes. This pre-registered study aimed to examine the associations between SES (i.e. income and educational attainment) and motivational precursors of PA (i.e. explicit and implicit attitudes), and whether gender and age may moderate these relationships. METHOD: We used data from 970 adults (64% of women; mean age = 33 ± 12 years) from the Attitudes, Identities, and Individual Differences (AIID) study. RESULTS: Results of multiple linear regression analyses showed that participants with the highest level of income (>150,000$ per year) reported more positive explicit and implicit attitudes towards PA than those with lower income. Exploratory analysis further showed that women reported weaker explicit attitudes towards PA, while both explicit and implicit attitudes towards PA became weaker at age increases. In contrast, educational attainment was not significantly associated with those attitudes, and there was only mixed evidence for a moderating role of participants' gender on the pattern of associations. CONCLUSION: Our findings suggest that both the explicit and implicit attitudes towards PA may be socially patterned. Future intervention studies should examine whether these attitudinal differences could be reduced, and whether such a reduction could help buffer the unequal participation in PA behaviors across social groups.

7.
Front Psychol ; 15: 1355213, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38993339

RESUMO

Introduction: Across various cultural contexts, success in goal realization relates to individuals' well-being. Moreover, commitment to and successful pursuance of goals are crucial when searching for a meaningful identity in adolescence. However, individuals' goals differ in how much they match their implicit motive dispositions. We hypothesized that successful pursuance of affiliation goals positively relates to commitment-related dimensions of interpersonal identity development (domain: close friends) that, in turn, predict adolescents' level of well-being. However, we further assumed that the links between goal success and identity commitment are particularly pronounced among adolescents who are characterized by a high implicit affiliation motive. Methods: To scrutinize the generalizability of the assumed relationships, data were assessed among adolescents in individualistic (Germany) and collectivistic (Zambia) cultural contexts. Results: Regardless of adolescents' cultural background, we found that commitment-related dimensions of interpersonal identity development mediate the link between successful attainment of affiliation goals and well-being, particularly among adolescents with a pronounced implicit affiliation motive; that is, the strength of the implicit affiliation motive moderates the association between goal success and identity commitment. Conclusion: We discuss findings concerning universal effects of implicit motives on identity commitment and well-being.

8.
Health Equity ; 8(1): 351-354, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39011081

RESUMO

There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient's point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.

9.
Nurs Crit Care ; 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39011651

RESUMO

BACKGROUND: Implicit rationing of nursing care is defined as the withholding of necessary nursing measures for patients because of a lack of nursing resources. However, no studies have explored the experience of decision-making about implicit rationing of nursing care in an intensive care unit (ICU). AIM: To explore the process of ICU nurses' decisions and judgement based on the conceptual framework of implicit rationing of nursing care. STUDY DESIGN: A qualitative study was undertaken between June 2020 and September 2020. The data collection methods were participative observation and interview. Eighteen ICU nurses participated in interviews. A thematic analysis was performed for the data analysis. RESULTS: The following five themes emerged: assessment of the condition and nature of nursing and time taken; strategies for setting personal priorities; plan implementation under mitigation strategy; existing nursing in reality; evaluation of the implementation of implicit rationing care. Nurses choose different strategies during plan implementation. CONCLUSIONS: In the absence of explicit guidelines on rationing nursing care, nurses often rely on intuitive and situational decision-making processes for setting priorities. Given the vulnerability of ICU patients and the absence of family caregivers, nurses bear a heightened ethical responsibility to provide care. Establishing a positive nursing culture is essential. It is both reasonable and effective to organize work by accurately quantifying workload, improving staffing levels and optimizing scheduling methods. These themes align with the decision-making process outlined in the conceptual framework and offer fresh perspectives. RELEVANCE TO CLINICAL PRACTICE: Nurses have a greater responsibility to provide care in an ethical manner and to increase awareness of the importance of holistic nursing care for the patient, that is to raise awareness of the importance of care that is often missed. Nurses actively adopt strategies to reduce implicit rationing of nursing care, including teamwork, organized nursing, working overtime and ignoring quality. The findings highlight the importance of creating a positive nursing culture that encourages nurses to adopt positive strategies.

10.
Front Comput Neurosci ; 18: 1387077, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38966128

RESUMO

Adversarial attacks are still a significant challenge for neural networks. Recent efforts have shown that adversarial perturbations typically contain high-frequency features, but the root cause of this phenomenon remains unknown. Inspired by theoretical work on linear convolutional models, we hypothesize that translational symmetry in convolutional operations together with localized kernels implicitly bias the learning of high-frequency features, and that this is one of the main causes of high frequency adversarial examples. To test this hypothesis, we analyzed the impact of different choices of linear and non-linear architectures on the implicit bias of the learned features and adversarial perturbations, in spatial and frequency domains. We find that, independently of the training dataset, convolutional operations have higher frequency adversarial attacks compared to other architectural parameterizations, and that this phenomenon is exacerbated with stronger locality of the kernel (kernel size) end depth of the model. The explanation for the kernel size dependence involves the Fourier Uncertainty Principle: a spatially-limited filter (local kernel in the space domain) cannot also be frequency-limited (local in the frequency domain). Using larger convolution kernel sizes or avoiding convolutions (e.g., by using Vision Transformers or MLP-style architectures) significantly reduces this high-frequency bias. Looking forward, our work strongly suggests that understanding and controlling the implicit bias of architectures will be essential for achieving adversarial robustness.

11.
Front Psychol ; 15: 1353271, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38966737

RESUMO

Studies documenting and seeking to understand the mindset effect have yielded mixed and inconclusive findings. The present study sought to address the research question pertaining to the mindset effect on creative thinking and its underlying mechanism from the perspectives of social cognitive theory and mindset theory, which postulate a motivational mechanism underlying the mindset-creativity link. Specifically, this study aimed to examine the mediating role of creativity motivation in the effects of growth and fixed creative mindsets on creative thinking. A convenience sample of 948 college students from three universities in Hong Kong participated in the study. Creative mindset, creativity motivation, and creative thinking were assessed using the Chinese version of the Creative Mindset Scale, the Creativity Motivation Scale, and the Test for Creative Thinking-Drawing Production (TCT-DP), respectively. Lending support to the perspectives of social cognitive and mindset theories, the results of mediation analyses conducted using Preacher and Hayes's bootstrapping approach indicated that creativity motivation had partial mediating effects on the positive and negative roles of growth and fixed mindsets, respectively, in creative thinking. Enriching the research on the motivation mechanism underlying the impacts of creative mindsets on creative thinking, the results further illustrated that creativity motivation has a stronger mediating effect on the impact of growth creative mindset on creative thinking than on that of fixed creative mindset. The possible theoretical and educational implications of the findings of this research are discussed.

12.
Front Psychol ; 15: 1346029, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38952830

RESUMO

This article explores the implicit self-concept pertaining to psychopathy. Two online studies showed inconsistent results, with Study 1 (n = 243) suggesting that psychopathy is linked to an implicit self-concept marked by low empathy and Study 2 (n = 230) implying no such relationship. In a sample of offenders and community controls (Study 3a, n = 166), higher scores on the Psychopathy Checklist-Revised (PCL-R) were related to an implicit self-concept of being less rather than more antisocial, and the implicit self-concept showed incremental validity compared to the explicit self-concept. The retesting of an offender subsample (Study 3b, n = 47) yielded no evidence for temporal stability or convergent validity. The implicit self-concept of highly psychopathic individuals thus appears to vary, depending on the social context. Future studies should replicate these results in different samples, using additional external correlates.

13.
Proc Natl Acad Sci U S A ; 121(28): e2320870121, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38959033

RESUMO

Efficient storage and sharing of massive biomedical data would open up their wide accessibility to different institutions and disciplines. However, compressors tailored for natural photos/videos are rapidly limited for biomedical data, while emerging deep learning-based methods demand huge training data and are difficult to generalize. Here, we propose to conduct Biomedical data compRession with Implicit nEural Function (BRIEF) by representing the target data with compact neural networks, which are data specific and thus have no generalization issues. Benefiting from the strong representation capability of implicit neural function, BRIEF achieves 2[Formula: see text]3 orders of magnitude compression on diverse biomedical data at significantly higher fidelity than existing techniques. Besides, BRIEF is of consistent performance across the whole data volume, and supports customized spatially varying fidelity. BRIEF's multifold advantageous features also serve reliable downstream tasks at low bandwidth. Our approach will facilitate low-bandwidth data sharing and promote collaboration and progress in the biomedical field.


Assuntos
Disseminação de Informação , Redes Neurais de Computação , Humanos , Disseminação de Informação/métodos , Compressão de Dados/métodos , Aprendizado Profundo , Pesquisa Biomédica/métodos
14.
Int J Equity Health ; 23(1): 132, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951888

RESUMO

BACKGROUND: An array of evidence shows how the presence of implicit bias in clinical encounters can negatively impact provider-patient communication, quality of care and ultimately contribute to health inequities. Reflexive practice has been explored as an approach to identify and address implicit bias in healthcare providers, including medical students. At the Lausanne School of Medicine, a clinically integrated module was introduced in 2019 to raise students' awareness of gender bias in medical practice using a reflexivity and positionality approach. The purpose of this study is to describe the gender bias that were identified by medical students, analysing their types, places and modes of emergence during a clinical encounter. It further explores how positionality supported students' reflection on the way in which social position modulates their relationship to patients. METHODS: As part of the teaching activity, medical students individually reflected on gender bias in a specific clinical encounter by answering questions in their electronic portfolio. The questionnaire included a section on positionality. We qualitatively analysed the students' assignments (n=76), applying a thematic analysis framework. RESULTS: Medical students identified and described gender biases occurring at different moments of the clinical encounter (anamnesis (i.e. patient history), physical exam, differential diagnosis, final management). They causally associated these biases with wider social phenomena such as the gendered division of labour or stereotypes around sexuality and gender. Analysing students' reflections on how their position influenced their relationship with patients, we found that the suggested exercise revealed a major contradiction in the process of medical enculturation: the injunction to be neutral and objective erases the social and cultural context of patients and impedes an understanding of gender bias. CONCLUSION: Gender biases are present in the different steps of a clinical consultation and are rooted in broader gendered social representations. We further conclude that the tension between a quest for objectivity and the reality of social encounters should be made explicit to students, because it is constitutive of medical practice.


Assuntos
Sexismo , Estudantes de Medicina , Humanos , Sexismo/psicologia , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Masculino , Feminino , Suíça , Inquéritos e Questionários , Relações Médico-Paciente , Universidades , Adulto , Comunicação
15.
Environ Res ; : 119573, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38972339

RESUMO

The beneficial effects of nature exposure have been repeatedly documented and encourage frequent and regular contact with nature and especially highlight forests. However, in human history, forests have also been associated with negative emotions such as fear and were seen as dangerous environments. While existing literature could demonstrate that natural environments can evoke fear, the focus was on the explicit perception. Given that research has shown the significance of additional implicit processes in fear-related behaviour, we aim to explore the presence of an implicit fear response to forests. Therefore, in an online study, we investigated the explicit and implicit fear reactions to forests by a Northern German sample of N=256. Using three explicit measurements, we investigated fear and danger perception on a semantic and visual level of the stimulus category "forest" compared to the human-made urban green space "park" and the urban setting "house". Additionally, we assessed the unconscious response tendencies towards the forest within three implicit tasks: Subliminal Priming Procedure (SPP), Affect Misattribution Procedure (AMP) and Approach-Avoidance Task (AAT). Within the analyzed sample, the subliminally presented word forest evoked a stronger positive valence response compared to park. In contrast to houses, the forest showed a stronger approach and weaker avoidance tendency. At the same time, both the three explicit and one implicit measurement showed a stronger fear perception of forests compared to parks or houses. Considering the increasingly utilised beneficial effects of nature in interventions, these findings should be acknowledged when implementing nature exposure in interventions and treatments.

16.
J Fluency Disord ; 81: 106073, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38971016

RESUMO

PURPOSE: The Public Opinion Survey of Human Attributes - Stuttering (POSHA-S, St. Louis, 2013) was developed as a standard measure of public attitudes about people who stutter. As with any survey-based methods, threats to validity may occur because of social desirability bias. Using computer mouse-tracking, we were interested in observing changes in cognition that are manifested in intentionality through action by evaluating underlying cognitive processes that drive social judgments of people who stutter. METHODS: Twenty-two women, 1 non-binary person, and 47 men reported using a computer mouse to complete an online, remote, and modified version of the POSHA-S. Responses were categorized as correct/helpful or incorrect/unhelpful relative to each component of the POSHA-S and were used as measures of explicit cognitive processes. Computer-mouse trajectory metrics, including area under the curve (AUC) and reaction time (RT), were used to measure implicit cognitive processes. RESULTS: Although participants' explicit responses were significantly more likely to be correct/helpful than incorrect/unhelpful, with endorsement of correct/helpful prompts 77 % of the time, participants also endorsed incorrect/unhelpful prompts more than half (i.e., 52 %) of the time. Familiarity with people who stutter was associated with disagreeing with incorrect/unhelpful prompts. As indicated by greater AUC, participants exhibited significantly more implicit cognitive processes indicating competition when responding "disagree" compared to "agree", regardless of whether the prompts were correct/helpful or incorrect/unhelpful. Similarly, participants took significantly longer to respond to prompts with "disagree" rather than "agree". CONCLUSION: The findings of this study offer evidence of participants reporting cognitive processes that are overall more correct/helpful than incorrect/unhelpful, in their explicit responses to the dichotomous response tasks of the POSHA-S. However, these findings are tempered by evidence of a tendency to agree with statements in the measure and suggest the need for further research to increase understanding of how to measure and improve explicit and implicit cognitive processes related to people who stutter.

17.
Am J Surg ; : 115834, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38991911

RESUMO

BACKGROUND: Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors. METHODS: We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys. RESULTS: Access and bias were related to surgical complications in 14 â€‹% of cases. 97 â€‹% reported enhanced M&M presentations with the grading system, and 47 â€‹% reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues. CONCLUSIONS: Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.

18.
Sci Rep ; 14(1): 16068, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992163

RESUMO

Impressions of trustworthiness are formed quickly from faces. To what extent are these impressions shared among observers of the same or different races? Although high consensus of trustworthiness evaluation has been consistently reported, recent studies suggested substantial individual differences. For instance, negative implicit racial bias and low contact experience towards individuals of the other race have been shown to be related to low trustworthiness judgments for other-race faces. This pre-registered study further examined the effects of implicit social bias and experience on trustworthiness judgments of other-race faces. A relatively large sample of White (N = 338) and Black (N = 299) participants completed three tasks: a trustworthiness rating task of faces, a race implicit association test, and a questionnaire of experience. Each participant rated trustworthiness of 100 White faces and 100 Black faces. We found that the overall trustworthiness ratings for other-race faces were influenced by both implicit bias and experience with individuals of the other-race. Nonetheless, when comparing to the own-race baseline ratings, high correlations were observed for the relative differences in trustworthiness ratings of other-race faces for participants with varied levels of implicit bias and experience. These results suggest differential impact of social concepts (e.g., implicit bias, experience) vs. instinct (e.g., decision of approach-vs-avoid) on trustworthiness impressions, as revealed by overall vs. relative ratings on other-race faces.


Assuntos
Julgamento , Confiança , Humanos , Masculino , Feminino , Confiança/psicologia , Adulto , Adulto Jovem , Racismo/psicologia , População Branca/psicologia , Adolescente , Reconhecimento Facial , Grupos Raciais/psicologia , Percepção Social , Face , Inquéritos e Questionários
19.
Heliyon ; 10(12): e32842, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38975112

RESUMO

Background: A good physician should be empathic and altruistic, among other qualities. Therefore, the levels of socially undesirable personality traits (Dark Triad) as well as implicit motives of achievement, affiliation and power (Multi-Motive Grid) among medical students as future physicians were analyzed at two different points in their medical training. Methods: This study includes 380 medical students in their first year and 217 in their third year in Germany. All participants completed the Dirty Dozen (DD) and Multi-Motive Grid (MMG) questionnaires at the end of two different classes as paper-and-pencil tests. Relevant differences of the Dark Triad traits between the medical students and reference sample and the two different cohorts, as well as their implicit motives, the associations of Dark Triad traits and MMG components and gender differences of the Dark Triad traits were calculated. Results: There were no significant group differences between year one and year three medical students in narcissism, psychopathy and Machiavellianism (Dark Triad). There were no significant differences between the medical students and reference sample except in psychopathy. Male students scored significantly higher in the Dark Triad traits than female students. In the MMG, first-year students scored significantly higher levels in Fear of Rejection, and lower levels in Hope of Success and Hope of Power than the third-year students. Some associations were found between narcissism and Machiavelliansim with Hope of Success, Hope of Power and Fear of power. Conclusions: Dark Triad traits already appear to exist before the commencement of medical studies. These traits do not differ significantly between the medical students and reference sample; only a few MMG components seem to differ at different stages of their studies. This lack of differences between the medical students and validation cohort indicates that tests based on (undesirable) personality traits are not suitable criteria for the admission selection of medical students.

20.
MedEdPORTAL ; 20: 11416, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38957531

RESUMO

Introduction: The influence of implicit biases in virtual interviews must be addressed to ensure equity within the admissions process. ABATE is a mnemonic framework of five specific categories of implicit bias (affinity-based, backdrop-based, appearance-based, technology and media-based, and enunciation-based biases) that should be anticipated and mitigated for faculty, staff, health professionals, and medical students who conduct virtual interviews at medical schools. Methods: A 60-minute workshop was developed to educate medical school admissions interviewers about the ABATE model and strategies to mitigate implicit bias during virtual interviews. Four workshops were held over 1 year totaling 217 individual attendees. The workshops were evaluated using a single-group, pre-post questionnaire designed with the Kirkpatrick evaluation model. Results: Attendees reported that they found the ABATE workshop useful and relevant to improving their ability to minimize implicit bias during virtual interviews. Significant improvements were found in attendee reactions to the utility of implicit bias training (M pre = 2.6, M post = 3.1, p = .002). Significant changes were also reported in attendees' attitudes about interviewing confidence (M pre = 3.0, M post = 3.2, p = .04), bias awareness (M pre = 3.0, M post = 3.4, p = .002), and identifying and applying bias mitigation solutions (M pre = 2.5, M post = 3.0, p = .003). Knowledge specific to backdrop-based biases also significantly increased (M pre = 3.2, M post = 3.4, p = .04). Discussion: The ABATE workshop demonstrates promise in mitigating implicit bias in virtual medical school interviews.


Assuntos
Entrevistas como Assunto , Faculdades de Medicina , Humanos , Entrevistas como Assunto/métodos , Inquéritos e Questionários , Critérios de Admissão Escolar , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Viés , Educação/métodos , Masculino , Feminino
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