Peer Relationships and Indonesian Muslim Adolescents' Religiosity and Religious Coping: Selection and Influence.

The religious similarity of adolescents and their friends can arise from selection or influence. Prior studies were limited because of confounds that arose from the ethnic and religious heterogeneity of the samples and the use of cross-sectional designs. SIENA was used in this two-year longitudinal study of 825 Indonesian Muslim high school students (445 girls; mean age = 16.5 years) to assess peer selection and influence as these pertained to religiosity and religious coping. The analyses yielded significant influence but not selection effects for both religiosity and religious coping. This study is an important methodological advance over prior research and although limited by correlational data, nevertheless, provides evidence that adolescents influence their peers' religiousness.

Religiosity and Effortful Control as Predictors of Indonesian Adolescents' Tobacco and Alcohol Use: Moderation and Mediation.

Moderation and mediation models of religiosity and effortful control as predictors of tobacco and alcohol use were tested in this 2-year longitudinal study of 563 16-year-old Muslim Indonesian adolescents. Adolescents reported their effortful control, religiosity, and tobacco and alcohol use and peers provided reports of adolescents' effortful control. Although both moderation and mediation effects emerged when predicting Year 2 substance use, predictions of change from Year 1 to Year 2 substance use yielded effects of moderation for peer- but not self-reported effortful control for boys; no mediation effects emerged. These findings provide evidence of interconnections between effortful control and religiosity as predictors of substance use and suggest the need for further longitudinal studies that compare moderation and mediation models.

Trajectories of Indonesian adolescents' religiosity, problem behavior, and friends' religiosity: covariation and sequences.

Changes in religiosity, problem behavior, and their friends' religiosity over a 2-year period were assessed in a sample of five hundred and fifty-nine 15-year-old Indonesian Muslim adolescents. Adolescents self-reported their religiosity, problem behavior, and friendships; the religiosity of mutual friends came from friends' self-reports. A parallel process analysis of growth curves showed that adolescents' religiosity trajectories covaried with both problem behavior and friends' religiosity. Using a cross-lagged model in which prior levels were controlled, religiosity at 10th and 11th grades predicted friends' religiosity 1 year later, suggesting that adolescents select friends of similar religiosity. This study provides evidence that religion is intertwined with other aspects of adolescent development and illustrates the importance of contextualizing adolescent religiosity within an ecological framework.

Perception of threat and national identity: Investigation of the mediating role of collective self esteem.

This article examines whether perceived threat can predict national identity mediated by collective self-esteem in the context of students in Indonesia. The notion of national identity can be described as an individual's attachment to a country. The strength of the bond between national identity and its individuals has an impact on raising collective self-esteem. This article shows that national identity is latent, as it can emerge and be self-reinforced when stimulated by a perceived threat. The connection between the perception of threat and national identity is indirect but mediated by collective self-esteem. This study involved 504 students from 49 universities in Indonesia. The samples of the research were obtained by using convenience sampling. The Lisrell 8.7 program was used to conduct this study's entire data analysis process. The analysis showed that the perception of threat affects the national identity, which was mediated by collective self-esteem. From the result above, collective self-esteem is influential as the mediator variable. Additionally, the impact of the perception of the threat on national identity can indicate collective self-esteem. People who perceive social phenomena in their environment will strengthen ties to the nation but this correlation is affected by the strengh of collective self-esteem.

Tobacco and Alcohol Use by Muslim Indonesian Adolescents: Longitudinal Associations With Religiosity and Problem Behavior.

OBJECTIVE: This three-wave (10th to 12th grade) longitudinal study explored the interrelations of religiosity, tobacco and alcohol use, and problem behavior in Indonesian Muslim adolescents. METHOD: The sample included 721 Muslim Indonesian adolescents (48% girls) who participated in at least one assessment when they were in 10th, 11th, or 12th grade. Of these, 499 were recruited in 10th grade, with others added at 11th and 12th grades. RESULTS: Prior month use for 10th-grade boys and girls, respectively, was 49.2% and 5.2% for tobacco and 19.0% and 3.6% for alcohol. Tobacco use and alcohol use were negatively associated with religiosity for boys, but these associations were more inconsistent for girls. Consistent with U.S. findings, there was a bidirectional longitudinal association between tobacco and alcohol use. The longitudinal models and associations with problem behavior were similar for both sexes. CONCLUSIONS: These results provide evidence of negative longitudinal associations between religiosity and tobacco use. The more frequent use of tobacco than alcohol may be attributable to religion, cost differentials, and social norms. Despite large gender differences in the frequencies of use, the similar predictors of tobacco and alcohol use for boys and girls suggest that models accounting for substance use are comparable for both sexes. These results have implications for the design of prevention programs in Indonesia and other culturally and religiously similar countries.

Friendship and the religiosity of Indonesian Muslim adolescents.

Adolescents' religious involvement occurs within a social context, an understudied aspect of which is relationships with peers. This longitudinal study assessed changes in religiosity over 1 year and explored the extent to which these were associated with their friends' religiosity and problem behavior. The first year sample included 1,010 (52.5% female) Muslim 13 and 15 year old Indonesian adolescents; 890 of these were assessed 1 year later. Adolescents were similar to their friends in religiosity. Changes in religiosity from year one to two were associated with friends' religiosity such that adolescents with religious friends were more religious at year two than those with less religious friends. Reductions in religiosity were also associated with the presence of problem behavior, consistent with the inverse relationship between these. Peers may play an important role in the development of adolescent religiousness and exploring these influences deserves further study.

The relations of majority-minority group status and having an other-religion friend to Indonesian youths' socioemotional functioning.

In this study, the authors examined the relations of Indonesian adolescents' socioemotional functioning to their majority-minority status and the presence of cross-religion friendships and whether sex moderated these relations. At Time 1, 1,254 7th graders and their peers in Bandung, Indonesia, reported on their friendships, prosocial behavior, and peer likability; months later, a selected sample of 250 youths and their teachers and parents rated the youths' social functioning and (mal)adjustment. When controlling for socioeconomic status and initial sociometric status, girls were generally higher in measures of adjustment, whereas majority children were lower in externalizing problems and, for boys, loneliness. For minority children's social competence and prosocial behavior at school, there was evidence of a buffering effect of having a cross-religion friend.

Religious involvement and the social competence and adjustment of Indonesian Muslim adolescents.

This study assessed the relation between religious involvement and multiple indices of competence in 183 eighth- and ninth-grade Indonesian Muslim adolescents (M = 13.3 years). The authors assessed spirituality and religiosity using both parent and adolescent reports, and social competence and adjustment using multiple measures and data sources. Structural equation modeling analyses revealed that parent and adolescent reports of religiosity and spirituality yielded a single religious involvement latent variable that was related to peer group status, academic achievement, emotional regulation, prosocial behavior, antisocial/problem behavior, internalizing behavior, and self-esteem. The consistency of relations between religious involvement and competence may be in part attributable to the collectivist context of religion in West Java, Indonesia, within which people exhibit strong beliefs in Islam and religion permeates daily life.

Teaching the medical interview: methods and key learning issues in a faculty development course.

OBJECTIVE: To describe the American Academy on Communication in Healthcare's (AACH) Faculty Development Course on Teaching the Medical Interview and report a single year's outcomes. DESIGN: We delivered a Faculty Development course on Teaching the Medical Interview whose theme was relationship-centered care to a national and international audience in 1999. Participants completed a retrospective pre-post assessment of their perceived confidence in performing interview, clinical, teaching, and self-awareness skills. PARTICIPANTS AND SETTING: A total of 79 participants in the 17th annual AACH national faculty development course at the University of Massachusetts Medical School in June 1999. INTERVENTION: A 5-day course utilized the principles of learner-centered learning to teach a national and international cohort of medical school faculty about teaching the medical interview. MEASUREMENTS AND MAIN RESULTS: The course fostered individualized, self-directed learning for participants, under the guidance of AACH faculty. Teaching methods included a plenary session, small groups, workshops, and project groups all designed to aid in the achievement of individual learning goals. Course outcomes of retrospective self-assessed confidence in interview, clinical, teaching, self-awareness, and control variables were measured using a 7-point Likert scale. Participants reported improved confidence in interview, clinical, teaching, and self-awareness variables. After controlling for desirability bias as measured by control variables, only teaching and self-awareness mean change scores were statistically significant (p < .001). CONCLUSIONS: The AACH Faculty Development course on Teaching the Medical Interview utilized learner-centered teaching methods important to insure learning with experienced course participants. Perceived teaching and self-awareness skills changed the most when compared to other skills.

Tracking the longitudinal stability of medical students' perceptions using the AAMC graduation questionnaire and serial evaluation surveys.

BACKGROUND: This study examined the longitudinal stability of students' perceptions by comparing ratings on similar survey items in three sequential evaluations: end-of-clerkship (EOC), AAMC graduation questionnaire (GQ), and a postgraduate survey (PGY1). METHOD: For the classes of 2000 and 2001, ratings were compiled from EOC evaluations and comparable items from the GQ. For both cohorts, selected GQ items were included in the PGY1 survey and these ratings were compiled. Matched responses from EOC versus GQ and PGY1 versus GQ were compared. RESULTS: Proportions of "excellent" ratings were consistent across EOC and GQ surveys for all clerkships. Comparison of GQ and PGY1 ratings revealed significant differences in only seven of 31 items. CONCLUSION: Student perceptions as measured by GQ ratings are notably consistent across the clinical years and internship. This longitudinal stability supports the usefulness of the GQ in programmatic assessment and reinforces its value as a measure of student satisfaction.

Managed care education: what medical students are telling us.

PURPOSE: To examine graduating medical students' perceptions of the adequacy of instruction in managed care and in 11 curricular content areas identified by experts as a necessary part of managed care education. This study sought to determine whether medical students perceived these content areas as relevant to managed care and to evaluate the extent to which students' perceptions of the adequacy of instruction varied as a function of managed care penetration in the locations of their respective medical schools. METHOD: Data from the Association of American Medical Colleges' 1999 Medical School Graduation Questionnaire (GQ) were analyzed. Students' ratings of adequacy of instruction were summarized. Correlations between ratings of instruction in managed care and 11 related content areas were calculated, as well as correlations between managed care penetration in the locations of the students' schools and the proportion of students rating instruction as inadequate. RESULTS: A majority of 1999 medical school graduates (60%) rated instruction in managed care as inadequate; other content areas to which majorities of graduates gave inadequate ratings were practice management (72%), quality assurance (57%), medical care cost control (57%), and cost-effective medical practice (56%). Ratings in these four content areas were highly correlated with ratings of instruction in managed care. The correlation between managed care penetration and rating of instruction in managed care was statistically significant (r = -.37); correlations between managed care penetration and instruction in the other content areas were not. CONCLUSIONS: On the 1999 GQ, a majority of medical students responded that they felt they had not received adequate instruction in managed care. Further, the responses suggest that these medical students defined managed care in terms of managing costs, rather than managing health care, or developing population-based approaches to the delivery of health care.

Parent-adolescent relationships, religiosity, and the social adjustment of Indonesian Muslim adolescents.

Parent-adolescent relationships invariably occur within a complex cultural context that in some populations include strong religious influences. Using data from multiple sources that were analyzed using structural equation modeling, we found that parental warmth and parental religiosity predicted adolescent religiosity in a sample of 296 Indonesian 15-year-old adolescents. The significant interaction of parental warmth and parent religiosity indicated that parental warmth moderated the relation between parent religiosity and adolescent religiosity. We expanded this model to predict externalizing and prosocial behavior where direct paths from adolescent religiosity to outcomes were significant for prosocial but not antisocial behavior; parental warmth, parent religiosity, and their interaction did not predict either outcome. Adolescent religiosity was found to be a mediator of these relations between predictor and outcomes for prosocial but not antisocial behavior. These results suggest that, in Indonesia and perhaps other highly religious cultures, parent-adolescent relationships and social competence may be interconnected with religion.

Indonesian adolescents' spiritual and religious experiences and their longitudinal relations with socioemotional functioning.

The spirituality and religiosity of Indonesian Muslim adolescents were examined longitudinally as were the relations of spirituality and religiosity with (mal)adjustment. At Time 1 (T1), 959 seventh-grade Muslim adolescents were screened for selection of a sample; at Time 2 (T2), 183 eighth-grade adolescents participated; and at Time 3 (T3), 300 ninth-grade adolescents (164 new participants) participated. At T1, adolescents' peer likeability was assessed; at T2, adolescents' global and cognitive esteem were measured; and at T2 and T3, adolescents' (mal)adjustment, spirituality, and religiosity were assessed. Adolescents and parents rated aspects of (mal)adjustment, spirituality, and religiosity. Teachers also rated adolescents' (mal)adjustment. In general, we found that T2 spirituality and religiosity were positively related to T3 adjustment and negatively related to T3 maladjustment, although in panel models, support for prediction of outcomes from spirituality and religiosity was found only for loneliness and socially appropriate behavior. In addition, there was some evidence in the models that certain aspects of (mal)adjustment (self-esteem and social competence, and to a marginal degree, parent-rated internalizing problems and teacher-rated prosociality) predicted spirituality and religiosity longitudinally.

Obtaining patient permission for student participation in obstetric-gynecologic outpatient visits: a randomized controlled trial.

OBJECTIVES: Our purpose was to compare a scripted verbal query with a detailed written permission slip in obtaining patient satisfaction and permission for student involvement in outpatient obstetrics-gynecologic visits. STUDY DESIGN: A prospective, randomized, controlled study was performed using a questionnaire to compare current practice to the study groups. The chi(2) test was used to calculate P values; P<.05 was considered significant. RESULTS: Patient demographics and satisfaction were similar among the three groups: 86% of controls and 79% of study groups agreed to student participation (P=.056). All preferred having the nurse ask permission (86% vs 86%) versus the physician (34% vs 25%) or the student (6% vs 3%). Permission was independent of student gender, visit purpose, or previous exposure to students. CONCLUSION: Patients want a nonphysician to ask permission for student participation independent of method of request, visit purpose, student gender, or previous experience with students. Physician or student requests for consent may unduly influence participation.