The impact of a nutrition course on self-epistemic authority, professional meaning as mediating factors on professional identity among nursing students.

BACKGROUND: The professional competence of nursing personnel is integral to the efficacy of nursing procedures. Educational endeavors, especially those encompassing professional training programs, are critical in fostering a professional identity among nurses. The role of nurses within a multi-disciplinary nutrition team has the potential to enhance professional identity and improve the quality of care provided. OBJECTIVE: This study aimed to explore the potential impact of knowledge acquisition and practical nutrition education on the development of professional identity among nursing school students. Furthermore, we hypothesize that professional autonomy and self-epistemic authority mediated the relationship between a sense of meaning, professional mission, and professional identity. DESIGN: A cross-sectional survey compared nursing students who had completed a practical nutrition course with those who had not. The study measured professional identity, professional autonomy, self-epistemic authority, and sense of meaning. Data collection was conducted using validated questionnaires, with questions tailored to suit the study demographic. Mediation analysis was conducted on the combined sample of both groups. PARTICIPANTS: The study included 98 nursing students, divided into a study group (57 students who completed a nutrition course) and a control group (41 students who did not complete the course). RESULTS: Significant differences were found between the groups in measures of professional identity (t = 3.42, p < .001), professional autonomy (t = 2.93, p < .005), and self-epistemic authority (t = 2.78, p < .007). There was no significant difference in the sense of meaning (t = 1.45, p = .150). Mediation analysis on the combined sample revealed that self-epistemic authority mediated the relationship between professional meaning and professional identity, while professional autonomy did not. CONCLUSION: The findings suggest that practical nutrition education enhances nursing students' professional identity, autonomy, and self-epistemic authority. Future studies should include larger and more diverse samples to further explore these relationships.

What Does That Mean? Complementizers and Epistemic Authority.

A core goal of research in language is to understand the factors that guide choice of linguistic form where more than one option is syntactically well-formed. We discuss one case of optionality that has generated longstanding discussion: the choice of either using or dropping the English complementizer that in sentences like I think (that) the cat followed the dog. Existing psycholinguistic analyses tie that-usage to production pressures associated with sentence planning (Ferreira & Dell, 2000), avoidance of ambiguity (Hawkins, 2004), and relative information density (Jaeger, 2010). Building on observations from cross-linguistic fieldwork, we present a novel proposal in which English that can serve to mark a speaker's "epistemic authority" over the information packaged within the embedded clause; that is, it indicates that the speaker has more knowledge of the embedded proposition compared with their addressee and thus has a perspective that they believe their addressee doesn't share. Testing this proposal with a forced-choice task and a series of corpus surveys, we find that English that is keyed to the use of embedded speaker (first-person) subject pronouns and occurs in sentences containing newsworthy information. Our account of that-optionality takes into account why that is associated with both (i) a dense information signal and (ii) semantic-pragmatic content, as well as extending to cases of non-optionality in subject/sentence-initial clauses (e.g., *(That) the cat is following the dog, I already know) and fragment answers (e.g., What do you already know? *(That) the cat is following the dog), where that is required.

AI-driven decision support systems and epistemic reliance: a qualitative study on obstetricians' and midwives' perspectives on integrating AI-driven CTG into clinical decision making.

BACKGROUND: Given that AI-driven decision support systems (AI-DSS) are intended to assist in medical decision making, it is essential that clinicians are willing to incorporate AI-DSS into their practice. This study takes as a case study the use of AI-driven cardiotography (CTG), a type of AI-DSS, in the context of intrapartum care. Focusing on the perspectives of obstetricians and midwives regarding the ethical and trust-related issues of incorporating AI-driven tools in their practice, this paper explores the conditions that AI-driven CTG must fulfill for clinicians to feel justified in incorporating this assistive technology into their decision-making processes regarding interventions in labor. METHODS: This study is based on semi-structured interviews conducted online with eight obstetricians and five midwives based in England. Participants were asked about their current decision-making processes about when to intervene in labor, how AI-driven CTG might enhance or disrupt this process, and what it would take for them to trust this kind of technology. Interviews were transcribed verbatim and analyzed with thematic analysis. NVivo software was used to organize thematic codes that recurred in interviews to identify the issues that mattered most to participants. Topics and themes that were repeated across interviews were identified to form the basis of the analysis and conclusions of this paper. RESULTS: There were four major themes that emerged from our interviews with obstetricians and midwives regarding the conditions that AI-driven CTG must fulfill: (1) the importance of accurate and efficient risk assessments; (2) the capacity for personalization and individualized medicine; (3) the lack of significance regarding the type of institution that develops technology; and (4) the need for transparency in the development process. CONCLUSIONS: Accuracy, efficiency, personalization abilities, transparency, and clear evidence that it can improve outcomes are conditions that clinicians deem necessary for AI-DSS to meet in order to be considered reliable and therefore worthy of being incorporated into the decision-making process. Importantly, healthcare professionals considered themselves as the epistemic authorities in the clinical context and the bearers of responsibility for delivering appropriate care. Therefore, what mattered to them was being able to evaluate the reliability of AI-DSS on their own terms, and have confidence in implementing them in their practice.

Introduction to Special Issue: Geneses, organizations and transformations of psychiatric epidemiology.

Recent historiography has revealed a growing interest in the developments of psychiatric epidemiology. This volume aims to explicitly tackle the problem of transforming a diversity of knowledge into a structured scientific unit. Furthermore, it aims to answer this by bringing together historical studies that demonstrate how epistemic authority has led to the hierarchization of knowledge and the institutionalization of psychiatric epidemiology. Interdisciplinary research teams are traced back in history, and their organization is interrogated. Tracing the history of psychiatric epidemiology involves an exploration of disciplinary divisions of labour, such as how survey methods are based on theoretical frameworks, how research programmes are regulated with political and moral ideals, and how the wider public recognizes public health expertise.

Some problems with particularism.

Particularists maintain that conspiracy theories are to be assessed individually, while generalists hold that conspiracy theories may be assessed as a class. This paper seeks to clarify the nature and importance of the debate between particularism and generalism, while offering an argument for a version of generalism. I begin by considering three approaches to the definition of conspiracy theory, and offer reason to prefer an approach that defines conspiracy theories in opposition to the claims of epistemic authorities. I argue that particularists rely on an untenably broad definition of conspiracy theory. Then, I argue that particularism and its counterpart are best understood as constellations of theses, rather than a pair of incompatible theses. While some particularist theses are highly plausible, I argue that one important particularist thesis is false. The argument for this conclusion draws on the history of false conspiracy theories. I then defend this conclusion against a pair of potential objections.

Culture, context, and ethics in the therapeutic use of hallucinogens: Psychedelics as active super-placebos?

Following decades of prohibition and widespread concern about their mind-altering properties, there is increasing public, scholarly, and clinical interest in the therapeutic potential of psychedelic substances. Serotonergic substances in particular (DMT, psilocybin, and LSD) are now being tested as treatments for such ailments as depression, anxiety, and substance use disorder. This thematic issue of Transcultural Psychiatry presents articles that investigate the cultural assumptions, political dimensions, and clinical and ethical implications that arise from this renewed interest. After reviewing ongoing debates on therapeutic mechanisms of action and the importance of context, we argue that psychedelics can be conceptualized as "active super-placebos"-that is, substances that enhance ritual, symbolic, and interpersonal therapeutic processes by increasing suggestibility and the influence of extra-pharmacological, "non-specific" factors. Rather than simply freeing up habitual constraints on perception, the articles in this issue support the claim that psychedelic encounters typically entail processes of sense-making, crystallization of meaning, and enculturation into contextually mediated assumptive worlds (or ideologies) and behaviours that necessarily install novel constraints with potentially maladaptive consequences. We highlight the importance of clinical and epistemic integrity in the framing of psychedelic therapies. The importance of structuring and providing oversight for the therapeutic context raises difficult questions about the search for appropriate forms of epistemic authority that are at once respectful of the plural cultural origins of psychedelic rituals and mindful of best practices and standards in clinical care.

Nursing students' satisfaction with clinical placements: The contribution of role modeling, epistemic authority, and resilience-a cross- sectional study.

BACKGROUND: Clinical learning is an essential and irreplaceable component of nursing studies. Satisfaction with clinical placements may improve students' learning outcomes as well as their retention in nursing studies. Satisfaction with clinical placements has mostly been associated with environmental factors. The associations between students' satisfaction with clinical placement and students' resilience, clinical instructors' (CI) epistemic authority and perception as a role model have yet to be fully explored. OBJECTIVE: To explore the associations between students' satisfaction with clinical placement and resilience, as well as CI epistemic authority and perception as a role model. DESIGN AND METHODS: A cross-sectional survey design with a convenience sample of 131 Israeli nursing students in advanced years of studies, at a large university in central Israel. Data were collected through a self-administered structured questionnaire. RESULTS: Strong positive correlations were found between students' satisfaction with the clinical placement and their perception of the CI as an epistemic authority and as a role model. Additionally, strong positive correlations were also found between students' satisfaction with the clinical placements and the three sub-categories included in the perception of their CI as a role model (personal traits, clinical skills, and teaching skills). Resilience and CI's teaching skills explained 75.3% of students' satisfaction with their clinical placement. CONCLUSIONS: Nurse educators and CIs should be aware of their significant role in students' professional development and satisfaction with clinical placements. Special attention should be given to the refinement of clinical skills and teaching skills during CI training, along with deeper awareness of one's personal traits. CIs have the potential to be significant professional role models for their students, while enhancing students' resilience and promoting clinical competencies and quality care. These lead to higher student satisfaction and retention in studies as future nurses.

The Deception of Certainty: how Non-Interpretable Machine Learning Outcomes Challenge the Epistemic Authority of Physicians. A deliberative-relational Approach.

Developments in Machine Learning (ML) have attracted attention in a wide range of healthcare fields to improve medical practice and the benefit of patients. Particularly, this should be achieved by providing more or less automated decision recommendations to the treating physician. However, some hopes placed in ML for healthcare seem to be disappointed, at least in part, by a lack of transparency or traceability. Skepticism exists primarily in the fact that the physician, as the person responsible for diagnosis, therapy, and care, has no or insufficient insight into how such recommendations are reached. The following paper aims to make understandable the specificity of the deliberative model of a physician-patient relationship that has been achieved over decades. By outlining the (social-)epistemic and inherently normative relationship between physicians and patients, I want to show how this relationship might be altered by non-traceable ML recommendations. With respect to some healthcare decisions, such changes in deliberative practice may create normatively far-reaching challenges. Therefore, in the future, a differentiation of decision-making situations in healthcare with respect to the necessary depth of insight into the process of outcome generation seems essential.

Says Who? Credibility Effects in Self-Verification Strivings.

Research shows that people prefer self-consistent over self-discrepant feedback-the self-verification effect. It is not clear, however, whether the effect stems from striving for self-verification or from the preference for subjectively accurate information. We argue that people prefer self-verifying feedback because they find it to be more accurate than self-discrepant feedback. We thus experimentally manipulated feedback credibility by providing information on its source: a student (control condition) or an experienced psychologist (experimental condition). In line with our expectations, the results of two preregistered studies with 342 adults showed that people preferred self-verifying feedback only in the control condition. In the experimental condition, the effect disappeared (or reversed, in Study 1). Study 2 showed that individual differences in credibility (epistemic authority) ascribed to the self and to psychologists matter as well. These findings suggest that feedback credibility, rather than the desire for self-verification, often drives the self-verification effect.

Perceived Epistemic Authority (Source Credibility) of a TV Interviewer Moderates the Media Bias Effect Caused by His Nonverbal Behavior.

The Media Bias Effect (MBE) represents the biasing influence of the nonverbal behavior of a TV interviewer on viewers' impressions of the interviewee. In the MBE experiment, participants view a 4-min made-up political interview in which they are exposed only to the nonverbal behavior of the actors. The interviewer is friendly toward the politician in one experimental condition and hostile in the other. The interviewee was a confederate filmed in the same studio, and his clips are identical in the two conditions. This experiment was used successfully in a series of studies in several countries (Babad and Peer in J Nonverbal Behav 34(1):57-78, 2010. 10.1007/s10919-009-0078-x) and was administered in the present research. The present investigation focused on the interviewer's source credibility and its persuasive influence. The viewers filled out questionnaires about their impressions of both the interviewer and the interviewee. A component of "interviewer's authority" was derived in PCA, with substantial variance in viewers' impressions of the interviewer. In our design, we preferred the conception of Epistemic Authority (Kruglanski et al. in Adv Exp Soc Psychol 37:345-392, 2005)-based on viewers' subjective perceptions for deriving authority status-to the conventional design of source credibility studies, where dimensions of authority are pre-determined as independent variables. The results demonstrated that viewers who perceived the interviewer as an effective leader demonstrated a clear MBE and were susceptible to his influencing bias, but no bias effect was found for viewers who did not perceive the interviewer as an effective leader. Thus, Epistemic Authority (source credibility) moderated the Media Bias Effect.

Integrating Genomic Professional Skills Into Nursing Practice: Results From a Large Cohort of Israeli Nurses.

PURPOSE: To explore the association of genomic knowledge, self-epistemic authority (SEA; i.e., subjective perception of knowledge expertise), perceived importance of genomics in nursing, and the integration of genomic skills into nursing practice. DESIGN: A cross-sectional study of nurses working in pediatric, obstetric, and internal wards of two medical centers in Israel between February and October 2018. METHODS: Participants completed anonymous questionnaires about genomic knowledge, SEA, perceived importance of genomics, and the performance of genomic skills in nursing practice. Associations between variables were analyzed using Pearson correlations, and a hierarchical regression model was used to determine which variables explained the performance of genomic practices among participants. FINDINGS: Altogether 423 nurses participated in the study. The mean genomic knowledge was low (55.05 ± 14.82%). Nurses reported a low integration of genomic skills in their practice (M = 1.90, SD = 0.71), although their overall perceived importance of genomics was positive (M = 2.88, SD = 0.68). Positive correlations were found between SEA and the integration of genomic skills in nursing practice. Obstetric nurses had more genomic knowledge, more positive perceptions about genomics, and performed more genomic skills in their nursing practice. CONCLUSIONS: Although nurses realized the importance of genomics to their practice, and genomics is part of the Israeli nursing core curriculum, we found disappointingly low levels of knowledge and performance of genomic skills in nursing practice. CLINICAL RELEVANCE: The results call for action to establish ongoing education programs in genomics for nurses, which would lead to the inclusion of genomic skills into routine nursing practice, and prepare nurses for providing personalized medicine.

Performing 'the authoritative account': How the BBC's Horizon produces epistemic authority.

Viewers have often looked upon the BBC's science documentary strand, Horizon, as an authoritative source for scientific knowledge. Through interviews with the series' producers, this article examines the practices its producers perform to buttress their authority and generate the view that this show is itself a producer of knowledge, even while it is also televising and mediating science. Of particular note are references to science fiction to police boundaries between science and pseudoscience, and the use of original experimental trials to generate witnesses. These position Horizon as at least a node in the network of scientific knowledge production.

Perceptions of provider's epistemic authority in response to variant of uncertain significance-related recommendations.

Uncertain genetic information such as variants of uncertain significance (VUS) is often encountered by patients in clinical cancer genetic testing. Although healthcare providers facilitate patient's understanding of VUS-associated empirical risk and its medical implications, patients' understanding and perceptions of risk often differ and may be based on subjective evaluations such as their perception of provider's epistemic authority (EA). This study examines the hypothesis that individuals attribute greater EA to genetic counselors (GCs) (compared to gastrointestinal oncologists) and to providers who recommend more active VUS-related recommendations (compared to inactive). In a factorial experiment, 652 adult participants recruited on Amazon Mechanical Turk were block-randomized to read one of 10 different types of VUS-related scenarios in the context of colon cancer (5 recommendation types × 2 provider types). GCs were attributed higher EA than gastrointestinal oncologists (p = <.001). Active recommendations (comprehensive, check back, wrong) were attributed lower EA (M = 3.67, SD = 0.79) compared to the inactive (stand by, disregard) (M = 3.89, SD = 0.67) (p-value = <.001). The wrong recommendation was attributed lowest EA compared to the four correct recommendations (mean difference = -0.34, -0.45, -0.35, and -0.44, respectively; p = .002), which, when dropped from the analysis, showed no difference between the correct active and inactive recommendations (3.78 vs. 3.89, p = .095). The higher EA attributed to GCs is encouraging and possibly explained by increased public awareness of the genetic counseling profession. The lack of difference in EA attributed to various correct, yet incomplete forms of VUS-related recommendation indicates that individuals may be unaware of and thus completely rely on providers for complex medical topics like VUS. Communicating VUS-related uncertainty warrants caution and further research to elucidate best practices and outcomes.

'That proves my point': How mediums reconstrue disconfirmation in medium-sitter interactions.

Previous research has examined how the talk of mediums attends to the epistemological status of their readings. Such work has identified that mediums frequently use question-framed propositions that are typically confirmed by the sitter, thereby conferring epistemological status on the medium. This study seeks to investigate what happens when the sitter disconfirms the propositions of the medium. The study focuses on the ways in which such disconfirmation can be responded to such that it is reconstrued as evidence of the psychic nature of the medium's reading. Televised demonstrations of psychic readings involving British and US mediums and their sitters are analysed. The results suggest that mediums rework disconfirmation as proof in several ways: first, by emphasizing the different access that sitter and medium have to knowledge (e.g., about the future); second, as evidence that the medium has access to the actual voice of the deceased (and may therefore mishear what the deceased has said to them); and third, as revealing an important truth that has hitherto been concealed from the sitter. The implications of these findings are considered for cases where speakers bring different and potentially competing, epistemological resources to an interaction.

Industrial Safety and Utopia: Insights from the Fukushima Daiichi Accident.

Feedback from industrial accidents is provided by various state or even international, institutions, and lessons learned can be controversial. However, there has been little research into organizational learning at the international level. This article helps to fill the gap through an in-depth review of official reports of the Fukushima Daiichi accident published shortly after the event. We present a new method to analyze the arguments contained in these voluminous documents. Taking an intertextual perspective, the method focuses on the accident narratives, their rationale, and links between "facts," "causes," and "recommendations." The aim is to evaluate how the findings of the various reports are consistent with (or contradict) "institutionalized knowledge," and identify the social representations that underpin them. We find that although the scientific controversy surrounding the results of the various inquiries reflects different ethical perspectives, they are integrated into the same utopian ideal. The involvement of multiple actors in this controversy raises questions about the public construction of epistemic authority, and we highlight the special status given to the International Atomic Energy Agency in this regard.

What Makes You Think That You Are a Health Expert? The Effect of Objective Knowledge and Cognitive Structuring on Self-Epistemic Authority.

Self-epistemic authority (SEA) refers to the subjective judgement of the level of expertise and knowledge a person has in a given domain. While it is reasonable to assume that people's perception of SEA reflects their level of objective knowledge in the given domain, there is evidence to show that people are not optimal judges of their own knowledge. Thus, the present study examined the interaction between the participants' trait-like characteristics of need for cognitive closure (NFC) and efficacy to fulfill the need for cognitive closure (EFNC), which affects the use of cognitive structuring, as a source of SEA. Results of the study confirm that objective knowledge as well as a cognitive-motivational epistemic process (interaction between NFC and EFNC) affect SEA. For high EFNC individuals, the effect of NFC on SEA was positive. However, for low EFNC individuals, the relationship was negative.

Quality of life and uncertainty in Crohn's disease.

INTRODUCTION: Crohn's disease impairs patients' perception of health and has a negative impact on health-related quality of life. Although it is apparent that uncertainty is a significant factor that decreases quality of life, it has never been studied in patients with Crohn's disease. The objective of the present study was to examine the association between level of certainty, self-epistemic authority, Internet information gathering habits, and health-related quality of life. METHODS: A cross-sectional study of 105 Crohn's disease patients was conducted. Data were collected using a questionnaire composed of five parts: (1) demographic and clinical information; (2) health-related quality of life; (3) level of certainty; (4) self-epistemic authority; and (5) Internet information gathering habits regarding Crohn's disease. RESULTS: A significant positive correlation was demonstrated between levels of certainty and health-related quality of life. Self-epistemic authority correlated positively with certainty, while information gathering via the Internet was related to decreased certainty. Multiple regression analysis for factors associated with health-related quality of life showed a positive association with the level of certainty, while negative associations were found between Internet information seeking and disease activity with the quality of life. CONCLUSION: Level of certainty proved an important variable associated with health-related quality of life in Crohn's disease patients. Improving patients' self-epistemic authority can increase certainty and, thus, improve health-related quality of life.

Why do we remember? The communicative function of episodic memory.

Episodic memory has been analyzed in a number of different ways in both philosophy and psychology, and most controversy has centered on its self-referential, 'autonoetic' character. Here, we offer a comprehensive characterization of episodic memory in representational terms, and propose a novel functional account on this basis. We argue that episodic memory should be understood as a distinctive epistemic attitude taken towards an event simulation. On this view, episodic memory has a metarepresentational format and should not be equated with beliefs about the past. Instead, empirical findings suggest that the contents of human episodic memory are often constructed in the service of the explicit justification of such beliefs. Existing accounts of episodic memory function that have focused on explaining its constructive character through its role in 'future-oriented mental time travel' neither do justice to its capacity to ground veridical beliefs about the past nor to its representational format. We provide an account of the metarepresentational structure of episodic memory in terms of its role in communicative interaction. The generative nature of recollection allows us to represent and communicate the reasons for why we hold certain beliefs about the past. In this process, autonoesis corresponds to the capacity to determine when and how to assert epistemic authority in making claims about the past. A domain where such claims are indispensable are human social engagements. Such engagements commonly require the justification of entitlements and obligations, which is often possible only by explicit reference to specific past events.

Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias.

The goal of this experimental project was to investigate lay peoples' perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients' expectations (in the case of politicians). However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and - particularly - 3 suggested that this bias might also be due to clients' desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients' own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client's positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo, but this effect is limited by confirmation bias: when the client's a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this sense, results presented in the present paper suggest that the action advice effect might be also interpreted as a specific manifestation of confirmation bias.