Assessing the Impact of Shifting Enfolded Neurosurgery Fellowships to Follow the Chief Resident Experience: National Survey of Program and Fellowship Directors.

OBJECTIVE: The neurosurgery chief resident year is traditionally completed during the final residency year; however, a recent directive decried that enfolded fellowships should be undertaken following completion of the chief experience for most fellowships. METHODS: A national survey was distributed to U.S.-based neurosurgery residency/fellowship directors regarding these changes. RESULTS: We received 135 completed surveys (37% response rate). Respondents tended to feel the new post-chief enfolded fellowship mandate represented positive effects on residency training (58%) and chief experiences (54%)-overall, 47% agreed the changes are net positive, 17% neutral, and 36% negative. In addition, 66% respondents thought the enfolded fellowship was enhanced due to previous completion of the chief year. Most did not feel the directives had a negative impact on resident case minimums completion, total case volumes, or overall case mix during residency; but 64% felt it would reduce post-graduate training. Of those who said the mandate would reduce post-graduate training, 45% thought this would be positive. Throughout all questions, most respondents tended to feel strongly, although with little overall consensus across many of these questions. One area of relative agreement was a 60% preference to allow program discretion for chief/enfolded fellowship training timing-with 41% strongly supporting versus 15% strongly rejecting reversion to program-directed administration. CONCLUSIONS: Fervent bimodal opinions exist among residency program and fellowship directors regarding the directives for enfolded fellowships to follow successful completion of the chief resident experience. However, there was broad support for allowing greater program discretion for directing certain enfolded fellowship timing and structure.

Genius begins at home: Shared social identity enhances the recognition of creative performance.

The present research examines the extent to which the recognition of creative performance is structured by social group membership. It does this by analysing the award of merit prizes for Best Actor and Actress in a Leading Role for the international award of US-based Oscars and British-based BAFTAs since BAFTA's inception of this category in 1968. For both awards, the exclusive assessment criterion is the quality of artists' performance in the international arena. Results show that US artists won a greater proportion of Oscars than BAFTAs (odds ratio: 2.10), whereas British artists won a greater proportion of BAFTAs than Oscars (OR: 2.26). Furthermore, results support the hypothesis that these patterns are more pronounced as the diagnostic value of a quality indicator increases - that is, in the conferring of actual awards rather than nominations. Specifically, US artists won a greater proportion of Oscar awards than nominations (OR: 1.77), while British artists won a greater proportion of BAFTA awards than nominations (OR: 1.62). Additional analyses show that the performances of in-group actors in movies portraying in-group culture (US culture in the case of Oscars, British culture in the case of BAFTAs) are more likely to be recognized than the performances of in-group actors in movies portraying the culture of other (out-)groups. These are the first data to provide clear evidence from the field that the recognition of exceptional creative performance is enhanced by shared social identity between perceivers and performers.

Shock treatment: using immersive digital realism to restage and re-examine milgram's 'obedience to authority' research.

Attempts to revisit Milgram's 'Obedience to Authority' (OtA) paradigm present serious ethical challenges. In recent years new paradigms have been developed to circumvent these challenges but none involve using Milgram's own procedures and asking naïve participants to deliver the maximum level of shock. This was achieved in the present research by using Immersive Digital Realism (IDR) to revisit the OtA paradigm. IDR is a dramatic method that involves a director collaborating with professional actors to develop characters, the strategic withholding of contextual information, and immersion in a real-world environment. 14 actors took part in an IDR study in which they were assigned to conditions that restaged Milgrams's New Baseline ('Coronary') condition and four other variants. Post-experimental interviews also assessed participants' identification with Experimenter and Learner. Participants' behaviour closely resembled that observed in Milgram's original research. In particular, this was evidenced by (a) all being willing to administer shocks greater than 150 volts, (b) near-universal refusal to continue after being told by the Experimenter that "you have no other choice, you must continue" (Milgram's fourth prod and the one most resembling an order), and (c) a strong correlation between the maximum level of shock that participants administered and the mean maximum shock delivered in the corresponding variant in Milgram's own research. Consistent with an engaged follower account, relative identification with the Experimenter (vs. the Learner) was also a good predictor of the maximum shock that participants administered.

'Happy to have been of service': the Yale archive as a window into the engaged followership of participants in Milgram's 'obedience' experiments.

This study examines the reactions of participants in Milgram's 'Obedience to Authority' studies to reorient both theoretical and ethical debate. Previous discussion of these reactions has focused on whether or not participants were distressed. We provide evidence that the most salient feature of participants' responses - and the feature most needing explanation - is not their lack of distress but their happiness at having participated. Drawing on material in Box 44 of Yale's Milgram archive we argue that this was a product of the experimenter's ability to convince participants that they were contributing to a progressive enterprise. Such evidence accords with an engaged followership model in which (1) willingness to perform unpleasant tasks is contingent upon identification with collective goals and (2) leaders cultivate identification with those goals by making them seem virtuous rather than vicious and thereby ameliorating the stress that achieving them entails. This analysis is inconsistent with Milgram's own agentic state model. Moreover, it suggests that the major ethical problem with his studies lies less in the stress that they generated for participants than in the ideologies that were promoted to ameliorate stress and justify harming others.