Selecting Instruments for Measuring the Clinical Learning Environment of Medical Education: A 4-Domain Framework.

Learning environments shape the experiences of learners and practitioners, making them an important component of program evaluation. However, educators find it challenging to decide whether to measure clinical learning environments with existing instruments or to design their own new instrument and, if using an existing instrument, which to choose. To assist educators with these decisions, the authors compared clinical learning environment instruments based on their characteristics, underlying constructs, and degree to which items reflect 4 domains (personal, social, organizational, material) from a recently developed model for conceptualizing learning environments in the health professions. Building on 3 prior literature reviews as well as a literature search, the authors identified 6 clinically oriented learning environment instruments designed for medical education. They collected key information about each instrument (e.g., number of items and subscales, conceptual frameworks, operational definitions of the learning environment) and coded items from each instrument according to the 4 domains. The 6 instruments varied in number of items, underlying constructs, subscales, definitions of clinical learning environment, and domain coverage. Most instruments focused heavily on the organizational and social domains and less on the personal and material domains (half omitted the material domain entirely). The variations in these instruments suggest that educators might consider several guiding questions. How will they define the learning environment and which theoretical lens is most applicable (e.g., personal vitality, sociocultural learning theory)? What aspects or domains of the learning environment do they most wish to capture (e.g., personal support, social interactions, organizational culture, access to resources)? How comprehensive do they want the instrument to be (and correspondingly how much time do they expect people to devote to completing the instrument and how frequently)? Whose perspective do they wish to evaluate (e.g., student, resident, fellow, attending, team, patient)? Each of these considerations is addressed.

Inconsistencies between mental fatigue measures under compensatory control theories / Inconsistencias entre medidas de fatiga mental bajo las teorías del control compensatorio

Mental fatigue has traditionally been defined as a condition of reduced cognitive efficiency and performance, accompanied by a subjective feeling of fatigue. Even though we could expect to find associations between the three defining characteristic of mental fatigue (performance impairment, physiological deactivation and subjective fatigue), research has shown that the emergence of inconsistencies between measures is more frequent than one might expect: people proved capable of maintaining adequate performance levels even after having declared themselves fatigued. This could be explained under the compensatory control mechanism models, which state that humans are able to provide additional resources under demanding conditions, but only at the expense of psychophysiological cost and subjective fatigue. We tested this explanation by manipulating task complexity and time performing a simulated air-traffic control task. We collected psychophysiological, performance and subjective data. A decrease in pupil size was seen in the low-aircraft-density condition, while pupil size remained constant in the high-aircraft-density condition. Participants' task performance was optimal in both conditions, though they showed an increase in subjective feelings of fatigue, especially in the high-complexity task condition. Thus, complexity seemed to trigger compensatory mechanisms, which reallocated extra resources that physiologically activated participants in order to deal with a higher complexity task, whereas subjective fatigue could be acting as a signal to the organism of impending resource depletion. Our findings support compensatory control theories and offer an explanation of inconsistencies between fatigue measures. Further research on compensatory mechanisms is needed to enable better management of fatigue effects to prevent work-related accidents

Tradicionalmente, la fatiga mental ha sido definida como una condición de reducción en los niveles de eficiencia cognitiva y rendimiento, acompañada de una sensación subjetiva de fatiga mental. A pesar de que podríamos esperar encontrar asociaciones (convergencia) entre las tres características definitorias de la fatiga mental (deterioro en el rendimiento, reducción en los niveles de activación fisiológica y surgimiento de fatiga subjetiva), la literatura ha revelado que la aparición de inconsistencias (divergencia) entre las medidas de fatiga es más frecuente de lo esperado: la gente se muestra capaz de mantener niveles adecuados de rendimiento a pesar de haber declarado encontrarse fatigados. Esto puede explicarse a partir de los modelos del mecanismo de control compensatorio, los cuales afirman que los seres humanos son capaces de proveerse con recursos adicionales bajo condiciones de elevada demanda cognitiva, únicamente a expensas de un coste psicofisiológico y del surgimiento de la sensación subjetiva de fatiga mental. En el presente estudio, ponemos a prueba esta explicación manipulando el tiempo y la complejidad de una tarea de simulación de control de tráfico aéreo. Recabamos datos psicofisiológicos, de rendimiento y subjetivos. Nuestros resultados desvelan una disminución del diámetro pupilar en la condición de baja densidad de tráfico aéreo, en tanto que se mantiene constante en la condición de alta densidad. El nivel de rendimiento de los participantes resultó ser óptimo en ambas condiciones, a pesar de que se aprecia un incremento lineal en los niveles de fatiga subjetiva, especialmente en la condición de alta complejidad. Así, la complejidad parece activar el mecanismo compensatorio, el cual provee al organismo con recursos adicionales que mantienen fisiológicamente activados a los participantes de la condición de alta densidad de tráfico al objeto de hacer frente a una tarea de mayor dificultad, mientras que la fatiga subjetiva podría estar actuando como una señal del organismo para impedir el agotamiento de los recursos cognitivos. Nuestros hallazgos apoyan las teorías del control compensatorio y ofrecen una posible explicación sobre algunas inconsistencias entre las medidas de fatiga mental. La ciencia necesita seguir investigando el fenómeno del mecanismo compensatorio para favorecer la gestión de los efectos de la fatiga mental y prevenir los accidentes laborales

Measurement invariance of the moral vitalism scale across 28 cultural groups.

Moral vitalism refers to a tendency to view good and evil as actual forces that can influence people and events. The Moral Vitalism Scale had been designed to assess moral vitalism in a brief survey form. Previous studies established the reliability and validity of the scale in US-American and Australian samples. In this study, the cross-cultural comparability of the scale was tested across 28 different cultural groups worldwide through measurement invariance tests. A series of exact invariance tests marginally supported partial metric invariance, however, an approximate invariance approach provided evidence of partial scalar invariance for a 5-item measure. The established level of measurement invariance allows for comparisons of latent means across cultures. We conclude that the brief measure of moral vitalism is invariant across 28 cultures and can be used to estimate levels of moral vitalism with the same precision across very different cultural settings.

Art-making and lived experience of schizophrenia: a vitalist materialist analysis.

BACKGROUND: This paper responds to calls for more lived experience research with a vitalist-materialist style of analysis inspired by Deleuze and Guattari. It challenges traditional understandings of art as a therapy associated with medical and psychological perceptions of schizophrenia, which have been found to be reductive. METHODS: Using Deleuze and Guattari's relational assemblages, the flows of affect are mapped as bodies and things, ideas and sensations connect and disconnect through the community arts sense-event "Schizy Jam". RESULTS: Opening a much broader territory for understanding the many ways that art can express, affirm and communicate difference, enables exploration of new ways in which art-makers are activating changes in feeling and thinking about schizophrenia. CONCLUSIONS: Art-makers can be supported to connect with others with shared experience to find expression for things that have previously been inexpressible and create a world that is more inclusive of them.

Quality of life in Swedish patients with post-polio syndrome with a focus on age and sex.

To investigate the health-related quality of life (QOL) in Swedish patients with post-polio syndrome (PPS), with a focus on sex and age. A total of 364 patients were recruited from five Swedish post-polio clinics. Analysis was carried out using SF-36 and data were compared with those of a normal population. QOL was significantly lower in PPS patients for all eight subdomains and the two main scores (physical compound score and mental compound score) when compared with the controls. Male patients had a significantly higher QOL than female patients for all subdomains and also for mental compound score and physical compound score, a phenomenon also observed in the normal population. There was a decrease in QOL in the physical domains and an increase in vitality with age. PPS decreases health-related QOL in both sexes, more in female patients. QOL for physical domains decreases whereas vitality increases with age in both sexes.

Vitalistic thinking in adults.

Vitalistic thinking has traditionally been associated with reasoning about biological phenomena. The current research aimed to investigate a broader range of vitalistic thinking than previously studied. Esoteric notions of 'energy' are frequently used by individuals when making causal attributions for strange occurrences, and previous literature has linked such thinking with paranormal, magical, and superstitious beliefs. Two experiments are described that aim to investigate whether adults are vitalistic when asked to make causal judgments, and whether this can be predicted by thinking styles and prior paranormal belief. Experiment 1 asked participants to rate three causal options (one of which was vitalistic) for six vignettes. Scores on one dimension of paranormal belief (New Age Philosophy) and analytical thinking significantly predicted vitalism, but scores on intuitive thinking and Traditional Paranormal Beliefs did not. Experiment 2 extended the findings by asking participants to generate their own causal responses. Again, paranormal belief was found to be the best predictor of vitalism, but this time Traditional Paranormal Beliefs were associated with vitalistic responses whilst both intuitive and analytical thinking were unable to significantly predict classification. Results challenge previous findings, suggesting that vitalistic thinking may operate differently when applied to everyday causal reasoning.

Cultural differences in the relationships among autonomy support, psychological need satisfaction, subjective vitality, and effort in British and Chinese physical education.

Using basic psychological needs theory (BPNT; Ryan & Deci, 2000) as our guiding framework, we explored cultural differences in the relationships among physical education students' perceptions of teacher autonomy support, psychological need satisfaction, subjective vitality and effort in class. Seven hundred and fifteen students (age range from 13 to 15 years) from the U.K. and Hong Kong, China, completed a multisection inventory during a timetabled physical education class. Multilevel analyses revealed that the relationships among autonomy support, subjective vitality and effort were mediated by students' perceptions of psychological need satisfaction. The relationship between autonomy support and perceptions of competence was stronger in the Chinese sample, compared with the U.K. sample. In addition, the relationship between perceptions of relatedness and effort was not significant in the Chinese students. The findings generally support the pan-cultural utility of BPNT and imply that a teacher-created autonomy supportive environment may promote positive student experiences in both cultures.

Re-energize yourself / Re-energize yourself

Lack of ongoing challenge, monotony, and boredom can numb your abition and sap your energy. But you dont't have to fall prey to th s all-too-common management problem. Re-energize Yourself can help you rekindle your enery, spark your vitality, and rediscover your zest for work. You'll discover an array of practical tips on refocusing your mental and physical resources to maximize your performance both on and off the job

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La vida y la muerte

El cuerpo humano, fisiologia, metabolismo alimenticio, la vida, origen de la vida, animismo, vitalismo, dinamismo fisico, quimico, materialismo, energia, la muerte