Professional development of medical students: problems and promises

Observers and critics of the medical profession, both within and without, urge that more attention be paid to the moral sensibilities, the characters, of medical students. Passing on particular moral values and actions to physicians has always been an essential core of medical training, and this call for renewal is not new in modern medicine. Some of the structures and characteristics of modern medical education, however, often work directly against the professionalism that the education espouses. For example, medical students are socialized into a hierarchy that has broad implications for relations among health care professionals, other health care workers, and patients, and academic medicine has not promoted and taught critical reflection about the values and consequences of this hierarchy. Further, behind the formal curriculum lies the "hidden curriculum" of values that are unconsciously or half-consciously passed on from the faculty and older trainees. Two resources for thinking anew about professional development for medical students are feminist standpoint theory and critical multicultural theory, each of which raises important and fundamental questions about defining the role of medicine in society and the role of the physician in medicine. The author discusses these two theories and their implications for medical education, showing how they can be used to move discussions of professional development into analysis of the widespread social consequences of how a society organizes its health care and into critical reflection on the nature of medical knowledge.     

Paradigm as a methodological approach to analyzing Russia's public health system

A concept of paradigm is applied to the analysis of the national public health system. Whether it can be used as a methodological regulator in public health management is considered. Evidence is provided for the theoretical premises of constructing a paradigm of the public health system, its philosophical bases, the notional system, methodology, and the technological framework. The theoretical and practical aspects of public health paradigm, such as identification, interpretation, and rationalization are used to analyze at the conceptual and practical level, as well as search for new ways of reforming the public health system by the paradigm approach as a deeper development of the existing paradigm or its modification. This can become a foundation for the realignments of the theoretical and practical bases of the national public health system. The formation of the new paradigm of the public health system is to take place not in a revolutionary, but in a developmental mode. Priority should be given not to radical transformations and drastic changing of the key concepts, but to the fluent increasing of new knowledge and their inclusion of the theory and practice of public health. The promises of using the paradigm methodology, allowing the internal and external principles of the operation and function of the public health system to be integrated. In this context, the paradigm approach may be used as a methodological tool for analyzing person-society-state-economy-management relations within the framework of the public health system.     

Asian immigrants and the stress process: a study of Koreans in Canada

The stress process paradigm is one of the most widely held perspectives in the sociology of mental health. While this model has been applied to a large number of research problems, relatively little work has examined whether the paradigm can assist in understanding the link between socially induced stressors and their consequences for the mental health of immigrants. In this paper, we employ a stress process formulation to examine the interplay among stressors, psychological and social resources, and psychological distress among a large sample of Korean immigrants living in Toronto, Canada. Data from a longitudinal study of over 600 respondents indicate that the stress process paradigm provides a useful perspective for understanding how chronic stressors associated with the immigration experience manifest themselves in psychological distress. Our results suggest that social and psychological resources have important deterrent effects on the experience of stressors and their subsequent distressful consequences. Ethnic social support and mastery are especially important factors in this process.     

Education, training, and evaluation of practitioners today and in the future.

Presents new possibilities and paradigms for school psychology education, training, practice, and their evaluation, challenging school psychologists to examine their own views and make suggestions about points of future dialog between the psychology specialties. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The broad applicability of memory bias and its coexistence with the planning fallacy: Reply to Griffin and Buehler (2005).

People chronically underestimate how long tasks will take. In their original article, the present authors (M. M. Roy, N. J. S. Christenfeld, & C. R. M. McKenzie, see record 2005-11504-008) suggested a simple, broadly applicable explanation: Biased predictions result from biased memories. In their comment article, D. Griffin and R. Buehler (see record 2005-11504-009) suggested that in many domains in which this memory-bias account appears to outpredict their own account, theirs actually makes no prediction at all. However, the present authors did not suggest that only 1 theory is right but that theirs is consistent with data that prior theories, including their own, cannot explain. Ignoring memories of past tasks is not a complete explanation for the phenomenon if the memories people could consult are themselves biased. Nonetheless, underestimating future task duration is almost certainly multiply determined, and thus our account and theirs can coexist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evelyn Lee (1944-2003).

Presents an obituary of Evelyn Yee-Wai Miu Lee Fong. She was born on June 25, 1944, in Macau, China, and died in San Francisco on March 26, 2003. This obituary describes her contributions to the field of psychology, and the concept of cultural competence in particular. The ideas of cultural competence in mental health services and cultural diversity in the workforce as means to reduce health care disparities among ethnic minorities have increasingly influenced health care policy at governmental, professional organizational, and provider levels. Although people from many disciplines and cultural backgrounds have contributed to this paradigm shift over the past 25 years, among those from the Asian American and Pacific Islander community, Evelyn Lee was one of those pioneering spirits who was widely respected and loved as a clinician, administrator, teacher, author, community advocate, and humanitarian. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A critical look at the psychotherapeutic outcome research paradigm.

Discusses the pressure to demonstrate the effectiveness of psychotherapy exerted by clinicians and clinical researchers as well as by public consumer and congressional groups who are increasingly holding mental health practitioners accountable for the benefits of their treatment in advance. Though much is known about what influences therapy outcomes, it is evident that sizable research-methodological problems inhibit researchers' ability to make causal and predictive statements about outcome. The literature has become complex and conflict-ridden. In part this is due to the narrowly selective attention of researchers to variables of interest to them. The outcome research paradigm is characterized and critiqued using synthesis of assumptions drawn from various sources, including traditional empiricism, dialectical psychology, and structuralism. It is concluded that alternate sets of basic assumptions can lead to new ways of researching outcome. Structuralist and dialectical perspectives are shown to address some of the problems of the current paradigm. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health psychology training in doctoral psychology programs.

Presents the results of a Division 38 (the health psychology division of the American Psychological Association) survey of graduate training programs in psychology, along with facility-specific information on doctoral training opportunities in health psychology as of Fall 1981. 310 questionnaires were returned from psychology programs; 53 indicated that doctoral training in health psychology was available at their institution. It was found that established subspecialty programs were expanding to include health psychology, and new programs were developing in that area. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counter-transference: A story.

Presents a short story to illustrate how developmental themes of therapists' own lives are inextricably tied to their therapeutic styles, and to the client issues that rivet attention. The story tells about an aging man who sits in his office and looks at his paintings and imagines that his paintings are looking back at him. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obituary: Barbara Snell Dohrenwend (1927–1982).

Presents an obituary for Barbara Snell Dohrenwend, whose career coincided with and in fact led the growth of the interrelated fields of community psychology, health psychology, and a psychological epidemiology. Her work helped to focus these fields on their present interest in stressed people and the contexts of stress. Barbara Dohrenwend's work was marked by very special and direct caring about psychological suffering, accompanied by the clear conviction that scientific study could and should serve to alleviate suffering. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

American psychology in the eighties: Who will buy?

Presents a planning model for American psychology (AP) that leads to 9 concrete action proposals. AP is viewed as a nonprofit business whose products involve the creation, application, and dissemination of scientifically and technologically derived information about the human mind and behavior. Investigation of the present status of these knowledge bases finds psychology wanting and strongly suggests 3 disquieting conclusions: (a) Potential achievements of basic research are being undermined by a misdirected incentive system of publication criteria that disregards many of this field's basic precepts; (b) psychological problem solution can be served by a technological research paradigm qualitatively different from that of basic research; and thus (c) if AP is to compete successfully for future public support, the technological paradigm must be much better articulated, expanded, and integrated into the organization of the discipline. (75 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of scattergrams for the representation and analysis of lateralized interference effects in neuropsychology.

Presents an approach and method for the representation and analysis of group differences in dual-task performance. Although designed to deal with complex data sets typically encountered in the analysis of lateralized interference effects in neuropsychology, it is, in principle, applicable to any dual-task paradigm in which variations in 1 performance measure are accompanied by variations in another. The use of scattergrams and the associated statistical analytic techniques discussed should facilitate communication and understanding of the complex sets of data typically generated with this paradigm. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The exercise of nursing in its bioethical dimension

In the present study we approached Bioethics, an area that has been targeted for discussion and reflection within the scope of biological and health sciences, in order to rethink human conduct towards moral values in the current context of great technological and scientific development. We started a discussion about the exercise of nursing in its bioethical dimension, analyzing how such exercise has been occurring at the level of the ethics of principles, which is based on beneficence, autonomy and justice. In this respect, in their relations with patients, the members of the nursing team have adopted a posture based on beneficence linked to the subordination of their practice to the medical act. On the other hand, close contact with patients enables the nursing team to form ties that confer a certain power, which can be used to lead patients to exercise the ir autonomy.     

Subject effects in laboratory research: An examination of subject roles, demand characteristics, and valid inference.

Presents 4 conceptualizations of the role that Ss adopt in laboratory experiments, and assesses empirical support for each. There is no unconfounded evidence that Ss adopt a good S role and seek to confirm hypotheses or that they adopt a negativistic role and seek to sabotage experiments. There is some evidence that in specific contexts Ss may adopt a faithful S role, and there is considerable evidence that Ss are apprehensive about how their performance will be evaluated. Furthermore, providing S with a hypothesis about a study consistently produces bias. These relationships are then examined with respect to their implications for improving research in general and for drawing valid inferences from experimental data. (69 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Skilled or unskilled, but still unaware of it: How perceptions of difficulty drive miscalibration in relative comparisons.

People are inaccurate judges of how their abilities compare to others'. J. Kruger and D. Dunning (1999, 2002) argued that unskilled performers in particular lack metacognitive insight about their relative performance and disproportionately account for better-than-average effects. The unskilled overestimate their actual percentile of performance, whereas skilled performers more accurately predict theirs. However, not all tasks show this bias. In a series of 12 tasks across 3 studies, the authors show that on moderately difficult tasks, best and worst performers differ very little in accuracy, and on more difficult tasks, best performers are less accurate than worst performers in their judgments. This pattern suggests that judges at all skill levels are subject to similar degrees of error. The authors propose that a noise-plus-bias model of judgment is sufficient to explain the relation between skill level and accuracy of judgments of relative standing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failure of a moral enterprise: Attitude of the public toward mental illness.

Presents a critical analysis of published reports on the public's attitudes toward mental illness and toward deviant conduct. The mental health movement fits the defining criteria for a moral crusade, motivated and supported by moral entrepreneurs. The reported data indicate that the mental illness paradigm, as a formula for understanding and controlling deviant conduct, has not been widely accepted by the public. The central objective of the mental health movement has been to influence the general public to regard mental illness with the same nonrejecting valuations as somatic illness. Social survey reports and other data point to the conclusion that the public tends to declare negative (rejecting) valuations on persons diagnosed as mentally ill. However, the public tends to be more tolerant of deviant conduct when it is not described with mental illness labels. (37 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couple therapy in a health maintenance organization (HMO).

Presents case examples of treatment for a 25-yr-old couple with a commitment impasse and a married couple with anxiety about becoming parents in a health maintenance organization setting. Such treatment requires conceptualizing the problem within a developmental framework, prompt identification of a focal issue, and emphasis on the couple's part in bringing about desired changes. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An invitation to visual thinking.

Presents commentary by Lauren S. Seifert, President of Division 10, regarding Rudolf Arnheim's contributions. The work of Gestalt psychologists, Arnheim's included, so permeates post-millennial thinking about visual abstraction that we, ironically, scarcely recognize their contributions, as such. Some contemporary psychologists might be under the impression that Gestalt psychology had a brief and limited effect on the field, which has now abated. Psychology in the 21st century might even suffer from source amnesia regarding key aspects of our thinking about: (1) how sensation becomes abstracted into perceptual categories, and (2) how perceptual categories or worked and reworked into representational concepts. Psychologists who study artists and their work understand how remarkable it is to observe evidence of this lurching forward from sensation, to perceptual abstractions (and their interplay with other abstractions), and then, onto beautiful representations. This issue of Psychology of Aesthetics, Creativity, and the Arts embodies an expressive representation of Arnheim's contributions, which began long ago in Arnheim's own writings, moved forward as communications in aesthetics (by many scholars and including the symposium to honor him at the APA), and advanced to a truly beautiful, expressive representation of genuinely splendid ideas (e.g., in this issue). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI item differences between smoker and nonsmoker college freshmen males.

Presents an item analysis of scores on the MMPI for 81 smoker and 59 nonsmoker undergraduates, cross-validated with 60 smokers and 40 nonsmokers. 10 items were found that significantly distinguished the groups, while an additional 36 items were suggestively discriminating. Results indicate that nonsmokers (a) generally showed greater aversion to social and other kinds of excitement, (b) indicated more worry about their health, (c) admitted to a lack of confidence. Smokers revealed a preference for excitement and admitted to behavior conflicting with authority or social mores. (PsycINFO Database Record (c) 2010 APA, all rights reserved)