A binomial test for hierarchical dependency

A binomial test for hierarchical dependency is presented. The null hypothesis is that all members of a population who possess a certain skill are a subset of the members who possess another skill. This hypothesis is basic to the writings of several prominent theorists, such as Gagné and Piaget. The model, assumptions, formula derivations, and procedures for the test are explained. An illustrative example is also provided.     

Identification of typographically transformed words: instance-based skill acquisition

Two hypotheses concerning the development of skill at identifying typographically transformed words were tested. One claim is that a general skill independent of specific training instances is involved, and the other is that skill is based on memory for the analysis of specific instances encountered during training. Contrary to the general skill view, a series of experiments demonstrated that transfer of word identification skill was highly specific and occurred only when training and test instances shared common letters printed in the same case (i.e., uppercase or lowercase). Transfer of skill also depended on the visual patterns formed by adjacent letters and word shape. Presentation of a word in training and test phases significantly improved test phase identification of that word even when a unique visual pattern was used. These results are compatible with an instance-based view of word identification skill in which it is assumed that subjects develop skilled analysis of the visual and conceptual characteristics of specific words, and that this skill can be used to identify repeatedly presented words as well as predictable sets of novel words.     

Faith-to-faith at the bedside: theological and ethical issues in ecumenical clinical chaplaincy.

Chaplains who serve in a clinical context often minister to patients representing a wide variety of faiths. In order to offer the best pastoral care possible, the chaplain should first possess a set of personal theological convictions as a foundation for ministry. Second, he or she needs to be sensitive to the beliefs and practices of the patients. Third, it is vital to develop a relationship of acceptance and trust not only with patients under their care, but also with family members and caregivers as well. At times, situations will arise that are purely religious or theological. In a clinical setting, however, the questions and problems that arise more often are both theological and ethical. It is beneficial for the chaplain to be involved in an ethics committee, where the specifics of each case can be discussed, and staff can offer counsel to patients and their families. This study examines issues that chaplains face at the bedside, such as terminal care, life-prolonging treatments, dementia, persistent vegetative state, and euthanasia-assisted suicide. We will discover that those who are involved in clinical pastoral ministry will be called upon to be a comforter, mediator, educator, ethicist, and counselor.     

Case Report: Direct Access Genetic Testing and A False-Positive Result For Long QT Syndrome

We report the case of a woman who pursued direct access genetic testing and then presented with concerns regarding a positive test result for Long-QT syndrome. Although the result ultimately proved to be a false positive, this case illustrates that costs associated with follow-up of direct access genetic testing results can be non-trivial for both the patient and for health care systems. Here we raise policy questions regarding the appropriate distribution of these costs. We also discuss the possibility that, when confronted by a direct access genetic test result that reports high risk for one or more actionable diseases, a family physician might feel compelled to act out of a desire to avoid liability, even when information regarding the accuracy and validity of the testing were not easily accessible. This case outlines lessons that can easily be translated into clinical practice, not only by genetic counselors, but also by family physicians, medical specialists and members of the public.     

Hermeneutical Injustice and Liberatory Education

Hermeneutical injustice occurs when there is a gap in the interpretive resources available to members of a society due to the marginalization of members of a social group from sense‐making practices. In this paper, I address two questions about hermeneutical injustice that are undertheorized in the recent literature: (1) what do we mean when we say that someone lacks the interpretive resources for making sense of an experience? and (2) how do marginalized individuals develop interpretive resources? In response to (1), I argue that to lack interpretive resources is to lack conceptual skill or know how. In response to (2), I draw on resources from Gilbert Ryle and Andy Clark and provide a model of how marginalized individuals develop new conceptual skills by naming their shared experience and using it as a tool for scaffolding each other's conceptual performance. At the same time, I draw on the work of Gaile Pohlhaus and Kristie Dotson to show how these practices succeed only through the redistribution of epistemic power across differently situated social groups.     

To Resume a Stalled Psychotherapy? Psychological Testing to Understand an Impasse and Reevaluate Treatment Options

Clinical wisdom holds that psychological testing is a useful tool for consultation when there is a need to untangle and resolve a psychotherapeutic impasse. However, there has been a lack of empirical research in this area, and only a few cases have been published demonstrating how psychological testing can be used toward this end. In this article, the author offers a case illustration of the application of testing with a patient who sought to resume psychotherapy following a previous impasse and premature termination. Specific referral questions for the evaluation are explicated followed by discussion of the test data that answered each of them. The findings pointed not only to intrapsychic and object relational characteristics of the patient that contributed to the impasse but, importantly, alerted the author-therapist to his contributions as well. Treatment implications of the findings are also highlighted.     

Models of Service Delivery for Cancer Genetic Risk Assessment and Counseling

Increasing awareness of and the potentially concomitant increasing demand for cancer genetic services is driving the need to explore more efficient models of service delivery. The aims of this study were to determine which service delivery models are most commonly used by genetic counselors, assess how often they are used, compare the efficiency of each model as well as impact on access to services, and investigate the perceived benefits and barriers of each. Full members of the NSGC Familial Cancer Special Interest Group who subscribe to its listserv were invited to participate in a web-based survey. Eligible respondents were asked which of ten defined service delivery models they use and specific questions related to aspects of model use. One-hundred ninety-two of the approximately 450 members of the listserv responded (42.7 %); 177 (92.2 %) had provided clinical service in the last year and were eligible to complete all sections of the survey. The four direct care models most commonly used were the (traditional) face-to-face pre- and post-test model (92.2 %), the face-to-face pretest without face-to-face post-test model (86.5 %), the post-test counseling only for complex results model (36.2 %), and the post test counseling for all results model (18.3 %). Those using the face-to-face pretest only, post-test all, and post-test complex models reported seeing more new patients than when they used the traditional model and these differences were statistically significantly. There were no significant differences in appointment wait times or distances traveled by patients when comparing use of the traditional model to the other three models. Respondents recognize that a benefit of using alternative service delivery models is increased access to services; however, some are concerned that this may affect quality of care.     

Instructional support for novice law students: Reducing search processes and explaining concepts in cases

Reasoning about legal cases is a complex skill that imposes a high working memory load, especially for novice students. Not only do novices lack necessary conceptual knowledge, searching through the information sources that are used during reasoning can also be assumed to impose a high additional working memory load that does not contribute to learning. Therefore, this study investigated the effects of supporting novice law students' learning by (a) providing the meaning of important concepts in the case and (b) reducing the search process by providing a condensed (relevant articles only) rather than a complete civil code. Results show that performance on a test case (for which they had to use the complete civil code) was significantly better for participants who had used the condensed civil code during learning. Performance on a conceptual knowledge post‐test was significantly enhanced when students had received the concept explanations during learning. Copyright © 2010 John Wiley & Sons, Ltd.     

Self-esteem predicts quality of responding to interview questions when skill in responding is low

Self-esteem, skill in responding, and skill appraisals have each been posited to influence the quality of information gathered during interviews about witnessed events. This study examined whether self-esteem exacerbates or buffers skill related deficits and awareness of skill. Participants viewed a video, completed measures of self-esteem, estimated their skill in responding, responded to answerable and unanswerable questions about the video, and re-estimated their skill. Skill was indexed as effectiveness in resisting unanswerable questions. Moderated regression analyses showed that high self-esteem was associated with higher accuracy and fewer errors to answerable questions, but only when skill was low. Low skill individuals overestimated their ability. Following practice, low skill individuals with low trait self-esteem recalibrated their skill appraisals, while low skill high self-esteem individuals did not become aware of their lack of skill. When skill was high, self-esteem was not related to responding. Understanding the influence of self-esteem on the quality of information gathered during interviews about witnessed events requires attention to interactions with skill and performance appraisals.     

Self-reported Magic Eye stereogram skill predicts stereoacuity

Autostereograms--commonly known as Magic Eye stereograms (MESs)--are two-dimensional images that support stereoscopic depth perception given an appropriate crossing or uncrossing of the eyes. We find that self-reported MES skill is highly predictive of stereoacuity as measured by a standard clinical test (r142 = 0.45, p < 0.0001; TNO test). Indeed, in our sample of 194 individuals, those who report poor MES skill have a five-fold increased risk of stereo impairment. Those who report poor MES skill also require on average five times greater binocular disparity to perceive stereoscopic depth than those who report good MES skill. Reported MES skill thus carries significant information about stereoacuity.     

The attribution of intentionality: the role of skill and morality

The present study contributes to the discussion on the different components which constitute the intentionality concept about an undesired side effect, focusing on the morality and the skill. Two hundred and forty participants were asked to read a brief story about a car accident, in which it was explained the motivation of the high speed and objective and subjective skill of the agent to drive the car, and to fill in six questions about intentionality, objective risk, mental representation of risk, risk acceptance and blameworthiness for the outcome. The principal results showed that when the motivation is morally negative, people judge the side effect more intentional, also because they make more severe judgments about risk and blameworthiness. Moreover, when people are objectively proficient to perform the action (objective skill) the side effect is considered less risky and intentional and, in the case of a negative outcome, they are judged less severely than if they have a poor ability. Finally, a self-assessment of low skill to make the action (subjective skill) leads people to assess higher risks and, consequently, more intentionality for the side effect. The results are discussed on the basis of the literature about some specific components that make up the intentionality concept.     

The impact of political skill on impression management effectiveness

In this study, the authors investigated the effect of an individual's political skill on the relationships between 5 different impression management tactics (intimidation, exemplification, ingratiation, self-promotion, and supplication) and supervisor evaluations of performance. To test these relationships, the authors used a matched sample of 173 supervisor-subordinate dyads who worked full time in a state agency. Findings showed that individuals who used high levels of any of the tactics and who were politically skilled achieved more desirable supervisor ratings than did those who used the tactics but were not politically skilled. Opposite results were found when impression management usage was low. That is, individuals who were not politically skilled created a more desirable image in their supervisors' eyes than did their politically skilled counterparts when they did not use these tactics. Practical and research implications for the findings as well as directions for future research are offered.     

The relevance of specific conversational behaviors to ratings of social skill: An experimental analysis

Research on the social effectiveness of specific conversational behaviors is reviewed and a new study is presented. Eight versions of the same tape-recorded conversation between a man and a woman were prepared in a 2×2×2 design, where the woman systematically varied her conversation either high or low on questions, compliments, and 4-sec latencies. Subjects listened to one of these tapes and rated the female's social skill. Results of the major social skill variable showed that high questions and high compliments elicited higher skill ratings. The effect of low latencies was only marginally significant. While other factors such as personal appearance or self-evaluation differences may also be important, this study suggests that it may be valuable to include assessment and training relevant to compliments and questions (and possibly latencies) in programs for women who are socially anxious.     

Cognitive Ability and Personality Predictors of Training Program Skill Acquisition and Job Performance

Two important issues in the training process concern (1) the relative impact of cognitive ability and personality traits on the ability to acquire skills, and (2) whether training skill acquisition predicts subsequent job performance. We used a sample of 9,793 trainees to address these questions and were able to compare those who succeeded on the job with those who did not succeed on the job. We found that some personality factors positively correlate with skill acquisition and that skill acquisition can predict the level of subsequent job performance.     

Why don't health professionals check patient understanding? A questionnaire-based study

Checking patient understanding, by asking questions about information presented in a medical consultation, is a core communication skill but its use is not frequently assessed. The newborn hearing screening commenced in England with a pilot of its implementation in January 2002. Because it is a new screening test, it provided an opportunity for studying the effective communication of novel information. A randomized controlled trial of training newborn hearing screeners to present information about the screening test and to ask questions to check understanding was commenced but had to be prematurely ended as the majority of the screeners did not ask the questions. The aim of this study was to understand why the screeners did not ask questions to check understanding of the information provided. Questionnaires were sent to screeners who participated in the study to elicit their responses to the use of the questions to check understanding. A response rate of 87% (26/30) was achieved. Screeners who reported not asking the questions were more likely to express a lack of confidence in their ability to ask questions, and to perceive asking questions as an ineffective way of increasing patient understanding. The study suggests that the ability and willingness of healthcare professionals to use simple communication skills may have been overestimated and training needs to target skills as well as beliefs about the effectiveness of using them.     

The Effectiveness of an Occupational Therapy Program for Chemically Dependent Adolescents

This research study, conducted at a residential treatment center for chemically dependent and emotionally disturbed youth, was designcd to answer the following questions: is occupational therapy effective in producing behavioral change in the adolescent chemically dependent population and, if so, what are the factors producing the change? An assessment tool was designed and used in conjunction with observations to determine each resident's behavioral status before and after involvement in occupational therapy groups. All residents admitted to James- town wcre involved in a Work Skills Group (focusing on pre- work skill development) and/or a Relationship Skills Group (fo-cusing on interpersonal skill development). The behavioral status was measured by the therapist using a defined rating scale in an interview format. The changc in ratings from pre- to post-treatment was used as the basis for the data analysis. Groups of residcnts were compared to each other on the, variables of age, sex, attendance, rate of goal completion, group membership, and completion and type of occupational therapy goals. The results of the study indicate that rcsidents who attended occupational therapy, were involved in both groups, completed their occupational thcrapy goals, and completed the occupational therapy program demonstrated significant behavioral change, especially in relationship skills. Age and sex variables alone did not produce significant behavioral change.     

A comparative analysis of the effects of social skill training and teacher-directed contingencies on social behavior of preschool children with disabilities

This study investigated the effects of an analog social skill training program and a teacher-directed contingency strategy on promoting social responding among four preschool children with mild disabilities and their peers. The social skill training program consisted of five lessons targeting the skill areas: Initiating, responding, and maintaining social interactions. The teacher directed contingency consisted of prompting target children when they were not socially involved with peers, and providing verbal praise when they were socially involved with peers. Subjects were divided into two training pairs and received both interventions in a reversal design. Presentation order was counterbalanced across the two training pairs. Results indicated that the teacher directed contingency was more effective in promoting higher levels of social responding in a free-play setting. Results also suggest that social skill training may not always be a necessary prerequisite to promote increased social interactions among children who display low rates of social interaction with peers, but possess necessary skills.     

Assessing students' use of optional online lecture reviews

Online practice quizzes can be used to supplement instruction in the classroom. Such quizzes can engage retrieval practice, thereby improving learning and retention. However, despite their potential benefits, recent work suggests that students typically underutilize online practice quizzes. This article reports an observational classroom study, in which students were provided optional online reviews throughout the semester. The reviews could be accessed in test format, in which students were given multiple-choice questions and provided correct answer feedback, or in read format in which students were given the same questions and were shown the correct answers. Students who used the test format performed better on exams than students who used the read format or did not use the reviews. Nevertheless, the massive majority of the online reviews (approximately 88%) were not completed, highlighting the tendency for students to underutilize optional online reviews.     

Performance evaluation: On choosing to know the related attributes of others when we know their performance

It was hypothesized that people will choose to find out about the performance attributes of others who perform similarly to themselves if they believe the attributes are related to performance. Subjects within a group of nine were supposedly given different amounts of practice prior to taking a test on which performance was said to be either related or unrelated to practice. After taking the test, each subject was given his score, his rank order in the group, and the score obtained by each of the other group members. The subject was then allowed to find out about the number of items practiced by one other person in the group. A second choice was also given. On both first and second choices, subjects in the related condition chose to learn about others who were adjacent to them in the rank order. Subjects in the unrelated condition chose to learn about others with extreme scores. First choices in both conditions were strongly biased upward, supporting the unidirectional drive hypothesis.     

A functional assessment of heterosocial initiation behaviors in adults

The present investigation was designed to assess the relationship between empirically defined behavioral strategies and ratings of social effectiveness, liking, and skill. Female subjects rated audiotapes of dyadic heterosocial interactions. The dyads' verbal behavior was manipulated experimentally such that each male actor exhibited one of two strategies, other-enhancement and positive self-presentation, and each female coactor exhibited one of two responses, encourages and discourages. After each audiotaped interaction, subjects rated each male on five questions: liking, continued interaction, effectiveness, social skill, and similarity. The results indicated that subjects distinguished between effective and ineffective strategies. The data obtained from all questions indicated that subjects preferred the male who was encouraged irrespective of what strategy he used. This study analyzed relevant variables within an interactional framework allowing for a functional, rather than topographic, analysis of social behavior. From this functional perspective, topographically different heterosocial initiation strategies may be viewed as appropriate or effective based on the reactions of the other person in the interaction.