Voltaire's Candide, medical students, and mentoring

In Voltaire's work, Candide, a young, naïve man, who has been taught that humans live in the best of all possible worlds, is thrust into the world only to find that this may not be so. He learns over time to balance his optimism with the skepticism he acquires through experience. While today's medical students are not naïve like the character Candide, they, nonetheless, carry an impression of the ideal medical practice, along with the expectation of a successful medical practice. Good mentors and role models are important to students in order to temper their optimism, control their skepticism, and to help them to be realistic, not only about their expectations of medical practice, but what society expects of them.     

从"历史先天"来看福柯的知识考古学

该文试图考察福柯的自律的话语理论并反思考古学的症结。文章从“历史先天”这一关键词出发,阐述福柯的知识考古学如何将对话语的实证描述和探索话语构成的先天规则结合起来,从而保证其在对话语的形式分析的同时,超越传统哲学深陷其中的三对矛盾：“经验-先验”、“我思-未思”、“本源的隐退-回归”。围绕着“陈述”的三个特性,我们可以看到福柯为此所做的努力,即打通共时与历时之隔,经验与先验之分,实现结构主义和实证主义的联姻。文章最后指出这种自律的话语理论的症结所在,认为福柯并没有如愿以偿地跳出“有限性解析”的窠臼。     

论福柯性道德观中的虚无主义

福柯打着“我控诉”的战斗口号,否定一切善恶与人道主义;宣传各种离经叛道的思想和令人生畏的观点;认为人世间没有一个必须遵守的道德罗盘。围绕“生死爱欲、抒情内核、生命顶点和肉体黑箱”,通过同性恋、施虐／受虐性行为,及至可怖的艾滋病的“极限体验”来认识扑朔迷离的性本性,发现未曾感受过的性快感;向陈旧腐朽的道德观、性爱观挑战;以将传统观念中各种“邪恶的”性行为变得可以接受;推动性意识、性观念摆脱传统观念的制约,通过性话语转向性科学。     

Temporal disruptions in the "accurate" speech of articulatory defective speakers and stutterers

Durational measures of vocalic steady states and transitions were made on phonetically accurate and fluently produced vowel-plosive, consonant-vowel bisyllables embedded in a carrier phrase. in the first experiment, these measures were taken from the speech of ten articulatory defective adult speakers and ten matched normal speakers. The second experiment analyzed durational measures in the speech of ten adult stutterers and ten matched nonstutterers. Using wideband spectrography, durational measurements were used to infer timing of articulatory movements during the subsegments of the VCV sequences. The results of both experiments suggest that the two groups of speech disordered subjects were able to produce transitional shifts appropriate to the phonetic environment but appeared to delay the initiation of coarticulatory movements. Aberrant speech timing may imply an involvement in the planning or integration of articulatory/coarticulatory movements rather than difficulty with movement execution per se.     

A funny thing happened on the way to the journal: a commentary on Foucault's ethics and Stuart Murray's "Care of the self"

Stuart Murray's 'Care and the self: biotechnology, reproduction, and the good life' utilizes Foucault's "care of the self" to examine health domains in its title. The present author discusses three important articulations of concern with the Foucauldian concepts of care of the self that are absent in the work of Murray and others: first, the voluntarism and individualism inherent in ideas about care of the self; second, the absence of the interactional and relational; and, third, the perpetuation of the interpretation of Foucault's concept of governmentality, 'the conduct of conduct', as primarily coercive.     

"Evidence-debased medicine" and the integrity of the medical profession

Patients trust physicians to prescribe based on their fiduciary duty to act in the best interests of their patients, and physicians prescribe based on confidence in research data and clinical guidelines. Recent reports erode confidence in evidence-based medicine. Through self-regulation and a willingness to change, the medical profession can assert its status as a profession distinct from outside influence, serving one interest: the healthcare of patients and the public.     

Exploring the relationship between mentoring and counselling

In this article, the author examines the relationship between mentoring and counselling in the context of a mentoring relationship. Drawing on Clutterbuck and Megginson's (1999) Mentoring Executives & Directors, Butterworth-Heinemann, seven roles in mentoring, he explores how career functions of mentoring are incommensurable with psycho-social functions--following Kram's (1983) original terms--with a specific focus on counselling. This analysis raises some problems with the notion of counselling as part of the repertoire of the mentor, with the aim of the article not being to resolve these tensions but, instead, to put them forward as issues worthy of attention, debate and empirical investigation.     

Engagement mentoring for socially excluded youth: problematising an 'holistic' approach to creating employability through the transformation of habitus

This paper traces the emergence of engagement mentoring, which seeks to re-engage socially excluded youth with the formal labour market by altering their attitudes, values, and beliefs. Engagement mentoring has been promoted in European and British policy as an holistic response to social exclusion, for example, in the new Connexions service. However, the original meaning of 'holism' has become contested, and policies and practices which claim to be holistic require clearer analysis. Drawing on Bourdieuian theory, and evidence from recent research, this paper interrogates the holistic claims of engagement mentoring from the perspective of its intended effects on mentees. It argues that the model treats personal disposition--habitus--as a raw material to be wrought into 'employable' dispositions, with little or no acknowledgement of institutional or structural fields of power. However, habitus is highly complex, with deep-rooted and collective aspects not easily transformed. A greater understanding of habitus might result in more genuinely holistic approaches to mentoring, and counter a perceptible policy drift towards totalitarian rather than holistic practice.     

Pervasiveness of framing effects among physicians and medical students

Researchers have been documenting the influence of framing upon decision making for more than two decades; decisions appear to change in response to superficial changes in the presentation of possible outcomes. Several studies of medical decision making have revealed; for instance, that clinical decisions differ when options are presented as gains (survival rates) rather than losses (mortality rates). However, most studies of framing effects in the medical domain have utilized a very limited number of clinical problems that have not allowed an adequate test of the prevalence of the phenomena. To extend previous studies, we presented three groups of subjects (experienced internists, residents, and third-year medical students) with booklets containing twelve hypothetical medical cases. Half of the subjects received gain versions and half received loss versions of the same cases. Chi-square analyses revealed that framing did not influence any of the decisions of medical students and influenced the decisions of residents and experienced physicians on only two of the clinical problems (the same two problems). It appears that the prevalence of framing effects in the clinical domain may be limited.     

Mentor and protégé predictors and outcomes of mentoring in a formal mentoring program

This study examines the predictors and outcomes of mentoring received by participants of a 12-month formal mentoring program. Based on relationship theory, we examined how the personality of the individuals in the mentoring dyad, their perceived similarity, and mentor perceived support for mentoring contributed to relationship outcomes. The study includes data from both mentors and protégés at the program launch, midway through the program, and at program close. Mentor proactivity was related to more career and psychosocial mentoring; protégé’s perceptions of similarity to the mentor was related to more psychosocial mentoring. More mentoring was related to positive protégé and mentor outcomes, including improved protégé career clarity over the duration of the study.     

Scientific misconduct and findings against graduate and medical students

Allegations of scientific misconduct against graduate students appear to have unique attributes in the detection, investigation, processes used and sanctions imposed vis-à-vis other populations against which misconduct is alleged and found. An examination of the cases closed by the Department of Health and Human Services' Office of Research Integrity and the National Science Foundation reveals that most of the allegations made against graduate and medical students are for falsification and fabrication. Further, additional processes are used in these cases, e.g., student judicial processes, more students are "set up" and more students admit misconduct. Finally, the sanctions imposed when a finding is made typically involve separation from the institution and the federal sanction ranges from none to debarment. Drawing upon the teachings and circumstances of cases involving graduate student peers is a good vehicle for illustrating the concepts and perils of misconduct to graduate students.     

Sex differences in the professional orientation of first-year medical students

This article, presenting the findings from a 1975 survey of first-year medical students in the state of North Carolina, explores the relationship between students' sex and professional orientations considered relevant to current health care problems. The professional orientations concern four problem areas: (1) physicians' relationships with patients, (2) political and economic change in the medical profession, (3) the treatment of women physicians and women patients, and (4) geographic and specialty mal-distribution of physicians. Substantial sex differences are found for some professional orientations. As hypothesized, women orient more highly than men to humanizing physician-patient relationships, political and economic change in medicine, the problems facing women physicians and patients, and expecting an inner-city practice. Implications of the findings for health care and medical education are discussed.This report is based on the author's doctoral dissertation, Boys and Girls in White: Professional Orientation of the Student Physician Department of Sociology, Duke University, 1976. The author would like to express appreciation to Jim House for his continued guidance and encouragement as dissertation advisor.     

"Blue and seven phenomena" among Japanese students

To investigate color and number preferences in Japan, 586 university undergraduates (239 men and 347 women; M age = 20.9 yr.) were asked to name a color (Question 1), to name their preferred color (Question 2), and to name their preferred number between zero and nine (Question 3). The results showed that Japanese students chose blue (33.5%) or red (26.0%) when asked to name a color but that red was not chosen as frequently as blue as a preferred color (red: 11.1%, blue: 37.1%). Sex differences were found on both Questions 1 and 2 by chi-squared test. Black was chosen more by men, while pink was selected more by women. 22.5% subjects also selected the number seven, supporting Simon's observation of the "blue-seven phenomenon." The reasons given for the choice showed that seven was "a lucky number" and "represented happiness" among Japanese students. Four colors (blue, red, white, and black) accounted for 76.8% and 65.1% of responses to Questions 1 and 2, respectively, and odd numbers 68.4% for Question 3.     

Crossmodal binding: evaluating the "unity assumption" using audiovisual speech stimuli

We investigated whether the "unity assumption," according to which an observer assumes that two different sensory signals refer to the same underlying multisensory event, influences the multisensory integration of audiovisual speech stimuli. Syllables (Experiments 1, 3, and 4) or words (Experiment 2) were presented to participants at a range of different stimulus onset asynchronies using the method of constant stimuli. Participants made unspeeded temporal order judgments regarding which stream (either auditory or visual) had been presented first. The auditory and visual speech stimuli in Experiments 1-3 were either gender matched (i.e., a female face presented together with a female voice) or else gender mismatched (i.e., a female face presented together with a male voice). In Experiment 4, different utterances from the same female speaker were used to generate the matched and mismatched speech video clips. Measuring in terms of the just noticeable difference the participants in all four experiments found it easier to judge which sensory modality had been presented first when evaluating mismatched stimuli than when evaluating the matched-speech stimuli. These results therefore provide the first empirical support for the "unity assumption" in the domain of the multisensory temporal integration of audiovisual speech stimuli.