On the Role of Biomedical Knowledge in Clinical Reasoning by Experts,Intermediates and Novices

In two studies the role of biomedical knowledge in the diagnosis of clinical cases was explored. Experiment 1 demonstrated a decrease in the use of biomedical knowledge with increasing expertise. This result appeared to be at variance with some findings reported in the literature (e.g., Lesgold, 1984), but supported those of others (e.g., Patel, Evans, & Groen, 1989). In Experiment 2, three possible explanations for this phenomenon were investigated: (1) rudimentation of biomedical knowledge, (2) inertia, and (3) encapsulation of biomedical knowledge under higher order concepts. Using a combined think-aloud and post-hoc explanation methodology, it was shown that experts have more in-depth biomedical knowledge than novices and subjects at intermediate levels of expertise. The findings generally support a three-stage model of expertise development in medicine consisting of acquisition of biomedical knowledge, practical experience, and integration of theoretical and experiental knowledge resulting in knowledge encapsulation.     

Prosody and parsing in coordination structures

The effect of prosodic boundary cues on the off-line disambiguation and on-line parsing of coordination structures was examined. It was found that relative clauses were attached to coordinated object noun phrases in preference to second conjuncts in sentences like: The lawyer greeted the powerful barrister and the wise judge who was/were walking to the courtroom. Naive speakers signalled the syntactic contrast between the two structures by a prosodic break between the conjuncts when the relative clause was attached to the second conjunct. Listeners were able to use this prosodic information in both off-line syntactic disambiguation and on-line syntactic parsing. The findings are compatible with a model in which prosody has a strong immediate effect on parsing. It is argued that the current experimental design has avoided confounds present in earlier studies on the on-line integration of prosodic and syntactic information.     

The Relation of Self‐Control Demands to Job Strain: The Moderating Role of Organisational Commitment

Drawing on recent theoretical developments in cognitive and social psychology, self‐control demands were introduced as a new source of stress at work. Affective organisational commitment was expected to operate as a buffer in the relation between self‐control demands and indicators of job strain. Data provided by 260 nurses in homes for elderly people revealed both significant relationships of self‐control demands and commitment to a broad spectrum of strain indicators that included not only self‐report measures (burnout, psychosomatic complaints, intentions of quitting), but also a measure of absenteeism. Self‐control demands were positively related to all indicators of job strain, whereas the associations were negative for affective commitment. In addition, the results provided clear evidence for the buffer hypothesis of commitment. The positive relations of high self‐control demands to all strain indicators were attenuated as a function of affective commitment. The results suggest that the buffer effect of commitment is mainly due to stress‐contingent appraisal processes rendering highly committed employees less vulnerable to the adverse effects of high stress.