The Resources We Bring: The Cultural Assets of Diverse Medical Students

In response to the need for a more diverse workforce, our medical school developed new policies and procedures that focus on the recruitment and selection of diverse students with a specific focus on those considered underrepresented in medicine. To understand what these students bring to the practice of medicine, researchers investigated their perception of their cultural assets and how they plan to use these assets as physicians. A cross-section of 23 ethnically, culturally, and geographically diverse medical students were interviewed and data were analyzed through phenomenographical methods. The results indicate that students view themselves as having multiple assets that could be of significant value in their future practice of medicine, including: a) an interest in science and access to family members in medicine, b) personal and familial struggles with health, c) self and family as immigrants, and d) strong family and community orientations. Students perceived these as cultural assets because they could directly identify where these assets could be valuable in medicine but questioned how to maintain them throughout medical school. Now that our institution has identified these assets, next steps include administrators' investigation of ways to leverage them through curricular and educational programs.     

Medical Students’ Efforts to Integrate and/or Reclaim Authentic Identity: Insights from a Mask-Making Exercise

Medical students’ mask-making can provide valuable insights into personal and professional identity formation and wellness. A subset of first- and second-year medical students attending a medical school wellness retreat participated in a mask-making workshop. Faculty-student teams examined student masks and explanatory narratives using visual and textual analysis techniques. A quantitative survey assessed student perceptions of the experience. We identified an overarching theme: “Reconciliation/reclamation of authentic identity.” The combination of nonverbal mask-making and narrative offers rich insights into medical students’ experience and thinking. This activity promoted reflection and self-care, while providing insight regarding personal and professional development.     

Feeling Guilty or Not Guilty. Identifying Burnout Profiles among Italian Teachers

This study aimed at the assessment of psychometric properties of the Italian version of the Spanish Burnout Inventory (SBI-Ita) in a sample of Italian teachers and the analysis of burnout profiles based on a model that includes four dimensions: Enthusiasm toward job, Psychological exhaustion, Indolence, and Guilt. A self-reported questionnaire was filled out by 689 Italian teachers. Data analyses performed Multi-sample Confirmatory Factor Analysis and Hierarchical Cluster Analysis. Results confirmed the hypothesized four-factor structure and the discriminant role of Guilt in differentiating clusters. Results highlights the reliability of the SBI-Ita in the assessment of teachers’ burnout. Furthermore, results evidence for a new typology of burnout that differentiate guilty from non-guilty professionals.     

Gifting Knowledge for Long Life

During nonemergency appointments at traditional sites of āyurvedic healthcare in Kerala, South India, classically trained Brāhma?a physicians and their patients seldom exchange anything of substance (whether medicinal or monetary). The physician-patient interface instead routinely involves an exchange of knowledge. Interactions between physicians and patients in these meetings evoke the highly theorized notion of the “Indian gift” and the question of prestation in South Indian societies. This article explores the nature of exchange in the supply and reception of healthcare among physicians and patients at traditional sites of āyurvedic treatment (that is, sites not affiliated with governmental or private hospitals or clinics) in contemporary Kerala. Drawing on classical treatises about the dharma of gifts (dānadharma) and the Sanskrit medical classics of āyurveda, it examines reciprocity, ideal preconditions of givers and receivers of gifts, and the possibility of a “pure gift” in the appraisal and production of wellbeing.     

The Identifiable Victim Effect: Using an Experimental-Causal-Chain Design to Test for Mediation

The identifiable victim effect (IVE) refers to individuals’ tendency to offer greater aid to identifiable victims than to statistical victims. The purpose of this study was to investigate whether emotional reactions work to mediate IVE. In two experiments based on the experimental-causal-chain design proposed by Spencer et al. (Journal of Personality and Social Psychology, 89, 845–851, 2005), it was shown that an identifiable victim evokes stronger emotional reactions than does a statistical victim (Study 1). It was also demonstrated that the identifiable victim shown or described with a specific expression or information to evoke stronger emotional reactions elicited greater willingness to donate money in participants (Study 2). The results of two studies based on the experimental-causal-chain approach demonstrated that the underlying causal mechanism for the IVE is participants’ emotional reactions to identified victims. The theoretical and practical implications of the results are discussed.     

Trait Procrastination,Hoarding, and Continuous Performance Attention Scores

We examined the relationship between chronic procrastination, hoarding, attention deficit hyperactivity disorder (ADHD), and a computer measure of continuous performance with 84 adult patients evaluated for diagnoses. Patients were administered the General Procrastination Inventory, the Saving Inventory-Revised, the Adult ADHD Self-Report Scale and the IVA + Plus Continuous Performance Test. Procrastination scores correlated negatively with auditory attention scores, while self-reported hoarding tendencies correlated negatively with visual attention. Measures of procrastiation, hoarding, and ADHD were positively correlated. Implications and limitations of findings are discussed as well as directions for futher research.     

Literacy Interventions for Secondary Students Formally Identified with Emotional and Behavioral Disorders: Trends and Gaps in the Research

There has historically been much less research on the literacy skills of adolescents with emotional and behavioral disorders (EBD) compared to the amount of intervention research targeting their behavior. Within the limited literacy research available, there are multiple issues that need to be addressed, including (a) a predominant focus on children in elementary school, (b) gender differences in students with EBD, and (c) variation in the labels of research participants. The purpose of this integrative, comprehensive review was to investigate these concerns and provide a summary of the data to guide future research studies. A total of 63 articles targeting the reading and/or writing skills of middle and high school students with EBD were identified, spanning 37 years of research (1980–2016). Analysis of the articles revealed that less than 15% of the participants were female, and the percentage of females included in this research has declined across time; 11 different labels have been used to describe research participants; oral reading fluency, persuasive writing, and reading comprehension were the three most common dependent variables; and less than 5% of studies took place in inclusive general education settings. Recommendations for practitioners serving students with EBD and for researchers are discussed.     

Reimagining the Cuckoo’s Nest

One Flew Over the Cuckoo's Nest (1962) by Ken Kesey and The Devil in Silver (2012) by Victor LaValle are two novels that focus on mental hospitalization as a medical and social practice. Published fifty years apart, however, the books possess important differences in setting, method, and message reflecting the times that spawned them. The purpose of this paper is to examine the changing documentary and metaphorical uses of the asylum novel by comparing an iconic work in the genre with a respectful, but divergent, successor. What emerges from this comparison is an appreciation of the literary conventions shared by Kesey and LaValle but also the ingredients that separate their work. Whereas Kesey produced an enduring tribute to the virtue of nonconformity, LaValle's social criticism expresses itself as a disturbing portrayal of class-based disparities and administrative dysfunction inside the contemporary American mental health system.     

Beyond Pathologizing Harm: Understanding PTSD in the Context of War Experience

An alternative to objectifying approaches to understanding Post-traumatic Stress Disorder (PTSD) grounded in hermeneutic phenomenology is presented. Nurses who provided care for soldiers injured in the Iraq and Afghanistan wars, and sixty-seven wounded male servicemen in the rehabilitation phase of their recovery were interviewed. PTSD is the one major psychiatric diagnosis where social causation is established, yet PTSD is predominantly viewed in terms of the usual neuro-physiological causal models with traumatic social events viewed as pathogens with dose related effects. Biologic models of causation are applied reductively to both predisposing personal vulnerabilities and strengths that prevent PTSD, such as resiliency. However, framing PTSD as an objective disease state separates it from narrative historical details of the trauma. Personal stories and cultural meanings of the traumatic events are seen as epiphenomenal, unrelated to the understanding of, and ultimately, the therapeutic treatment of PTSD. Most wounded service members described classic symptoms of PTSD: flashbacks, insomnia, anxiety etc. All experienced disturbance in their sense of time and place. Rather than see the occurrence of these symptoms as decontextualized mechanistic reverberations of war, we consider how these symptoms meaningfully reflect actual war experiences and sense of displacement experienced by service members.