Organizational change in health care: A strategic perspective please!

Abstract

Commentary on “Making Sense of “Resistance”: Responses to Organizational Change in a Private Nursing Home for the Elderly” by C. Meston and N. King     

Control Options in Managing Strategic Decision-making Processes

Abstract

Top decision making processes are generally depicted as chaotic, unstructured, incremental or spasmodic, and protracted. In this article it is shown, based on data from 25 strategic decision processes from 12 organizations in three industry sectors, that, within certain limits, there certainly are control options in strategic decision-making processes. In addition, their use tums out to be profitable. The analyses of patterns in the use of control dimensions in the 25 cases leads to a typology of four types of decision models or strategies: the neo-rational model (n = 3), the bureaucratic model (n = 4), the arena model (n = 8) and the open-end model (n = 10). This empirical typology confirms earlier typologies based on literature.

The use of control strategies is shown to vary across industry sectors and topics of decisions and have adifferential effect. It is concluded that context and content variables have either a selection effect (some strategies do not occur in some sectors) or a optimization effect (some strategies are more effective than others in a given context).     

10 years of illusions

A decade ago, S. Aglioti, J. F. X. DeSouza, and M. A. Goodale (1995) published an experiment that has had a big influence on the way that visual information is thought to control human behavior. Their findings have often been simplified as suggesting that action is immune to perceptual illusions. The current authors critically analyze the 4 steps involved in this simplification and argue that research during the last 10 years has shown that the validity of 3 of the 4 steps is doubtful. They conclude that this experiment cannot be regarded as firm support for the 2-visual-systems hypothesis (i.e., that the ventral stream is for perception and the dorsal stream is for visually guided actions).     

Priming in implicit memory tasks: prior study causes enhanced discriminability, not only bias

R. Ratcliff and G. McKoon (1995, 1996, 1997; R. Ratcliff, D. Allbritton, & G. McKoon, 1997) have argued that repetition priming effects are solely due to bias. They showed that prior study of the target resulted in a benefit in a later implicit memory task. However, prior study of a stimulus similar to the target resulted in a cost. The present study, using a 2-alternative forced-choice procedure, investigated the effect of prior study in an unbiased condition: Both alternatives were studied prior to their presentation in an implicit memory task. Contrary to a pure bias interpretation of priming, consistent evidence was obtained in 3 implicit memory tasks (word fragment completion, auditory word identification, and picture identification) that performance was better when both alternatives were studied than when neither alternative was studied. These results show that prior study results in enhanced discriminability, not only bias.     

Depth perception by the active observer

The connection between perception and action has classically been studied in one direction only: the effect of perception on subsequent action. Although our actions can modify our perceptions externally, by modifying the world or our view of it, it has recently become clear that even without this external feedback the preparation and execution of a variety of motor actions can have an effect on three-dimensional perceptual processes. Here, we review the ways in which an observer's motor actions--locomotion, head and eye movements, and object manipulation--affect his or her perception and representation of three-dimensional objects and space. Allowing observers to act can drastically change the way they perceive the third dimension, as well as how scientists view depth perception.     

Job control and burnout across occupations

Researchers have reported that, for individual workers, low job control is associated with high burnout; however, as yet it is unclear whether this association holds for occupations as well. Whether differences in job control between occupations as assessed by eight expert judges could account for individual-level and occupational-level differences in burnout rates. Data were obtained from 9,503 incumbents of 28 occupations in The Netherlands (M age = 37.9 yr., SD = 8.7; 50% were men). Burnout was measured on the Maslach Burnout Inventory. Occupational-level job control was inversely correlated with burnout, explaining 16% of the variation in occupational-level burnout. Thus, between-occupation differences in job control are somewhat systematically related to burnout.     

Sustained conscious access to incidental memories in RSVP

In visual search of natural scenes, differentiation of briefly fixated but task-irrelevant distractor items from incidental memory is often comparable to explicit memorization. However, many characteristics of incidental memory remain unclear, including the capacity for its conscious retrieval. Here, we examined incidental memory for faces in either upright or inverted orientation using Rapid Serial Visual Presentation (RSVP). Subjects were instructed to detect a target face in a sequence of 8–15 faces cropped from natural scene photographs (Experiment 1). If the target face was identified within a brief time window, the subject proceeded to an incidental memory task. Here, subjects used incidental memory to discriminate between a probe face (a distractor in the RSVP stream) and a novel, foil face. In Experiment 2 we reduced scene-related semantic coherency by intermixing faces from multiple scenes and contrasted incidental memory with explicit memory, a condition where subjects actively memorized each face from the sequence without searching for a target. In both experiments, we measured objective performance (Type 1 AUC) and metacognitive accuracy (Type 2 AUC), revealing sustained and consciously accessible incidental memory for upright and inverted faces. In novel analyses of face categories, we examined whether accuracy or metacognitive judgments are affected by shared semantic features (i.e., similarity in gender, race, age). Similarity enhanced the accuracy of incidental memory discriminations but did not influence metacognition. We conclude that incidental memory is sustained and consciously accessible, is not reliant on scene contexts, and is not enhanced by explicit memorization.     

Can false memories be created through nonconscious processes?

Presentation times of study words presented in the Deese/Roediger and McDermott (DRM) paradigm varied from 20 to 2000 ms per word in an attempt to replicate the false memory effect following extremely short presentations reported by. Both in a within-subjects design (Experiment 1) and in a between-subjects design (Experiment 2) subjects showed memory for studied words as well as a false memory effect for related critical lures in the 2000-ms condition. However, in the conditions with shorter presentation times (20 ms in Experiment 1; 20 and 40 ms in Experiment 2) no memory for studied words, nor a false memory effect was found. We argue that there is at present no strong evidence supporting the claim for a nonconscious basis of the false memory effect.     

Computer Ethics and Moral Methodology

In computer ethics, as in other branches of applied ethics, the problem of the justification of moral judgment is still unresolved. I argue that the method which is referred to as "The Method of Wide Reflective Equilibrium" (WRE) offers the best solution to it. It does not fall victim to the false dilemma of having to choose either case-based particularist or principle-based universalist approaches to the problem of moral justification. I claim that WRE also provides the best model of practical moral reasoning available for computer ethics. It does not pretend to provide quasi-algorithmic procedures for moral decision-making, but neither does it abandon the regulative ideal of communicative transparency in discursive public justification.     

A criterion-shift model for enhanced discriminability in perceptual identification: A note on the counter model

The original version of the counter model for perceptual identification (Ratcliff & McKoon, 1997) assumed that word frequency and prior study act solely to bias the identification process (i.e., subjects have a tendency to prefer high-frequency and studied low-frequency words, irrespective of the presented word). In a recent study, using a two-alternative forced-choice paradigm, we showed an enhanced discriminability effect for high-frequency and studied low-frequency words (Wagenmakers, Zeelenberg, & Raaijmakers, 2000). These results have led to a fundamental modification of the counter model: Prior study and high frequency not only result in bias, but presumably also result in a higher rate of feature extraction (i.e., better perception). We demonstrate that a criterion-shift model, assuming limited perceptual information extracted from the flash as well as a reduced distance to an identification threshold for high-frequency and studied low-frequency words, can also account for enhanced discriminability.