Medical education in a community model of care: The future of medical education in a large academic community hospital

Profound changes in the practice of medicine have led to new demands on the profession and on the process of medical education. In recognition of the expanded role of a physician as a professional responsible for the welfare of individuals, Lehigh Valley Hospital has developed an ambitious, innovative Strategic Plan for Education. The plan entitled, Medical Education in a Community Model of Care, emphasizes the organizational importance of education in the hospital's achievement of its mission of community service. The Strategic Plan for Education is community focused. In addition to its primary role of serving its local community, the plan is intended as a educational model for organizations in other parts of the country.Preparation of this paper was supported by a grant from the Dorothy Rider Pool Health Care Trust.     

Discrete‐trial training performance of behavior interventionists with autism spectrum disorder: A systematic replication and extension

Further research is needed on strategies to improve employment outcomes for individuals with autism spectrum disorder (ASD). We replicated and extended prior research by examining the acquisition, maintenance, and generalization of discrete‐trial training (DTT) performance of adults with ASD who were interested in careers as behavior technicians. Three participants received training on how to implement DTT with children and we assessed the maintenance and generalization of DTT performance in the absence of feedback. Results indicated that procedural integrity generalized across children and targets and maintained for 6 to 17 session days without feedback. Results have implications for the successful employment of individuals with ASD as behavior technicians and for future research on strategies to enhance their performance on the job.     

Dreading the pain of others? Altruistic responses to others' pain underestimate dread

A dislike of waiting for pain, aptly termed ‘dread’, is so great that people will increase pain to avoid delaying it. However, despite many accounts of altruistic responses to pain in others, no previous studies have tested whether people take delay into account when attempting to ameliorate others' pain. We examined the impact of delay in 2 experiments where participants (total N = 130) specified the intensity and delay of pain either for themselves or another person. Participants were willing to increase the experimental pain of another participant to avoid delaying it, indicative of dread, though did so to a lesser extent than was the case for their own pain. We observed a similar attenuation in dread when participants chose the timing of a hypothetical painful medical treatment for a close friend or relative, but no such attenuation when participants chose for a more distant acquaintance. A model in which altruism is biased to privilege pain intensity over the dread of pain parsimoniously accounts for these findings. We refer to this underestimation of others' dread as a ‘Dread Empathy Gap’.     

A Review of Occupation-Based Life Skills Interventions for Adults with Neurodevelopmental Disorders

Adults with neurodevelopmental disorders are at a higher risk for poverty, unemployment, and difficulties in relationships. Instrumental activities of daily living deficits often go unaddressed and minimal research has explored interventions to address them. The purpose of this study was to synthesize findings about occupation-based life skills interventions for adults with neurodevelopmental disorders. Ten articles met inclusion criteria and the American Occupational Therapy Association level of evidence and quality ratings were identified. Results indicate that occupation-based life skills interventions effectively address limitations experienced by adults with neurodevelopmental disorders but the overall quantity and quality of evidence-based interventions are lacking.     

Questioning Gender and Sexual Identity: Dynamic Links Over Time

Dichotomous models of gender have been criticized for failing to represent the experiences of individuals who claim neither an unambiguously female nor male identity. In this paper we argue that the feminist theoretical framework of intersectionality provides a generative approach for interpreting these experiences of gender multiplicity. We review our previous research on four young sexual-minority (i.e., nonheterosexual) women who are participants in a 10-year longitudinal study of sexual identity development, applying the framework of intersectionality to understand their exploration of transgendered experience and identification. Our analysis highlights the value of intersectionality as a framework for understanding not only multiplicity across identity constructs (e.g.., race, gender, etc.) but also within identity constructs (i.e., female and male).     

Women's neuroethics? Why sex matters for neuroethics

The Neuroethics Affinity Group of the American Society for Bioethics and Humanities (ASBH) met for the third time in October 2007 to review progress in the field of neuroethics and consider high-impact priorities for the future. Closely aligned with ASBH's own goals of recruiting junior scholars to bioethics and mentoring them to successful careers, the Neuroethics Affinity Group placed a call for new ideas to be presented at the Group meeting, specifically by junior attendees. One group responded with the idea to probe a new direction for neuroethics focused on the neuroscience of gender differences. In the spirit of full disclosure, two of the authors are a student (Chalfin) and fellow (Murphy) of the program I formerly directed at Stanford University. The third (Karkazis) is junior faculty there. The intellectual ownership of the ideas in the report below, however, are entirely theirs. Like lit torches in a juggling act, there are many directions this project can go. The report is a snapshot of these authors' first iteration of the concept of women's neuroethics. Many thanks are extended to participants of the ASBH Neuroethics Affinity Group meeting whose enthusiasm and feedback was immensely helpful in shaping the concept and moving it ahead.     

The imposter phenomenon, achievement dispositions, and the five factor model

This study investigated the imposter phenomenon (IP) in relation to common achievement dispositions and the Five Factor Model (FFM). A total of 129 college students were administered measures of achievement including the Harvey Imposter Phenomenon, Cooperation, Debilitating Anxiety, Hypercompetitive Attitude, Personal Development Competition, and Self-handicapping scales, in addition to the NEO-PI-R. IP scores were related to all achievement constructs, but were best predicted by Fear of Failure (+) and Self-handicapping (+). Consistent with previous findings [Chae, J. H., Piedmont R., Estadt, B., & Wicks, R. (1995). Personal evaluation of Clance’s impostor phenomenon scale in a Korean sample. Journal of Personality Assessment, 65(3), 468–485.] the IP was related to Neuroticism (+), Extraversion (−), and Conscientiousness (−). However, Neuroticism accounted for the vast majority of variance in the FFM predicting IP scores. In addition, a pattern of correlations was found for the IP and facet scales of the NEO-PI-R that is highly similar to those reported by Chae et al. Taken together, these findings expand our understanding of the IP in achievement and confirm earlier findings for the FFM.