Construction and validation of a physician career development inventory

The development and psychometric characteristics of the Medical Career Development Inventory (MCDI) are described. The MCDI represents the initial construction of a career maturity measure for a homogeneous population of adults who encounter a common set of vocational development tasks. The inventory is intended to measure both degree of vocational development and readiness to cope with the developmental tasks encountered in a physician's career. The MCDI includes 35 items that address coping behaviors germane to dealing with the vocational tasks constituting the career development continuum of physicians. Initial evaluation of the MCDI's psychometric properties with a sample of 160 student-physicians supported the content validity of the items, construct validity of the scales, and criterion validity of the inventory.     

The role of comprehension in children's observational learning of a syntactic rule

This experiment tested the hypothesis that there is a relationship between children's comprehension of a syntactic form and the effectiveness of modeling in promoting imitation of that form. Nursery and kindergarten children received pretests for both comprehension and production of reversible passive sentences. Children who produced no passive sentences were classified either as high, intermediate, or low comprehenders on the basis of their comprehension test performance. Within each of these three groups, children were randomly assigned either to a modeling or to a no-modeling control condition. Children in the treatment condition heard a model use passive sentences to describe a series of pictures. As predicted, the imitation post-test scores of these children were significantly related to their comprehension pretest scores. No significant relationship between the post-test scores and the comprehension scores of control subjects was detected. Children exposed to the model in all three comprehension groups received significantly higher post-test scores than did their respective counterparts in the no-modeling condition. These results are discussed in terms of the hypothesis that language learning proceeds from comprehension to imitation to production.     

Perceptual, cognitive and linguistic development after early hemispherectomy: two case studies.

Longitudinal data on perceptual-motor, cognitive, and linguistic functioning is reported for two children: one with right hemispherectomy and one with left hemispherectomy. Both levels of functioning and specific profiles of abilities within an area of function are evaluated. The subjects both show effects from damage to the brain: shortened memory span, general perceptual and motor disabilities, and somewhat depressed general intellectual functioning. Areas of comparative strength and weakness in functioning in the two subjects are suggestive of adult patterns of hemispheric specialization, despite the young age of the subjects at the time of brain damage.     

Design of randomized controlled trials: Principles and methods applied to a treatment for early stuttering

The “gold standard” methodology for treatment efficacy research is the randomized controlled trial (RCT), which is used extensively in medical research and in other areas such as psychology. Results from a well designed and conducted RCT, which show a new treatment to be clinically and statistically superior to current standard practice, can lead to a change in clinical practice. This paper presents a tutorial on RCTs, presenting and discussing the following principles and methods: the trial protocol, choice of control treatment, eligibility criteria, random allocation, outcomes and hypotheses, sample size, subject recruitment, analysis by intention to treat, interim analysis, stopping rules, safety data monitoring/trial management, and study documentation. RCTs are a complicated and logistically involved methodology. Hence, prior to the commitment of resources to such a trial in the development of a new treatment, the safety and clinical promise of the new treatment needs to be demonstrated with preliminary studies. Such preliminary studies have been completed for the Lidcombe Program (LP) of early stuttering intervention, and an RCT of that treatment is being conducted at the time of writing. The principles and methods of RCTs are illustrated with reference to that study.

Educational objectives: The reader will understand the design principles and methods of RCTs. The reader will understand the logistics of conducting a RCT of a treatment for early stuttering.     

Differential levels of speech and manual dysfluency in adults who stutter during simultaneous drawing and speaking tasks

We examined the disruptive effects of stuttering on manual performance during simultaneous speaking and drawing tasks. Fifteen stuttering and fifteen non-stuttering participants drew continuous circles with a pen on a digitizer tablet under three conditions: silent (i.e., neither reading nor speaking), reading aloud, and choral reading (i.e., reading aloud in unison with another reader). We counted the frequency of stuttering events in the speaking tasks and measured pen stroke duration and pen stroke dysfluency (normalized jerk) in all three tasks. The control group was stutter-free and did not increase manual dysfluency in any condition. In the silent condition, the stuttering group performed pen movements without evidence of dysfluency, similar to the control group. However, in the reading aloud condition, the stuttering group stuttered on 12% of the syllables and showed increased manual dysfluency. In the choral reading condition stuttering was virtually eliminated (reduced by 97%), but manual dysfluency was reduced by only 47% relative to the reading aloud condition. Trials where more stuttered events were generally positively correlated with higher manual dysfluency. The results are consistent with a model in which episodes of stuttering and motor dysfluency are related to neural interconnectivity between manual and speech processes.     

A probabilistic model of semantic plausibility in sentence processing

Experimental research shows that human sentence processing uses information from different levels of linguistic analysis, for example, lexical and syntactic preferences as well as semantic plausibility. Existing computational models of human sentence processing, however, have focused primarily on lexico-syntactic factors. Those models that do account for semantic plausibility effects lack a general model of human plausibility intuitions at the sentence level. Within a probabilistic framework, we propose a wide-coverage model that both assigns thematic roles to verb–argument pairs and determines a preferred interpretation by evaluating the plausibility of the resulting ( verb , role , argument ) triples. The model is trained on a corpus of role-annotated language data. We also present a transparent integration of the semantic model with an incremental probabilistic parser. We demonstrate that both the semantic plausibility model and the combined syntax/semantics model predict judgment and reading time data from the experimental literature.     

Using Planned Adaptation to Implement Evidence-Based Programs with New Populations

The Interactive Systems Framework (ISF) for Dissemination and Implementation (Wandersman et al. 2008) elaborates the functions and structures that move evidence-based programs (EBPs) from research to practice. Inherent in that process is the tension between implementing programs with fidelity and the need to tailor programs to fit the target population. We propose Planned Adaptation as one approach to resolve this tension, with the goal of guiding practitioners in adapting EBPs so that they maintain core components of program theory while taking into account the needs of particular populations. Planned Adaptation is a form of capacity building within the Prevention Support System that provides a framework to guide practitioners in adapting programs while encouraging researchers to provide information relevant to adaptation as a critical aspect of dissemination research, with the goal of promoting wider dissemination and better implementation of EBPs. We illustrate Planned Adaptation using the JOBS Program (Caplan et al. 1989), which was developed for recently laid-off, working- and middle-class workers and subsequently implemented with welfare recipients.