加强住院医师临床思维能力培养的探讨

良好的临床思维能力,是住院医师能否成为合格和高水平医生的关键。对住院医师临床思维能力的培养必须明确临床思维的哲学本质和组成的关键要素,并结合住院医师的特点去培养。要注重基本知识、基本理论和基本技能训练,把握正确的恩维程序,运用哲学思想,并以学科综合为中心。     

基于认知设计系统的几何类比推理测验的编制及认知模型分析

认知诊断是一种新的测量范式。本研究首先根据Mulholland,Pellegrino＆Glaser和Whitely＆Schneider关于类比推理的研究结果,采用认知设计系统编制了几何类比推理测试题,并对所编制的测试题的质量进行验证,然后采用口语报告法分析解决几何类比推理所涉及的认知模型,结果表明：1）编制的几何类比推理测试题的质量比较好;2）学生解决类比推理所涉及的认知属性主要为置换、翻转、旋转、数量、大小、颜色与条纹和形状。     

拓广分部评分模型下计算机自适应测验变加权选题策略

摘要: 在计算机自适应测验中, 对0-1评分模型按a-分层选题是高效安全的策略,但多级评分模型的项目难度/步骤参数有多个而无法直接应用这种选题策略。信息函数能够很好地综合项目所有参数及能力参数,但最大信息量选题策略会影响考试安全。本文提出一种变加权选题策略,它通过调用一个与信息量相关联的函数,该函数与信息量成正比,与区分度的某个幂函数成反比,从而达到既能综合项目所有参数又按a分层的效果。在GPCM模型下用蒙特卡罗实验进行比较研究,结果显示新的选题策略总体效果比已有相关结果好。     

Accounting for fluctuations in body dissatisfaction

The present study evaluated whether the strength of relationship between contextual cues (presence of company and mood) and state body dissatisfaction varied as a function of individual differences in key trait measures (body shame, body surveillance tendencies, internalization of appearance standards, and trait affect) which have been linked to trait body dissatisfaction. Fifty-five undergraduate women completed a questionnaire containing the trait-based measures and then carried a Personal Digital Assistant (PDA) for a 7-day period. The PDA prompted participants six times daily to self-report their current mood and state body dissatisfaction. Multi-level modeling revealed that individual differences in body shame predicted inter-individual variability in the strength of the relationships between presence of company and state body dissatisfaction, and positive mood and state body dissatisfaction. Trait positive affect also explained variance in the positive mood state-body dissatisfaction relationship. The implications of the findings for prevention of body image disturbances are discussed.     

Hiding in plain sight: Older U.S. purpose exemplars

ABSTRACT

Despite significant research on purpose in adolescence and early adulthood, little is known about purpose in older adults. This paper defines purpose as ongoing commitment to and sustained action toward goals that are meaningful to the self and aim to contribute beyond the self. This study of purpose in later life draws on interviews of 102 respondents drawn from a U.S. nationally representative sample of 1198 men and women aged 50–92. Eighteen interviewees are identified as exemplars of purpose beyond the self and are matched with a comparison group of non-purposeful peers. Interview coding revealed that, in contrast to the non-purposeful comparison group, the purpose exemplars describe their lives as including several interconnected sources of well-being: purpose beyond the self, positive relationships, positive life engagement, a sense of competence, and freedom balanced with the desire to contribute. Implications for practitioners and the public are discussed.     

The selective directed forgetting effect: Can people forget only part of a text?

Participants studied sentences describing two different characters and then were told to forget the sentences about only one of the characters. A second list contained sentences attributed to a third character. Subsequently, they received a recall test on the sentences about the original two characters. When the sentences could be thematically integrated, participants showed no directed forgetting relative to a control group that was never told to forget. However, with unrelated sentences, participants selectively forgot the target character's sentences without forgetting the other character's sentences. This selective directed forgetting effect is a novel empirical result. We interpret the results as consistent with Radvansky's (1999) ideas about inhibition with textual materials.     

Waiting for a treat. Studying behaviors related to self-regulation in 18- and 24-month-olds

The ability to delay gratification – conceived as an early expression of self-regulation – develops in the second half of the second year of life. We used inductive methodology to identify different behaviors and set of behaviors performed by children while waiting for a treat. We asked which sets are more effective when it comes to successfully delaying gratification and how all observed sets change during toddler age. 130 children were tested twice – at 18 and at 24 months – using a Snack Delay Task. We observed 20 different behaviors and distinguished 4 sets of behaviors. The most important and effective set for delaying gratification in 18 and in 24 month olds was the set called Attention and Movements. We concluded that growth in the ability to delay gratification resulted from increased ability to overcome temptation by using an active strategy mainly based on attention.     

A conservative inverse normal test procedure for combining p-values in integrative research

The use ofp-values in combining the results of independent studies often involves studies that are potentially aberrant either in quality or in actual values. A robust data analysis suggests the use of a statistic that takes these aberrations into account by trimming some of the largest and smallestp-values. We present a trimmed statistic based on an inverse cumulative normal transformation of the orderedp-values, together with a simple and convenient method for approximating the distribution and first two moments of this statistic.The author thanks Ingram Olkin, David Rogosa, Jim Hodges and two anonymous reviewers for providing many useful comments and suggestions.     

Pairwise comparisons of trimmed means for two or more groups

The paper takes up the problem of performing all pairwise comparisons amongJ independent groups based on 20% trimmed means. Currently, a method that stands out is the percentile-t bootstrap method where the bootstrap is used to estimate the quantiles of a Studentized maximum modulus distribution when all pairs of population trimmed means are equal. However, a concern is that in simulations, the actual probability of one or more Type I errors can drop well below the nominal level when sample sizes are small. A practical issue is whether a method can be found that corrects this problem while maintaining the positive features of the percentile-t bootstrap. Three new methods are considered here, one of which achieves the desired goal. Another method, which takes advantage of theoretical results by Singh (1998), performs almost as well but is not recommended when the smallest sample size drops below 15. In some situations, however, it gives substantially shorter confidence intervals.