临床技能培训中心在临床医学教育中的作用初探

临床医学是医学教育的关键,随着社会的进步,科技的发展及患者自我保护意识的提高,传统的临床医学技能教育模式面临新的考验。本文探讨了医学模拟教学在临床教学中的重要意义,介绍了临床技能培训中心的建设及应用评价,对其未来的发展方向进行了展望。     

The effect of in-vehicle warning systems on speed compliance in work zones

The purpose of this research was to evaluate the effectiveness of augmented in-vehicle speed warnings on driver behavior in work zones. The influence of three device configurations were examined as the drivers entered a work zone which was presented in a simulated driving environment. The first configuration was a control condition which used only traditional signage. The second condition had the addition of a visual in-vehicle warning while the final condition had the addition of an auditory in-vehicle warning. Results indicated that adding in-vehicle warnings did affect driver compliance to the work zone speed limit. Participants in the audio warning condition responded more quickly to the warning than those in the visual condition. Both augmented warning configurations differed significantly and were each respectively different from the drivers in the control condition. Based on these results we suggest a combination of in-vehicle warnings. Upon entry of the work zone we suggest a combined audio and visual warning message. However, after the initial entry phase, a visual warning message shows greater promise for the on-going modulation of driver speed transit.     

计算机模拟技术在漏斗胸治疗中的应用

NUSS手术是矫治儿童漏斗胸畸形的首选方法,但目前对制定个体化手术和评估术后矫形效果尚缺乏科学的手段。以有限元分析法为基础的计算机三维成像技术能模拟NUSS手术术后矫形效果,测算钢板的数量、塑形和置入部位及胸廓应力状态,预计手术并发症的发生。计算机模拟技术可为减少手术风险,制定科学的个体化NUSS手术提供有效的指导。     

关于两种Angoff法比较的模拟实验研究

采用模拟实验法比较研究了两种Angoff法——概率法和对错法——设定分数线的准确性和稳定性,结果表明:(1)当真能力低于测验的平均难度时,概率法高估分数线,而对错法低估分数线;反之,当真能力高于测验平均难度时,概率法低估,而对错法高估;(2)当真能力接近测验平均难度时,概率法比对错法更准确;反之,当真能力远高于或低于测验平均难度时,对错法更准确;(3)无论在何种实验条件下,概率法均比对错法更稳定。     

Probability estimation in poker: A qualified success for unaided judgment

Poker players make strategic decisions on the basis of imperfect information, which are informed by their assessment of the probability they will hold the best set of cards among all players at the conclusion of the hand. Exact mental calculations of this probability are impossible—therefore, players must use judgment to estimate their chances. In three studies, 69 moderately experienced poker players estimated the probability of obtaining the best cards among all players, based on the limited information that is known in the early stages of a hand. Although several of the conditions typically associated with well‐calibrated judgment did not apply, players' judgments were generally accurate. The correlation between judged and true probabilities was r > .8 for over five‐sixths of the participants, and when judgments were averaged across players and within hands this correlation was .96. Players slightly overestimated their chance of obtaining the best cards, mainly where this probability was low to moderate (<.7). Probability estimates were slightly too strongly related to the strength of the two cards that a player holds (known only to themselves), and insufficiently influenced by the number of opponents. Seemingly, players show somewhat insufficient regard for the cards that other players could be holding and the potential for opponents to acquire a strong hand. The results show that even when judgment heuristics are used to good effect in a complex probability estimation task, predictable errors can still be observed at the margins of performance. Copyright © 2009 John Wiley & Sons, Ltd.     

The Effects of Delayed Report and Motive for Reporting on Perceptions of Sexual Harassment

We examined whether the timing of the report and the victim's apparent motive for reporting influences women's and men's perceptions of sexual harassment. Undergraduates (153 women, 149 men) listened to 1 of 6 versions of audiotaped testimony of the victim and defendant. The report was filed either immediately or 18 months later, and motive either was presented as altruistic, retaliatory, or was not specified. Participants chose a verdict, rated the defendant's guilt, and rated the defendant and victim on several dimensions. Higher guilt ratings, more positive evaluations of the victim, and more negative evaluations of the defendant were associated with immediate reporting and an altruistic motive, although women weighed these factors more heavily than did men.     

Activating a mental simulation mind-set through generation of alternatives: Implications for debiasing in related and unrelated domains

Encouraging people to consider multiple alternatives appears to be a useful debiasing technique for reducing many biases (explanation, hindsight, and overconfidence), if the generation of alternatives is experienced as easy. The present research tests whether these alternative generation procedures induce a mental simulation mind-set (cf. Galinsky & Moskowitz, 2000), such that debiasing in one domain transfers to debias judgments in unrelated domains. The results indeed demonstrated that easy alternative generation tasks not only debiased judgments in the same domain but also generalized to debias judgments in unrelated domains, provided that participants were low in the need for structure. The alternative generation tasks (even when they were easy to perform) showed no evidence of activating a mental simulation mind-set in individuals high in need for structure, as these individuals displayed no transfer effects. Implications of the results for understanding the role of the need for structure, ease of generation, and mental simulation mind-set activation for debiasing are discussed.     

On Guessing: An Alternative Adjusted Positive Learning Estimator and Comparing Probability Misspecification With Monte Carlo Simulations

Practitioners in the sciences have used the “flow” of knowledge (post-test score minus pre-test score) to measure learning in the classroom for the past 50 years. Walstad and Wagner, and Smith and Wagner moved this practice forward by disaggregating the flow of knowledge and accounting for student guessing. These estimates are sensitive to misspecification of the probability of guessing correct. This work provides guidance to practitioners and researchers facing this problem. We introduce a transformed measure of true positive learning that under some knowable conditions performs better when students’ ability to guess correctly is misspecified and converges to Hake’s normalized learning gain estimator under certain conditions. We then use simulations to compare the accuracy of two estimation techniques under various violations of the assumptions of those techniques. Using recursive partitioning trees fitted to our simulation results, we provide the practitioner concrete guidance based on a set of yes/no questions.     

Is disability really an obstacle to success? Impact of a disability simulation on motivation and performance

In Western societies, statistics on the integration of people with disabilities into the labor market consistently indicate that this category of workers faces serious discrimination. Research has evidenced negative perceptions about their occupational skills, despite positive beliefs about their personal qualities. The main purpose of this study was to show how these subjective beliefs about disability can shape performance (speed and accuracy, Studies 1, 3, and 4) and self‐reported motivation (Studies 2, 3, and 4) of able‐bodied persons simulating a disability. Participants were 281 French students without disabilities who carried out a task either with or without a simulated disability. This simulated disability constituted an actual handicap to perform the task (Studies 1 and 2) or not (Studies 3 and 4). The first three studies were focused on cognitive abilities, whereas Study 4 introduced a job interview component. Results consistently showed that participants in the simulated disability situation completed the task more accurately than controls, but took more time to do so. Higher degrees of motivation and perseverance are found for participants in the simulated disability situation, except in a job interview setting. These results are important for understanding how subjective beliefs about persons with disabilities can constitute objective barriers to social participation, and more specifically, to access to the labor market.