Moral growth in medical students

Although students bring to medical school a fairly well established value system, the potential for moral growth through the medical school environment and experience is substantial. The educational environment poses a succession of developmental and adaptive tasks to be accomplished. Several of these tasks are discussed here, tasks that are value-laden and involve, directly or indirectly, the interplay of ethical theory and practice. During the past quarter century, the two influences that have had the greatest impact on the moral growth and moral reasoning capacity of medical students have been the incorporation into the medical school curriculum of courses in medical humanities and the admission to medical school of an increasing number of female students. The female students have brought to medical school a level or dimension of moral reasoning (morality as care or responsibility for others) to augment the male students' focus on rights and justice considerations.     

A stochastic growth model applied to repeated tests of academic knowledge

In the course of the medical program at the University of Limburg, students complete a total of 24 progress tests, consisting of items drawn from a constant itembank. A model is presented for the growth of knowledge reflected by these results. The Rasch model is used as a starting point, but both ability and difficulty parameters are taken to be random, and moreover the logistic distribution is replaced by the normal. Both individual and group abilities are estimated and explained through simple linear regression. Application to real data shows that the model fits very well.     

Cross-Sectional Analysis of Longitudinal Mediation Processes

Statistical mediation analysis can help to identify and explain the mechanisms behind psychological processes. Examining a set of variables for mediation effects is a ubiquitous process in the social sciences literature; however, despite evidence suggesting that cross-sectional data can misrepresent the mediation of longitudinal processes, cross-sectional analyses continue to be used in this manner. Alternative longitudinal mediation models, including those rooted in a structural equation modeling framework (cross-lagged panel, latent growth curve, and latent difference score models) are currently available and may provide a better representation of mediation processes for longitudinal data. The purpose of this paper is twofold: first, we provide a comparison of cross-sectional and longitudinal mediation models; second, we advocate using models to evaluate mediation effects that capture the temporal sequence of the process under study. Two separate empirical examples are presented to illustrate differences in the conclusions drawn from cross-sectional and longitudinal mediation analyses. Findings from these examples yielded substantial differences in interpretations between the cross-sectional and longitudinal mediation models considered here. Based on these observations, researchers should use caution when attempting to use cross-sectional data in place of longitudinal data for mediation analyses.     

Posttraumatic growth and parental bonding in young adults of parents with physical disabilites: testing mediation model of resilience

Positive parent-child relationships are associated with positive youth development, but little is known about the relationships between parental bonding, resilience, and posttraumatic growth, which is positive change resulting from the struggle with trauma. This study examined a mediation model among 119 female young adults with disabled parents. The model included resilience as a mediator of the relationship between the paternal Care and posttraumatic growth. The results revealed that resilience did mediate the relationship between the paternal Care and posttraumatic growth. The findings indicate that paternal Care helps to foster female young adults’ resilience, which benefits their growth after suffering adversities.     

The life tasks model: Enhancing psychological and spiritual growth in the aged

ABSTRACT

The life tasks model is an active, mutual, and potentially universal approach to the spiritual care of the aged. A life task is a responsibility, once undertaken, that lasts a lifetime. Three tasks are identified. Task 1 is the discovery of hidden learning. The process of discovery draws on implicit learning that comes into awareness. This leads to task 2, testing in which learning brought into awareness is tested by other life experiences. The final task is task 3, integration, in which a more aware and cohesive self is formed. Ideally, this leads to service or vocation. Progress on the life tasks is illustrated by responses in a qualitative study of older adults. Although this model can be applied to self-growth and ministry to all ages, it is well suited to the care of the aged.     

Positive Metacognitions and Meta-Emotions as Predictors of Posttraumatic Stress Disorder and Posttraumatic Growth in Survivors of a Natural Disaster

ABSTRACT

Exposure to natural disasters can lead to both negative and positive mental health consequences (i.e., posttraumatic stress disorder [PTSD] and posttraumatic growth [PTG]). While there is evidence linking metacognition to these outcomes, the focus is mostly on maladaptive metacognitions. The present study investigated the role of positive metacognitions and meta-emotions (i.e., confidence in extinguishing perseveration [Extinguishing], confidence in interpreting emotions as cues [Interpreting], and confidence in setting flexible and attainable hierarchies of goals [Setting]) on PTSD and PTG among Filipino typhoon survivors. Findings supported a model wherein Extinguishing and Setting, but not Interpreting, predicted PTSD and PTG through posttraumatic cognitions.     

Natural Disasters in Indonesia: Relationships Among Posttraumatic Stress,Resource Loss,Depression, Social Support,and Posttraumatic Growth

ABSTRACT

Indonesia is at significant risk for catastrophic natural disasters, including earthquakes, volcanic eruptions, and tsunamis. Few studies have examined psychological functioning following disaster exposure in Indonesia, the fourth most populous country in the world. This study assesses variables associated with posttraumatic stress and posttraumatic growth following a devastating earthquake in Central Java that ranks as one of the costliest in Indonesia. The participants were 85 men and women living in rural farming villages. Almost all (95%) experienced major home damage or total home destruction. Posttraumatic stress symptoms were associated with resource loss, depression, and concerns about future earthquakes. Participants reported moderate posttraumatic growth. Posttraumatic growth was associated with energy resource loss and social support. The findings support conservation of resources stress theory. The implications of the findings for intervention and recovery programs are discussed.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.     

Growth curve models in retrospective memory and prospective memory: the relationship between prediction and performance with task experience

Older adults commonly experience declines in episodic memory that affect their daily lives. The aim was to examine whether the acquired metacognitive awareness that comes with task experience, indexed by meta-retrospective memory (meta-RM)/meta-prospective memory (meta-PM), influences how older adults predict performance on later trials. Participants were 178 community-dwelling older adults. RM performance and predictions were measured using a multi-trial word-list learning task. Predictions and performance for PM were measured using a PM paradigm. Change in RM/PM performance and predictions over the trials/blocks were modelled using latent growth curve analyses. For RM, both predictions and performance increased with task experience. However, for PM, neither performance nor predictions changed with task experience. Hierarchical multiple regressions revealed that metacognitive awareness acquired during the RM and PM tasks influenced how older adults’ modified their predictions of subsequent task performance. Findings are consistent with [Toglia and Kirk’s (2000). Understanding awareness deficits following brain injury. NeuroRehabilitation, 15(1), 57–70] hypothesis that individuals compare ongoing performance to expectations based on metacognitive knowledge, such that a discrepancy between actual and expected performance may influence emergent awareness.