Systems 1 and 2 thinking processes and cognitive reflection testing in medical students

Background: Diagnostic decision-making is made through a combination of Systems 1 (intuition or pattern-recognition) and Systems 2 (analytic) thinking. The purpose of this study was to use the Cognitive Reflection Test (CRT) to evaluate and compare the level of Systems 1 and 2 thinking among medical students in pre-clinical and clinical programs. Methods: The CRT is a three-question test designed to measure the ability of respondents to activate metacognitive processes and switch to System 2 (analytic) thinking where System 1 (intuitive) thinking would lead them astray. Each CRT question has a correct analytical (System 2) answer and an incorrect intuitive (System 1) answer. A group of medical students in Years 2 & 3 (pre-clinical) and Years 4 (in clinical practice) of a 5-year medical degree were studied. Results: Ten percent (13/128) of students had the intuitive answers to the three questions (suggesting they generally relied on System 1 thinking) while almost half (44%) answered all three correctly (indicating full analytical, System 2 thinking). Only 3-13% had incorrect answers (i.e. that were neither the analytical nor the intuitive responses). Non-native English speaking students (n = 11) had a lower mean number of correct answers compared to native English speakers (n = 117: 1.0 s 2.12 respectfully: p < 0.01). As students progressed through questions 1 to 3, the percentage of correct System 2 answers increased and the percentage of intuitive answers decreased in both the pre-clinical and clinical students. Conclusions: Up to half of the medical students demonstrated full or partial reliance on System 1 (intuitive) thinking in response to these analytical questions. While their CRT performance has no claims to make as to their future expertise as clinicians, the test may be used in helping students to understand the importance of awareness and regulation of their thinking processes in clinical practice.

Development of InAlN HEMTs for space application

This thesis investigates the emerging InAlN high electron mobility transistor (HEMT) technology with respect to its application in the space industry. The manufacturing processes and device performance of InAlN HEMTs were compared to AlGaN HEMTs, also produced as part of this work. RF gain up to 4 GHz was demonstrated in both InAlN and AlGaN HEMTs with gate lengths of 1 μm, with InAlN HEMTs generally showing higher channel currents (~150 c.f. 60 mA/mm) but also degraded leakage properties (~ 1 x 10-4 c.f. < 1 x 10-8 A/mm) with respect to AlGaN. An analysis of device reliability was undertaken using thermal stability, radiation hardness and off-state breakdown measurements. Both InAlN and AlGaN HEMTs showed excellent stability under space-like conditions, with electrical operation maintained after exposure to 9.2 Mrad of gamma radiation at a dose rate of 6.6 krad/hour over two months and after storage at 250°C for four weeks. Furthermore a link was established between the optimisation of device performance (RF gain, power handling capabilities and leakage properties) and reliability (radiation hardness, thermal stability and breakdown properties), particularly with respect to surface passivation. Following analysis of performance and reliability data, the InAlN HEMT device fabrication process was optimised by adjusting the metal Ohmic contact formation process (specifically metal stack thicknesses and anneal conditions) and surface passivation techniques (plasma power during dielectric layer deposition), based on an existing AlGaN HEMT process. This resulted in both a reduction of the contact resistivity to around 1 x 10-4 Ω.cm2 and the suppression of degrading trap-related effects, bringing the measured gate-lag close to zero. These discoveries fostered a greater understanding of the physical mechanisms involved in device operation and manufacture, which is elaborated upon in the final chapter.