Medical education as moral formation: an Aristotelian account of medical professionalsim.

The medical professionalism movement, bolstered by many influential medical organizations and institutions, has in the last decade produced a number of conceptual definitions of professionalism and a number of concrete proposals for its measurement and teaching. These projects, however laudable, are misguided when they treat professionalism as a unitary descriptive concept rather than as a contested and therefore primarily evaluative one; when they conceive professionalism as a domain of medical practice separable in principle from other domains; and when they treat professionalism as, in principle, a specifiable goal or product of sufficiently well designed educational curricula. The logic of professionalism-as-product corresponds to the logic of techne (art or practical skill) in Aristotle's Nicomachean Ethics. Aristotle provides a cogent argument, however, that the moral excellences denoted by "professionalism" cannot be "produced" or even prespecified in the concrete; rather, they must be acquired through long practice under the careful concrete guidance of teachers who themselves embody these moral excellences. Phronesis (practical wisdom) rather than techne must therefore be the guiding logic of educational initiatives in medical professional formation, with particular emphasis on close mentorship and on the moral character both of students and of those who teach them.

Essays on the Economics of Higher Education

At least since the seminal works of Jacob Mincer, labor economists have sought to understand how students make higher education investment decisions. Mincer’s original work seeks to understand how students decide how much education to accrue; subsequent work by various authors seeks to understand how students choose where to attend college, what field to major in, and whether to drop out of college.

Broadly speaking, this rich sub-field of literature contributes to society in two ways: First, it provides a better understanding of important social behaviors. Second, it helps policymakers anticipate the responses of students when evaluating various policy reforms.

While research on the higher education investment decisions of students has had an enormous impact on our understanding of society and has shaped countless education policies, students are only one interested party in the higher education landscape. In the jargon of economists, students represent only the `demand side’ of higher education---customers who are choosing options from a set of available alternatives. Opposite students are instructors and administrators who represent the `supply side’ of higher education---those who decide which options are available to students.

For similar reasons, it is also important to understand how individuals on the supply side of education make decisions: First, this provides a deeper understanding of the behaviors of important social institutions. Second, it helps policymakers anticipate the responses of instructors and administrators when evaluating various reforms. However, while there is substantial literature understanding decisions made on the demand side of education, there is far less attention paid to decisions on the supply side of education.

This dissertation uses empirical evidence to better understand how instructors and administrators make decisions and the implications of these decisions for students.

In the first chapter, I use data from Duke University and a Bayesian model of correlated learning to measure the signal quality of grades across academic fields. The correlated feature of the model allows grades in one academic field to signal ability in all other fields allowing me to measure both ‘own category' signal quality and ‘spillover' signal quality. Estimates reveal a clear division between information rich Science, Engineering, and Economics grades and less informative Humanities and Social Science grades. In many specifications, information spillovers are so powerful that precise Science, Engineering, and Economics grades are more informative about Humanities and Social Science abilities than Humanities and Social Science grades. This suggests students who take engineering courses during their Freshman year make more informed specialization decisions later in college.

In the second chapter, I use data from the University of Central Arkansas to understand how universities decide which courses to offer and how much to spend on instructors for these courses. Course offerings and instructor characteristics directly affect the courses students choose and the value they receive from these choices. This chapter reveals the university preferences over these student outcomes which best explain observed course offerings and instructors. This allows me to assess whether university incentives are aligned with students, to determine what alternative university choices would be preferred by students, and to illustrate how a revenue neutral tax/subsidy policy can induce a university to make these student-best decisions.

In the third chapter, co-authored with Thomas Ahn, Peter Arcidiacono, and Amy Hopson, we use data from the University of Kentucky to understand how instructors choose grading policies. In this chapter, we estimate an equilibrium model in which instructors choose grading policies and students choose courses and study effort given grading policies. In this model, instructors set both a grading intercept and a return on ability and effort. This builds a rich link between the grading policy decisions of instructors and the course choices of students. We use estimates of this model to infer what preference parameters best explain why instructors chose estimated grading policies. To illustrate the importance of these supply side decisions, we show changing grading policies can substantially reduce the gender gap in STEM enrollment.

The effects of financial education in the workplace: Evidence from a survey of employers

We examine the effects of education on financial decision-making skills by identifying an interesting source of variation in pertinent training. During the 1990s, an increasing number of individuals were exposed to programs of financial education provided by their employers. If, as some have argued, low saving frequently results from a failure to appreciate economic vulnerabilities, then education of this form could prove to have a powerful effect on behavior. The current article undertakes an analysis of these programs using a previously unexploited survey of employers. We find that both participation in and contributions to voluntary savings plans are significantly higher when employers offer retirement seminars. The effect is typically much stronger for nonhighly compensated employees than for highly compensated employees. The frequency of seminars emerges as a particularly important correlate of behavior. We are unable to detect any effects of written materials, such as newsletters and summary plan descriptions, regardless of frequency. We also present evidence on other determinants of plan activity. © 2008 Western Economic Association International.

Division of labor in frontal eye field neurons during presaccadic remapping of visual receptive fields.

Our percept of visual stability across saccadic eye movements may be mediated by presaccadic remapping. Just before a saccade, neurons that remap become visually responsive at a future field (FF), which anticipates the saccade vector. Hence, the neurons use corollary discharge of saccades. Many of the neurons also decrease their response at the receptive field (RF). Presaccadic remapping occurs in several brain areas including the frontal eye field (FEF), which receives corollary discharge of saccades in its layer IV from a collicular-thalamic pathway. We studied, at two levels, the microcircuitry of remapping in the FEF. At the laminar level, we compared remapping between layers IV and V. At the cellular level, we compared remapping between different neuron types of layer IV. In the FEF in four monkeys (Macaca mulatta), we identified 27 layer IV neurons with orthodromic stimulation and 57 layer V neurons with antidromic stimulation from the superior colliculus. With the use of established criteria, we classified the layer IV neurons as putative excitatory (n = 11), putative inhibitory (n = 12), or ambiguous (n = 4). We found that just before a saccade, putative excitatory neurons increased their visual response at the RF, putative inhibitory neurons showed no change, and ambiguous neurons increased their visual response at the FF. None of the neurons showed presaccadic visual changes at both RF and FF. In contrast, neurons in layer V showed full remapping (at both the RF and FF). Our data suggest that elemental signals for remapping are distributed across neuron types in early cortical processing and combined in later stages of cortical microcircuitry.