Doctors' thinking about the system as a threat to patient safety

‘Systems thinking’ is an important feature of the emerging ‘patient safety’ agenda. As a key component of a ‘safety culture’, it encourages clinicians to look past individual error to recognise the latent factors that threaten safety. This paper investigates whether current medical thinking is commensurate with the idea of ‘systems thinking’ together with its implications for policy. The findings are based on qualitative semistructured interviews with specialist physicians working within one NHS District General Hospital in the English Midlands. It is shown that, rather then favouring a 'person-centred’ perspective, doctors readily identify ‘the system’ as a threat to patient safety. This is not necessarily a reflection of the prevailing safety discourse or knowledge of policy, but reflects a tacit understanding of how services are (dis)organised. This line of thinking serves to mitigate individual wrong-doing and protect professional credibility by encouraging doctors to accept and accommodate the shortcomings of the system, rather than participate in new forms of organisational learning.

Relations among Topic Knowledge, Individual Interest, and Relational Reasoning, and Critical Thinking in Maternity Nursing

Critical thinking in learners is a goal of educators and professional organizations in nursing as well as other professions. However, few studies in nursing have examined the role of the important individual difference factors topic knowledge, individual interest, and general relational reasoning strategies in predicting critical thinking. In addition, most previous studies have used domain-general, standardized measures, with inconsistent results. Moreover, few studies have investigated critical thinking across multiple levels of experience. The major purpose of this study was to examine the degree to which topic knowledge, individual interest, and relational reasoning predict critical thinking in maternity nurses. For this study, 182 maternity nurses were recruited from national nursing listservs explicitly chosen to capture multiple levels of experience from prelicensure to very experienced nurses. The three independent measures included a domain-specific Topic Knowledge Assessment (TKA), consisting of 24 short-answer questions, a Professed and Engaged Interest Measure (PEIM), with 20 questions indicating level of interest and engagement in maternity nursing topics and activities, and the Test of Relational Reasoning (TORR), a graphical selected response measure with 32 items organized in scales corresponding to four forms of relational reasoning: analogy, anomaly, antithesis, and antinomy. The dependent measure was the Critical Thinking Task in Maternity Nursing (CT2MN), composed of a clinical case study providing cues with follow-up questions relating to nursing care. These questions align with the cognitive processes identified in a commonly-used definition of critical thinking in nursing. Reliable coding schemes for the measures were developed for this study. Key findings included a significant correlation between topic knowledge and individual interest. Further, the three individual difference factors explained a significant proportion of the variance in critical thinking with a large effect size. While topic knowledge was the strongest predictor of critical thinking performance, individual interest had a moderate significant effect, and relational reasoning had a small but significant effect. The findings suggest that these individual difference factors should be included in future studies of critical thinking in nursing. Implications for nursing education, research, and practice are discussed.

A divide-and-conquer bound for aggregate's quality and algebraic connectivity

info:eu-repo/semantics/submittedForPublication

Very special divisors on 4-gonal real algebraic curves

International audience

Proportion dominance in valuing lives: The role of deliberative thinking

Proportion responding (PR) is the preference for proportionally higher gains, such that the same absolute quantity is valued more as the reference group decreases. This research investigated this kind of proportion PR in decisions about saving lives (e.g., saving 10/10 lives is preferred to saving 10/100 lives). The results of two studies suggest that PR does not stem from an overall tendency to choose higher proportions, but rather from faulty deliberative reasoning. In particular, people who display PR are less likely to engage in deliberative reflection as measured by response time, the Process Dissociation Procedure, the Cognitive Reflection Test, a numeracy test, and a task assessing denominator neglect. This association between faulty deliberation and PR was observed only when choosing the highest proportion was non-normative because it came at the expense of absolute gains (e.g., saving 10/10 lives is preferred to saving 11/100 lives). These results help to make sense of discrepant findings in previous research, pertaining to how PR relates to biased reasoning and decision making.

System Thinking to Understand Networked Innovation

Part 9: Innovation Networks

DIGITAL HISTORY: DESIGNING VIRTUAL ENVIRONMENTS THAT SUPPORT CRITICAL THINKING AND IDEA EXCHANGE, MOTIVATE AND ENGAGE USERS

Thesis (Master, Education) -- Queen's University, 2016-08-29 15:56:53.748

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.

The role of information literacy competence and higher order thinking skills to develop academic writing in science and engineering students

This article discusses a study organized to develop academic writing skills in undergraduate students pursuing engineering courses. The target group consisted of 30 students pursuing a Bachelor of Technology in their third year. The classroom observations regarding teaching writing revealed that writing proficiency for most of the students was at a very low level. Followed by this, an intervention program was organized in one college, where the researcher taught academic writing to the students. Units comprising tasks that focused on raising awareness of the academic texts and involving the students in the cognitive processes of writing were designed. The study focused on raising student awareness regarding the nature and characteristics of academic texts in order to develop academic writing skills. The study also emphasized that involving the students in the cognitive processes of writing (e.g., defining the rhetorical problem, identifying the rhetorical situation, determining the audience, setting goals for writing, planning for the text by generating, and organizing ideas) is necessary. The study further suggests that discussions between students and teachers regarding the construction of a text and the way language works in various text types facilitates better writing.

WEB6203 Interdisciplinary Thinking: Poster Mark sheet

Marking criteria for the poster assignment

Product/Brand co-creation methodology crossing marketing, design thinking, creativity and management: ideas(r)evolution

This thesis introduce a new innovation methodology called IDEAS(R)EVOLUTION that was developed according to an on-going experimental research project started in 2007. This new approach to innovation has initial based on Design thinking for innovation theory and practice. The concept of design thinking for innovation has received much attention in recent years. This innovation approach has climbed from the design and designers knowledge field towards other knowledge areas, mainly business management and marketing. Human centered approach, radical collaboration, creativity and breakthrough thinking are the main founding principles of Design thinking that were adapted by those knowledge areas due to their assertively and fitness to the business context and market complexity evolution. Also Open innovation, User-centered innovation and later on Living Labs models emerge as answers to the market and consumers pressure and desire for new products, new services or new business models. Innovation became the principal business management focus and strategic orientation. All this changes had an impact also in the marketing theory. It is possible now to have better strategies, communications plans and continuous dialogue systems with the target audience, incorporating their insights and promoting them to the main dissemination ambassadors of our innovations in the market. Drawing upon data from five case studies, the empirical findings in this dissertation suggest that companies need to shift from Design thinking for innovation approach to an holistic, multidimensional and integrated innovation system. The innovation context it is complex, companies need deeper systems then the success formulas that “commercial “Design thinking for innovation “preaches”. They need to learn how to change their organization culture, how to empower their workforce and collaborators, how to incorporate external stakeholders in their innovation processes, hoe to measure and create key performance indicators throughout the innovation process to give them better decision making data, how to integrate meaning and purpose in their innovation philosophy. Finally they need to understand that the strategic innovation effort it is not a “one shot” story it is about creating a continuous flow of interaction and dialogue with their clients within a “value creation chain“ mindset; RESUMO: Metodologia de co-criação de um produto/marca cruzando Marketing, Design Thinking, Criativity and Management - IDEAS(R)EVOLUTION. Esta dissertação apresenta uma nova metodologia de inovação chamada IDEAS(R)EVOLUTION, que foi desenvolvida segundo um projecto de investigação experimental contínuo que teve o seu início em 2007. Esta nova abordagem baseou-se, inicialmente, na teoria e na práctica do Design thinking para a inovação. Actualmente o conceito do Design Thinking para a inovação “saiu” do dominio da area de conhecimento do Design e dos Designers, tendo despertado muito interesse noutras áreas como a Gestão e o Marketing. Uma abordagem centrada na Pessoa, a colaboração radical, a criatividade e o pensamento disruptivo são principios fundadores do movimento do Design thinking que têm sido adaptados por essas novas áreas de conhecimento devido assertividade e adaptabilidade ao contexto dos negócios e à evolução e complexidade do Mercado. Também os modelos de Inovação Aberta, a inovação centrada no utilizador e mais tarde os Living Labs, emergem como possiveis soluções para o Mercado e para a pressão e desejo dos consumidores para novos productos, serviços ou modelos de negócio. A inovação passou a ser o principal foco e orientação estratégica na Gestão. Todas estas mudanças também tiveram impacto na teoria do Marketing. Hoje é possivel criar melhores estratégias, planos de comunicação e sistemas continuos de diálogo com o público alvo, incorporando os seus insights e promovendo os consumidores como embaixadores na disseminação da inovação das empresas no Mercado Os resultados empiricos desta tese, construídos com a informação obtida nos cinco casos realizados, sugerem que as empresas precisam de se re-orientar do paradigma do Design thinking para a inovação, para um sistema de inovação mais holistico, multidimensional e integrado. O contexto da Inovação é complexo, por isso as empresas precisam de sistemas mais profundos e não apenas de “fórmulas comerciais” como o Design thinking para a inovação advoga. As Empresas precisam de aprender como mudar a sua cultura organizacional, como capacitar sua força de trabalho e colaboradores, como incorporar os públicos externos no processo de inovação, como medir o processo de inovação criando indicadores chave de performance e obter dados para um tomada de decisão mais informada, como integrar significado e propósito na sua filosofia de inovação. Por fim, precisam de perceber que uma estratégia de inovação não passa por ter “sucesso uma vez”, mas sim por criar um fluxo contínuo de interação e diálogo com os seus clientes com uma mentalidade de “cadeia de criação de valor”

Try thinking like a tree

Reflections on the value of experimente over project on architecture thinking. An essay on the operativity of the notions of: "Collections"; "Tools"; "Instructions"; "Walks" and "reCollections"

Measuring with our memory, Thinking with our feet: Patrick Geddes and Richard Serra, two worldviews with walking in the centre

A reflection on the relevance of the experience of walking in the production and thinking of a pioneer urban planer, such as Patrick Geddes, and a pioneer landscape artist, such as Richard Serra. Despite the fact that are two unknown visions one from the other, and dispite the fact that are territorialy apart and scientifically apart, also, the subjectivity of the dimension of the experience of the body when walkin a place, have sparkling similarities.