Using XML and XSLT for flexible elicitation of mental-health risk knowledge

Current tools for assessing risks associated with mental-health problems require assessors to make high-level judgements based on clinical experience. This paper describes how new technologies can enhance qualitative research methods to identify lower-level cues underlying these judgements, which can be collected by people without a specialist mental-health background. Methods and evolving results: Content analysis of interviews with 46 multidisciplinary mental-health experts exposed the cues and their interrelationships, which were represented by a mind map using software that stores maps as XML. All 46 mind maps were integrated into a single XML knowledge structure and analysed by a Lisp program to generate quantitative information about the numbers of experts associated with each part of it. The knowledge was refined by the experts, using software developed in Flash to record their collective views within the XML itself. These views specified how the XML should be transformed by XSLT, a technology for rendering XML, which resulted in a validated hierarchical knowledge structure associating patient cues with risks. Conclusions: Changing knowledge elicitation requirements were accommodated by flexible transformations of XML data using XSLT, which also facilitated generation of multiple data-gathering tools suiting different assessment circumstances and levels of mental-health knowledge

An examination of Cultural Competence Training in US Medical Education Guided by the Tool for Assessing Cultural Competence Training

In the United States, medical students must demonstrate a standard level of “cultural competence,” upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in systems, organizations, and among professionals to enable effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify content gaps and opportunities for curriculum improvement. A total of 18 programs are assessed. Findings support previous research that cultural competence training can improve the knowledge, attitudes, and skills of medical trainees. However, wide variation in the conceptualization, implementation, and evaluation of cultural competence training programs exists, leading to differences in training quality and outcomes. More research is needed to establish optimal approaches to implementing and evaluating cultural competence training that incorporate cultural humility, the social determinants of health, and broader structural competency within the medical system

Eliciting Expertise

Since the last edition of this book there have been rapid developments in the use and exploitation of formally elicited knowledge. Previously, (Shadbolt and Burton, 1995) the emphasis was on eliciting knowledge for the purpose of building expert or knowledge-based systems. These systems are computer programs intended to solve real-world problems, achieving the same level of accuracy as human experts. Knowledge engineering is the discipline that has evolved to support the whole process of specifying, developing and deploying knowledge-based systems (Schreiber et al., 2000) This chapter will discuss the problem of knowledge elicitation for knowledge intensive systems in general

“[She] said : ‘take the test’ and I took the test”. Relational work as a framework to approach directiveness in prenatal screening of Chinese clients in Hong Kong

In this paper we apply the framework of relational work, or the work individuals invest in maintaining their relationships (Locher and Watts 2005), to the analysis of prenatal screening (PS) for Down Syndrome of Chinese clients in Hong Kong. PS has traditionally followed a nondirective principle that calls for an unbiased presentation of information and women’s autonomous decision- making regarding testing. However, in Chinese contexts, healthcare providers appear extremely directive; and women, in turn, explicitly express their expectations of being led in decision-making (Zayts et al. 2013). These observations lend support to previous politeness studies of Chinese institutional contexts wherein hierarchical communication has been described as “listening-centered, asymmetrical and differential” (Gao and Ting-Toomey 1998: 48). More recent politeness studies, however, warn against such stereotyping at a cultural level (Eelen 2001; Mills 2003, 2004; Watts 2003). In this paper, rather than using culture as an a priori explanatory variable to account for the directive stance of the healthcare providers, we argue that using the framework of relational work enables researchers to focus on how meaning is created and negotiated at the micro-level of an interaction, and to move away from “grand generalizations” about culture specific behaviors and expectations