37 research outputs found

    The effect of clinical experience, judgment task difficulty and time pressure on nurses’ confidence calibration in a high fidelity clinical simulation

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    Background: Misplaced or poorly calibrated confidence in healthcare professionals’ judgments compromises the quality of health care. Using higher fidelity clinical simulations to elicit clinicians’ confidence 'calibration' (i.e. overconfidence or underconfidence) in more realistic settings is a promising but underutilized tactic. In this study we examine nurses’ calibration of confidence with judgment accuracy for critical event risk assessment judgments in a high fidelity simulated clinical environment. The study also explores the effects of clinical experience, task difficulty and time pressure on the relationship between confidence and accuracy. Methods: 63 student and 34 experienced nurses made dichotomous risk assessments on 25 scenarios simulated in a high fidelity clinical environment. Each nurse also assigned a score (0–100) reflecting the level of confidence in their judgments. Scenarios were derived from real patient cases and classified as easy or difficult judgment tasks. Nurses made half of their judgments under time pressure. Confidence calibration statistics were calculated and calibration curves generated. Results: Nurse students were underconfident (mean over/underconfidence score −1.05) and experienced nurses overconfident (mean over/underconfidence score 6.56), P = 0.01. No significant differences in calibration and resolution were found between the two groups (P = 0.80 and P = 0.51, respectively). There was a significant interaction between time pressure and task difficulty on confidence (P = 0.008); time pressure increased confidence in easy cases but reduced confidence in difficult cases. Time pressure had no effect on confidence or accuracy. Judgment task difficulty impacted significantly on nurses’ judgmental accuracy and confidence. A 'hard-easy' effect was observed: nurses were overconfident in difficult judgments and underconfident in easy judgments. Conclusion: Nurses were poorly calibrated when making risk assessment judgments in a high fidelity simulated setting. Nurses with more experience tended toward overconfidence. Whilst time pressure had little effect on calibration, nurses’ over/underconfidence varied significantly with the degree of task difficulty. More research is required to identify strategies to minimize such cognitive biases

    Vertical Integration and Media Regulation in the New Economy

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    Metaphor And Art Interactionism and Reference in the Verbal and Nonverbal Art

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    Charles S. Peirce's evolutionary philosophy

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    In this systematic introduction to the philosophy of Charles S. Peirce, the author focuses on four of Peirce's fundamental conceptions: pragmatism and Peirce's development of it into what he called 'pragmaticism'; his theory of signs; his phenomenology; and his theory that continuity is of prime importance for philosophy. He argues that at the centre of Peirce's philosophical project is a unique form of metaphysical realism, whereby continuity and evolutionary change are both necessary for our understanding of experience. In his final chapter Professor Hausman applies this version of realism to contemporary controversies between anti-realists and anti?idealists. Peirce's views are compared to those of such contemporary figures as Davidson, Putnam, and Rorty. The book will be of particular interest to philosophers concerned with American philosophy and current debates on realism as well as linguists working in semiotics

    Carta de 1981-11-16 a José Ferrater Mora des de Pensilvània (Estats Units d'Amèrica)

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    Es demana a Ferrater un informe confidencial sobre l'activitat investigadora de Priscilla Cohn i una valoració sobre la seva carrera en comparació amb altres professors del mateix nivell professiona

    Faith and the Arts: A Biblical Understanding of Christian Arts

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