Knowledge, skills and beetles: respecting the privacy of private experiences in medical education

In medical education, we assess knowledge, skills, and a third category usually called values or attitudes. While knowledge and skills can be assessed, this third category consists of ‘beetles’, after the philosopher Wittgenstein’s beetle-in-a-box analogy. The analogy demonstrates that private experiences such as pain and hunger are inaccessible to the public, and that we cannot know whether we all experience them in the same way. In this paper, we claim that unlike knowledge and skills, private experiences of medical learners cannot be objectively measured, assessed, or directly accessed in any way. If we try to do this anyway, we risk reducing them to knowledge and skills—thereby making curriculum design choices based on what can be measured rather than what is valuable education, and rewarding zombie-like student behaviour rather than authentic development. We conclude that we should no longer use the model of representation to assess attitudes, emotions, empathy, and other beetles. This amounts to, first of all, shutting the

Satisfying basic psychological needs among people with complex support needs:A self-determination theory-guided analysis of primary relatives' perspectives

Background: The fulfilment of basic psychological needs (BPNs) is seen as an integral part of human self-determination, subjective wellbeing, and overall quality of life. However, the meaning of these psychological constructs for individuals with the most extensive support needs remains elusive. Methods: Primary relatives of nine people diagnosed with severe or profound intellectual and multiple disabilities were interviewed about their perceptions of autonomy, competence, and relatedness regarding their family member with complex care needs, and about the ways in which they tried to support their family member in fulfilling specific BPNs. The interview analysis followed a grounded theory with the sensitizing concepts approach. Results: The relatives assigned important meaning to the BPNs, providing insights into their subtle nature, their implicit drivers, and how they were experienced. The relatives also identified serious challenges in detecting, clarifying, and creating opportunities for BPNs. Conclusions: The themes in the relatives’ perspectives can be summarized into a conceptual framework that may contribute to better mutual understanding between people with complex care needs, their relatives, and healthcare providers

Designing Efficient Taxi Pickup Operations at Airports

This paper provides a practical procedure for designing efficient taxi pickup operations at airports. How to do this effectively is an open question. Solutions are not available, and practices vary. They reflect different approaches to and lack of research on the subject. The solutions are often unsatisfactory. At many airports, passengers routinely suffer long waits outdoors, exposed to the elements, after a tiring journey. Such disagreeable experiences are avoidable. Designing efficient taxi pickup operations at airports is problematic. The peculiarities of the process preclude easy solutions. First, the process involves queuing, so system performance is a nonlinear function of the loads. Second, it features unstable transient situations, since travelers typically arrive in bulk over short periods. Third, traffic is significantly differentiated and consists of a wide variety of groups implying different service characteristics. Standard results from queuing theory thus do not have a useful application to this problem. The design process uses simulation that is based on detailed observation of local practices. It involves four steps: (a) detailed local measurements of the arrival of both travelers and taxis, and the service rates provided by taxis in different queuing positions; (b) creation and validation of a simulation model sufficiently detailed to account for these realities; (c) exploration of design alternatives to estimate the characteristics of the service they would provide; and (d) selection of a preferred design that properly balances efforts to minimize average and extreme wait times. The paper demonstrates the procedure through application to Lisbon International Airport, Portugal.SIMUL8 Corporatio

Organic or organised: An interaction analysis to identify how interactional practices influence participation in group decision meetings for residency selection

Objectives This study aims to shed light on interactional practices in real-life selection decision-making meetings. Adequate residency selection is crucial, yet currently, we have little understanding of how the decision-making process takes place in practice. Since having a wide range of perspectives on candidates is assumed to enhance decision-making, our analytical focus will lie on the possibilities for committee members to participate by contributing their perspective. Design We analysed interaction in seven recorded real-life selection group decision meetings, with explicit attention to participation. Setting Selection meetings of four different highly competitive specialties in two Dutch regions. Participants 54 participants discussed 68 candidates. Methods To unravel interactional practices, group discussions were analysed using a hybrid data-driven, iterative analytical approach. We paid explicit attention to phenomena which have effects on participation. Word counts and an inductive qualitative analysis were used to identify existing variations in the current practices. Results We found a wide variety of practices. We highlight two distinct interactional patterns, which are illustrative of a spectrum of turn-taking practices, interactional norms and conventions in the meetings. Typical for the first pattern - organised' - is a chairperson who is in control of the topic and turn-taking process, silences between turns and a slow topic development. The second pattern - organic' - can be recognised by overlapping speech, clearly voiced disagreements and negotiation about the organisation of the discussion. Both interactional patterns influence the availability of information, as they create different types of thresholds for participation. Conclusions By deconstructing group decision-making meetings concerning resident selection, we show how structure, interactional norms and conventions affect participation. We identified a spectrum ranging from organic to organised. Both ends have different effects on possibilities for committee members to participate. Awareness of this spectrum might help groups to optimise decision processes by enriching the range of perspectives shared

An OLG model of growth with longevity : when grandparents take care of grandchildren

By assuming that grandparents take care of grandchildren, this paper aims at studying the effects of longevity on long-term economic growth in a model with overlapping generations and endogenous fertility. We show that an increase in longevity may: (i) reduce the long-term economic growth; (ii) increase the supply of labour, and (iii) cause fertility either to increase of decrease depending on the size of time spent by grandparents to rise grandchildren. These findings also hold in an endogenous growth setting a` la Romer (J Polit Econ 94:1002–1037, 1986).info:eu-repo/semantics/publishedVersio