Professional decision-making in medicine: Development of a new measure and preliminary evidence of validity

INTRODUCTION: This study developed a new Professional Decision-Making in Medicine Measure that assesses the use of effective decision-making strategies: seek help, manage emotions, recognize consequences and rules, and test assumptions and motives. The aim was to develop a content valid measure and obtain initial evidence for construct validity so that the measure could be used in future research or educational assessment. METHODS: Clinical scenario-based items were developed based on a review of the literature and interviews with physicians. For each item, respondents are tasked with selecting two responses (out of six plausible options) that they would choose in that situation. Three of the six options reflect a decision-making strategy; these responses are scored as correct. Data were collected from a sample of 318 fourth-year medical students in the United States. They completed a 16-item version of the measure (Form A) and measures of social desirability, moral disengagement, and professionalism attitudes. Professionalism ratings from clerkships were also obtained. A sub-group (n = 63) completed a second 16-item measure (Form B) to pilot test the instrument, as two test forms are useful for pre-posttest designs. RESULTS: Scores on the new measure indicated that, on average, participants answered 75% of items correctly. Evidence for construct validity included the lack of correlation between scores on the measure and socially desirable responding, negative correlation with moral disengagement, and modest to low correlations with professionalism attitudes. A positive correlation was observed with a clerkship rating focused on professionalism in peer interactions. CONCLUSIONS: These findings demonstrate modest proficiency in the use of decision-making strategies among fourth-year medical students. Additional research using the Professional Decision-Making Measure should explore scores among physicians in various career stages, and the causes and correlates of scores. Educators could utilize the measure to assess courses that teach decision-making strategies

Forensic investigation of microtraces on an item of Dutch eighteenth century clothing in the Rijksmuseum collection

Most garments in museum collections have belonged to people of high societal status. Clothing of the common people, however, has rarely been preserved. Because of this, the conservation of such rare items is of special importance. The current study focuses on such an object from the Rijksmuseum collection; a pair of eighteenth century breeches that were retrieved from an anonymous grave on Spitsbergen. As these breeches contain several unidentified materials, it is unclear how best to conduct the conservation of the object. The identification of trace material plays a key role within criminal law and therefore, it is hypothesized that a forensic approach could provide a suitable framework within this case of cultural heritage as well. After forensic examination, trace material was analyzed using a microscopy-based approach and was found to be mainly of biological origin. Energy-dispersive X-ray (EDX) and Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) spectroscopy indicated the presence of human skin remains. It was concluded that a modern forensic approach can successfully be applied to a historical object within cultural heritage and can assist decision-making regarding possible future conservation of the object. The systematic application of the forensic methodology was found to be appropriate with little to no modification to classify and identify trace materials, but further improvements could be made. The current work should be seen as a starting point that allows for more questions regarding museum objects to be answered in a forensic manner, including aspects such as authenticity, the chain of custody, the context, original use and object conservation

The concentration and origins of carboxylic acid groups in oil paint

Although the concentration of carboxylic acid (COOH) groups is crucial to understand oil paint chemistry, analytical challenges hindered COOH quantification in complex polymerised oil samples thus far. The concentration of COOH groups is important in understanding oil paint degradation because it drives the breakdown of reactive inorganic pigments to dissolve in the oil network and form metal carboxylates. The metal ions in such an ionomeric polymer network can exchange with saturated fatty acids to form crystalline metal soaps (metal complexes of saturated fatty acids), leading to serious problems in many paintings worldwide. We developed two methods based on ATR-FTIR spectroscopy to accurately estimate the COOH concentration in artificially aged oil paint models. Using tailored model systems composed of linseed oil, ZnO and inert filler pigments, these dried oil paints were found to contain one COOH group per triacylglycerol unit. Model systems based on a mixture of long chain alcohols showed that the calculated COOH concentration originates from side chain autoxidation at low relative humidity (RH). The influence of increasing RH and ZnO concentration on COOH formation was studied and high relative humidity conditions were shown to promote the formation of COOH groups. No significant ester hydrolysis was found under the conditions studied. Our results show the potential of quantitative analysis of oil paint model systems for aiding careful (re)evaluation of conservation strategies

Interface alloying and magnetic properties of Fe/Rh multilayers

Rh(20 Å)/57Fe(tFe) multilayers with Fe thicknesses tFe of 2, 5, 10, and 15 Å prepared by alternate evaporation in UHV have been investigated by x-ray diffraction (XRD), Mössbauer spectroscopy, and SQUID magnetometry. First- and second-order superstructure Bragg peaks (but no higher-order peaks) in small-angle XRD patterns suggest some compositional modulation. Mössbauer spectra taken at 4.2 K are characterized by a distribution P(Bhf) of hyperfine fields Bhf. Peaks observed in the P(Bhf) curves near 17 and 35 T are assigned to an fcc-RhFe interface alloy (~7–24 at. % Fe) with spin-glasslike properties and to a disordered ferromagnetic bcc-FeRh alloy (~96 at. % Fe), respectively. The magnetic transition temperature of the fcc alloy was found to be 23 and 45 K for tFe=2 and 5 Å, respectively, and Bhf follows a T3/2 law. For tFe=2 Å, spin-glasslike behavior was observed by magnetometry. Journal of Applied Physics is copyrighted by The American Institute of Physics