Boas razões para um desempenho ruim em testes: o substrato interacional dos exames educacionais

This paper was originally published in 1992. It arose out of a project to study how clinicians tell parents a diagnosis of a developmental disability. That specific project was part of a larger one conducted in 1985-1986 to study the delivery of bad and good news in both ordinary and medical settings (Maynard, 2003). As part of the developmental disabilities study, we also examined how testing was done as a precedent to deciding on diagnosis (Marlaire and Maynard, 1989), and the paper here about the “interactional substrate” was meant to show the orderliness of testing interactions – the basic structures that made it possible to generate valid and reliable examination scores that could lend to the official assessment. More recently (2013-2015), a research team and I returned to the same clinic with a grant from the U.S. National Science Foundation, to study more intensively the testing and diagnosis of Autism Spectrum Disorders (ASD). In the time between the 1985 study and the recent one, the prevalence of ASD had skyrocketed in the U.S. from 1 in 5000 children to the current rate of 1 in 68. A study of the micro-interactions surrounding testing and diagnosis does not explain the increase in prevalence but it does say just how testing is done and how clinicians use results and other information to diagnose children. With regard to testing, in particular, we have come back to the paper on the interactional substrate again and again because probing this substrate and the practices by which it is constituted remains as an avenue in to understanding ASD as not just a condition of the child but as something that is manifested as a feature of social interaction. There are ways in which ASD as a child’s condition is co-produced by way of (i) the orderliness of interactions between clinicians and children, and (ii) how tests constrain both the clinician and the child in terms of what is visible as “competence.” Thus, in current work, we distinguish between what we call first-order, or concrete competence, which, by way of the interactional substrate, allows testing to be done, regardless of what the official results may be, and second-order displays of abstract competence (Maynard and Turowetz, 2016). Abstract competence involves the ability to produce general answers or ones that are shorn of embodied or other contextual orientations to questions or that involve what Donaldson (1978) has called “disembedded knowledge.” The emphasis of clinical tests on measuring second-order, abstract competence may obscure various kinds of first-order, concrete competence and “autistic intelligence” a child displays (Maynard, 2005). By doing so, testing can potentially make the child seem more impaired than he or she is, or at least suppress information that could improve performance and/or be informative for how to design home and schooling environments that enhance a child’s skills and integration into these social units.Keywords: psychological testing, conversation analysis, disability.Este artigo foi originalmente publicado em 1992. Ele surgiu de um projeto para estudar como os médicos apresentam aos pais um diagnóstico de deficiência no desenvolvimento infantil. Tal projeto específico fazia parte de outro mais amplo, conduzido entre 1985-1986, para estudar a comunicação de boas ou más notícias tanto em cenários cotidianos quanto em cenários de tratamento de saúde (Maynard, 2003). No estudo das deficiências de desenvolvimento, também examinamos o modo como eram realizados os testes que precediam a decisão sobre o diagnóstico (Marlaire e Maynard, 1989), sendo que o artigo aqui apresentado, sobre o “substrato interacional”, visava a mostrar o caráter ordenado das interações durante os testes – as estruturas básicas que possibilitavam gerar escores de exames válidos e confiáveis que pudessem levar à avaliação oficial. Mais recentemente (2013-2015), retornei à mesma clínica com um grupo de pesquisa, com financiamento da Fundação Nacional de Pesquisa dos EUA (U.S. National Science Foundation), para estudar mais intensivamente a testagem e o diagnóstico dos Transtornos do Espectro Autista, TEA, (Autism Spectrum Disorders, ASD). Entre o estudo de 1985 e o mais recentemente realizado, a prevalência de TEA nos EUA disparou de 1 em 5000 crianças para a taxa atual de 1 em 68. Um estudo das microinterações envolvidas nos testes e diagnósticos não explica o aumento na prevalência, mas revela, sim, como os testes são realizados e como os médicos usam os seus resultados e outras informações para diagnosticar as crianças. Em relação à testagem, em particular, retomamos inúmeras vezes o artigo de 1992 sobre o substrato interacional, pois o exame desse substrato e das práticas que o constituem continua sendo um caminho para que se compreendam os TEA não só como condição da criança, mas também como algo que se manifesta como traço da interação social. Há, pois, maneiras de se coproduzir os Transtornos do Espectro Autista como uma condição da criança, as quais se prendem a: (i) o caráter ordenado das interações entre médicos e crianças, e (ii) o modo como os testes cerceiam tanto o médico como a criança em termos do que é visível como “competência”. Assim, no trabalho atual, distinguimos entre, primeiro, o que chamamos de competência concreta ou de primeira-ordem, que permite, por meio do substrato interacional, que a testagem seja realizada, independentemente de quais possam ser os resultados oficiais; e, segundo, o que chamamos de demonstrações de competência abstrata, ou de segunda-ordem (Maynard e Turowetz, 2016). A competência abstrata envolve a habilidade de produzir respostas gerais ou que sejam despidas de orientações para a pergunta com base em elementos corporais ou contextuais de outra natureza, ou que envolvam o que Donaldson (1978) chamou de “conhecimento desencaixado” (“disembedded knowledge”). A ênfase dos testes clínicos em medir a competência abstrata, de segunda-ordem, pode tornar obscuros vários tipos de competência concreta, de primeira-ordem, e de “inteligência autista” que uma criança demonstre (Maynard, 2005). Realizada assim, a testagem pode, potencialmente, fazer uma criança parecer mais incapacitada do que realmente é, ou pode, no mínimo, suprimir informação que pudesse melhorar o desempenho e/ou contribuir para projetar ambientes domésticos e escolares que ampliem as habilidades da criança e a sua integração nessas unidades sociais.Palavras-chave: teste psicológico, análise de conversa, deficiência

Problems and prospects in the study of physician-patient interaction: 30 years of research

■ Abstract Working within the functionalist perspective that he did so much to develop, Parsons (1951) conceptualized the physician-patient relationship according to a normative framework defined by the pattern variable scheme. As Parsons clearly recognized, this normative conceptualization was one that empirical reality at best only approximates. In the 1970s, two major studies established doctor-patient interaction as a viable research domain. In the present review, we consider approaches to the medical interview developing from these initiatives and that have a primary focus on observable features of doctor-patient interaction. Within this orientation, we consider literature dealing with social, moral, and technical dilemmas that physicians and patients face in primary care and the resources that they deploy in solving them. This literature embodies a steady evolution away from a doctor-centered emphasis toward a more balanced focus on the conduct of doctors and patients together

Boas razões para um desempenho ruim em testes: o substrato interacional dos exames educacionais

This paper was originally published in 1992. It arose out of a project to study how clinicians tell parents a diagnosis of a developmental disability. That specific project was part of a larger one conducted in 1985-1986 to study the delivery of bad and good news in both ordinary and medical settings (Maynard, 2003). As part of the developmental disabilities study, we also examined how testing was done as a precedent to deciding on diagnosis (Marlaire and Maynard, 1989), and the paper here about the “interactional substrate” was meant to show the orderliness of testing interactions – the basic structures that made it possible to generate valid and reliable examination scores that could lend to the official assessment. More recently (2013-2015), a research team and I returned to the same clinic with a grant from the U.S. National Science Foundation, to study more intensively the testing and diagnosis of Autism Spectrum Disorders (ASD). In the time between the 1985 study and the recent one, the prevalence of ASD had skyrocketed in the U.S. from 1 in 5000 children to the current rate of 1 in 68. A study of the micro-interactions surrounding testing and diagnosis does not explain the increase in prevalence but it does say just how testing is done and how clinicians use results and other information to diagnose children. With regard to testing, in particular, we have come back to the paper on the interactional substrate again and again because probing this substrate and the practices by which it is constituted remains as an avenue in to understanding ASD as not just a condition of the child but as something that is manifested as a feature of social interaction. There are ways in which ASD as a child’s condition is co-produced by way of (i) the orderliness of interactions between clinicians and children, and (ii) how tests constrain both the clinician and the child in terms of what is visible as “competence.” Thus, in current work, we distinguish between what we call first-order, or concrete competence, which, by way of the interactional substrate, allows testing to be done, regardless of what the official results may be, and second-order displays of abstract competence (Maynard and Turowetz, 2016). Abstract competence involves the ability to produce general answers or ones that are shorn of embodied or other contextual orientations to questions or that involve what Donaldson (1978) has called “disembedded knowledge.” The emphasis of clinical tests on measuring second-order, abstract competence may obscure various kinds of first-order, concrete competence and “autistic intelligence” a child displays (Maynard, 2005). By doing so, testing can potentially make the child seem more impaired than he or she is, or at least suppress information that could improve performance and/or be informative for how to design home and schooling environments that enhance a child’s skills and integration into these social units.Keywords: psychological testing, conversation analysis, disability.Este artigo foi originalmente publicado em 1992. Ele surgiu de um projeto para estudar como os médicos apresentam aos pais um diagnóstico de deficiência no desenvolvimento infantil. Tal projeto específico fazia parte de outro mais amplo, conduzido entre 1985-1986, para estudar a comunicação de boas ou más notícias tanto em cenários cotidianos quanto em cenários de tratamento de saúde (Maynard, 2003). No estudo das deficiências de desenvolvimento, também examinamos o modo como eram realizados os testes que precediam a decisão sobre o diagnóstico (Marlaire e Maynard, 1989), sendo que o artigo aqui apresentado, sobre o “substrato interacional”, visava a mostrar o caráter ordenado das interações durante os testes – as estruturas básicas que possibilitavam gerar escores de exames válidos e confiáveis que pudessem levar à avaliação oficial. Mais recentemente (2013-2015), retornei à mesma clínica com um grupo de pesquisa, com financiamento da Fundação Nacional de Pesquisa dos EUA (U.S. National Science Foundation), para estudar mais intensivamente a testagem e o diagnóstico dos Transtornos do Espectro Autista, TEA, (Autism Spectrum Disorders, ASD). Entre o estudo de 1985 e o mais recentemente realizado, a prevalência de TEA nos EUA disparou de 1 em 5000 crianças para a taxa atual de 1 em 68. Um estudo das microinterações envolvidas nos testes e diagnósticos não explica o aumento na prevalência, mas revela, sim, como os testes são realizados e como os médicos usam os seus resultados e outras informações para diagnosticar as crianças. Em relação à testagem, em particular, retomamos inúmeras vezes o artigo de 1992 sobre o substrato interacional, pois o exame desse substrato e das práticas que o constituem continua sendo um caminho para que se compreendam os TEA não só como condição da criança, mas também como algo que se manifesta como traço da interação social. Há, pois, maneiras de se coproduzir os Transtornos do Espectro Autista como uma condição da criança, as quais se prendem a: (i) o caráter ordenado das interações entre médicos e crianças, e (ii) o modo como os testes cerceiam tanto o médico como a criança em termos do que é visível como “competência”. Assim, no trabalho atual, distinguimos entre, primeiro, o que chamamos de competência concreta ou de primeira-ordem, que permite, por meio do substrato interacional, que a testagem seja realizada, independentemente de quais possam ser os resultados oficiais; e, segundo, o que chamamos de demonstrações de competência abstrata, ou de segunda-ordem (Maynard e Turowetz, 2016). A competência abstrata envolve a habilidade de produzir respostas gerais ou que sejam despidas de orientações para a pergunta com base em elementos corporais ou contextuais de outra natureza, ou que envolvam o que Donaldson (1978) chamou de “conhecimento desencaixado” (“disembedded knowledge”). A ênfase dos testes clínicos em medir a competência abstrata, de segunda-ordem, pode tornar obscuros vários tipos de competência concreta, de primeira-ordem, e de “inteligência autista” que uma criança demonstre (Maynard, 2005). Realizada assim, a testagem pode, potencialmente, fazer uma criança parecer mais incapacitada do que realmente é, ou pode, no mínimo, suprimir informação que pudesse melhorar o desempenho e/ou contribuir para projetar ambientes domésticos e escolares que ampliem as habilidades da criança e a sua integração nessas unidades sociais.Palavras-chave: teste psicológico, análise de conversa, deficiência

Good reasons for bad testing performance: The interactional substrate of educational exams

This paper was originally published in 1992. It arose out of a project to study how clinicians tell parents a diagnosis of a developmental disability. That specific project was part of a larger one conducted in 1985-1986 to study the delivery of bad and good news in both ordinary and medical settings (Maynard, 2003). As part of the developmental disabilities study, we also examined how testing was done as a precedent to deciding on diagnosis (Marlaire and Maynard, 1989), and the paper here about the “interactional substrate” was meant to show the orderliness of testing interactions – the basic structures that made it possible to generate valid and reliable examination scores that could lend to the official assessment. More recently (2013-2015), a research team and I returned to the same clinic with a grant from the U.S. National Science Foundation, to study more intensively the testing and diagnosis of Autism Spectrum Disorders (ASD). In the time between the 1985 study and the recent one, the prevalence of ASD had skyrocketed in the U.S. from 1 in 5000 children to the current rate of 1 in 68. A study of the micro-interactions surrounding testing and diagnosis does not explain the increase in prevalence but it does say just how testing is done and how clinicians use results and other information to diagnose children. With regard to testing, in particular, we have come back to the paper on the interactional substrate again and again because probing this substrate and the practices by which it is constituted remains as an avenue in to understanding ASD as not just a condition of the child but as something that is manifested as a feature of social interaction. There are ways in which ASD as a child’s condition is co-produced by way of (i) the orderliness of interactions between clinicians and children, and (ii) how tests constrain both the clinician and the child in terms of what is visible as “competence.” Thus, in current work, we distinguish between what we call first-order, or concrete competence, which, by way of the interactional substrate, allows testing to be done, regardless of what the official results may be, and second-order displays of abstract competence (Maynard and Turowetz, 2016). Abstract competence involves the ability to produce general answers or ones that are shorn of embodied or other contextual orientations to questions or that involve what Donaldson (1978) has called “disembedded knowledge.” The emphasis of clinical tests on measuring second-order, abstract competence may obscure various kinds of first-order, concrete competence and “autistic intelligence” a child displays (Maynard, 2005). By doing so, testing can potentially make the child seem more impaired than he or she is, or at least suppress information that could improve performance and/or be informative for how to design home and schooling environments that enhance a child’s skills and integration into these social units.Keywords: psychological testing, conversation analysis, disability.</p

Book reviews

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45645/1/11199_2004_Article_BF00287975.pd

The challenges of intersectionality: Researching difference in physical education

Researching the intersection of class, race, gender, sexuality and disability raises many issues for educational research. Indeed, Maynard (2002, 33) has recently argued that ‘difference is one of the most significant, yet unresolved, issues for feminist and social thinking at the beginning of the twentieth century’. This paper reviews some of the key imperatives of working with ‘intersectional theory’ and explores the extent to these debates are informing research around difference in education and Physical Education (PE). The first part of the paper highlights some key issues in theorising and researching intersectionality before moving on to consider how difference has been addressed within PE. The paper then considers three ongoing challenges of intersectionality – bodies and embodiment, politics and practice and empirical research. The paper argues for a continued focus on the specific context of PE within education for its contribution to these questions

Assessment of examiner leniency and stringency ('hawk-dove effect') in the MRCP(UK) clinical examination (PACES) using multi-facet Rasch modelling

BACKGROUND: A potential problem of clinical examinations is known as the hawk-dove problem, some examiners being more stringent and requiring a higher performance than other examiners who are more lenient. Although the problem has been known qualitatively for at least a century, we know of no previous statistical estimation of the size of the effect in a large-scale, high-stakes examination. Here we use FACETS to carry out a multi-facet Rasch modelling of the paired judgements made by examiners in the clinical examination (PACES) of MRCP(UK), where identical candidates were assessed in identical situations, allowing calculation of examiner stringency. METHODS: Data were analysed from the first nine diets of PACES, which were taken between June 2001 and March 2004 by 10,145 candidates. Each candidate was assessed by two examiners on each of seven separate tasks. with the candidates assessed by a total of 1,259 examiners, resulting in a total of 142,030 marks. Examiner demographics were described in terms of age, sex, ethnicity, and total number of candidates examined. RESULTS: FACETS suggested that about 87% of main effect variance was due to candidate differences, 1% due to station differences, and 12% due to differences between examiners in leniency-stringency. Multiple regression suggested that greater examiner stringency was associated with greater examiner experience and being from an ethnic minority. Male and female examiners showed no overall difference in stringency. Examination scores were adjusted for examiner stringency and it was shown that for the present pass mark, the outcome for 95.9% of candidates would be unchanged using adjusted marks, whereas 2.6% of candidates would have passed, even though they had failed on the basis of raw marks, and 1.5% of candidates would have failed, despite passing on the basis of raw marks. CONCLUSION: Examiners do differ in their leniency or stringency, and the effect can be estimated using Rasch modelling. The reasons for differences are not clear, but there are some demographic correlates, and the effects appear to be reliable across time. Account can be taken of differences, either by adjusting marks or, perhaps more effectively and more justifiably, by pairing high and low stringency examiners, so that raw marks can be used in the determination of pass and fail

Problems of multi-species organisms: endosymbionts to holobionts

The organism is one of the fundamental concepts of biology and has been at the center of many discussions about biological individuality, yet what exactly it is can be confusing. The definition that we find generally useful is that an organism is a unit in which all the subunits have evolved to be highly cooperative, with very little conflict. We focus on how often organisms evolve from two or more formerly independent organisms. Two canonical transitions of this type—replicators clustered in cells and endosymbiotic organelles within host cells—demonstrate the reality of this kind of evolutionary transition and suggest conditions that can favor it. These conditions include co-transmission of the partners across generations and rules that strongly regulate and limit conflict, such as a fair meiosis. Recently, much attention has been given to associations of animals with microbes involved in their nutrition. These range from tight endosymbiotic associations like those between aphids and Buchnera bacteria, to the complex communities in animal intestines. Here, starting with a reflection about identity through time (which we call “Theseus’s fish”), we consider the distinctions between these kinds of animal–bacteria interactions and describe the criteria by which a few can be considered jointly organismal but most cannot

Facilitating the development of controlled vocabularies for metabolomics technologies with text mining

BACKGROUND: Many bioinformatics applications rely on controlled vocabularies or ontologies to consistently interpret and seamlessly integrate information scattered across public resources. Experimental data sets from metabolomics studies need to be integrated with one another, but also with data produced by other types of omics studies in the spirit of systems biology, hence the pressing need for vocabularies and ontologies in metabolomics. However, it is time-consuming and non trivial to construct these resources manually. RESULTS: We describe a methodology for rapid development of controlled vocabularies, a study originally motivated by the needs for vocabularies describing metabolomics technologies. We present case studies involving two controlled vocabularies (for nuclear magnetic resonance spectroscopy and gas chromatography) whose development is currently underway as part of the Metabolomics Standards Initiative. The initial vocabularies were compiled manually, providing a total of 243 and 152 terms. A total of 5,699 and 2,612 new terms were acquired automatically from the literature. The analysis of the results showed that full-text articles (especially the Materials and Methods sections) are the major source of technology-specific terms as opposed to paper abstracts. CONCLUSIONS: We suggest a text mining method for efficient corpus-based term acquisition as a way of rapidly expanding a set of controlled vocabularies with the terms used in the scientific literature. We adopted an integrative approach, combining relatively generic software and data resources for time- and cost-effective development of a text mining tool for expansion of controlled vocabularies across various domains, as a practical alternative to both manual term collection and tailor-made named entity recognition methods