The Ideal Judge: How Implicit Bias Shapes Assessment of State Judges

Judicial Performance Evaluation (JPE) is generally seen as an important part of the merit system, which often suffers from a lack of relevant voter information. Utah’s JPE system has undergone significant change in recent years. Using data from the two most recent JPE surveys, we provide a preliminary look at the operation of this new system. Our results suggest that the survey component has difficulty distinguishing among the judges on the basis of relevant criteria. The question prompts intended to measure performance on different ABA categories are also indistinguishable. We find evidence that, on some measures, female judges do disproportionately worse than male judges. We suggest that the free response comments and the new Court Observation Program results may improve the ability of the commission to make meaningful distinctions among the judges on the basis of appropriate criteria

Beyond High Hopes and Unmet Expectations: Judicial Selection Reforms in the States

The scholarly debate about how to select state judges has been ongoing for decades; the public debate on the issue spans more than a century. Proponents on each side seem confident that their preferred method of judicial selection is the best. Reformers argued that, “judicial elections deserve the limelight in the variety show of threats to judicial independence.” Defenders of judicial elections have countered that judicial reformers are “waging war on democratic processes and the rights of citizens to maintain control over government.” The empirical evidence to date, however, has largely resulted in a draw. The more we learn about the actual performance of these systems, the more difficult it becomes to declare one or the other system the winner. The purpose of this article is not to settle this debate, but neither will I shy away from it. Instead, I discuss what we currently know about judicial selection in the American states and what it means for the future

Implicit Bias in Judicial Performance Evaluations: We Must Do Better Than This

Judicial performance evaluations (JPEs) are a critical part of selecting judges, especially in states using merit-based selection systems. This article shows empirical evidence that gender and race bias still exist in attorney surveys conducted in accordance with the ABA’s Guidelines. This systematic bias is related to a more general problem with the design and implementation of JPE surveys, which results in predictable problems with the reliability and validity of the information obtained through these survey instruments. This analysis raises questions about the validity and reliability of the JPE. This is a particularly poor outcome, as it means that we are subjecting many judges to state-sponsored evaluations that are systematically biased against women and minorities

The 2018 Midterm Election: Nevada and the Nation Post-Election Analysis

Brookings Mountain West, in partnership with CSUN, was pleased to present part two of a two-part analysis on the 2018 Midterm elections. The 2018 Midterms included elections for all 435 members of the House of Representatives, including four seats in Nevada. In the U.S. Senate, 34 seats were up for election, including one seat in Nevada. Across the United States, 36 states elected governors, including the State of Nevada. The Democratic Party sought to flip a minimum of 24 seats to become the majority party in House and 2 seats to become the majority party in the Senate. Two Mountain West states, Nevada and Arizona, presented the best opportunity for the Democratic Party to flip seats in the U.S. Senate. Republicans looked to flip seats in 10 states that Donald Trump won in 2016. Panelists reacted to the policy issues and voting trends that resulted from the 2018 Midterm elections

Factors supporting and constraining the implementation of robot-assisted surgery: a realist interview study

YesTo capture stakeholders’ theories concerning how and in what contexts robot-assisted surgery becomes integrated into routine practice. A literature review provided tentative theories that were revised through a realist interview study. Literature-based theories were presented to the interviewees, who were asked to describe to what extent and in what ways those theories reflected their experience. Analysis focused on identifying mechanisms through which robot-assisted surgery becomes integrated into practice and contexts in which those mechanisms are triggered. Nine hospitals in England where robot-assisted surgery is used for colorectal operations. Forty-four theatre staff with experience of robot-assisted colorectal surgery, including surgeons, surgical trainees, theatre nurses, operating department practitioners and anaesthetists. Interviewees emphasised the importance of support from hospital management, team leaders and surgical colleagues. Training together as a team was seen as beneficial, increasing trust in each other’s knowledge and supporting team bonding, in turn leading to improved teamwork. When first introducing robot-assisted surgery, it is beneficial to have a handpicked dedicated robotic team who are able to quickly gain experience and confidence. A suitably sized operating theatre can reduce operation duration and the risk of de-sterilisation. Motivation among team members to persist with robot-assisted surgery can be achieved without involvement in the initial decision to purchase a robot, but training that enables team members to feel confident as they take on the new tasks is essential. We captured accounts of how robot-assisted surgery has been introduced into a range of hospitals. Using a realist approach, we were also able to capture perceptions of the factors that support and constrain the integration of robot-assisted surgery into routine practice. We have translated these into recommendations that can inform future implementations of robot-assisted surgery

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

YesBackground: The implementation of robot-assisted surgery (RAS) can be challenging, with reports of surgical robots being underused. This raises questions about differences compared with open and laparoscopic surgery and how best to integrate RAS into practice. Objectives: To (1) contribute to reporting of the ROLARR (RObotic versus LAparoscopic Resection for Rectal cancer) trial, by investigating how variations in the implementation of RAS and the context impact outcomes; (2) produce guidance on factors likely to facilitate successful implementation; (3) produce guidance on how to ensure effective teamwork; and (4) provide data to inform the development of tools for RAS. Design: Realist process evaluation alongside ROLARR. Phase 1 – a literature review identified theories concerning how RAS becomes embedded into practice and impacts on teamwork and decision-making. These were refined through interviews across nine NHS trusts with theatre teams. Phase 2 – a multisite case study was conducted across four trusts to test the theories. Data were collected using observation, video recording, interviews and questionnaires. Phase 3 – interviews were conducted in other surgical disciplines to assess the generalisability of the findings. Findings: The introduction of RAS is surgeon led but dependent on support at multiple levels. There is significant variation in the training provided to theatre teams. Contextual factors supporting the integration of RAS include the provision of whole-team training, the presence of handpicked dedicated teams and the availability of suitably sized operating theatres. RAS introduces challenges for teamwork that can impact operation duration, but, over time, teams develop strategies to overcome these challenges. Working with an experienced assistant supports teamwork, but experience of the procedure is insufficient for competence in RAS and experienced scrub practitioners are important in supporting inexperienced assistants. RAS can result in reduced distraction and increased concentration for the surgeon when he or she is supported by an experienced assistant or scrub practitioner. Conclusions: Our research suggests a need to pay greater attention to the training and skill mix of the team. To support effective teamwork, our research suggests that it is beneficial for surgeons to (1) encourage the team to communicate actions and concerns; (2) alert the attention of the assistant before issuing a request; and (3) acknowledge the scrub practitioner’s role in supporting inexperienced assistants. It is beneficial for the team to provide oral responses to the surgeon’s requests. Limitations: This study started after the trial, limiting impact on analysis of the trial. The small number of operations observed may mean that less frequent impacts of RAS were missed. Future work: Future research should include (1) exploring the transferability of guidance for effective teamwork to other surgical domains in which technology leads to the physical or perceptual separation of surgeon and team; (2) exploring the benefits and challenges of including realist methods in feasibility and pilot studies; (3) assessing the feasibility of using routine data to understand the impact of RAS on rare end points associated with patient safety; (4) developing and evaluating methods for whole-team training; and (5) evaluating the impact of different physical configurations of the robotic console and team members on teamwork.National Inst for Health Research (NIHR

AACP Basic Resources for Pharmacy Education

The AACP Basic Resources for Pharmacy Education is produced as a guide for those developing or maintaining the library collections that serve colleges and schools of pharmacy. The goal of the Basic Resources list is to make recommendations of books and other works to be included in pharmacy libraries, but not all titles are required to be purchased. Each pharmacy college has its own mission and its own program(s), and so each college’s library collection must reflect that mission and support the college’s program(s). Excellent library collections are built by knowledgeable librarians and drug information specialists using their professional judgment along with the expertise of the college’s faculty. The Basic Resources list should not be used as a benchmark and is not prescriptive but is instead a starting place for librarians who are building a new collection or maintaining an established one

Eliciting Context-Mechanism-Outcome configurations: Experiences from a realist evaluation investigating the impact of robotic surgery on teamwork in the operating theatre

YesThis article recounts our experience of eliciting, cataloguing and prioritizing conjectured Context-Mechanism-Outcome configurations at the outset of a realist evaluation, to provide new insight into how Context-Mechanism-Outcome configurations can be generated and theorized. Our construction of Context-Mechanism-Outcome configurations centred on how, why and in what circumstances teamwork was impacted by robotic surgery, rather than how and why this technology improved surgical outcomes as intended. We found that, as well as offering resources, robotic surgery took away resources from the theatre team, by physically reconfiguring the operating theatre and redistributing the surgical task load, essentially changing the context in which teamwork was performed. We constructed Context-Mechanism-Outcome configurations that explain how teamwork mechanisms were both constrained by the contextual changes, and triggered in the new context through the use of informal strategies. We conclude by reflecting on our application of realist evaluation to understand the potential impacts of robotic surgery on teamwork

A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment.

ABSTRACT: Background: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings. Methods: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care. 81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ≥8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant’s physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant’s mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient’s self efficacy to solve their problems. Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation. Discussion: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care. Trial registration: ISRCTN21615909