“Back to the Dark Side”

This article was migrated. The article was marked as recommended. Innovation in medical education has almost become synonymous with technology and its use in the field is growing exponentially. The benefits of technology-enhanced learning (TEL) are manifold; however, in this article some of the more contentious, potentially hazardous and oft unexplored aspects of TEL are highlighted - we have termed these the 'dark side' of technology in medical education. To further advance the application of technology in medical education, we contend that academics and educators need to turn their attention to the 'dark side' to complement the traditional focus on breakthroughs and innovation. Shedding light on the 'dark side' of TEL will help educators to develop a more nuanced understanding of the risks and benefits of the technology, that will then facilitate more judicious use of TEL in their teaching. Thus, within this article we outline some key areas for consideration, highlight barriers to exploring these and consider how we might shine a light on the 'dark side' of technology in medical education.

Photic preference of the short-tailed opossum (Monodelphis domestica)

Purpose The paper aims to explore the beliefs of doctors in leadership roles of the concept of "the dark side", using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: "What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the 'dark side'?". Design/methodology/approach The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes. Findings Medical leaders had four key beliefs about the "dark side" as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as "the dark side" are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place. Research limitations/implications This research was conducted within the Western developed-nation setting of Australia and only involved interviews with doctors in medical leadership roles. The findings are therefore limited to the doctors' own perceptions of themselves based on their past experiences and beliefs. Future research involving doctors who have not chosen to transition to leadership roles, or other health practitioners in other settings, may provide a broader perspective. Also, this research was exploratory and descriptive in nature using qualitative methods, and quantitative research can be carried out in the future to extend this research for statistical generalisation. Practical implications The paper includes implications for health organisations, training providers, medical employers and health departments and describes a multi-prong strategy to address this important issue. Originality/value This paper fulfils an identified need to study the concept of "moving to the dark side" as a negative perception of medical leadership and contributes to the evidence in this under-researched area. This paper has used data from two similar studies, combined together for the first time, with new analysis and coding, looking at the concept of the "dark side" to discover new emergent findings.

Theory suggests that personality traits evolved to have costs and benefits, with the effectiveness of a trait dependent on how these costs and benefits relate to the present circumstances. This suggests that traits that are generally viewed as positive can have a ‘dark side’ and those generally viewed as negative can have a ‘bright side’ depending on changes in context. We test this in a sample of 220 UK medical students with respect to associations between the Big 5 personality traits and learning outcomes across the 5 years of a medical degree. The medical degree offers a changing learning context from pre-clinical years (where a more methodical approach to learning is needed) to the clinical years (where more flexible learning is needed, in a more stressful context). We argue that while trait conscientiousness should enhance pre-clinical learning, it has a ‘dark side’ reducing the acquisition of knowledge in the clinical years. We also suggest that anxiety has a ‘bright side’ enhancing the acquisition of skills in the clinical years. We also explore if intelligence enhances learning across the medical degree. Using confirmatory factor analysis and structural equation modelling we show that medical skills and knowledge assessed in the pre-clinical and clinical years are psychometrically distinguishable, forming a learning ‘backbone’, whereby subsequent learning outcomes are predicted by previous ones. Consistent with our predictions conscientiousness enhanced preclinical knowledge acquisition but reduced the acquisition of clinical knowledge and anxiety enhanced the acquisition of clinical skills. We also identified a curvilinear U shaped association between Surgency (extraversion) and pre-clinical knowledge acquisition. Intelligence predicted initial clinical knowledge, and had a positive total indirect effect on clinical knowledge and clinical skill acquisition. For medical selection, this suggests that selecting students high on conscientiousness may be problematic, as it may be excluding those with some degree of moderate anxiety.

‘Bright side’ and ‘dark side’ hypomania are associated with differences in psychological functioning, sleep and physical activity in a non-clinical sample of young adults


 Islamophobia: A Projection of the West's 'Dark Side'
 Humankind is more interconnected now than ever before. Some celebrate this shared humanity while too many others appear fixated more on their own ethnic group, nationality, or religion. In the personal view of the author, ‘islamophobia’ is an ungrounded fear of something/someone that does not exist in reality and which involves a psychological projection to create ‘the other’ as enemy. The focus of this spirited article is on the development of ‘islamophobia’ out of an earlier ‘syndrome’ of religio-political antagonism. It is seen by the author as spreading via the mass media ‘like a virus’. He argues that this phenomenon is a psychological defence mechanism involving the projection of what he refers to as ‘the West’s dark side’ onto Islam and its followers.

Big data analytics (BDA) and artificial intelligence (AI) may provide both bright and dark sides that may affect user participation in ridesharing. We do not know whether the juxtaposed sides of these IT artefacts influence users’ cognitive appraisals, and if so, to what extent will their participative behaviour be affected. This paper contributes to the IS research by uncovering the interplay between the dark and bright sides of BDA and AI and the underlying mechanisms of cognitive appraisals for user behaviour in ridesharing. We performed two phases of the study using mixed-methods. In the first study, we conduct 21 semi-structured interviews to develop the research model. The second study empirically validated the research model using survey data of 332 passengers. We find that the usage of BDA and AI on ridesharing platforms have a bright side (usefulness, “the good”) but also a dark side (uncertainty and invasion of privacy, “the bad and the ugly”). The bright side generates perceived benefits, and the dark side shape perceived risks in users, which discount the risks from the benefits of using the ridesharing platform. Privacy control exerts a positive effect on the perceived benefits to encourage individuals to use the ridesharing platform.

Looking at the dark and bright sides of identity formation: New insights from adolescents and emerging adults in Japan

Dark, down, and destructive side of entrepreneurship: Unveiling negative aspects of unsuccessful entrepreneurial action

La Santísima Muerte, the death saint patron of the marginalized and dispossessed in Mexico, the United States, and beyond, is especially favored by devotees who identify with her duality between dark and light, and good and evil. Most of Santa Muerte’s devotees understand that good and evil coexist in her, and they often simultaneously appeal to both. At the same time, illegality and marginalization, which are generally associated with the saint’s “dark” or “evil” sides, take on multiple, diverse forms, encompassing criminalized activity such as narcotrafficking, religious transgressions that reflect unorthodox spiritual practices such as witchcraft, and most contentiously of all, the very conditions of poverty and racialization in Mexico. Nevertheless, cultural representations of Santa Muerte often resist such diversity and persist in opposing her dark and light sides. Films such as Eva Aridjis’s La Santa Muerte and Pável Valenzuela Arámburo’s La Santísima Muerte aim to represent all Santa Muerte in all of her multiplicity and to correct stereotypical representations of the death saint in general. But perhaps inadvertently, Aridjis’s film reinforces the contrast, rather than the intersections, between “light” and “dark”. However, in La Santísima Muerte, Valenzuela Arámburo deliberately embraces the saint’s contradictory duality to provide a different perspective on illegality and criminality, simultaneously accepting such illegality as a dark menace in the vein of Santa Muerte’s typical detractors, and rearticulating it as a necessary aspect of the saint’s holy works. Valenzuela Arámburo’s film not only emphasizes that the very same devotees invoke Santa Muerte for her powers of “good” as well as for those of “evil”, it demonstrates that these devotees incorporate the saint’s dark side as they see fit not as a consequence of their marginalized status, but as a means to resist it. Thus, while both films underscore that marginalized populations are just as nuanced and contradictory as their patroness of death is, Valenzuela Arámburo’s film grounds itself in Santa Muerte’s duality in order to demonstrate how her seemingly contradictory aspects construct and shape each other. As such, the film combats the representation of marginalization and criminality in Mexico and beyond, highlighting the extent to which her devotees appeal to both her dark and light sides precisely because they are simultaneously victims of marginalization and agents of resistance.

It could be suggested that persistent workforce problems in the early childhood (EC) field in Australia – such as job satisfaction and turnover may be related to ineffective leadership practices, low pay and lack of professional acknowledgement. In this article we report on a small qualitative study completed in 2017, investigating 12 educators’ experiences of what could be described as ‘dark side’ leadership practices. Purposeful sampling was used to select educators who had expressed dissatisfaction with leaders on a Facebook forum for early childhood educators. Findings revealed all of Oplatka’s elements of ‘dark side’ leadership practices and ideologies at work, with the addition of two new types of ‘dark side’ leadership practices – ‘acts of courage’ and ‘meat in the sandwich’. The evidence these data provide of regulatory breaches, discrimination and bullying highlight the critical need for action by employers, regulatory authorities and unions to better support educators and their leaders in their work environments.

Drug seeking is associated with activation of reward neural circuitry. Here we argue that drug addiction also involves a 'dark side'--a decrease in the function of normal reward-related neurocircuitry and persistent recruitment of anti-reward systems. Understanding the neuroplasticity of the dark side of this circuitry is the key to understanding vulnerability to addiction.

The End of the Virtual Community

The emergence of negative affective symptoms during the course of alcohol use disorders (AUDs) (e.g. 'dark side' symptoms) has been suggested theoretically; however, the description of their occurrence is limited. This study operationalized two negative affect symptoms and tested the strength of association between these phenotypes and (1) indicators of the clinical course of the severity of AUD, (2) comorbid Axis I psychiatric disorders, suicidal behaviors and trait neuroticism and (3) whether participants reported drinking to relieve the negative affective symptoms. A retrospective cross-sectional study was used to evaluate associations, using logistic regression, between the two negative affective symptoms and clinical measures of AUD severity and progression as well as comorbidity with other psychiatric disorders and conditions, adjusted for demographic characteristics. US community-based studies. A total of 2568 individuals with AUDs obtained from larger population studies that targeted individuals of European American (n=1663), Mexican American and American Indian (n=905) ancestry. Semi-Structured Assessment for the Genetics of Alcoholism was used to ascertain the two 'dark side' phenotypes, clinical diagnoses, the clinical course of AUD and associated symptoms. The two phenotypes were: (1) being anxious or depressed when trying to cut down or stop drinking and (2) experiencing disabling depression for more than 24hours while drinking. Both phenotypes were found to be rare in mild and moderate use disorder and highly prevalent in severe AUDs. Having an independent anxiety or affective disorder and elevated scores on trait neuroticism were also associated significantly with the occurrence of both symptoms, as was alcohol 'craving', elevated treatment-seeking, suicidal behaviors and drinking to relieve the symptoms. Affective symptoms are common in severe alcohol use disorders are associated with a history of independent affective/anxiety disorders, neuroticism and suicidal behaviors; and may promote further heavy drinking.

Editorials18 August 2015On Being a Doctor: Shining a Light on the Dark SideChristine Laine, MD, MPH, Darren B. Taichman, MD, PhD, and Michael A. LaCombe, MDChristine Laine, MD, MPHSearch for more papers by this author, Darren B. Taichman, MD, PhDSearch for more papers by this author, and Michael A. LaCombe, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1144 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This issue includes an On Being a Doctor essay, titled “Our Family Secrets,” that we think, and hope, will make readers' stomachs churn (1). In this essay, the author describes teaching a medical humanities course to senior medical students and asking, “Do any of you have someone to forgive from your clinical experiences? Did anything ever happen that you need to forgive or perhaps still can't forgive?” One of the students—clearly distraught—recounts lacking the courage to object to a surgeon's highly disrespectful behavior to a patient under general anesthesia for a vaginal hysterectomy. The author then recounts how he was ...Reference1. Anonymous. Our family secrets. Ann Intern Med. 2015;163:321. doi:10.7326/M14-2168 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1144. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOur Family SecretsOur Family SecretsShining a Light on the Dark Side Elizabeth Allemann Shining a Light on the Dark Side Christine Laine , Darren B. Taichman , and Michael A. LaCombe Shining a Light on the Dark Side Alvaro F. Vargas Pelaez Shining a Light on the Dark Side Gaetan Sgro , Mark T. Gladwin , Alexander Teng , Akshata Moghe , and Shanta M. Zimmer Shining a Light on the Dark Side Jordan Cohen and Richard I. Levin Shining a Light on the Dark Side Shafik Dharamsi Shining a Light on the Dark Side Linda Ray Metrics Cited byUnfinished Business: J. E. R. Staddon’s The New Behaviorism, 2nd edBearing witness: United States and Canadian maternity support workers’ observations of disrespectful care in childbirthMeditation buffers medical student compassion from the deleterious effects of depressionSpeaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residentsBearing the Burden of Care: Emotional Burnout Among Maternity Support WorkersProfessional Integrity and the Role of Medical Students in Professional Self-RegulationShining a Light on the Dark SideAlvaro F. Vargas Pelaez, BSShining a Light on the Dark SideShafik Dharamsi, BEd, MSc, PhDShining a Light on the Dark SideLinda Ray, MDShining a Light on the Dark SideGaetan Sgro, MD, Mark T. Gladwin, MD, Alexander Teng, MD, Akshata Moghe, MD, PhD, and Shanta M. Zimmer, MDShining a Light on the Dark SideJordan Cohen, MD and Richard I. Levin, MDShining a Light on the Dark SideElizabeth Allemann, MDDoctors Behaving Badly and the Tyranny of Peer PressureTrends from the educators for anesthesia and critical care 2014/15 18 August 2015Volume 163, Issue 4Page: 320KeywordsBehaviorDisclosureGeneral anesthesiaHemorrhageHysterectomyMedical ethics, humanities, and educationMotivationPatient advocacyStomachSurgeons ePublished: 18 August 2015 Issue Published: 18 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...