Doctoral Work Research Articles

Психологическое благополучие больных злокачественными новообразованиями

<p><strong>Formulation of the Problem.</strong> In Russia, 2.73% of the population suffer from malignant neoplasms regardless of age. An important factor in successful treatment of cancer patients is psychological well-being, including the presence of positive emotions, engagement, meaning in life, autonomy, positive relationships with others, self-acceptance, and absence of psychological disorders. <strong>Actuality.</strong> According to scientific articles published between 2005 and present on Scopus, WoS, PubMed, cancer patients are characterized by impaired psychological well-being and require psychological support. Over 1/3 of them experience distress, depression, anxiety, demoralization, and suicidal ideation, which significantly reduces their chances of a favorable outcome. <strong>Summary.</strong> Positive components of psychological well-being are an important condition for recovery, as modern therapy allows over 60% of cancer patients to survive. Despite the need for psychological support, patients with malignant tumors are characterized by low rates of treatment and a high prevalence of psychological disorders. Violation of psychological well-being contributes to patients’ non-compliance with prescribed treatment, aggravates the course of the disease and increases mortality. <strong>С</strong><strong>onclusions.</strong> Ensuring psychological well-being can be achieved by improving psychological care for cancer patients through influencing subjective, informational and organizational factors. An ideal strategy for patient management is joint work of psychologists and doctors, especially in communicating a diagnosis to patients, using and improving questionnaires, scales and criteria for assessing the need of cancer patients for psychological care. It is necessary to actively implement digital and mobile healthcare, Internet services, and telemedicine, for obtaining information and communication between patients and doctors and psychologists online, which will improve the positive aspects of psychological well-being.</p>

A strategy to what end? “The strategy of model building in population biology” in its programmatic context

“The Strategy of Model Building in Population Biology” published by Richard Levins in 1966 has been cited over 2500 times. For a paper concerned with modeling approaches in population biology a surprisingly large part of the attention. The Strategy received comes from history and philosophy of biology, and specifically from accounts on model and model formulation. The Strategy is an unusual paper; it presents neither new data nor a new formal model; at times it reads like a manifesto for some modeling approach, without specifying which broader program that approach intends to support. When these peculiarities of The Strategy are even mentioned, the philosophical literature tends to explain them away by invoking Levins’ Marxist commitments. In contrast, I argue that those peculiarities can be explained by examining the programmatic purpose of the paper; starting from his doctoral work, Levins was trying to establish a research program meant to account for the relations between fitness and environment in different terms than the prevalent lock-and-key view. My paper brings that program back to the discussion, explains its relation to competing approaches and examines Levins’ approach to modeling in light of that context

Junior Doctor Retention Strategies: Integrating Knowledge Management with Supportive Leadership and Organizational Climate

AbstractThis study aims to evaluate interventions and strategies used to retain junior doctors, with a specific focus on the roles of organizational climate, supportive leadership, and work engagement influenced by effective knowledge management practices. We examine how knowledge management—the systematic process of creating, sharing, using, and managing the knowledge and information of an organization—contributes to creating a favorable organizational climate and supportive leadership strategies. Engaging in a quantitative study with a sample of 950 junior doctors across four Central European countries, we explore the impact of an integrated approach that combines traditional performance-oriented climate models (rational goals model) with knowledge management practices tailored to the unique demands of healthcare settings influenced by current healthcare reforms and bureaucratic systems. Our findings suggest that not only do supportive leadership and a positive organizational climate enhance work engagement among junior doctors, but robust knowledge management practices also play a crucial role in improving retention rates by facilitating continuous learning and effective information sharing. To the best of our knowledge, our research is the first to draw on the synergy between rational goals, organizational climate, supportive leadership, and knowledge management practices to explain the antecedents of junior doctor work engagement and retention. This approach offers new insights into the dynamics of employee retention and underscores fundamental factors influencing junior doctors’ retention, paving the way for a more resilient and thriving healthcare workforce amidst the ongoing turbulence in global healthcare.

‘Musical Reflections’

In this short piece, I reflect on my experience in organising and convening a public engagement event after submitting my PhD Thesis. I explain how my initial motivations to put together a seminar series on the philosophy of music were centred on the idea of distributing the finding of my doctoral work. Yet, I conclude showing how the two-way relationship with a small, motivated and enthusiastic audience ended up being the inspiration for further research. Funding Acknowledgement Funding supplied via the Early Career Research Fellowship, Institute of Advanced Study, University of Warwick.

Первая мировая. Екатеринбургский комитет Красного Креста в тылу и на фронте

On May 16, 2024, the Sverdlovsk regional branch of the Russian Red Cross turned 147 years old, whose main goal has always been to prevent and alleviate the suffering of people in various situations, both at the front and in the rear, selflessly and sparing no effort in responding to any challenges of the time. This publication presents materials revealing the activities of the Yekaterinburg Committee of the Russian Red Cross Society during the First World War (1914–1918). During the war, both at the front and in the rear, the Yekaterinburg Committee of the Red Cross held many events to assist various groups of the population affected by the hostilities: opening hospitals for the wounded, raising funds for their maintenance, providing humanitarian assistance to families of soldiers and forced refugees. One of the most important directions in the work of the Yekaterinburg Committee of the Red Cross was the mass training of nurses.Ural medical workers, who were members of the Russian Red Cross Society, went to the front, among whom were German Sokratovich Myshkin, Claudia Andreevna Myshkina-Beloborodova, Vasily Konstantinovich Shamarin, Valentina Nikolaevna Diomidovskaya, Dmitry Vasilyevich Hirin and others. Of particular interest is the work of the Ural doctor K. A. Beloborodova in the floating typhoid hospital of the Russian Red Cross "Petrograd".

Doctoral studies as a precarious identity process: deviance and the rational ideal of the doctoral process

ABSTRACT Based on narrative interviews with late-phase doctoral candidates and early postdoctoral researchers, complemented by an autoethnographic diary, this study analyses the experiences of junior academics. A rational ideal of the doctoral process is identified, and its implications for doctoral students’ identity work are discussed. While the rational ideal of the doctoral process has its uses, it prescribes the preferred conduct of doctoral studies and regulates doctoral identities through preferred conceptions of the self. Consequently, doctoral identity work often involves the construction of one’s self in ways that seek to conform to the rational ideal while continuously failing to do so, making deviance from expectations a prevailing feature of it. These experiences of deviance from the elusive ideal both increase the precariousness of doctoral identities and reproduce the regimes of power in which doctoral students are embedded. Thus, this paper challenges the rational ideal and provides a more nuanced understanding of doctoral studies as a precarious, emotional and embodied identity construction process.

Fostering Nurses’ Support in the Workplace: Addressing Job Burnout Among Malaysian Medical Doctors Working in Public Hospitals

Job burnout in employees is caused by individual factors, including demographic characteristics and nurses’ support. This study analyzed the relationship between nurses’ support and job burnout among medical doctors in Malaysian public hospitals. This research was a correlational study with a cross-sectional design. The research sample was 471 employees, using the non-probability sampling method with the purposive and quota sampling techniques. Data collection used the Abbreviated Maslach Burnout Inventory (aMBI) and nurses’ support items. The data in this study were analyzed using the Statistical Package Social Science (SPSS) and Partial Least Squares Structural Equation Modelling (PLS-SEM) software. Findings suggest that 77 medical doctors who participated in the study were from Hospital Pulau Pinang, from the Emergency Department, mostly female, ranging from 24-56 years old, single, and have an MBBS education level. The study assessed the measurement model’s loading, average variance extracted (AVE), and composite reliability (CR) where the loadings were above 0.60. AVEs were greater than 0.50 and CRs were greater than 0.708. Additionally, the bootstrap BCI LL (-0.079) and UL (-0.002) for nurses’ support and job burnout were not straddled a 0 in between. Job burnout had a negative association with nurses’ support. In particular, nurses’ support towards medical doctors lowers their risk of job burnout, which has a substantial impact on medical doctors’ overall well-being. The findings indicated that medical doctors who had complete support from their nurses performed their jobs more efficiently, displayed good task performance, and experienced less job burnout.

Design of a Universal Library of Components for the Development of Medical Systems in the Field of Thyroidology

Reducing the time and cost of developing application information systems by increasing the efficiency of the work performed is one of the main priorities of their modern production. With the development of AI technologies in all areas of activity, including medicine, there is a need for continuous improvement of both the client and server parts of information systems for many different nosologies. The purpose of this study is to form a ready-made library of components for the template design of user interfaces in the field of thyroidology (a field of medicine aimed at diagnosing and treating thyroid diseases) based on the experience gained in the development of several medical information systems for identifying thyroid diseases. Ensuring a conveyor mechanism for developing interfaces for medical information systems is possible only with specialized components of the tool based on a detailed understanding of the specifics of the actions of an endocrinologist. The components of the developed library cover up to 60 % of the component base of the interface of thyroidological systems, and are divided into several parts: for manipulating medical images and texts, annotating, creating input forms, working with tables of medical values, etc. The developed component library has been tested in the creation of intelligent information systems for the work of doctors of ultrasound and cytological diagnostics of thyroid diseases.

Occupational burnout of health care workers in a specialised COVID hospital setting

The aim is to evaluate the peculiarities of the development of professional burnout (PB) among physicians of therapeutic and surgical specialties, as well as middle medical workers, specialised red zones, as well as its prediction and prevention in this category of workers. Material and methods. The following groups of medical workers were examined: the 1st group consisted of doctors of therapeutic specialities (GPs) working in the red zone (n=111); the 2nd group consisted of doctors of surgical specialities (MDs) working in the ‘red zone’ (n=61); the 3rd group consisted of nurses working in the red zone (n=29); the 4th group – the control group included workers of engineering, technical and economic specialities not related to work in medical organisations (n=190). Professional burnout syndrome was assessed using the Maslach Burnout questionnaire and V.V. Boyko’s technique of diagnosing the level of burnout [4, 5]. The data were processed using Statistica statistical package by StatSoft (USA). Results. It was found that the work of therapeutic and surgical doctors, as well as middle medical workers of specialised red zones, is connected with the exposure of medical workers to a number of specific risk factors related to the provision of medical care to infected patients, as well as with significant changes in the work regarding aspects related to organisation, safety, which contribute to the increase in the level of stress and the increase in the level of SP. Conclusions. The work of physicians of therapeutic and surgical specialities, as well as middle medical workers of specialised red zones, is associated with an increase in the level of professional stress and the level of SP. It is necessary to continue the research of emotional state of medical doctors and average medical workers working in conditions of extreme epidemic situations with the purpose of timely preventive treatment for preservation of health of medical workers.

The Ideological Dilemma in Using Games in Global Citizenship and Development Education

The objective of this paper is to contribute to discourse informing the use of computer games in Global Citizenship and Development Education. In doing so, it addresses the incompatibility and conflict between the values imbedded in games and those informing development education practice. It is aimed at both formal and informal educators who see the potential in using games in their practice and want to reconcile this dilemma. It is also aimed at policy makers and influencers who want to shape the structures governing such digital spaces in the public interest. The research involved an interdisciplinary literature review across the fields of Education, Game Design, colonialism and social activism. The analysis takes a postcolonial perspective and is informed by the theory and practice of critical pedagogy in youth work and development education. The study was conducted as part of Doctoral research and project work with NGOs over a seven-year period to 2024. In this context it is important to note that this is a rapidly changing and evolving sector. The development of computer games and immersive technologies over the past 20 years has been transformational, in their interactive capabilities and global proliferation, particularly with the emergence of “The Metaverse”. Such expansion has been critiqued as a process of Colonialism, where young people’s time, creativity, identities and attention is being commodified, monetised, packaged and sold to the highest bidder. The structure of the games industry, their content and the ecosystem surrounding gaming are all ideologically driven. Such ideology aligns with one of three systems: the neoliberal hegemony emanating from transnational corporations and market economies; the state control being exerted by China and others; or a blind commitment to opensource being advocated by many industry innovators, developers and users. When using games in an educational context, and particularly when addressing Social Justice and Global Citizenship, the values and cultures underpinning all three of these ideologies are problematic. It is the contention in this paper that such spaces can also be developed as informal educational spaces informed by values aligned with critical global citizenship and development education. Now is the time for development educational practitioners, conscientious games designers and policymakers to collaborate, to act, to legislate, to experiment and carve out a safe, progressive, dynamic, decolonised digital space for engagement with issues of global citizenship and development education

Trial by fire: The qualitative essence of interns’ baptism into medical responsibility

BACKGROUND: The transition from medical student to intern represents a challenging period of professional and personal development. This study aimed to explore junior doctors’ experiences navigating this critical passage. MATERIALS AND METHODS: An exploratory qualitative study was conducted on a junior intern doctor working in a tertiary care hospital, in Gujarat. About 40 junior doctors participated in semi-structured interviews reflecting on their internship transition. Data were analyzed using thematic analysis. RESULTS: Perceived deficits in preparedness for clinical work and emotional readiness were a major theme. Interns felt underprepared in skills like clinical reasoning and procedures. The abrupt onset of patient care responsibility provoked anxiety and eroded confidence. Difficulty adapting to workplace culture and hierarchies was another challenge. Long work hours, unfamiliar team dynamics, and new professional relationships were demanding. The intensity of workload and patient care duties provoked overwhelming stress, fatigue, and burnout risk during the junior doctor transition. Peer support and mentoring facilitated adaptation. Enhanced undergraduate training in practical skills and professional competencies was advised to improve preparedness. CONCLUSION: Junior doctors face major challenges to their well-being, confidence, and competence as they transition into clinical practice. Support structures to ease this demanding passage of professional development are needed. Medical schools must strengthen curricula to address preparedness gaps. Improved onboarding and supervised orientation may also benefit new interns. Facilitating an optimal student-to-doctor transition has important implications for physician training, satisfaction, and retention.

The Education and Implementation of Clinical Reasoning Education in Post-Graduate Emergency Medicine Training: An Integrative Review

The ability to clinically reason is a necessity for doctors to reduce the possibility of diagnostic error in patients. Emergency medicine doctors work in a highly active, challenging and, at times, cognitively formidable setting that can affect clinical reasoning. This review aims to study the literature on post-graduate training programs and how clinical reasoning education is incorporated. Methods: CINAHL, Embase and Medline were used to obtain relevant literature from 2010 to 2023. A review was undertaken of clinical reasoning curriculums and resources in medical and surgical specialties in Australia, New Zealand, USA, UK, Ireland and Canada. Results: 23 articles were included in the review. Educational themes to teach clinical reasoning were a) simulation b) technological and innovative methods, c) morning report, d) peer teaching, and e) curriculum related. Surgery, General practice, and Internal Medicine colleges appear to have embedded clinical reasoning courses and resources within their curriculum and training. Conclusion: Specialty colleges are recognising the importance of clinical reasoning and have incorporated formal curricula into their training. Teaching can occur at a college, hospital and departmental level using a variety of educational modalities that vary in the resources required and is a possible option for Emergency Medicine training.

The neglected giant Tchen-Ngo Liou:The enlightenment of his dynamic geobotany theory to current studies in vegetation ecology and biodiversity.

Prof. Tchen-Ngo Liou is one of the founders of China's botany, geobotany, and forest ecology. Theory of dynamic geobotany, established by Prof. Liou, can track back from his doctoral work in Alps in France, and was developed based on his long-term field works in northeast, southeast, north, northeast parts of China, India, North Korea and other regions. In the short course on dynamics geobotany in 1962, he gave a series of lectures which formed a synthesized system. The key elements of this theory are the comprehensive review and critical thinking on climax theory of vegetation science and community succession. Prof. Liou has applied this theory into the establishment of artificial vegetation, the improvement of natural vegetation, forest harvesting and regeneration, and the prevent and control of desertification in China. Here, we gave a short summary about this theory, and discussed its potential influence on important topics in vegetation ecology and biodiversity science, including mountain biodiversity, natural forest conservation, forest management, global change, and vegetation classification.

Impact Assessment of the "4+1 Nursing Operation Mode" on Enhancing the Efficacy of Alveolar Surgery Diagnosis and Treatment.

The aim of this study is to evaluate the impact of the "4+1 Nursing Operation Mode" on improving the efficacy of alveolar surgery and the effectiveness of nursing. A total of 200 patients were recruited from the oral and maxillofacial surgery outpatient department at the School and Hospital of Stomatology, Wuhan University, between November and December 2023. These patients were allocated into 2 groups: a control group and an experimental group. The treatment for these groups involved different combinations of physicians and nurses, including doctors A and B, and nurses A, B, and C. In November 2023, doctor A treated 50 patients with the assistance of nurses A and C under the "4+1 Nursing Operation Mode," while another 50 patients were treated by doctor A with the assistance of nurse A following the "Four-Handed Operation Mode." In December 2023, doctor B treated 50 patients with the assistance of nurse B under the "Four-Handed Operation Mode," and another 50 patients were treated by doctor B with the assistance of nurses B and C using the "4+1 Nursing Operation Mode." Patient visit durations were documented, and patient satisfaction with diagnostic and treatment services was evaluated via a questionnaire survey. In comparison to the "Four-Handed Operation Mode," the "4+1 Nursing Operation Mode" resulted in a 27% reduction in patient visit times and an improvement in patient satisfaction with nursing services. The "4+1 Nursing Operation Mode" surpasses the "Four-Handed Operation Mode" in terms of efficiency. It not only reduces patient visit times and enhances doctor work efficiency but also improves patient satisfaction with nursing services.

THE FIRST PEDIATRICIAN OF THE MONGOLIAN PEOPLE’S REPUBLIC

At the present stage, the effective system of maternity and childhood protection of the Mongolian People’s Republic functions thanks to the invested work of Soviet doctors. The article provides updated information about the first pediatrician of Mongolia, a Soviet doctor, a representative of the Buryat people Sergi-Mydyk Tsyrendorzhievna Dasheeva.

The use of locum doctors in the NHS: understanding and improving the quality and safety of care.

The use of locum doctors in the National Health Service is widely believed to have increased, and there have been widespread and sustained concerns among policy-makers, healthcare providers, professional associations and professional regulators about the quality/safety, cost and effective use of locum doctors. To provide evidence on the extent, quality and safety of medical locum practice and the implications of medical locum working for health service organisation and delivery in primary and secondary care in the English National Health Service, to support policy and practice. Four interlinked work packages involving surveys of National Health Service trusts and of general practices in England; semistructured interviews and focus groups across 11 healthcare organisations in England; analysis of existing routine data sets on the medical workforce in primary care and in National Health Service trusts in England from National Health Service Digital and National Health Service Improvement; and analysis of data from the Clinical Practice Research Datalink in primary care and of electronic patient record data from two National Health Service hospitals in secondary care. In primary care, about 6% of general practice medical consultations were undertaken by locums in 2010 and this had risen slightly to about 7.1% in 2021. In National Health Service trusts (mostly secondary care and mental health), about 4.4% of medical staff full-time equivalent was provided by locum doctors. But those overall national rates of locum use hide a great deal of variation. In primary care, we found the National Health Service Digital workforce returns showed the rate of locum use by Clinical Commissioning Group varied from 1% to almost 31%. Among National Health Service trusts, the reported rate of locum use varied from < 1% to almost 16%. We found that there was poor awareness of and adherence to national guidance on locum working arrangements produced by National Health Service England. Our research showed that locum working can have adverse consequences for the quality and safety of care, but that such consequences were probably more likely to result from the organisational setting and the working arrangements than they were from the locum doctors themselves and their competence, clinical practice or behaviours. Our research was hampered in some respects by the COVID pandemic which both resulted in some delays and other challenges. Our efforts to use electronic patient record data in secondary care to explore locum doctor working were stymied by the problems of data access and quality. Locum doctors are a key component of the medical workforce in the National Health Service, and provide necessary flexibility and additional capacity for healthcare organisations and services. We found that the extent of reliance on locum doctors varied considerably, but that an over-reliance on locums for service provision was undesirable. Some differences in practice and performance between locum and permanent doctors were found, but these seemed often to arise from organisational characteristics. We found that patients were more concerned with the clinical expertise and skills of the doctor they saw than whether they were a locum or not. Organisational arrangements for locum working could be improved in many respects. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128349) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 37. See the NIHR Funding and Awards website for further award information.

Exploring learning characteristics and progression ofGPtrainees based in regional, rural and remote settings:Aqualitative study.

Globally, most doctors train and work in metropolitan areas but a key strategy for developing the rural health workforce is expanding rural training. The aim of this study was to describe the scope and quality of learning along with skill acquisition of GP trainees based in regional, rural, and remote settings. Regional, rural and remote settings in Queensland Australia excluding Brisbane. Thirty-seven general practice trainees who had undertaken their first community placement were recruited from regional, rural and remote learning settings within Queensland. Qualitative descriptive methodology based on constructionist epistemology was employed which allowed for the exploration of current GP trainees' experiences. Trainees were interviewed and data were thematically analysed as to the scope and quality of learning by the setting of training. Learning experiences were then mapped against the Dreyfus and Dreyfus model to explore skill acquisition. In terms of the scope and quality of learning, rural and remote trainees mainly focused on the diverse and unique (sometimes challenging) experiences their setting offered compared with regionally based trainees. Mapping of the trainee comments to the Dreyfus model of skill acquisition demonstrated that regardless of setting, equivalent learning occurred by GP trainees. This exploratory study provides evidence that rural and remote learning may provide a more diverse and challenging experience. It suggests an equivalence of quality of education and skill acquisition across settings rural, regional and remote. This suggests that the training distribution policies may not disadvantage GP trainees and the scope and quality of more remote learning may increase uptake of remote placements.

Development and implementation determinants of competency frameworks for mental health clinicians and service providers working with youth: a scoping review protocol

IntroductionDespite high prevalence, access to mental healthcare for Canadian youth is limited, with less than 20% receiving adequate treatment. Marginalised and at-risk youth face particular challenges, including cultural misunderstandings, long...

Australian medical practitioners: trends in demographics and regions of work 2013-2022.

ObjectiveThis study aimed to examine changes in the demographics and regions of work of Australian doctors over a period of 9years.MethodsA retrospective study of Australian Health Practitioner Regulation Agency (AHPRA) registration data was performed. Data were sourced from the Health Workforce Dataset Online Data Tool which was derived from annual registration data from AHPRA for 2013-2022. The demographic factors analysed were gender, age, and origin of qualification. Regions of work were defined using the Modified Monash (MM) model.ResultsThe number of registered doctors increased from 82,408 in 2013 to 111,908 in 2022 but mean hours worked per week decreased from 41 to 39 leading up to 2020. Trends in age and origin of qualification remained stable, but the proportion of female workers increased from 38.5% in 2013 to 44.5% in 2022. While female hours per week (~37) were consistent from 2013 to 2020, male hours per week decreased from 43 to 41. The number of registrations and total full-time equivalent (FTE) outcomes increased consistently in metropolitan (MM1) and rural (MM2-5) regions but did not increase for remote and very remote (MM6-7) regions.ConclusionThe Australian medical workforce both grew and changed between 2013 and 2022. An overall decrease in mean hours worked appears to be driven by a decline in hours worked by male workers and the increased proportion of female workers. While increased gender parity and a decrease in hours worked per week were positive outcomes, a lack of growth in the medical workforce was noted in remote and very remote regions of Australia.

ARCHIVE PAPER: Micro worlds versus boundary objects in group model building: evidence from the literature on problem definition and model conceptualization (2007)

Foreword by David AndersenWhen I saw the call for papers for the Special Issue on Qualitative Aspects of System Dynamics Modeling, I immediately thought of the unpublished work completed by my graduate student Aldo Zagonel. I nominated it for consideration as an Archives paper. I believe this 2007 working paper (originally posted on the Sandia website) may be one of the best unpublished pieces of early work on the qualitative nature of our client‐based modeling efforts. (Although Dr. Zagonel included me as an author of the 2007 working paper, my involvement was simply that of a graduate advisor. He deserves all the credit for this work and manuscript.) Zagonel developed this work in his doctoral program and presented an earlier version at the 2002 International System Dynamics Conference (Zagonel 2002). That version of the paper won the Dana Meadows Award for the best student paper.Zagonel's doctoral work was part of our early efforts at UAlbany to develop group model building (GMB) as a technique in system dynamics. These approaches to model conceptualization and formulation blend quantitative and qualitative methods with strong scripted facilitation techniques. Zagonel was the first to note how this combination of approaches creates the ideal‐type dichotomy between “micro worlds” and “boundary objects” that he describes in this paper. His suggestion that much of the good work in system dynamics draws on both of these ideal types was prescient. The ideas discussed here have influenced many others over the years. I am pleased they will now be more easily accessible for our field.I am especially pleased that this paper is being published in the same issue as Laura Black's (2024) thoughtful reflection on Dr. Zagonel's paper and extension of the ideal‐type dichotomy he presents. Her paper offers an update on the idea of Zagonel's “straw man” comparison of micro worlds and boundary objects, suggesting that these are two points on a continuum of models that contribute to decision making and stakeholder interaction. She shows how this aspect of our field has developed in the last few decades and provides a clear framework for how to think about our work.Black, LJ. 2024. Reflecting on Zagonel's Dichotomy of Microworlds and Boundary Objects. System Dynamics Review.Zagonel AA. 2002. Model conceptualization in Group Model Building: A review of the literature exploring the tension between representing reality and negotiating a social order. Proceedings of the 20th International Conference of the System Dynamics Society. Palermo, Italy (July 28‐August 1).AbstractBased upon participant observation in group model building and content analysis of the system dynamics literature, I postulate that modeling efforts have a dual nature. On one hand, the modeling process aims to create a useful representation of a real‐world system. This must be done, however, while aligning the clients' mental models around a shared view of the system. There is significant overlap and confusion between these two goals and how they play out on a practical level. This research clarifies these distinctions by establishing an ideal‐type dichotomy. To highlight the differences, I created two straw men: “micro world” characterizes a model that represents reality and “boundary object” represents a socially negotiated model. Using this framework, the literature was examined, revealing evidence for several competing views on problem definition and model conceptualization. The results are summarized in the text of this article, substantiated with strikingly polarized citations, often from the same authors. I also introduce hypotheses for the duality across the remaining phases of the modeling process. Understanding and appreciation of the differences between these ideal types can promote constructive debate on their balance in system dynamics theory and practice. © 2024 System Dynamics Society.