Knowledge Judgment Research Articles

Impact of a TeamSTEPPS Trauma Nurse Academy at a Level 1 Trauma Center

ProblemNurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. MethodsSince 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents’ trauma bay experience and injury prevention activities. ResultsInternal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. Implications for practiceAlthough trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential.Image 1

Improving risk characterisations in practical situations by highlighting knowledge aspects, with applications to risk matrices

Current practice for risk characterisations is based on methods reflecting threats, their consequences and probability, as well as concepts like risk factors and sources. The risk matrix is an example of such a method. The risk analysis field has demonstrated that there are many challenges related to this practice and there is a substantial potential for improvements in how the characterisations can be conducted. The key is to better reflect the knowledge aspect of risk. The purpose of the present paper is to present a set of practical methods that can be used for characterising risk in this setting in line with these findings of the risk analysis field. Extended risk matrix approaches are highlighted. These approaches include strength of knowledge judgements and rankings of risk factors and assumptions supporting the analysis. Special attention is given to potential surprises relative to the current knowledge. Simple examples are presented to illustrate the use of these methods and approaches.

HISTORIA ŻYCIA I PRACY TEOFILI JACUŃSKIEJ (1900−1984)

The article explores the biography of Teofilia Jacuńska and her work for the common good inthe four parishes in the Suwalszczyzna region. Born in the US, well-educated and multitalented,Jacuńska abandons a promising career in order to come back to Poland and to focus solely on socialwork for the good of people and the Church. The article discloses facts previously unknown to thepublic but of vital importance to our national awareness. These stories enrich our knowledge of thepast generation and review unfair judgment about people devoted to Church.

How Journalists Think about Media Effects—And Why We Should Care

ABSTRACTResearch suggests that journalists’ beliefs about media effects are influenced by unsystematically gathered knowledge and subjective-intuitive judgments. However, it has also been shown that these presumptions must be considered important factors for the formation of journalistic coverage. Against this background, this article synthesizes existing research on dimensions, determinants, and consequences of journalists’ presumptions of media effects. The resulting framework offers researchers in the field of journalistic content production a comprehensive overview of the possible role that presumptions of media effects could play for journalistic content creation. In a second step, we summarize the implications that the current state of research points at. We discuss why journalism scholars should integrate presumed media effects into their research agendas and what communication researchers, as well as journalists themselves, could do to promote more realistic beliefs about media effects among journalists.

SEQUENCING JUDGEMENT SKILLS AND DECISIONS-MADE ON RUGBY ATHLETES: AN ANALYSIS ON INJURY PREVENTION

ObjectiveTo analyse rugby athletes' judgement knowledge and decisions-made where there is the potential to minimise error and prevent injury.Material and methodsA prospective cohort of 300 rugby athletes participated in the...

Knowledge elicitation practices for organizational development intervention

Based on a sensemaking methodology and the use of narratives from a case study in a quality assurance department of an electronics manufacturing company, a Group Reflection and Inquiry Protocol (GRIP) technique is developed to solicit judgmental knowledge from the staff of an organization in regard to formulating business strategy. The method combines knowledge elicitation (KE) and organizational development (OD) intervention for the change to be brought about in an organization. An open communication platform is created for the participants, with minimum influence of the consultant, as well as there being no demand for any special expertise of the consultant or researcher in the OD intervention.

Descartes’s Schism, Locke’s Reunion: Completing the Pragmatic Turn in Epistemology

Centuries ago, Descartes and Locke initiated a foundational debate in epistemology over the relationship between knowledge, on the one hand, and practical factors, on the other. Descartes claimed that knowledge and practice are fundamentally separate. Locke claimed that knowledge and practice are fundamentally united. After a period of dormancy, their disagreement has reignited on the contemporary scene. Latter-day Lockeans claim that knowledge itself is essentially connected to, and perhaps even constituted by, practical factors such as how much is at stake, how important the situation is, or how one should act. Latter-day Cartesians claim, by contrast, that knowledge is entirely constituted by truth-related factors such as truth, belief, and evidence. Each side has supported its case with claims about patterns in ordinary behavior and knowledge judgments. Lockeans argue that these patterns are best explained by positing a fundamental and direct link between knowledge and practical factors. Cartesians argue that the patterns can be equally well explained by positing an indirect link, entirely mediated by the traditional factors of truth, belief, and evidence, thereby rendering the Lockean hypothesis unnecessary. We argue that Cartesians are right about some practical factors, in particular stakes and how important a situation is, which have, at best, a modest indirect relationship to knowledge. However, Lockeans are right about actionability: whether a person should pursue a course of action is unquestionably very powerfully and directly connected to knowledge.

DESCARTES’S SCHISM, LOCKE’S REUNION: COMPLETING THE PRAGMATIC TURN IN EPISTEMOLOGY

Abstract Centuries ago, Descartes and Locke initiated a foundational debate in epistemology over the relationship between knowledge, on the one hand, and practical factors, on the other. Descartes claimed that knowledge and practice are fundamentally separate. Locke claimed that knowledge and practice are fundamentally united. After a period of dormancy, their disagreement has reignited on the contemporary scene. Latter-day Lockeans claim that knowledge itself is essentially connected to, and perhaps even constituted by, practical factors such as how much is at stake, how important the situation is, or how one should act. Latter-day Cartesians claim, by contrast, that knowledge is entirely constituted by truth-related factors such as truth, belief, and evidence. Each side has supported its case with claims about patterns in ordinary behavior and knowledge judgments. Lockeans argue that these patterns are best explained by positing a fundamental and direct link between knowledge and practical factors. Cartesians argue that the patterns can be equally well explained by positing an indirect link, entirely mediated by the traditional factors of truth, belief, and evidence, thereby rendering the Lockean hypothesis unnecessary. We argue that Cartesians are right about some practical factors, in particular stakes and how important a situation is, which have, at best, a modest indirect relationship to knowledge. However, Lockeans are right about actionability: whether a person should pursue a course of action is powerfully and directly connected to knowledge.

Knowledge and Morality of School-Age Children and Adolescents Regarding Environmental Issues and Moral Dilemmas

A research gap exists with regard to the analysis of school children and adolescents’ awareness on environmental issues. Current investigation analyzes data of 240 children and adolescents, aged between 8 and 14 years, within different school contexts in the mid-southern region of Brazil, on their knowledge level and moral judgment on solid wastes, river water and tree life. Whereas the exploratory research with different groups of different ages verifies the manner behavior emerges and changes, the transversal design gives an evolution aspect of data through the examination of a great number of agents. Results showed that children and adolescents have similar knowledge on the environment within different school contexts, except differences at environmental knowledge level. The latter revealed a mild broadening trend in proportion to the 8 - 14 years age bracket. Environmental moral judgment varied a lot, regardless of the agents’ age, and failed to be related to the knowledge that children and adolescents had on the environmental themes. Schools featuring well-defined pedagogical proposals were positively salient among the others. Environmental knowledge and moral judgment on environmental issues are not determining but implied chiefly as from the age of eleven, since both are the result of the agents’ social interactivity within the environment and basically require affectivity and cooperation.

Knowledge Attributions in Iterated Fake Barn Cases

In a single-iteration fake barn case, the agent correctly identifies an object of interest on the first try, despite the presence of nearby lookalikes that could have mislead her. In a multiple-iteration fake barn case, the agent first encounters several fakes, misidentifies each of them, and then encounters and correctly identifies a genuine item of interest. Prior work has established that people tend to attribute knowledge in single-iteration fake barn cases, but multiple-iteration cases have not been tested. However, some theorists contend that multiple-iteration cases are more important and will elicit a strong tendency to deny knowledge. Here I report a behavioral experiment investigating knowledge judgments in multiple-iteration fake barn cases. The main finding is that people tend to attribute knowledge in these cases too. Ironically, the results indicate that the presence of fakes could prevent iterated errors from lowering knowledge attributions. The results also provide evidence that ordinary knowledge attributions are based on attributions of cognitive ability.

Knowledge attributions in iterated fake barn cases

In a single-iteration fake barn case, the agent correctly identifies an object of interest on the first try, despite the presence of nearby lookalikes that could have mislead her. In a multiple-iteration fake barn case, the agent first encounters several fakes, misidentifies each of them, and then encounters and correctly identifies a genuine item of interest. Prior work has established that people tend to attribute knowledge in single-iteration fake barn cases, but multiple-iteration cases have not been tested. However, some theorists contend that multiple-iteration cases are more important and will elicit a strong tendency to deny knowledge. Here I report a behavioral experiment investigating knowledge judgments in multiple-iteration fake barn cases. The main finding is that people tend to attribute knowledge in these cases too. Ironically, the results indicate that the presence of fakes could prevent iterated errors from lowering knowledge attributions. The results also provide evidence that ordinary knowledge attributions are based on attributions of cognitive ability.

Incidental Learning of Melodic Structure of North Indian Music.

Musical knowledge is largely implicit. It is acquired without awareness of its complex rules, through interaction with a large number of samples during musical enculturation. Whereas several studies explored implicit learning of mostly abstract and less ecologically valid features of Western music, very little work has been done with respect to ecologically valid stimuli as well as non-Western music. The present study investigated implicit learning of modal melodic features in North Indian classical music in a realistic and ecologically valid way. It employed a cross-grammar design, using melodic materials from two modes (rāgas) that use the same scale. Findings indicated that Western participants unfamiliar with Indian music incidentally learned to identify distinctive features of each mode. Confidence ratings suggest that participants' performance was consistently correlated with confidence, indicating that they became aware of whether they were right in their responses; that is, they possessed explicit judgment knowledge. Altogether our findings show incidental learning in a realistic ecologically valid context during only a very short exposure, they provide evidence that incidental learning constitutes a powerful mechanism that plays a fundamental role in musical acquisition.

Moving beyond probabilities – Strength of knowledge characterisations applied to security

Many security experts avoid the concept of probability when assessing risk and vulnerabilities. Their main argument is that meaningful probabilities cannot be determined and they are consequently not useful for decision-making and security management. However, to give priority to some measures and not others, the likelihood dimension needs to be addressed in some way; the question is how. One approach receiving attention recently is to add strength of knowledge judgements to the probabilities and probability intervals generated. The judgements provide a qualitative labelling of how strong the knowledge supporting the probability assignments is. Criteria for such labelling have been developed, but not for a security setting. The purpose of this paper is to develop such criteria specific to security applications and, using some examples, to demonstrate their suitability.

Location of abnormal parathyroid glands: lessons from 810 parathyroidectomies

BackgroundPrimary hyperparathyroidism (pHPT) is commonly treated with targeted parathyroidectomy (PTX) guided by preoperative imaging and intraoperative parathormone monitoring. Despite advanced imaging techniques, failure of parathyroid localization still occurs. This study determines the anatomical distribution of single abnormal parathyroid glands, which may help direct the surgeon in PTX when preoperative localization is unsuccessful. MethodsA retrospective review of prospectively collected data of 810 patients with pHPT who underwent initial PTX at a tertiary medical center was performed. All patients had biochemically confirmed pHPT and single-gland disease. Abnormal parathyroid gland localization was determined at time of operation, correlated with operative and pathology reports, and confirmed by operative success defined as eucalcemia for ≥6 mo after PTX. Patients with multiple endocrine neoplasia, secondary, tertiary, or familial hyperparathyroidism, multiglandular disease, parathyroid cancer, and ectopic glands were excluded. Data were analyzed by chi-square and Z-test analyses. ResultsAmong 810 patients who underwent PTX for pHPT, single abnormal parathyroid glands were unequally distributed among the four eutopic locations (left superior, 15.7%; left inferior, 31.3%; right superior, 15.8%; right inferior, 37.2%; P < 0.01). Abnormal inferior parathyroid glands (68.5%) were significantly more common than abnormal superior glands (31.5%), respectively (P < 0.01). In men, the most common location for single abnormal parathyroid glands was the right inferior position (43.4%, P < 0.01). Overall, there was no significant difference in laterality. ConclusionsThis large series of patients suggests that single eutopic abnormal parathyroid glands are more likely to be inferior. In men, moreover, if an abnormal parathyroid gland is not localized preoperatively, the right inferior location should be explored first. Nevertheless, successful PTX remains predicated on knowledge of parathyroid anatomy, experience, and judgment of the surgeon.

On the Difference Between Risk as Seen From the Perspectives of the Analysts and Management

In its general form, risk is quantitatively described by analysts by identifying a set of consequences C of an activity and using a measure Q to express the uncertainties related to these consequences. This risk description (C,Q) is based on a background knowledge K, including assumptions on which the (C,Q) assessment was found. The purpose of the present paper is to draw attention to the fact that risk from the perspective of the decision-maker necessarily needs to see beyond (C,Q); judgments of the background knowledge K of the analysts are an integral part of the management’s and the decision-maker’s risk description and evaluation. Thus, this risk description of the analyst is (C,Q|K), whereas the management and the decision-maker need to reflect on the unconditional description (C,Q,K), seeing K as containing potential risk sources. Ways of characterizing this risk are presented and discussed. An example from the oil and gas industry is used to illustrate the discussions and show the importance for the practice of risk assessment and management.

Sosa on Animal Knowledge and Emotions

Our goal in this paper is to discuss the notion of animal knowledge in Judgment and Agency. Our approach has two stages. First, we offer a positive contribution, attempting to show that there is room for the introduction of emotions into an animal knowledge approach and into Sosa's theory of competence. If we follow Sosa and conceive knowledge as a kind of action or successful performance, then emotions can contribute functionally for enhancing performance and are essential for the sharing of knowledge among social agents. Second, we offer criticism of Sosa's integrative project. It's not clear that reflective knowledge always improves animal knowledge; rather, in order to avoid regress, Sosa should recognize that we can have perfectly safe animal knowledge. Finally, we argue that reflective knowledge has a more marginal role than Sosa seems at first sight to suggest.mm

Validation of a simplified micromodel for analysis of infilled RC frames exposed to cyclic lateral loads

An RC frame structure with masonry infill walls (“framed-masonry”) exposed to lateral loads acts as a composite structure. Numerical simulation of framed-masonry is difficult and generally unreliable due to many difficulties and uncertainties in its modelling. In this paper, we reviewed the usability of an advanced non-linear FEM computer program to accurately predict the behaviour of framed-masonry elements when exposed to cyclic lateral loading. Numerical results are validated against the test results of framed-masonry specimens, with and without openings. Initial simplified micromodels were calibrated by adjustment of the input parameters within the physically justifiable borders, in order to obtain the best correlation between the experimental and numerical results. It has been shown that the use of simplified micromodels for the investigation of composite masonry-infilled RC frames requires in-depth knowledge and engineering judgement in order to be used with confidence. Modelling problems were identified and explained in detail, which in turn offer an insight to practising engineers on how to deal with them.

Tertiary Pharmaceutical Care Services Between Facts and Realities

Pharmacy practice is dynamic, evolving and requires high level of drug knowledge in clinical judgment, decision making and advanced skills in actively and systematically identifying and resolving patients pharmacotherapy problems for desired outcomes to be achieved in patient care. This study organized literatures and identified the evidence based and ever increasing roles of pharmacists in tertiary pharmaceutical care. Literature search was conducted in Embase, Medline and Cochrane for evidence based studies describing pharmacist’s tertiary pharmaceutical care. Studies were selected based on their relivance to the subject, existing theories and models, and were summarized based on qualitative level. Results indicated that clinical pharmacist led pharmaceutical care improved clinical, economic, and humanistic outcomes in tertiary care settings. Pharmacists’ roles have evolved from a product to cost effective patient oriented services.

Development of cognitive processing and judgments of knowledge in medical students: Analysis of progress test results

Background: Beside acquiring knowledge, medical students should also develop the ability to apply and reflect on it, requiring higher-order cognitive processing. Ideally, students should have reached higher-order cognitive processing when they enter the clinical program. Whether this is the case, is unknown. We investigated students’ cognitive processing, and awareness of their knowledge during medical school.Methods: Data were gathered from 347 first-year preclinical and 196 first-year clinical students concerning the 2008 and 2011 Dutch progress tests. Questions were classified based upon Bloom’s taxonomy: “simple questions” requiring lower and “vignette questions” requiring higher-order cognitive processing. Subsequently, we compared students’ performance and awareness of their knowledge in 2008 to that in 2011 for each question type.Results: Students’ performance on each type of question increased as students progressed. Preclinical and first-year clinical students performed better on simple questions than on vignette questions. Third-year clinical students performed better on vignette questions than on simple questions. The accuracy of students’ judgment of knowledge decreased over time.Conclusions: The progress test is a useful tool to assess students’ cognitive processing and awareness of their knowledge. At the end of medical school, students achieved higher-order cognitive processing but their awareness of their knowledge had decreased.

Treinamento e desenvolvimento de pessoal: agregando valor às pessoas e à organização

The article aims to identify the possibilities of inclusion of people through training and development, carrying out the study at the Center of continuous training of the Fire Department of Santa Catarina. It was developed as a participatory research, through non-structured interviews with open questions, in a Itajai Valley corporation covering three municipalities along the highway BR 470, which has a high traffic accident rate. The selection process for volunteer firefighters had 46 candidates, among them the brothers P. In the first stage of the selection, the result presented by the brothers was unsatisfactory, but by decision of the Continuing Training Center both received the opportunity to continue, considering not only performance, but their education, simplicity, humbleness and interest. During the training the resourcefulness of the brothers was observed, being notorious the application of knowledge in daily life, autonomy, forward thinking and judgment in decision making. At the end of the course the P brothers were the ones who had 100% attendance and considering their initial difficulties, they stood out in the program, being approved with merit. Both opted to take work at the corporation on Sundays with fixed schedule. What was observd was a unique experience that has occurred in training for volunteer firefighters and the various aspects of human development, considering the decision of being willing to learn, motivation; influence of the context, knowledge; team spirit and, above all, the value of human dignity in the simplest aspects, such as friendliness and the desire to do good.