Use Of Vignettes Research Articles

Student and clinician perceptions of medical student mistreatment: a cross-sectional vignette survey

ObjectivesThe mistreatment of medical students remains pervasive in medical education. Understanding the extent to which clinicians and students recognise mistreatment can assist in creating targeted interventions that reduce mistreatment. The...

The Limit Notion at Three Educational Levels in Three Countries

This paper documents how the limit concept is treated in high school, at a university and in teacher education in England, France and Sweden. To this end we make use of vignettes, data-grounded accounts of the situation at the three levels in the three countries. These are analysed using the Anthropological Theory of the Didactic (ATD). While university praxeologies are relatively similar across the three countries, greater differences manifest themselves in high school and teacher education. For instance, at the high school level, in France a local praxeology on the limits of sequences is taught, which is not the case in England or Sweden. Results from the analysis of limits are extrapolated to comment on implications for the teaching of calculus, and for teacher education, in the three countries. The paper also raises methodological issues in our approach.

Development and use of research vignettes to collect qualitative data from healthcare professionals: a scoping review

ObjectivesTo clarify the definition of vignette-based methodology in qualitative research and to identify key elements underpinning its development and utilisation in qualitative empirical studies involving healthcare professionals.DesignScoping review according to...

The Autonomous Thinking Teacher: Preparing English Teachers for the 21st Century

This concept paper describes the changes made to Singapore’s initial teacher preparation (ITP) programmes with a specific focus on its thinking teacher model (NIE, 2009) – a model of teacher agency and an approach to ITP that requires self-reflection on roles and practice, understanding theories and research, and adapting to changing learner needs (Tan & Liu, 2015). An important component of this model is a ‘meta’ course which all pre-service teachers are required to undergo. This ‘meta’ course called Professional Practice and Inquiry (PPI) initiative – which was introduced to develop reflective professionals – cuts through the entire ITP programme providing them with both a framework and a platform to curate their understandings across all their courses, reflect deeply about teaching and learning and highlight their best work. This paper demonstrates, by the use of vignettes from their reflective pieces, how the goals and various components made possible by the PPI initiative provided the impetus for English pre-service teachers to develop into autonomous thinking teachers.

Contours of citizen science: a vignette study.

Citizen science has expanded rapidly over the past decades. Yet, defining citizen science and its boundaries remained a challenge, and this is reflected in the literature—for example in the proliferation of typologies and definitions. There is a need for identifying areas of agreement and disagreement within the citizen science practitioners community on what should be considered as citizen science activity. This paper describes the development and results of a survey that examined this issue, through the use of vignettes—short case descriptions that describe an activity, while asking the respondents to rate the activity on a scale from ‘not citizen science’ (0%) to ‘citizen science’ (100%). The survey included 50 vignettes, of which five were developed as clear cases of not-citizen science activities, five as widely accepted citizen science activities and the others addressing 10 factors and 61 sub-factors that can lead to controversy about an activity. The survey has attracted 333 respondents, who provided over 5100 ratings. The analysis demonstrates the plurality of understanding of what citizen science is and calls for an open understanding of what activities are included in the field.

The role of an educational vignette to teach dental students on issues of substance use and mental health disorders in patients at the University of British Columbia: an exploratory qualitative study

BackgroundInverted classroom approaches and the use of vignettes have been suggested in health care education. The objective of this study was to use an educational vignette to discuss issues of stigma around substance use and mental disorders within undergraduate Doctor of Medicine in Dentistry (DMD) and Bachelor of Dental Science in Dental Hygiene (BDSc-DH) students at the University of British Columbia, Canada. Our research question was “how can an educational vignette, depicting a fictitious patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?”MethodsAn educational vignette was developed based on individuals’ lived-experiences with a variety of substance use and/or mental health disorders. This vignette was used to generate in-class discussion involving all the DMD and BDSc-DH undergraduate students enrolled between 2015/16 and 2018/19 who attended a mandatory 2.5 h didactic session using an inverted classroom approach. Students were also encouraged to provide a post-class voluntary written reflection, between 200 and 300 words, around stigma. The authors took written field notes on students’ response to the vignette and used excerpts from students’ de-identified reflections to illustrate the impact of such an educational tool.ResultsA total of 323 DMD and BDSc-DH students attended the didactic sessions between 2015/16 and 2018/19, and 148 reflections were submitted over the same time period. The inverted classroom approached showed to be engaging and collaborative. The vignette promoted open dialogue and was determined to be a conducive tool to generate in-class discussion and reflection. Major themes from the textual data included ‘exploring power relations’ and ‘patient-centered care approach to counteract stigma’. The vignette also enabled the discussion of positive experiences characterized by empathy, reassurance and communication, although it might not have prompted all students to participate in class or in writing the reflections.ConclusionThe inverted classroom approach and the vignette seemed to be an effective way to facilitate dialogue and reflection for most students. This study highlighted the need to explore innovative ways in which to continuously prepare current and future oral health care providers to professionally address the needs of patients with a history of substance use and/or mental health disorders.

PRO67 The Use of Vignettes to Derive Health Utilities for Spinal Muscular Atrophy Type I (SMA-I)

Spinal muscular atrophy type I (SMA-I) is a rare genetic condition usually diagnosed before 6 months of age. Health utilities are required to evaluate the economic impact of treatments for SMA-I. However, it is impossible for these to be derived directly from affected children. The aim of this study was to derive SMA-I health utilities via vignettes. Participants were presented with 4 vignettes describing SMA-I health states that differed in levels of severity: 1. Permanent Assisted Ventilation (PAV); 2. Non-sitting; 3. Sitting; and 4. Walking. Participants were asked to imagine themselves as parents to a child with SMA. For each vignette participants first determined whether the state was worse than death (WTD) using a visual analogue scale (VAS) (range: -100 to 100). Health state utilities were then captured using time trade-off (TTO) and standard gamble (SG). Task wording was varied depending on whether the state was rated WTD. The study was completed online with a representative sample of the UK adult population. 321 participants completed the study (age: 18-65; 49.7% females). Mean health state utilities for TTO were: -0.0243 [PAV, 95% confidence interval: -0.0914, 0.0428]; -0.0264 [Non-sitting, -0.0966, 0.0438]; 0.0977 [Sitting, 0.0291, 0.1664]; 0.3844 [Walking, 0.3225, 0.4463]. For the SG: 0.0028 [-0.0611, 0.0677], 0.0139 [-0.0505, 0.0783], 0.0946 [0.0302, 0.1591] and 0.3782 [0.3176, 0.4388]. The least severe health state (“Walking”) differed significantly from the other three states (p<0.0001). Mean utilities were not statistically significant for the worst 2 health states. Mean health state utilities differed in line with severity of SMA-I. Although participants were not able to discriminate between the two worst health states, this, and the relatively low spread between mean utilities reflect the severity of SMA. These results contribute to a growing body of utility data for use in economic models of SMA treatments.

Evidence and practice: a review of vignettes in qualitative research.

Developing and working through a PhD research study requires tenacity, continuous development and application of knowledge. It is paramount when researching sensitive topics to consider carefully the construction of tools for collecting data, to ensure the study is ethically robust and explicitly addresses the research question. To explore how novice researchers can develop insight into aspects of the research process by developing vignettes as a research tool. This article focuses on the use of vignettes to collect data as part of a qualitative PhD study investigating making decisions in the best interests of and on behalf of people with advanced dementia. Developing vignettes is a purposeful, conscious process. It is equally important to ensure that vignettes are derived from literature, have an evidence base, are carefully constructed and peer-reviewed, and are suitable to achieve the research's aims. Using and analysing a vignette enables novice researchers to make sense of aspects of the qualitative research process and engage with it to appreciate terminology. Vignettes can provide an effective platform for discussion when researching topics where participants may be reluctant to share sensitive real-life experiences.

Design and use of vignettes to investigate referral decision-making by optometrists

PurposeThis study describes the design and application of a range of online clinical vignettes for measuring the impact of Continuing Education and Training (CET) and identifying unwarranted variation in optometric decision-making concerning referrals to secondary care. MethodsTwenty computerised vignettes were developed to assess clinical and referral management decisions taken in primary care optometry. The online system was specifically designed to present vignettes (ten pre-CET and ten post-CET) that avoided prompting correct answers. The main study group was qualified optometrists (N = 31) who chose any CET options available to United Kingdom optometrists over six months. Participants submitted a record of the CET undertaken, which was compared with an anonymised General Optical Council (GOC) reference sample. The vignettes were also completed by newly-qualified (N = 18) and pre-registration (N = 11) groups. ResultsCET had no significant correlation (p = 0.37) with improvement in optometric clinical decision-making and referral practice (qualified group). Selection bias affected this group who had more CET points (p = 0.008) and peer discussion points (p = 0.003) than the GOC reference sample. Results were indicative due to small sample sizes. Newly-qualified practitioners were significantly more likely to refer than the qualified group (p = 0.004). Number of referrals decreased with time since qualification (p = 0.006). ConclusionComputerised vignettes are a useful tool for comparing referral decisions between groups. Recruiting clinicians for time-consuming vignette studies is challenging. Strategies to reduce unwarranted variation in optometry, including support for newly-qualified optometrists, require further investigation.

Improving Nurse Preceptor Competence With Clinical Teaching on a Dedicated Education Unit.

Nurse preceptors have varying backgrounds of teaching experience and often cite insufficient preparation as a common reason for difficulties transitioning from the role of clinician to educator. This project evaluated an online education program for nurse preceptors of prelicensure students. Nurse preceptors received online instruction and howto examples in the form of clinical teaching vignettes to improve the teaching component of their role. Pre- and postsurveys were used to help determine program effectiveness. After the training, nurse preceptors indicated they felt more competent when teaching students, and likewise, students reported increased satisfaction with the quality of teaching. There are numerous roles assumed by nurse preceptors. Although many nurse preceptors are expert clinicians, they may lack expertise in the teaching role. Preceptor preparation programs that provide practical examples through the use of vignettes can contribute to the development of teaching competencies. [J Contin Educ Nurs. 2021;52(5):226-231.].

Implementação e Trabalhadores de Linha de Frente na Medida Socioeducativa de Liberdade Assistida

O trabalhador de linha de frente é descrito na literatura como o conjunto de atores diretamente responsáveis pelas atividades essenciais dos órgãos públicos, ocupando dessa forma uma posição de interface entre o Estado e o cidadão, o que os coloca como um ator com grande influência. O presente artigo analisa a atuação dos técnicos de referência na medida socioeducativa de liberdade assistida no Município de São Paulo, buscamos compreender, por meio de entrevistas semiestruturadas e o método de vinhetas, quais os fatores que influenciam a improvisação pragmática (adaptação entre as regras e as circunstâncias na implementação) e do uso da agência (habilidade de formar julgamentos) na atuação desses atores.

R12. Development of Vignettes for Healthcare Education and Research

Vignettes are widely used in healthcare and provide plausible controlled situations for assessing participant knowledge, beliefs, and approaches to decision making. The use of vignettes in healthcare and research facilitates learning while avoiding harm to patients. Vignettes are typically developed by an individual or group, using face validity of the vignette or not disclosed. This qualitative study was completed to validate 7 vignettes about patients with pain. This study was approved by the IRB.

The examination of a vignette activity sequence in a secondary mathematics methods course

AbstractBecause of their brief nature, vignettes are a strategic way to highlight or explore complex instructional practices. Using a qualitative approach, we examined how the use of vignettes in a Vignette Activity Sequence contributed to secondary mathematics preservice teachers’ understanding of the Mathematical Practices and the Mathematics Teaching Practices. By examining three vignettes used in two iterations of a secondary mathematics methods course, the researchers found that preservice teachers were able to draw connections between the vignettes and their own teaching experiences. However, some misconceptions or incomplete understandings related to the practices were revealed. Preservice teachers sometimes provided vague evidence when identifying particular practices in the vignettes that did not clearly indicate if they understood the practices. Taken together, the researchers found the Vignette Activity Sequence to be a valuable formative assessment that could be used to inform instruction in a secondary mathematics methods course. These findings have implications for teacher preparation programs and mathematics teacher educators.

Qualitative Vignette Experiments: A Mixed Methods Design

Despite emerging interest in mixing experimental and qualitative methods, a gap exists in integrating qualitative vignettes and experimental design. We present a novel mixed methods design, the qualitative vignette experiment, defined as the use of vignettes designed to introduce experimentally controlled variation in information within qualitative semistructured interviews. We argue that this design can provide context-rich data on causal mechanisms. This article contributes to the debate on integration in mixed methods research and is useful for scholars studying human practice and the link between macro-structural conditions and micro-interpretive processes. The design builds on an integrated ontology of critical realism and a complementary epistemological foundation of postpositivism and interpretivism. This means that researchers have to adhere to multiple validity criteria.

Specification and Testing of Hierarchical Ordered Response Models with Anchoring Vignettes

AbstractCollection and analysis of self-reported information on an ordered Likert scale is ubiquitous across the social sciences. Inference from such analyses is valid where the response scale employed means the same thing to all individuals. That is, if there is no differential item functioning (DIF) present in the data. A priori this is unlikely to hold across all individuals and cohorts in any sample of data. For this reason, anchoring vignettes have been proposed as a way to correct for DIF when individuals self-assess their health (or well-being, or satisfaction levels, or disability levels, etc.) on an ordered categorical scale. Using an example of self-assessed pain, we illustrate the use of vignettes to adjust for DIF using the compound hierarchical ordered probit model (CHOPIT). The validity of this approach relies on the two underlying assumptions of response consistency (RC) and vignette equivalence (VE). Using a minor amendment to the specification of the standard CHOPIT model, we develop easy-to-implement score tests of the null hypothesis of RC and VE both separately and jointly. Monte Carlo simulations show that the tests have good size and power properties in finite samples. We illustrate the use of the tests by applying them to our empirical example. The tests should aid more robust analyses of self-reported survey outcomes collected alongside anchoring vignettes.

Developing and Establishing Content Validity of Vignettes for Health Care Education and Research.

The use of vignettes in research and education is well documented. Documentation of how vignettes are developed and content validity is established, however, are rare. The purpose of this paper is to describe a method for development and establishing content validity of vignettes that can be used to assess student performance and research participant outcomes. This three-phase method was designed to validate seven vignettes for a future research project. Content validity index survey and expert panel interviews were used to inform improvements in validity. Findings showed that clinical vignettes were improved with respect to content relevance (from 0.93 to 0.96) and importance (from 0.68 to 0.93). Developing validated vignettes is essential when used to measure outcomes in education and in research. This three-phase method of vignette development and validation is feasible and effective in improving content validity of vignettes and can be used in other education and research projects.

Will the real “Mrs Smith” please stand up: a critical examination of the role of vignettes in integrated service development and delivery

PurposeTo explore the use of fictitious vignettes representing older people and the extent to which they serve as an effective resource in developing service provision and transforming health and social care.Design/methodology/approachBased on a critical review of research and academic discourse.FindingsFictitious vignettes or case studies of older adults, such as “Mrs Smith”, may be a useful means to promote communication with and between health and social care colleagues about current services and transforming or re-organising service provision. However, we argue that while there may be a role for vignettes, care should be taken in their use. The potential to “homogenise” older people into the “typical” patient personified by Mrs Smith may do very little to challenge age- based stereotypes and assumptions. Moreover, vignettes cannot match the potential value and importance of older men and women directly participating in the evaluation and development of services.Practical implicationsThis article argues that changing the way services are organised and delivered must be underpinned by critical reflection of the assumptions which underpin attitudes towards old age, including our tendency to define older people by chronological age and to homogenise “the elderly” into a single group. The value of participatory methods which meaningfully involve older citizens in both evaluating and planning services could contribute significantly to innovation in service development.Social implicationsThis paper highlights the critical importance of challenging age-based stereotypes and ageist policy and practice. Recognising old age as being characterised by diversity and difference could challenge the tendency to see old age, especially advanced old age, as an inevitable problem.Originality/valueThis article offers a critical perspective on the use of vignettes.

Context of Vignettes and Ethical Sensitivity in Decision-Making Among Undergraduate Business Studies Learners at University of Nairobi, Kenya

Vignettes have been applied to train professionals in various fields, which has contributed to significant improvements in learning outcomes, ethical sensitivity and learners&amp;rsquo; ethical decision-making. At the University of Nairobi&amp;rsquo;s Department of Educational Communication and Technology, most instructors have been slow to embrace experiential learning and inconsistent in applying vignettes to deliver business ethics lessons that emphasise ethical sensitivity in decision-making, with far reaching effects on the quality of graduates. This study responded to the information gap about the relationship between the use of vignettes and learners&amp;rsquo; ethical sensitivity in decision-making at the University of Nairobi. Cross-sectional survey design guided the research process, and primary data were sourced in 2018 from 116 learners. Both quantitative and qualitative analysis techniques were applied. Key results show that learners who agreed strongly that the context of vignettes influences ethical sensitivity in decision-making were about 3.9 times as likely to make ethically sensitive decisions as colleagues who disagreed strongly. Those who agreed that the context of vignettes influences ethical sensitivity in decision-making had about 2.3 times the odds of making ethically sensitive decisions as colleagues who indicted strong disagreement. This means that the more the learners appreciated that the context of vignettes influences ethical sensitivity in decision-making, the higher the chances of them making ethically sensitive decisions, and vice-versa. This brings to the fore the need for instructors to consistently apply the context of vignettes to deliver business ethics lessons to improve learners&amp;rsquo; ethical sensitivity and propensity to make ethical decisions. The study recommends that for practice, vignettes business contexts should be integrated in teacher training business studies ethics lessons.

From reflection to diffraction: exploring the use of vignettes within post-humanist and multi-species research

This article explores the use of vignettes in qualitative research from a post-humanist and multi-species perspective. Drawing on methodological principles espoused by Karen Barad and Donna Haraway, as well as empirical data from the Dementia Dog pilot project in Scotland, UK, we explore the use of vignettes as a technique for understanding human–dog relations in dementia. In so doing, we outline an approach to using vignettes that is guided by principles of diffraction, which is contrasted with humanist principles of interpretivism, reflection and representation. Moving away from humanist methodology, we argue, calls for new approaches to evaluating the quality of vignettes. This involves disrupting conventional approaches, within which vignettes are defined by their purpose and evaluated according to fixed criteria (e.g. validity, authenticity and trustworthiness). In their place, we argue for an approach to evaluating vignettes that is rooted in performativity and guided by the question: What can a vignette do?

Using vignettes to assess the contribution of goal adjustment in the adaptation to chronic musculoskeletal pain.

The quality of life of individuals with chronic musculoskeletal pain partly depends on their capacity to adjust their personal goals. Vignettes have been rarely used to assess this ability. Therefore, this study aimed to test the relationships between vignettes assessing different goal strategies and chronic pain adaptation (i.e., daily functioning, pain-related impairment, and psychological well-being). The sample comprised 258 individuals with chronic musculoskeletal pain who completed a series of questionnaires and vignettes. The vignettes presented a short description of a situation in which a person with chronic pain experienced a threat to a valued domain-specific goal and had to choose a possible goal management solution (i.e., goal persistence, flexibility reengagement, and disengagement). Hierarchical regression analyses were used to predict chronic pain adaptation using the selected vignette strategies as predictors. After controlling for age, sex, pain intensity, and the responses to the dispositional goal management scales, persistence, reengagement, and disengagement goal strategies presented in the case scenarios predicted daily functioning (p < .001). Persistence, flexibility, disengagement (p < .001), and reengagement (p < .05) predicted pain-related impairment. Persistence, disengagement (p < .001), and flexibility (p < .05) predicted psychological well-being scores. The use of vignettes could be useful to assess goal adjustment because this methodology enables respondents to provide more context-specific responses. The results of this approach could be used to improve clinical practice aimed at helping people with chronic musculoskeletal pain to better cope with this health condition.