Kelly Schmidtke

Differential outcomes facilitate same/different concept learning.

Commonly recognized, the training procedure one employs often affects the results they obtain. Here, we demonstrate for the first time that abstract-concept learning is affected by employing a differential-outcomes procedure. The differential-outcome effect has been shown to occur for item-specific strategies but has not been established for relational strategies. To test whether different-outcome expectancies can facilitate a relational strategy, eight pigeons were trained and tested in a two-item same/different task with pictures. After pecking an upper picture, they pecked a lower picture if the pictures were the same or a white rectangle if the pictures were different. Two groups of pigeons were rewarded with either different outcomes (sounds and food amounts) or same outcomes. Both groups were trained to criterion with successively larger picture sets (8–1,024 items) and were transfer tested with novel pictures following each acquisition. With the smallest training sets, neither group showed any novel-stimulus transfer. But after acquiring the task with 32 pictures, the different-outcomes group responded more accurately to novel pictures than the same-outcome group. As the training set-size increased, both groups’ transfer performance converged and became equivalent to training performance. These results show for the first time that training with different outcomes facilitates abstract-concept learning.

Considering chance in quality and safety performance measures: an analysis of performance reports by boards in English NHS trusts

Objectives Hospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so it is necessary to distinguish signals from noise (chance). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions. Methods Thirty English NHS trusts were selected at random and their board papers retrieved. Charts depicting quality and safety were identified. Categorical discriminations were then performed to document the methods used to present quality and safety data in board papers, with particular attention given to whether and how the charts depicted the role of chance, that is, by including control lines or error bars. Results Thirty board papers, containing a total of 1488 charts, were sampled. Only 88 (6%) of these charts depicted the role of chance, and only 17 of the 30 board papers included any charts depicting the role of chance. Of the 88 charts that attempted to represent the role of chance, 16 included error bars and 72 included control lines. Only 6 (8%) of the 72 control charts indicated where the control lines had been set (eg, 2 vs 3 SDs). Conclusions Hospital board members are expected to consider large amounts of information. Control charts can help board members distinguish signals from noise, but often boards are not using them. We discuss demand-side and supply-side barriers that could be overcome to increase use of control charts in healthcare.

The use of control charts by laypeople and hospital decision-makers for guiding decision making

Graphs presenting healthcare data are increasingly available to support laypeople and hospital staffs decision making. When making these decisions, hospital staff should consider the role of chance—that is, random variation. Given random variation, decision-makers must distinguish signals (sometimes called special-cause data) from noise (common-cause data). Unfortunately, many graphs do not facilitate the statistical reasoning necessary to make such distinctions. Control charts are a less commonly used type of graph that support statistical thinking by including reference lines that separate data more likely to be signals from those more likely to be noise. The current work demonstrates for whom (laypeople and hospital staff) and when (treatment and investigative decisions) control charts strengthen data-driven decision making. We present two experiments that compare peoples use of control and non-control charts to make decisions between hospitals (funnel charts vs. league tables) and to monitor changes across time (run charts with control lines vs. run charts without control lines). As expected, participants more accurately identified the outlying data using a control chart than using a non-control chart, but their ability to then apply that information to more complicated questions (e.g., where should I go for treatment?, and should I investigate?) was limited. The discussion highlights some common concerns about using control charts in hospital settings.

The use of commitment techniques to support weight loss maintenance in obese adolescents

Objectives: Obesity is a rising problem in adolescents related to unhealthy behaviours. Commitment devises are one type of behavioural intervention that may help people change their behaviours. The current pilot trial tests whether commitment devices delivered via text message help adolescents maintain their recent weight loss. Methods: During a 12-week pilot trial, adolescents who attended a weight loss camp were randomly assigned to either received text messages that contained only information, i.e. advice, about weight loss management (n = 13) or asked for them to commit to following the same advise (n = 14). Results: The BMI of the adolescents in the commitment group did not change. In contrast, the BMI of adolescents in the information group increased. A linear regression revealed that group was a significant predictor of BMI change. A logistic regression revealed that adolescents in the information group were nearly eight times more likely to regain weight than those in the commitment group. Conclusions: This is the first study with adolescents to show weight maintenance using a commitment device. The results suggest that commitment devices can help adolescents maintain their recent weight loss.

Lay intuitions about epistemic normativity

Recent empirical work on non-philosophers’ intuitions about epistemic normativity reveals patterns that cannot be fully accounted for by direct epistemic consequentialism. On the basis of these results, one might picture participants as “epistemic deontologists.” We present the results of two new experiments that support a more nuanced picture. We examine intuitions about guesses and hypotheses, and about beliefs. Our results suggest a two-factor model of intuitions, wherein both consequentialist and non-consequentialist considerations affect participants’ judgments about epistemic permissibility.

Validation of behavioral simulations: a case study on enhancing collaboration between partnership organizations

AimThe current article provides a detailed account of a behavioral simulation called Lateral Play. Lateral Play aimed to enhance collaborations and optimize shared decision-making across organizations within a newly formed partnership. The current article aims to enhance appreciation of the behavioral simulation methodology and encourage its use.Subjects and MethodsHealth service leaders from different organizations within a newly formed partnership gathered in the simulated community and took up roles similar to their real-life positions. The simulation presented participants with problems and opportunities similar to those that they would experience in real life, such as the need to consolidate services and create new care pathways. To evaluate Lateral Play’s effectiveness, self-reported and observational data were collected. These data include information about participants’ reactions, learning and behavior, and the newly formed partnership’s organizational results.ResultsLateral Play allowed health leaders to better understand how they could enhance collaborations and optimize shared decision-making across their newly formed partnership. The data suggest that simulations can promote effective collaborations.ConclusionsUse of behavioral simulations should be encouraged to promote policy awareness and understanding, refine implementation strategies and improve outcomes in newly formed partnerships.

Behavioural insights into benefits claimants' training

Purpose The purpose of this paper is to explore the behavioural determinants of work-related benefits claimants’ training behaviours and to suggest ways to improve claimants’ compliance with training referrals. Design/methodology/approach Qualitative interviews were conducted with 20 Jobcentre Plus staff and training providers, and 60 claimants. Claimants were sampled based on whether or not they had been mandated to training and whether or not they subsequently participated. Along with general findings, differences between these groups are highlighted. Findings Claimants’ behaviours are affected by their capabilities, opportunities, and motivations in interrelated ways. Training programmes should appreciate this to better ensure claimants’ completion of training programmes. Originality/value Whilst past papers have largely examined a limited number of factors that affect claimants’ training behaviours, this report offers a synchronised evaluation of all the behavioural factors that affect claimants’ training behaviours.

Relationalism about perceptible properties and the principle of charity

Color relationalism holds that the colors are constituted by relations to subjects. The introspective rejoinder against this view claims that it is opposed to our phenomenally-informed, pre-theoretic intuitions. The rejoinder seems to be correct about how colors appear when looking at how participants respond to an item about the metaphysical nature of color but not when looking at an item about the ascription of colors. The present article expands the properties investigated to sound and taste and inspects the mentioned asymmetry, with a particular focus on the principle of charity. Using a metaphysical item, we find that color and sound are no different from shape, our control for a clearly anti-relational property. Taste, on the other hand, is no different from likability, our control for a clearly relational property. Importantly, we find that the disparity between metaphysical and ascription items is due to participants using a principle of charity to interpret disagreement cases such that both parties can be correct.

Using behavioural economics concepts to increase organizational learning in an NHS hospital

Purpose The purpose of this paper is to assess whether the dissemination systems that hospitals use to spread information about particular safety incidents can be enhanced using behavioural economics concepts. Design/methodology/approach The current service evaluation took place within eight wards in a single acute care hospital. It was conducted as a randomized controlled trial with two groups. In the control group nothing was altered. In the intervention group ward managers received additional support to disseminate information to their nurses. Nurses were randomly selected to be surveyed during their scheduled shifts. The surveys revealed how the nurses learned about particular safety incidents and how many they remembered. Findings Nurses in the intervention group were more likely to learn about particular safety incidents than nurses in the control group. Practical implications Enhancing common dissemination systems in hospitals can increase organizational learning about safety incidents. The current study presents some means by which dissemination systems can be enhanced. Originality/value The current service evaluation is a unique application of behavioural economics concepts to enhance organizational learning of particular adverse safety incidents in an NHS hospital.