Preference, resistance to change, and the cumulative decision model

Response-dependent point loss and response force as disrupting operations on behavioral resistance to change in humans

Behavioral momentum theory (BMT) provides a theoretical and methodological framework for understanding how differentially maintained operant responding resists disruption. A common way to test operant resistance involves contingencies with suppressive effects, such as extinction or prefeeding. Other contingencies with known suppressive effects, such as response-cost procedures arranged as point-loss or increases in response force, remain untested as disruptive events within the BMT framework. In the present set of three experiments, responding of humans was maintained by point accumulation programmed according to a multiple variable-interval (VI) VI schedule with different reinforcement rates in either of two components. Subsequently, subtracting a point following each response (Experiment 1) or increasing the force required for the response to be registered (Experiments 2 and 3 decreased response rates, but responding was less disrupted in the component associated with the higher reinforcement rate. The point-loss contingency and increased response force similarly affected response rates by suppressing responding and human persistence, replicating previous findings with humans and nonhuman animals when other types of disruptive events (e.g., extinction and prefeeding) were investigated. The present findings moreover extend the generality of the effects of reinforcement rate on persistence, and thus BMT, extending the analysis of resistance to two well-known manipulations used to reduce responding in the experimental analysis of behavior.

Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study

BACKGROUND

The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners.

OBJECTIVE

This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework.

METHODS

A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model.

RESULTS

On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms.

CONCLUSIONS

This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.

Institutional dynamics and learning networks

Institutions have been described as ‘the humanly devised constraints that structure political, economic, and social interactions.’ This broad definition of institutions spans social norms, laws, companies, and even scientific theories. We describe a non-equilibrium, multi-scale learning framework supporting institutional quasi-stationarity, periodicity, and switching. Individuals collectively construct ledgers constituting institutions. Agents read only a part of the ledger–positive and negative opinions of an institution—its “public position” whose value biases one agent’s preferences over those of rivals. These positions encode collective perception and action relating to laws, the power of parties in political office, and advocacy for scientific theories. We consider a diversity of complex temporal phenomena in the history of social and research culture (e.g. scientific revolutions) and provide a new explanation for ubiquitous cultural resistance to change and novelty–a systemic endowment effect through hysteresis.

Resistance to extinction versus extinction as discrimination

The hypothesis that response strength might be measured by persistence of responding in the face of extinction was discredited in the 1960s because experiments showed that responding persists longer following intermittent reinforcers than following continuous reinforcers. Instead, researchers proposed that the longer persistence following intermittent reinforcers arises because intermittent reinforcement more closely resembles extinction-a discrimination theory. Attention to resistance to extinction revived because one observation seemed to support the persistence hypothesis: Following training on a multiple schedule with unequal components, responding usually persisted longer in the formerly richer component than in the formerly lean component. This observation represents an anomaly, however, because results with single schedules and concurrent schedules contradict it. We suggest that the difference in results arises because the multiple-schedule procedure, while including extensive training on stimulus discrimination, includes no training on discrimination between food available and food unavailable, whereas comparable single- and concurrent-schedule procedures include such training with repeated extinction. In Experiment 1, we replicated the original result, and in Experiment 2 showed that when the multiple-schedule procedure includes training on food/no-food discrimination, extinction following multiple schedules contradicts behavioral momentum theory and agrees with the discrimination theory and research with single and concurrent schedules.