Examining the influence of anecdotal stories and the interplay of individual differences on reasoning

Anecdotes impact medical decisions even when presented with statistical information or decision aids

People are inundated with popular press reports about medical research concerning what is healthy, get advice from doctors, and hear personal anecdotes. How do people integrate conflicting anecdotal and statistical information when making medical decisions? In four experiments (N = 4126), we tested how people use conflicting information to judge the efficacy of artificial and real medical treatments. Participants read an anecdote from someone in a clinical trial, or who had undergone a medical treatment previously, for whom the medical treatment was ineffective. We found that reading anecdotes for either artificial or real medical treatments shifted participants' beliefs about the efficacy of a medical treatment. We observed this result even when the anecdote was uninformative, was paired with an icon array, or when participants were provided with thorough medical decision aids about reproductive health procedures. Our findings highlight the pervasive effect of anecdotes on medical decision making.

Public Understanding of Childhood Obesity: Qualitative Analysis of News Articles and Comments on Facebook

Childhood obesity has become a major focus of public health and subject to increased news coverage. News can shape public understanding of childhood obesity by selective reporting (framing) which can affect policy support and weight stigma. As news is consumed on social media, comments on articles present a novel method to explore public understanding. This study examined how childhood obesity is framed by news articles on Facebook and how individuals commenting understand and react to these articles. This study used a qualitative research design. Facebook pages of 11 national UK news outlets were searched for news articles on childhood obesity published between May 2015 and May 2020. Of those, 30 articles were randomly selected. Framing analysis was used to determine whether childhood obesity was portrayed as a behavioral, societal or medical issue. Responding comments (N = 1,104) were grouped according to the dominant frame of the corresponding article and analyzed using qualitative content analysis. Of the 30 articles, 28 mentioned societal, 26 behavioral and 18 medical aspects of childhood obesity, highlighting that most articles included more than one frame. Three themes were generated from responding comments: Culprits and Remedies, Appraising Childhood Obesity and Making Sense of the News Article. Findings showed that comments related to Appraising Childhood Obesity differed between differently framed articles, while the other themes did not. This study highlights the need for improved communication on childhood obesity to address weight stigma and improve understanding of news articles.

Causal theory error in college students' understanding of science studies

When reasoning about science studies, people often make causal theory errors by inferring or accepting a causal claim based on correlational evidence. While humans naturally think in terms of causal relationships, reasoning about science findings requires understanding how evidence supports—or fails to support—a causal claim. This study investigated college students’ thinking about causal claims presented in brief media reports describing behavioral science findings. How do science students reason about causal claims from correlational evidence? And can their reasoning be improved through instruction clarifying the nature of causal theory error? We examined these questions through a series of written reasoning exercises given to advanced college students over three weeks within a psychology methods course. In a pretest session, students critiqued study quality and support for a causal claim from a brief media report  suggesting an association between two variables. Then, they created diagrams depicting possible alternative causal theories. At the beginning of the second session, an instructional intervention introduced students to an extended example of a causal theory error through guided questions about possible alternative causes. Then, they completed the same two tasks with new science reports immediately and again 1 week later. The results show students’ reasoning included fewer causal theory errors after the intervention, and this improvement was maintained a week later. Our findings suggest that interventions aimed at addressing reasoning about causal claims in correlational studies are needed even for advanced science students, and that training on considering alternative causal theories may be successful in reducing casual theory error.

When and why do people act on flawed science? Effects of anecdotes and prior beliefs on evidence-based decision-making

Today’s citizens are expected to use evidence, frequently presented in the media, to inform decisions about health, behavior, and public policy. However, science misinformation is ubiquitous in the media, making it difficult to apply research appropriately. Across two experiments, we addressed how anecdotes and prior beliefs impact readers’ ability to both identify flawed science and make appropriate decisions based on flawed science in media articles. Each article described the results of flawed research on one of four educational interventions to improve learning (Experiment 1 included articles about having a tidy classroom and exercising while learning; Experiment 2 included articles about using virtual/augmented reality and napping at school). Experiment 1 tested the impact of a single anecdote and found no significant effect on either participants’ evidence evaluations or decisions to implement the learning interventions. However, participants were more likely to adopt the more plausible intervention (tidy classroom) despite identifying that it was unsupported by the evidence, suggesting effects of prior beliefs. In Experiment 2, we tested whether this intervention effect was driven by differences in beliefs about intervention plausibility and included two additional interventions (virtual reality = high plausible, napping = low plausible). We again found that participants were more likely to implement high plausible than low plausible interventions, and that evidence quality was underweighed as a factor in these decisions. Together, these studies suggest that evidence-based decisions are more strongly determined by prior beliefs than beliefs about the quality of evidence itself.

Constraints and Affordances of Online Engagement With Scientific Information-A Literature Review

Many urgent problems that societies currently face—from climate change to a global pandemic—require citizens to engage with scientific information as members of democratic societies as well as to solve problems in their personal lives. Most often, to solve their epistemic aims (aims directed at achieving knowledge and understanding) regarding such socio-scientific issues, individuals search for information online, where there exists a multitude of possibly relevant and highly interconnected sources of different perspectives, sometimes providing conflicting information. The paper provides a review of the literature aimed at identifying (a) constraints and affordances that scientific knowledge and the online information environment entail and (b) individuals' cognitive and motivational processes that have been found to hinder, or conversely, support practices of engagement (such as critical information evaluation or two-sided dialogue). Doing this, a conceptual framework for understanding and fostering what we call online engagement with scientific information is introduced, which is conceived as consisting of individual engagement (engaging on one's own in the search, selection, evaluation, and integration of information) and dialogic engagement (engaging in discourse with others to interpret, articulate and critically examine scientific information). In turn, this paper identifies individual and contextual conditions for individuals' goal-directed and effortful online engagement with scientific information.

Portrayal of umbilical cord blood research in the North American popular press: promise or hype?

Aim: This study examined how umbilical cord blood (UCB) use was portrayed in the English language North American popular press. Methods: Directed content analysis was conducted on 400 articles from 2007 to 2017 containing 'cord blood,' published by the most read Canadian and American news sources. Results: A total of 86.3% of the articles detailed UCB treatments and therapies, the majority of which align with clinical evidence. Some articles portrayed speculative/experimental therapies as efficacious. Public and private banking initiatives received substantial attention, and were portrayed diversely. Promotional narrative messaging was evident around private banking. Conclusion: Findings demonstrate the need for continual monitoring of the media portrayals of UCB as stem cell and transplantation research develops and as clinics continue to operate.

The role of emotion in clinical decision making: an integrative literature review

BACKGROUND

Traditionally, clinical decision making has been perceived as a purely rational and cognitive process. Recently, a number of authors have linked emotional intelligence (EI) to clinical decision making (CDM) and calls have been made for an increased focus on EI skills for clinicians. The objective of this integrative literature review was to identify and synthesise the empirical evidence for a role of emotion in CDM.

METHODS

A systematic search of the bibliographic databases PubMed, PsychINFO, and CINAHL (EBSCO) was conducted to identify empirical studies of clinician populations. Search terms were focused to identify studies reporting clinician emotion OR clinician emotional intelligence OR emotional competence AND clinical decision making OR clinical reasoning.

RESULTS

Twenty three papers were retained for synthesis. These represented empirical work from qualitative, quantitative, and mixed-methods approaches and comprised work with a focus on experienced emotion and on skills associated with emotional intelligence. The studies examined nurses (10), physicians (7), occupational therapists (1), physiotherapists (1), mixed clinician samples (3), and unspecified infectious disease experts (1). We identified two main themes in the context of clinical decision making: the subjective experience of emotion; and, the application of emotion and cognition in CDM. Sub-themes under the subjective experience of emotion were: emotional response to contextual pressures; emotional responses to others; and, intentional exclusion of emotion from CDM. Under the application of emotion and cognition in CDM, sub-themes were: compassionate emotional labour - responsiveness to patient emotion within CDM; interdisciplinary tension regarding the significance and meaning of emotion in CDM; and, emotion and moral judgement.

CONCLUSIONS

Clinicians' experienced emotions can and do affect clinical decision making, although acknowledgement of that is far from universal. Importantly, this occurs in the in the absence of a clear theoretical framework and educational preparation may not reflect the importance of emotional competence to effective CDM.