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Liu D, Gan Q, Ma H. Activating argumentation schema to write argumentatively and tactfully. Acta Psychol (Amst) 2024; 246:104256. [PMID: 38615595 DOI: 10.1016/j.actpsy.2024.104256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/11/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024] Open
Abstract
To argue tactfully is a goal in argumentative writing, which entails balanced argumentation schema. Although computer-supported collaborative learning (CSCL) has been widely acknowledged as language learning mediation, especially in writing, few studies investigate its effectiveness in activating the balanced argumentation schema. This study explores the effectiveness of QQ group discussion, a kind of CSCL mediation most popular in China, in argumentative writing by means of quasi-experiment and interview. Fifty-six second-year college students in an English Department participated in this study. The experimental group were asked to have a pre-writing QQ group discussion on a disputable topic while the control group had an in-class face-to-face discussion (a regular teaching method for English majors). Content analysis of the essays was made to investigate the use of Counterargument elements, Qualifier and Concession. The results show that the two groups had no difference in the use of Counterargument-claim and Rebuttal. However, the experimental group surpassed the control group in Counterargument-data, Concession and Qualifier, which signifies more argumentativeness and tactfulness. In the delayed post-test this group still performed better. The interview transcriptions were coded and analyzed by inductive content analysis with the functions of QQ discussion as the themes. The result not only supported that of the experiment, but also revealed why and how QQ mediation could help activate the balanced argumentation schema. It is suggested that CSCL mediation should be promoted in argumentative writing instruction so that the students could write argumentatively and tactfully.
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Affiliation(s)
| | - Qiong Gan
- Central China Normal University, Wuhan, China
| | - Hui Ma
- Southeast University, Nanjing, China
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Roossien L, Boerboom T, Spaai G, van Klaveren LM, Dolmans D, de Vos R. Opening the black box of team-based learning (TBL): A study of verbal interactions in online application sessions. MEDICAL TEACHER 2024; 46:832-841. [PMID: 38035575 DOI: 10.1080/0142159x.2023.2285249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
CONTEXT In team-based learning (TBL), an instructional strategy that encourages in-depth team discussion and deep learning, interactions in terms of sharing, co-construction, constructive conflict and procedural interactions are important. Since TBL has also been applied online in recent years, the question is whether these interactions are sufficiently present in an online setting. AIM Gain insight into the nature and extent of these types of interactions in online TBL application sessions and to what extent these vary between teams and sessions. METHODS We made audiovisual recordings of 12 TBL teams in two online application sessions during assignments. Transcripts were coded and analyzed using a framework derived. RESULTS Teams spent more than 85% of their time on all four types of interactions in both sessions. The largest proportion of time was spent on sharing and co-construction. Constructive conflict occurred to a limited extent. We observed variation in proportion of time spent on and the distribution of the four types of interactions between teams and sessions. DISCUSSION All interactions important for achieving deep learning occurred in online TBL application sessions. However, the effective use of these types of interaction should not be left to chance.
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Affiliation(s)
- Linda Roossien
- Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, Teaching and Learning Center, the Netherlands
| | - Tobias Boerboom
- Faculty of Veterinary Medicine, Utrecht University, the Netherlands
| | - Gerard Spaai
- Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, Teaching and Learning Center, the Netherlands
| | - Lisa-Maria van Klaveren
- Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, Institute for Education and Training, the Netherlands
| | - Diana Dolmans
- Department of Educational Development and Research, Faculty of Medicine, University of Maastricht, the Netherlands
| | - Rien de Vos
- Amsterdam University Medical Centers, Faculty of Medicine, University of Amsterdam, Institute for Education and Training, the Netherlands
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Kreuz J, Luginbühl M. Demonstrating consensus in argumentative settings: Co-constructions in children's peer discussions. EUROPEAN JOURNAL OF PSYCHOLOGY OF EDUCATION 2024; 39:1739-1757. [PMID: 39301203 PMCID: PMC11412085 DOI: 10.1007/s10212-024-00840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 01/05/2024] [Accepted: 04/15/2024] [Indexed: 09/22/2024]
Abstract
'Taking part' in conversations requires different activities from the interactants depending on the kind of conversation. This article investigates co-constructions in oral peer group discussions of elementary school children from grades 2 to 6 (7-12 years old). Although dissent is the starting point of argumentations, negotiating processes in oral argumentations are often co-constructed by two or more speakers on different levels, including consensual contexts. Co-constructions presuppose that the second speakers recognize structures and expectations based on the turn of the first speaker and that they are able to complete or expand these structures. Therefore, co-constructions can be understood as an indicator for oral skills and as a key site of 'taking part' in small group discussions. The article will discuss two different kinds of co-constructions (morpho-syntactical and argumentative-structural) based on 60 transcripts from a bigger corpus of 180 peer discussions. The analysis will show that these co-constructions can be understood as synchronizations of thinking and acting and to what extent they are an indicator of oral skills and play an important role in cooperative learning settings. The results are relevant in school contexts when it comes to assess oral argumentation of students. For teachers, they are helpful to elicit requirements for children's argumentation skills and to design tasks conducive to learn to argue and develop assessment tools accordingly.
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Affiliation(s)
- Judith Kreuz
- Centre of Oral Communication, University of Teacher Education Zug, Zug, Switzerland
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Li HH, Zhang LJ. Investigating Effects of Small-Group Student Talk on the Quality of Argument in Chinese Tertiary English as a Foreign Language Learners’ Argumentative Writing. Front Psychol 2022; 13:868045. [PMID: 35783807 PMCID: PMC9240094 DOI: 10.3389/fpsyg.2022.868045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies have offered a rationale for engaging students in small-group student talk for the planning of L2 individual writing. To further investigate whether such talk effectively promotes the quality of argument in the context of Chinese tertiary EFL learners’ argumentative writing and whether such effects could be retained, the current study adopted a quasi-experimental design with a pretest, a posttest, and a delayed posttest in two intact EFL classes. The performance of the intervention group and the comparison group were scrutinized to examine the effects of the intervention. The analytic scores on six components of the writing task (claim, data, counterargument claim, counterargument data, rebuttal claim, and rebuttal data) and the holistic writing scores cumulated of all these components were measured to see the immediate and sustained effects. Significant changes of the holistic scores in both the immediate posttest and the delayed posttest indicated that such small-group student talk enabled students in the treatment class to achieve better performance in the overall quality of argumentation compared with those in the comparison class. Statistical analyses revealed immediate and sustained effects of small-group student talk on the quality of counterargument claim, counterargument data, and rebuttal claim. Counterargument claim was the only element in which students in both classes made significant improvement, but the treatment class demonstrated a larger effect size. No discernible differences were found either between or within the treatment class and the comparison class with respect to the quality of claim, data, and rebuttal data across tests. Possible explanations concerning the findings and limitations of the study were discussed.
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Affiliation(s)
- Hui Helen Li
- School of Foreign Languages, Wuhan University of Technology, Wuhan, China
- Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Lawrence Jun Zhang
- Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
- *Correspondence: Lawrence Jun Zhang,
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Gràcia M, Alvarado JM, Nieva S. Assessment of Oral Skills in Adolescents. CHILDREN 2021; 8:children8121136. [PMID: 34943332 PMCID: PMC8700146 DOI: 10.3390/children8121136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
There is broad consensus on the need to foster oral skills in middle school due to their inherent importance and because they serve as a tool for learning and acquiring other competences. In order to facilitate the assessment of communicative competence, we hereby propose a model which establishes five key dimensions for effective oral communication: interaction management; multimodality and prosody; textual coherence and cohesion; argumentative strategies; and lexicon and terminology. Based on this model, we developed indicators to measure the proposed dimensions, thus generating a self-report tool to assess oral communication in middle school. Following an initial study conducted with 168 students (mean age = 12.47 years, SD = 0.41), we selected 22 items with the highest discriminant power, while in a second study carried out with a sample of 960 students (mean age 14.11 years, SD = 0.97), we obtained evidence concerning factorial validity and the relationships between oral skills, emotional intelligence and metacognitive strategies related to metacomprehension. We concluded that the proposed model and its derived measure constitute an instrument with good psychometric properties for a reliable and valid assessment of students’ oral competence in middle school.
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Affiliation(s)
- Marta Gràcia
- Communication, Oral Language and Diversity Research Group (CLOD), Department of Cognition, Development and Psychology of Development, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain;
| | - Jesús M. Alvarado
- Cognitive Psychology, Measurement and Modelisation of Processes Research Team, Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Campus of Somosaguas, 28223 Madrid, Spain
- Correspondence:
| | - Silvia Nieva
- Cognitive Psychology, Measurement and Modelisation of Processes Research Team, Department of Experimental Psychology, Cognitive Processes and Speech and Language Therapy, Faculty of Psychology, Campus of Somosaguas, 28223 Madrid, Spain;
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Rapanta C, Felton MK. Learning to Argue Through Dialogue: a Review of Instructional Approaches. EDUCATIONAL PSYCHOLOGY REVIEW 2021. [DOI: 10.1007/s10648-021-09637-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractOver the past 20 years, a broad and diverse research literature has emerged to address how students learn to argue through dialogue in educational contexts. However, the variety of approaches used to study this phenomenon makes it challenging to find coherence in what may otherwise seem to be disparate fields of study. In this integrative review, we propose looking at how learning to argue (LTA) has been operationalized thus far in educational research, focusing on how different scholars have framed and fostered argumentative dialogue, assessed its gains, and applied it in different learning contexts. In total, 143 studies from the broad literature on educational dialogue and argumentation were analysed, including all educational levels (from primary to university). The following patterns for studying how dialogue fosters LTA emerged: whole-class ‘low structure’ framing with a goal of dialogue, small-group ‘high structure’ framing with varied argumentative goals, and studies with one-to-one dialectic framing with a goal of persuasive deliberation. The affordances and limitations of these different instructional approaches to LTA research and practice are discussed. We conclude with a discussion of complementarity of the approaches that emerged from our analysis in terms of the pedagogical methods and conditions that promote productive and/or constructive classroom interactions.
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Larrain A, Fortes G, Rojas MT. Deliberative Teaching as an Emergent Field: The Challenge of Articulating Diverse Research Agendas to Promote Educational Experiences for Citizenship. Front Psychol 2021; 12:660825. [PMID: 34234711 PMCID: PMC8255370 DOI: 10.3389/fpsyg.2021.660825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
Democracies are increasingly dependent upon sustainable citizenship, that is, active participation and engagement with the exercising of rights in a field of plural interests, often contradictory and in conflict. This type of citizenship requires not only social inclusion, habits of knowledge, and evidence-based reasoning but also argumentation skills, such as the individual and social capacity to dispute and exercise individual and social rights, and to deal peacefully with sociopolitical conflict. There is empirical evidence that educational deliberative argumentation has a lasting impact on the deep and flexible understanding of knowledge, argumentation skills, and political and citizenship education. However, these three trends of research have developed independently with insufficient synergy. Considering the relevance of deliberative education for contemporaneous democracies and citizenship, in this paper we seek to converge in a field of interlocution, calling it deliberative teaching. Our aim is to propose a way to increase the dialog and collaboration between the diffuse literature on argumentation and education, highlighting both the main theoretical and empirical gaps and challenges that remain and the possibilities to advance our knowledge and the educational impact that this integrating field could offer.
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Affiliation(s)
- Antonia Larrain
- Facultad de Psicología, Universidad Alberto Hurtado, Santiago, Chile
| | - Gabriel Fortes
- Facultad de Psicología, Universidad Alberto Hurtado, Santiago, Chile
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Zimmermann M, Mayweg-Paus E. The role of collaborative argumentation in future teachers' selection of online information. ZEITSCHRIFT FUR PADAGOGISCHE PSYCHOLOGIE 2021. [DOI: 10.1024/1010-0652/a000307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. (Future) teachers should acquire skills in sourcing science-related information online, so they can use evidence appropriately in their pedagogical practice. To successfully use such evidence, it is vital that teachers critically question their selection of online information. Based on findings from collaborative learning, we hypothesized that collaboration promotes teachers' critical elaboration of their selection of online educational information. Additionally, collaboration allows for social comparison and may thus impact teachers' self-efficacy in seeking information. In a 2 × 2 mixed-design study with the between-participants factor reasoning (individual vs. collaborative) and the within-participants factor self-reported information seeking self-efficacy (pre vs. post the reasoning task), each of N = 83 future teachers individually sought online information regarding the educational use of mobile phones in classrooms. This constituted a realistic search on the Internet, in a natural setting. Based on each participant's particular search, s/he was asked to select the online sources that s/he perceived relevant for reasoning whether mobile phones should be used in class. To foster reflection on how they selected information, participants were asked either to reason individually (individual group, n = 33) or to chat collaboratively (collaboration group, n = 50 in 25 dyads) about their selections. Participants in both groups reported higher information seeking self-efficacy after the reasoning task. Yet participants who collaboratively reflected on their selections more frequently showed elaborated reasoning behavior, than did participants in the individual group. Nonetheless, participants in both groups referred to certain criteria that guided their selection (i.e., criteria related to the information, the provider of information, or media) with the same frequency. Considering the potential benefits and challenges of collaboration, we discuss the findings in terms of how to promote future teachers' ability to critically reflect on their selection of online educational information.
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Hendriks F, Mayweg-Paus E, Felton M, Iordanou K, Jucks R, Zimmermann M. Constraints and Affordances of Online Engagement With Scientific Information-A Literature Review. Front Psychol 2020; 11:572744. [PMID: 33362638 PMCID: PMC7759725 DOI: 10.3389/fpsyg.2020.572744] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/16/2020] [Indexed: 12/05/2022] Open
Abstract
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.
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Affiliation(s)
- Friederike Hendriks
- Institute for Psychology in Education and Instruction, Department of Psychology and Sport Studies, University of Münster, Münster, Germany
| | - Elisabeth Mayweg-Paus
- Institute of Educational Studies, Faculty of Humanities and Social Sciences, Humboldt University of Berlin, Einstein Center Digital Future, Berlin, Germany
| | - Mark Felton
- Department of Teacher Education, Lurie College of Education, San Jose State University, San Jose, CA, United States
| | - Kalypso Iordanou
- School of Sciences, University of Central Lancashire, Larnaka, Cyprus
| | - Regina Jucks
- Institute for Psychology in Education and Instruction, Department of Psychology and Sport Studies, University of Münster, Münster, Germany
| | - Maria Zimmermann
- Institute of Educational Studies, Faculty of Humanities and Social Sciences, Humboldt University of Berlin, Einstein Center Digital Future, Berlin, Germany
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Paine AR, Knight JK. Student Behaviors and Interactions Influence Group Discussions in an Introductory Biology Lab Setting. CBE LIFE SCIENCES EDUCATION 2020; 19:ar58. [PMID: 33259280 PMCID: PMC8693937 DOI: 10.1187/cbe.20-03-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/17/2020] [Accepted: 09/25/2020] [Indexed: 06/12/2023]
Abstract
Past research on group work has primarily focused on promoting change through implementation of interventions designed to increase performance. Recently, however, education researchers have called for more descriptive analyses of group interactions. Through detailed qualitative analysis of recorded discussions, we studied the natural interactions of students during group work in the context of a biology laboratory course. We analyzed multiple interactions of 30 different groups as well as data from each of the 91 individual participants to characterize the ways students engage in discussion and how group dynamics promote or prevent meaningful discussion. Using a set of codes describing 15 unique behaviors, we determined that the most common behavior seen in student dialogue was analyzing data, followed by recalling information and repeating ideas. We also classified students into one of 10 different roles for each discussion, determined by their most common behaviors. We found that, although students cooperated with one another by exchanging information, they less frequently fully collaborated to explain their conclusions through the exchange of reasoning. Within this context, these findings show that students working in groups generally choose specific roles during discussions and focus on data analysis rather than constructing logical reasoning chains to explain their conclusions.
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Affiliation(s)
- Alex R. Paine
- Department of Molecular Cellular and Developmental Biology, University of Colorado Boulder, Boulder, CO 80309-0347
| | - Jennifer K. Knight
- Department of Molecular Cellular and Developmental Biology, University of Colorado Boulder, Boulder, CO 80309-0347
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Torralba KD, Jose D, Byrne J. Psychological safety, the hidden curriculum, and ambiguity in medicine. Clin Rheumatol 2020; 39:667-671. [PMID: 31902031 DOI: 10.1007/s10067-019-04889-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/04/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
Psychological safety is a feeling that individuals are comfortable expressing and being themselves, as well as comfortable sharing concerns and mistakes without fear of embarrassment, shame, ridicule, or retribution. It has long been recognized as part of successful patient safety and quality improvement processes. However, in the realm of medical education, psychological safety is a relatively unknown concept to many educators and learners alike. Learners, whether students or postgraduate trainees, are in a phase of cognitive apprenticeship whereby they learn not only skills and knowledge from teachers as part of an explicit and formal curriculum. At the same time, a hidden curriculum is also part of the learning environment in the form of norms, values, and behaviors exhibited by teachers. These norms, values, and behaviors become part of the culture of the clinical learning environment. The vulnerability of learners in this environment is magnified by the hierarchal nature of medicine, and the complexity, uncertainty, and the ambiguity inherent to medical conditions. This is especially true of cognitive specialties such as rheumatology. Educators who engage in unprofessional behaviors that result in learner humiliation and shame may serve to dampen productive discourse and scientific dialog. Therefore, educators must embrace psychological safety to foster learning and facilitate high-performing teams in the clinical learning environment.Key Points• Psychological safety improves communication and teamwork by allowing individuals to be comfortable expressing and being themselves, as well as comfortable sharing concerns and mistakes without fear of embarrassment, shame, ridicule, or retribution.• Commonly studied in the context of patient safety and quality improvement, psychological safety should extend towards medical education particularly in the context of allowing medical students and postgraduate trainees to be able to voice clinical reasoning in the face of ambiguity.• Educators take on a leadership role when having learners under their supervision; as leaders, educators are the prime movers of psychological safety• Learners in the process of developing their self-identity in the context of their chosen profession adopt not only knowledge and skills within the framework of an explicit and formal curriculum but also norms and values from daily behavior and language educators present in the clinical learning environment of learners; these norms and values are collectively part of the hidden curriculum.
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Affiliation(s)
- Karina D Torralba
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson St, MC 1519, Loma Linda, CA, 92373, USA.
| | - Donna Jose
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson St, MC 1519, Loma Linda, CA, 92373, USA
| | - John Byrne
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, 11234 Anderson St, MC 1519, Loma Linda, CA, 92373, USA.,Loma Linda Health Care System, Loma Linda, CA, USA
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Larrain A, Freire P, López P, Grau V. Counter-Arguing During Curriculum-Supported Peer Interaction Facilitates Middle-School Students’ Science Content Knowledge. COGNITION AND INSTRUCTION 2019. [DOI: 10.1080/07370008.2019.1627360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | | | - Valeska Grau
- Escuela de Psicología, Pontificia Universidad Católica de Chile
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Exploring enablers and inhibitors of productive peer argumentation: The role of individual achievement goals and of gender. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2018. [DOI: 10.1016/j.cedpsych.2018.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bigi S. Communication Skills for Patient Engagement: Argumentation Competencies As Means to Prevent or Limit Reactance Arousal, with an Example from the Italian Healthcare System. Front Psychol 2016; 7:1472. [PMID: 27729890 PMCID: PMC5037937 DOI: 10.3389/fpsyg.2016.01472] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/13/2016] [Indexed: 11/13/2022] Open
Abstract
The paper discusses the role of argumentative competencies for the achievement of patient engagement through communication in doctor-patient consultations. The achievement of patient engagement is being proposed by recent studies as a condition that can facilitate in particular patient adherence, which involves behavior change. One obstacle to behavior change that has been observed is reactance, i.e., resistance to persuasive messages when a threat to freedom is perceived. In the medical field, reactance theory has been mostly applied in the field of mental health, less frequently to understand non-adherence in general. However, a few studies have revealed that reactance can actually explain in part the motives behind non-adherence. These studies propose that the arousal of reactance could be limited or prevented by adopting relational measures aimed at giving patients the feeling that they still hold some control over the process of care and that the "impositions" on their freedoms are acceptable because they have had the opportunity to decide about them. However, they do not discuss how these strategies should be operationalized at the dialogical level. A debated issue in the study of reactance is the role played by knowledge. It seems that pure information regarding an issue is likely to represent a threat in itself. Complementary to this is the finding that quality of argument does not impact on the degree of reactance. These findings pose a problem in view of the goal of patient education, itself considered as a necessary premise for any process of patient engagement and adherence. It seems necessary to move away from a conception of education as mere transmission of information and look for more effective ways of transferring knowledge to patients. With regard to this issue, the paper argues that useful insights can be found in studies on science education, in which it is shown experimentally that argumentative processes favor learning and understanding. Drawing on previous studies and taking an interdisciplinary perspective on the issue, the paper brings into the discussion on engagement concepts developed in the field of argumentation theory, showing how the suggestions for avoiding reactance could be realized dialogically.
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Affiliation(s)
- Sarah Bigi
- Department of Linguistic Sciences and Foreign Literatures, Catholic University of the Sacred HeartMilan, Italy
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