[Clinical Validation of Chest X-ray Educational Content for Radiography Students Using Gaze Information]

PURPOSE

Radiography training for students in colleges of radiology should be based on real clinical situations. The purpose of this study was to verify the clinical validity of our originally developed scenarios for chest X-ray training and the instructional contents using gaze information of experienced radiology technologists (RTs).

METHODS

We divided 8 RTs with different experiences into an evaluator group (3 RTs) and a subject group (5 RTs). The evaluator group created a validation model consisting of 31 items, a chest X-ray scenario, instructional contents, and gaze attention objects during the scenario. The subject group simulated chest X-ray wearing an eye tracker. The evaluator group evaluated fit rates of the validation model to subjects' procedures based on gaze information to verify the clinical validity of the validation model.

RESULTS

The subject group procedures did not deviate from the scenario. We obtained a fit rate of 91.6±6.70%.

CONCLUSION

Our validation model showed more than 90% fitting with the chest X-ray techniques of five RTs with different backgrounds. This result suggested that the scenario and instructional contents in this study had clinical validity.

The ecosystem of human capital in care homes

Introduction

This qualitative study addresses the essential yet often overlooked experiences of knowledge transfer within care homes (CH). Conducted in a Slovenian CH in 2020 and 2023, participants, including CH management, staff, and residents with their relatives, shared perceptions of knowledge transfer at various levels. The study aims to explore barriers and facilitators for knowledge transfer crucial for creating new knowledge, services, and enhancing care quality for older individuals.

Methods

Structured focus group interviews were conducted, and data were collected within the CH. The participants' insights into knowledge transfer were probed, covering various dimensions such as between individuals, groups, organizations, and the community. Transcriptions of recorded interviews were analyzed using content analysis.

Results

Knowledge transfer within the CH was facilitated through continuous training, diverse communication channels, and mentoring. Collaboration with relatives improved understanding of resident preferences, habits, and overall enhanced the quality of care. This collaborative effort allowed mutual learning and knowledge transfer from the CH to the broader community. Despite potential benefits, there is an underutilization of information and communication technology, e-care, and untapped potential for partnerships, partly due to the scarcity of care. Barriers were identified in the form of stereotypical attitudes towards aging and care, further reinforced by negative news coverage on older people's care.

Conclusion

The multidimensional nature of knowledge in CH centers on resident well-being, emphasizing three key aspects of knowledge transfer: between staff and residents, staff and residents' families, and between the CH and the community. In the context of age management, creating opportunities for knowledge transfer is crucial, emphasizing a transition from traditional institutional care to an approach prioritizing knowledge about quality care. and involving experts from experiences in care process.

Tacit knowledge and the role of the dental educator

INTRODUCTION

This article seeks to explore tacit knowledge in the context of the practice and the role of a dental educator in a workplace learning environment.

MATERIAL AND METHODS

The key theoretical ideologies which underpin the definition of tacit knowledge have been outlined and practical examples to enable conceptualisation. The role tacit knowledge plays in procedural knowledge, performance of a skill and diagnosis and decision-making has been explained in further detail. Approaches to maximise the educational output of learning opportunities by using tacit knowledge and how an awareness of tacit knowledge can complement reflection have been considered.

RESULTS

It is acknowledged that workplace learning is of mutual benefit to the dental educator, trainee and clinical team and that the development of the educator to make tacit knowledge explicit, can be achieved through peer observation, amongst other methods.

CONCLUSION

Tacit knowledge is a key element underpinning learning in the workplace; the use of this knowledge can be applied in an advantageous manner, from both an educational and a personal developmental perspective.

A Low Mean Closing Load and a Decrease in Load Change at the Tip Increase the Comfort of Scissors

Introduction During surgery, surgeons intuitively recognize when they are using dull scissors and find them difficult to use. The purpose of this study was to objectively evaluate the physical characteristics of scissors and the comfort reported by surgeons to develop objective quality control standards for scissors used in surgery. Methods Sensory and measurement tests were conducted to evaluate the comfort and physical characteristics of ten pairs of Cooper scissors. As a sensory test, thirty-one volunteer surgeons opened and closed the scissors and selected three that felt comfortable and three that were uncomfortable. The results were scored. For measurement, a load was applied to the handle of the scissors. The load pressure and displacement of the width between each handle when the scissors were closed were measured. Results A strong negative correlation was found between the total comfort score and the mean load value between sensory and measurement tests (r=-0.717, p=0.0195). The correlation between the total score and the change in load at the tip showed a moderate negative correlation (r=-0.687, p=0.0282). Multiple regression analysis showed that the change in load at the tip was an independent factor affecting the total score. Conclusions Surgeons consider scissors with a low mean load required to close the scissors and a small change in load at the tip to be comfortable. The mean load on scissors and the change in load at the tip should be considered in the development of quality control standards for scissors used in surgery.

Finding Words for Feeling Bodies: Exploring Drawing Techniques in Dutch Care Practices

Feeling is difficult to put into words. Anthropologists have been seeking ways to articulate feeling or other bodily experiences, looking beyond words and borrowing from artistic methods. Drawings, for instance, have been used to make visible what words cannot describe and attributed with qualities associated with feeling or the body. Instead of placing drawing in opposition to words, and words in opposition to bodies, this article presents different ways of using drawing as an ethnographic technique to tentatively find practice-specific words to articulate practices of feeling the body. Rather than evaluating drawings based on their ability to capture feeling bodies, the author reflects on the drawing process as a way to learn about her research subjects in unexpected ways. Thereby, the author learns from artistic practices, not about making drawings, but about making methods. Acknowledging that methodologies are always generative, the author dives into the making of her methodologies to learn about her research subjects. .

Exploring tacit knowledge based on an expert nurse's practice for stroke patients

This study explored tacit knowledge based on an expert nurse's practice who cares for stroke patients by using the hermeneutic phenomenological approach. The participant ('Ms. A') was a nursing researcher and college faculty member involved in the education of advanced practice nurses; her specialty was stroke rehabilitation nursing. She was asked to describe the meaning and value she gained from her memorable nursing experiences. Four interviews-approximately 1 h each-were conducted, and the associated data were interpreted together with the participant based on the method of interpretive circulation. Notably, the analysis was ended when a fusion of horizons was recognized. The participant recalled her nursing experiences based on six model cases. During the analysis, the following five elements were extracted: [belief in the ability of vulnerable people to survive]; [being together]; [respect for human dignity]; [preparedness to respond to and bear suffering together]; and [theoretical knowledge base approaches true understanding of patient experience]. Further, the nursing model-the Roy Adaptation Model-utilized by Ms. A in the process of recognizing humans as whole beings was deeply interpreted and implemented as a guideline for her implicit advanced practice. Moreover, her deep understanding and utilization of theoretical knowledge base also built the foundation for her implicit advanced practice. In conclusion, Ms. A's tacit knowledge and the elements support the process of tacit knowledge acquisition. Her narratives, hermeneutic attitude as an interpreter, and learning attitude throughout interaction with others will strongly help her knowledge development. We intend to continue the study with multiple participants and explore the structure of tacit knowledge possessed by advanced practitioners. Future endeavours will include the development of a tacit knowledge learning strategy.

Tacit knowledge in dyads of persons with profound intellectual and multiple disabilities and their caregivers: An interpretative literature study

BACKGROUND

Caring for persons with profound intellectual and multiple disabilities (PIMD) demands specific expertise. Tacit knowledge seems to play an important role, but little is known about its nature, including what is necessary for its development and transfer.

AIM

To gain understanding of the nature and development of tacit knowledge between persons with PIMD and their caregivers.

METHOD

We conducted an interpretative synthesis of literature on tacit knowledge in caregiving dyads with persons with PIMD, persons with dementia or infants. Twelve studies were included.

RESULTS

Tacit knowledge is about caregivers and care-recipients becoming sensitive and responsive to each other's cues and together crafting care routines. Learning takes place in a constant process of action and response that transforms those involved.

CONCLUSION

Building tacit knowledge together is necessary for persons with PIMD to learn to recognise and express their needs. Suggestions are made for ways to facilitate its development and transfer.

Scientists as spies?: Assessing U.S. claims about the security threat posed by China's Thousand Talents Program for the U.S. life sciences

In 2008, the Chinese government created the Thousand Talents Program (TTP) to recruit overseas expertise to build up China's science and technology knowledge and innovation base. Ten years later, in 2018, the Federal Bureau of Investigation (FBI) announced a new "China Initiative" that aimed to counter the transfer by U.S.-based scientists involved in the TTP of knowledge and intellectual property that could support China's military and economic might and pose threats to U.S. national security. This initiative launched a number of investigations into major U.S. federal funding agencies and universities and charged several scientists, many of them life scientists, with failing to accurately report their work and affiliations with Chinese entities and illegally transferring scientific information to China. Although the FBI cases demonstrate a clear problem with disclosure of foreign contracts and research integrity among some TTP recipients, they have failed to demonstrate any harm to U.S. national security interests. At the heart of this controversy are core questions that remain unresolved and need more attention: What is required to transfer and develop knowledge to further a country's science and technology ambitions? And can the knowledge acquired by a visiting scientist be easily used to further a country's ambitions? Drawing on literature from the field of science and technology studies, this article discusses the key issues that should be considered in evaluating this question in the Chinese context and the potential scientific, intelligence, and policy implications of knowledge transfer as it relates to the TTP.

The impact of knowledge management on the quality of services in nursing homes

Introduction

Current management strategies in nursing homes (NH) aim to ensure effective knowledge management (KM) in order to provide both best possible services to residents, and care for staff in NH. Teamwork in NH is essential for effective delivery of the highest quality of services. As a result, NH are increasingly adopting KM activities to enable knowledge creation, storage, transfer, and implementation in an environment facing many challenges such as lack of staff, increasing demands, and expectations of residents.

Methods

In our quantitative study, we examined how two Slovenian state NH that adopted the E-Qalin quality management model (European quality-improving learning model) adapted their KM, and what impact their quality management system and KM activities actually have on the quality of services. Furthermore, we examined how two Slovenian private NH that have not adopted a certified quality management program (like ISO or E-Qalin) tackle the issue of quality of services from the KM perspective. The sample consisted of 80 nursing professionals. In every NH that is part of this study, teamwork is essential and every individual that was involved in our survey is part of a team. In our study, we analyzed relationships between individual variables using linear regression.

Results

We found a significant and positive relationship between knowledge creation, transfer, and implementation in NH with and without the E-Qalin certificate. We found a significant and positive relationship between knowledge storage and the quality of services only in NH without a E-Qualin certificate. It seems that when connecting multidisciplinary fields such as NH and KM, there is still a lack of awareness and knowledge on the topic of KM, which might be one of the reasons for some bias in the answers provided by respondents. We also found different teamwork approaches in NH with and without a E-Qalin certificate. Our research results therefore emphasize the need to gain additional insight into quality management and KM in the environment of NH.

Conclusion

Teamwork based on knowledge storage, transfer, the implementation of existing knowledge, and creation of new knowledge are essential for well-trained professionals and, as a result, contribute to continuous improvement in service quality. Implementation of KM is well received by NH, and enables them to better meet the needs and expectations of residents. More importantly, nursing staff also share and pass on tacit knowledge through teamwork. Finally, all of the NH in our study that implemented quality and KM activities noted an improvement in the quality of services that are offered to residents in practice. Our results indicate that the topic of KM in NH is interesting, and it has a positive impact on the quality of services in practice. However, the problem of awareness and knowledge on the topic of KM in the environment of NH still exists, highlighting the need for further research, additional insight, and dissemination of knowledge to every interested stakeholder functioning in the field of NH. The results of the study make an important contribution to the research of KM in NH, focusing on the transfer of tacit knowledge.

Awareness: An empirical model

In this work, we face the time-honored problem of the contraposition/integration of analytical and intuitive knowledge, and the impact of such interconnection on the onset of awareness resulting from human decision-making processes. Borrowing the definitions of concepts like intuition, tacit knowledge, uncertainty, metacognition, and emotions from the philosophical, psychological, decision theory, and economic points of view, we propose a skeletonized mathematical model grounded on Markov Decision Processes of these multifaceted concepts. Behavioral patterns that emerged from the solutions of the model enabled us to understand some relevant properties of the interaction between explicit (mainly analytical) and implicit (mainly holistic) knowledge. The impact of the roles played by the same factors for both styles of reasoning and different stages of the decision process has been evaluated. We have found that awareness emerges as a dynamic process allowing the decision-maker to switch from habitual to optimal behavior, resulting from a feedback mechanism of self-observation. Furthermore, emotions are embedded in the model as inner factors, possibly fostering the onset of awareness.

The cultural transmission of tacit knowledge

A wide variety of cultural practices have a 'tacit' dimension, whose principles are neither obvious to an observer, nor known explicitly by experts. This poses a problem for cultural evolution: if beginners cannot spot the principles to imitate, and experts cannot say what they are doing, how can tacit knowledge pass from generation to generation? We present a domain-general model of 'tacit teaching', drawn from statistical physics, that shows how high-accuracy transmission of tacit knowledge is possible. It applies when the practice's underlying features are subject to interacting and competing constraints. Our model makes predictions for key features of the teaching process. It predicts a tell-tale distribution of teaching outcomes, with some students near-perfect performers while others receiving the same instruction are disastrously bad. This differs from standard cultural evolution models that rely on direct, high-fidelity copying, which lead to a much narrower distribution of mostly mediocre outcomes. The model also predicts generic features of the cultural evolution of tacit knowledge. The evolution of tacit knowledge is expected to be bursty, with long periods of stability interspersed with brief periods of dramatic change, and where tacit knowledge, once lost, becomes essentially impossible to recover.

Cultural Intelligence: What Is It and How Can It Effectively Be Measured?

We administered both maximum-performance and typical-performance assessments of cultural intelligence to 114 undergraduates in a selective university in the Northeast of the United States. We found that cultural intelligence could be measured by both maximum-performance and typical-performance tests of cultural intelligence. Cultural intelligence as assessed by a maximum-performance measure is largely distinct from the construct as assessed by a typical-performance measure. The maximum-performance test, the Sternberg Test of Cultural Intelligence (SCIT), showed high internal consistency and inter-rater reliability. Sections with problems from two content domains—Business (SCIT-B) and Leisure (SCIT-L) activities—were highly intercorrelated, suggesting they measured largely the same construct. The SCIT showed substantial correlations with another maximum-performance measure of cultural intelligence, Views-on-Culture. It also was correlated, at more modest levels, with fluid intelligence and personal intelligence tests. Factorially, the (a) maximum-performance cultural intelligence tests, (b) typical-performance cultural intelligence test and a test of openness to experience, and (c) fluid intelligence tests formed three separate factors.

Entrepreneurs Can Know More Than They Can Tell: Conceptualizing and Measuring Tacit Entrepreneurial Knowledge

Organizational knowledge components dominate research on tacit knowledge. In order to overcome this dominance, we introduce Tacit Entrepreneurial Knowledge (TEK). TEK is conceptualized as one's experiential learning from past experiences and insights that result in tacit knowledge regarding entrepreneurship that is implicit, personal, and uncodified. For this study the situational judgment test (SJT) approach is adopted to overcome the common limitations in quantifying an individual's tacit knowledge. The SJT is a scenario-based measurement instrument that allows us to quantify an individual's TEK. The SJT is developed using three steps: first, scenarios were collected through interviews, followed by formulating responses to the scenarios, and finally, the effectiveness of the responses for each scenario was evaluated. The outcome of this research article is threefold; first, a comprehensive conceptualization of TEK, including delineation of its nomological network. Second, the development of a measurement instrument for TEK and subsequent scoring method. Finally, an antecedent-consequence model which includes potential contingencies associated with these relationships. In the debate on tacit knowledge, our measurement is innovative and relevant, as previous research failed to uncover an individual's tacit knowledge in the context of entrepreneurship, despite its importance in various entrepreneurial processes. This study aspires to ignite research into TEK by demonstrating important research opportunities unlocked by our conceptualization and subsequent measurement, offering future researchers a wide range of avenues to uncover the black box of tacit knowledge in entrepreneurship.

Conducting a good ward round: How do leaders do it?

RATIONALE, AIMS AND OBJECTIVES

Ward rounds (WRs) are complex social processes. Done well, WR discussions and decisions contribute to timely, safe, effective progression of care. However, literature highlights medical dominance; marginalisation or absence of other perspectives, safety risks and suboptimal resource use. This study examined leadership behaviours and what supported good interprofessional WRs, defined as enabling interprofessional collaboration and decision making which progresses patient care in a safe and timely manner. Deepening appreciation of this art should support learning and improvements.

METHOD

Mixed-method appreciative inquiry (AI) into how WRs go well and could go well more often.

CONTEXT

daily interprofessional consultant-led WRs in a large adult critical care unit.

DATA

ethnographic and structured observations (73 h, 348 patient reviews); AI conversations and interviews (71 participants). Inductive iterative analysis shaped by Activity Theory.

PARTICIPANTS

256 qualified healthcare professionals working in the unit.

RESULTS

Leadership of good WRs supported (and minimized contradictions to): making good use of expertise and time, and effective communication. These three key activities required careful and skilled orchestration of contributions to each patient review, which was achieved through four distinct phases (a broadly predictable script), ensuring opportunity to contribute while maintaining focus and a productive pace. This expertise is largely tacit knowledge, learnt informally, which is difficult to analyse and articulate oneself, or explain to others. To make this easier, and thus support learning, we developed the metaphor of a conductor leading musicians.

CONCLUSIONS

Whilst everyone contributes to the joint effort of delivering a good WR, WR leadership is key. It ensures effective use of time and diverse expertise, and coordinates contributions rather like a conductor working with musicians. Although WR needs and approaches vary across contexts, the key leadership activities we identified are likely to transfer to other settings.

Tacit knowledge in water management: a case study of Sponge City

Sustainable, resilient urban water management is fundamental to good environmental and public health. As an interdisciplinary task, it faces enormous challenges from project complexity, network dynamics and the tacit nature of knowledge being communicated between actors involved in design, decisions and delivery. Among others, some critical and persistent challenges to the implementation of sustainable urban water management include the lack of knowledge and expertise, lack of effective communication and collaboration, and lack of shared understanding and context. Using the Chinese Sponge City programme as a case study, this paper draws on the perspectives of Polanyi and Collins to investigate the extent to which knowledge can be used and exchanged between actors. Using Collins' conceptualisation of the terrain of tacit knowledge, the study identifies the use of relational, somatic and collective tacit knowledge (CTK) in the Sponge City pilot project. Structured interviews with 38 people working on a Sponge City pilot project provided data that was rigorously analysed using qualitative thematic analysis. The paper is original in identifying different types of tacit knowledge in urban water management, and the potential pathways for information and messages being communicated between actors. The methods and results provide the groundwork for analysing the access and mobilisation of tacit knowledge in the Sponge City pilot project, with relevance for other complex, interdisciplinary environmental projects and programmes.

Appealing to Tacit Knowledge and Axiology to Enhance Medical Practice in the COVID-19 Pandemic: A Systematic Review and Hermeneutic Bioethical Analysis

Background: The pressure of coronavirus disease 2019 (COVID-19) pandemic, epidemiological and demographic changes, personnel-patient relationship in healthcare, and the development of biotechnologies do not go unnoticed by the healthcare professional. Changes are so wide and at a high rate that guidelines and mere scientific knowledge, which are represented by evidence-based medicine, are not sufficient to lead actions, thus the experiential aspects in the configuration of an ethos present as a fundamental part of the resources to deal with critical scenarios, such as a pandemic. In this regard, the recognition of tacit knowledge as a way of teaching and learning skills related to ethical aspects such as principles, virtues, and values, revealed as a fundamental part of the clinical field. The challenge is to strengthen binomial evidence-based medicine and values-based in order to achieve excellence in the health care of the patients and the well-being of the clinical personnel.

Method: A 2-fold analysis was conducted taking pediatric endocrinology as an example. First, a systematic review was carried out in electronic databases BIREME, PubMed, and PhilPapers following PEO and PRISMA approaches. A total of 132 articles were garnered. After reading their title and abstract, 30 articles were obtained. Quantitative information was arranged in an Excel database according to three themes: ethics, axiology, and tacit knowledge. A quality criterion that meets our research question was assigned to each article and those which had a quality criterion of 3 (9) were taken to carry out the hermeneutic bioethical analysis, which consisted of three stages, namely naïve reading, codification, and interpretation. The results were analyzed in Atlas.ti. to elucidate the relations between the three main themes in accordance with the objective.

Results: Although there was no difference in the frequency of tacit knowledge skills, including cognitive, social, and technical, for medical practice, there is an intrinsic relationship between epistemic and ethical values with cognitive skills, this means that professionals who practice honesty, authenticity and self-control are capable of seeing patients as persons and thus respect their dignity. This suggested that there is a strong partnership between evidence-based medicine and value-based medicine, which reinforced this binomial as the two feet on which medical practice decisions rested. With regard to tacit knowledge in terms of the context of the COVID-19 pandemic, the challenges refer to (1) adapting and learning a new way of establishing trust with the patient and (2) how to capitalize on the new knowledge that new experiences have posed.

Discussion: The analysis of ethical-tacit knowledge in medicine is a recent phenomenon and is in full development. Although no references were found that dealt with any of the main topics in pediatric endocrinology, there is an interest in pediatrics to explore and discuss educational strategies in ethics related to its tacit dimension as a vector of enhancement in the clinical practice. Educational strategies ought to take into consideration the development of skills that promote reflection and discussion of experiences, even more vigorously in the context of the COVID-19 pandemic.

When and for whom do psychodynamic therapists use guided imagery? Explicating practitioners' tacit knowledge

Guided imagery psychotherapy (GIP) is an established therapeutic method using creative mental imagery within a psychodynamic frame of reference. Although there is evidence for the method's general effectiveness, it is yet unclear under which conditions and for which patients it should be used. The aim of this study was therefore to empirically identify indication criteria for the use of guided affective imagery (GAI) as part of psychodynamic therapies. We conducted semi-structured interviews with N=15 psychodynamic therapists also qualified as GAI training therapists. We asked them to recollect cases in which they had decided either for or against the use of imagery. The therapists described a complex interplay of different factors. Using grounded theory coding supplemented by elements of Consensual Qualitative Research we reconstructed from their accounts a sequential model of their indicative decisions. First, there is a consideration of clear contraindications related to reality testing and destructiveness. Second, there are aspects requiring a modified application of GAI such as emotional instability and post-traumatic stress disorder symptoms. In a final step, there are a number of characteristics of the patient, the therapist, the therapeutic relationship, the patients' initial imagery and different therapeutic goals and foci which are weighed relatively to each other in order for therapists to reach an indication decision. We end by discussing ways in which the indicative decision model may be used to improve GAI training as well as the method's differential efficacy and effectiveness.

The Modified Imitation Game: A Method for Measuring Interactional Expertise

The study of the sociology of scientific knowledge distinguishes between contributory and interactional experts. Contributory experts have practical expertise—they can “walk the walk.” Interactional experts have internalized the tacit components of expertise—they can “talk the talk” but are not able to reliably “walk the walk.” Interactional expertise permits effective communication between contributory experts and others (e.g., laypeople), which in turn facilitates working jointly toward shared goals. Interactional expertise is attained through long-term immersion into the expert community in question. To assess interactional expertise, researchers developed the imitation game—a variant of the Turing test—to test whether a person, or a particular group, possesses interactional expertise of another. The imitation game, which has been used mainly in sociology to study the social nature of knowledge, may also be a useful tool for researchers who focus on cognitive aspects of expertise. In this paper, we introduce a modified version of the imitation game and apply it to examine interactional expertise in the context of blindness. Specifically, we examined blind and sighted individuals’ ability to imitate each other in a street-crossing scenario. In Phase I, blind and sighted individuals provided verbal reports of their thought processes associated with crossing a street—once while imitating the other group (i.e., as a pretender) and once responding genuinely (i.e., as a non-pretender). In Phase II, transcriptions of the reports were judged as either genuine or imitated responses by a different set of blind and sighted participants, who also provided the reasoning for their decisions. The judges comprised blind individuals, sighted orientation-and-mobility specialists, and sighted individuals with infrequent socialization with blind individuals. Decision data were analyzed using probit mixed models for signal-detection-theory indices. Reasoning data were analyzed using natural-language-processing (NLP) techniques. The results revealed evidence that interactional expertise (i.e., relevant tacit knowledge) can be acquired by immersion in the group that possesses and produces the expert knowledge. The modified imitation game can be a useful research tool for measuring interactional expertise within a community of practice and evaluating practitioners’ understanding of true experts.

Investigating the Influence of Tacit Knowledge Transformation Approach on Students' Learning Ability

Tacit knowledge is an essential foundation for developing students’ learning ability, especially in understanding and solving problems. However, the transforming of tacit knowledge confront a big challenge during the outbreak of Corona Virus Disease 2019 (COVID-19), because most teaching and learning activities were conducted in online context, which impair a face-to-face interaction. To explore the effect of tacit knowledge on students’ learning ability in the online learning environments, the current study based on SECI model (The Socialization, Externalization, Combination, and Internalization) proposed to design the tacit knowledge transformation teaching approach. To assess the effectiveness of this approach, 60 elementary school students were recruited in the quasi-experiment. The results of retention test and transfer test showed that the experimental group, using the tacit knowledge transformation teaching approach, has significant improvement on learning ability than the control group. The current research theoretically provide a teaching strategy on tactic knowledge, and practically helps teachers to organize instructional activities, thereby, advocating the appropriate use of social media.

Study of Human Tacit Knowledge Based on Electroencephalogram Signal Characteristics

Tacit knowledge is the kind of knowledge that is difficult to transfer to another person by means of writing it down or verbalizing it. In the mineral grinding process, the proficiency of the operators depends on the tacit knowledge gained from their experience and training rather than on knowledge learned from a handbook. This article proposed a method combining the electroencephalogram (EEG) signals and the industrial process to detect the proficiency of the operators in the mineral grinding process to reveal the effect of tacit knowledge on the functional cortical connection. The functional brain networks of operators were established based on partial direct coherence and directed transfer function of EEG, and the multi-classifiers were used with the graph-theoretic indexes of the FBNs as input to distinguish the trained operators (Hps) from the non-trained operators (Lps). The results showed that the brain networks of Hps had a better connectivity than those of Lps (p < 0.01), and the accuracy of classification was up to 94.2%. Our studies confirm that based on the performance of EEG features and the combination of industrial operational operation and cognitive processes, the proficiency of the operators can be detected.

Expertise Across Disciplines: Establishing Common Ground in Interdisciplinary Disaster Research Teams

Hazards and disasters arise from interactions between environmental and social processes, so interdisciplinary research is crucial in understanding and effectively managing them. Despite support and encouragement from funding agencies, universities, and journals and growing interest from researchers, interdisciplinary disaster research teams face significant obstacles, such as the difficulty of establishing effective communication and understanding across disciplines. Better understanding of interdisciplinary teamwork can also have important practical benefits for operational disaster planning and response. Social studies of science distinguish different kinds of expertise and different modes of communication. Understanding these differences can help interdisciplinary research teams communicate more clearly and work together more effectively. The primary role of a researcher is in contributory expertise (the ability to make original contributions to a discipline); but interactional expertise in other disciplines (the ability to understand their literature and communicate with their practitioners) can play an important role in interdisciplinary collaborations. Developing interactional expertise requires time and effort, which can be challenging for a busy researcher, and also requires a foundation of trust and communication among team members. Three distinct aspects of communication play important roles in effective interdisciplinary communication: dialects, metaphors, and articulation. There are different ways to develop interactional expertise and effective communication, so researchers can pursue approaches that suit their circumstances. It will be important for future research on interdisciplinary disaster research to identify best practices for building trust, facilitating communication, and developing interactional expertise.

Perspectives of Multidisciplinary Professional Teams during Assessment Processes for ATD Selection in the Japanese Public Provision System

Selection of assistive technology devices (ATDs), which are imperative for persons with disabilities to improve their quality of life, requires collaboration of users and multidisciplinary professionals. However, it is still unknown how to design and implement an adequate collaborative work flow and a professional team. Under Japanese governmental ATD provision system, based on the application by clients, ATDs are mainly selected through collaborative processes with the clients and health professionals in public organizations, rehabilitation counseling centers (RCCs). By employing qualitative study methods in this study, we investigated the ATD selection process in which health professionals in RCCs collaboratively assess clients with physical disabilities so as to support them in selecting the adequate ATDs. To identify the perspectives required for ATD selection completely, the assessment processes were recorded and analyzed with a pseudo setting in two RCCs. Content analysis of the conversations between the client and professionals revealed the characteristics of the information exchanged in the assessment processes. A total of 760 assessment items were identified, thus indicating a broad array of interest. Despite the richness of information collected for the assessment, half of the assessment items did not have corresponding items in the documents that were employed during the prescription process. Thematic analysis of the interviews that followed revealed the common values and collaborative processes in ATD selection, which were shared and elaborated among the staff in daily social interactions. To facilitate implementation of ATD provision in various areas with few resources, it may be effective to convert this tacit-to-tacit knowledge sharing into a more explicit sharing by promoting analyses of good practices.

Expounding the knowledge conversion processes within the occupational safety and health management system (OSH-MS) using concept mapping

Objectives. Given the efforts made to incorporate knowledge management into the occupational safety and health management system (OSH-MS), this research attempts to illustrate how the knowledge conversion processes are accomplished within key elements of the OSH-MS. Methods. This study uses concept mapping (CM) as an integrated approach for mirroring participants' viewpoints about the interaction between tacit and explicit knowledge in the OSH-MS. OSH and knowledge management experts of the National Iranian Oil Company (NIOC) and its subdivisions were invited to complete the CM process. Results. Interpretation of the maps and graphical representations generated indicates that the concepts within the key elements of the OSH-MS are sorted into different clusters, including Knowledge Application, Knowledge Dissemination, Knowledge Socialization and Knowledge Presentation. Regarding the participants' ratings, the Knowledge Application cluster is rated as the most important, and Knowledge Socialization is rated as the most prevalent. Conversely, Knowledge Presentation is rated the least important and prevalent. Conclusions. The results simulated in MATLAB version R2018a and JMP version 13.2 help in better understanding the interplay between tacit and explicit knowledge in the key elements of the OSH-MS and clarify the potential programmable areas to improve organizational performance.

Strategic enablement investments: Exploring differences in human and technological knowledge transfers to supply chain partners

Business-to-business firms have a long history of investing in training their supply chain partners using primarily salespeople. However, advances in technology now allow for elements of sales enablement programs to be automated and run without human involvement. This paper examines how human and technology enablers are suited to transfer tacit and explicit knowledge respectively. It constructs a strategic enablement investment framework that, depending on the mix of investments in human or technology enablers, results in four types of learning environments: self-directed, collaborative, adaptive, and complex. We close by discussing the implications for future research and offer guidance for industrial marketing managers.

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Strategic enablement involves the transfer of a firm's knowledge to their partners.

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Tacit (explicit) knowledge is best transferred using human (technology) enablers.

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Enablement investments in human vs technology lead to diverse learning environments.

Revealing tacit knowledge used by experienced health professionals for interprofessional collaboration

With the current interest in interprofessional collaboration in health care as a response to ever-increasing complexity of health issues and scarcity of resources, many higher education institutions are developing interprofessional education (IPE) programs. However, there has been little empirical work on what. With the current interest for interprofessional collaboration in health care ever-increasing knowledge and skills are required to work collaboratively between health professions. We have undertaken to describe interprofessional collaboration as a practice largely underpinned by tacit knowledge acquired by experienced clinicians. Clinicians from all health professions in a large francophone university in Eastern Canada were invited to participate in explicitation interviews. Explicitation interviews require participants to freely recall an interprofessional collaboration event (e.g., team meeting or joint care delivery) and describe specific actions they personally enacted. An experienced health professional encounters many interprofessional situations over time; the actions they describe reflect their personal theories about the practice. Hence, it is highly probable that they use them frequently when working with colleagues in clinical settings. Unveiled tacit knowledge was divided into four themes: the importance of a sense of belonging to a team, the imperative to meet face-to-face, the practice of soliciting the working hypotheses of colleagues, and the art of summarizing meeting discussions.

Effects of an 8-Week Dairy Production Medicine Course on Veterinary Student Self-Confidence and Perceptions of Knowledge and Skills Used by Dairy Veterinarians

The 8-week dairy production medicine course at the National Center of Excellence in Dairy Production Medicine Education for Veterinarians is designed to equip senior veterinary students with the knowledge and skills needed to serve the dairy industry. Course developers identified 59 topics of importance for dairy production medicine veterinarians. Students (N = 50) were surveyed before and after the course to determine their perceptions of (a) the importance of the 59 topics for their intended positions and (b) their knowledge and skill in those areas. We expected the course to affirm or strengthen perceptions of importance and increase confidence. Students rated 57 of the topics as moderately or very important before the course. Ratings were unchanged (56 topics) or increased (3 topics) after the course. Before the course, students believed they had a lot of knowledge and skill in just one area: animal behavior and handling. At the end of the course, students believed they had a lot of knowledge and skill in 21 areas; confidence ratings were higher for 47 of the 59 topics. Alumni were surveyed 1-2 years after graduation to determine the importance of the 59 topics to their positions, their impressions about how well the course prepared them in those areas, and whether they referred back to course materials. Feedback was used to adjust the course. The topics alumni rated as most important were similar to those students predicted would be most important. Seventy-five percent of alumni used the course website as a resource in practice.

Scientism recognizes evidence only of the quantitative/general variety

RATIONALE, AIMS AND OBJECTIVES

McHugh and Walker introduced a model of knowledge to demonstrate that EBM is a form of scientism that ignores important sources of knowledge thereby impairing the practice of medicine. We study the development of this model and explore additional applications.

METHODS

Review of the relevant literature and identification of possible areas for fruitful application.

RESULTS

We show that the McHugh and Walker model is closely related to the model of evidence considered earlier by Upshur et al. We also indicate that the utility of this model is not limited to showing scientism distorts clinical practice. Several representative applications are identified, including psychotherapy, the Salk polio vaccine trial, and the placebo effect.

CONCLUSIONS

Priority should be given to Upshur et al for the development of a model that has far-reaching application to medical epistemology. It is shown that all four of the types of evidence considered-qualitative/personal, qualitative/general, quantitative/general, and quantitative/personal-are required to adequately characterize epistemology in medical research and practice.

Tacit knowledge and risk perceptions: Tullow Oil and lay publics in Ghana's offshore oil region

This study examines how local residents make sense of offshore oil production risks in Ghana's nascent petroleum industry. From a naturalistic-interpretive perspective, it is primarily based on in-depth interviews with community residents: 8 opinion leaders, 15 residents, and 1 journalist. Residents associate Tullow's oil activities with health concerns (e.g. conjunctivitis), environmental challenges (e.g. the emergence of decomposed seaweeds along the shore), and socio-economic concerns (e.g. loss of livelihoods, decline in fish harvest, and increased rent and cost of living). Focusing on how the local, practical knowledge of interviewees manifest in their sense of offshore oil risks, the study identifies two strategies-scapegoating and tacit knowing-underlying how residents construe offshore oil risks and benefits. Beyond its theoretical contribution to the social construction of risk process, the study illustrates the challenge the expert-lay publics dichotomy poses (and the potential bridging this dichotomy has) for corporate and societal risk management.

Are there patient-related factors that influence sickness certification in patients with severe subjective health complaints? A cross-sectional exploratory study from different European countries

OBJECTIVES

To develop hypotheses about whether there are patient-related factors that influence physicians' decision-making that can explain why some patients with severe subjective health complaints (SHCs) are more likely to be granted sick leave than others.

DESIGN

Exploratory cross-sectional.

SETTING

Assessments of patient-related factors after watching nine authentic video recordings of patients with severe SHC from a Norwegian general practice. Our previous study showed that three of these nine patients were less likely than the remaining six patients to be granted sick leave by physicians from five European countries.

PARTICIPANTS

In total, 10 assessors from Norway, the Netherlands and France.

OUTCOMES

The direction in which the assessments may contribute towards the decision to grant a sickness certificate (increasing or decreasing the likelihood of granting sick leave).

RESULTS

Physicians consider a wide variety of patient-related factors when assessing sickness certification. The overall assessment of these factors may provide an indication of whether a patient is more likely or less likely to be granted sick leave. Additionally, some single questions (notable functional limitations in the consultation, visible suffering, a clear purpose for sick leave and psychiatric comorbidity) may indicate differences between the two patient groups.

CONCLUSIONS

Next to the overall assessment, no notable effect of the complaints on functioning and suffering, a lack of a clear purpose for sick leave and the absence of psychiatric comorbidity may be factors that could help guide the decision to grant sick leave. These hypotheses should be tested and validated in representative samples of professionals involved in sickness certification. This may help to understand the tacit knowledge we believe physicians have when assessing work capacity of patients with severe SHC.

Michael Polanyi: Science as Personal Knowledge and Social Practice

Tacit knowing: 2016 marked the 125th anniversary of the birth of the physical chemist Michael Polanyi, as well as the 40th of his death. This essay discusses his philosophy of science-in particular, his most significant work in this area, Personal Knowledge-from the perspective of his personal biography, as well as its lasting influence on the social sciences. In the photograph: Michael Polanyi at the Fritz Haber Institute in 1968.

A guide to phenomenological research

Phenomenological research is a method with strong philosophical origins, which can sometimes be challenging for novice investigators. However, developing an appreciation of these philosophical origins can enhance and strengthen the research design. A fundamental challenge is to understand the range of philosophical and empirical approaches to situate one's own research. Such phenomenological approaches are often characterised and differentiated by the degree to which it is accepted that an investigator can achieve objective descriptions of, or interpret, lived experience. This article explains these issues, relating the philosophy to the research practicalities.

Approaching the Distinction between Intuition and Insight

Intuition and insight share similar cognitive and neural basis. Though, there are still some essential differences between the two. Here in this short review, we discriminated between intuition, and insight in two aspects. First, intuition, and insight are toward different aspects of information processing. Whereas intuition involves judgment about “yes or no,” insight is related to “what” is the solution. Second, tacit knowledge play different roles in between intuition and insight. On the one hand, tacit knowledge is conducive to intuitive judgment. On the other hand, tacit knowledge may first impede but later facilitate insight occurrence. Furthermore, we share theoretical, and methodological views on how to access the distinction between intuition and insight.

The patient-physician interaction as a meeting of experts: one solution to the problem of patient non-adherence

Patient non-adherence is a common and important concern in clinical medicine. Some cases of patient non-adherence are cases in which the patient disagrees with the physician's recommended treatment based on particular reasons. Drawing upon science and technology studies literature, specifically the discussion by Collins and Evans and Wynne of how best to understand scientific controversies, I relate their ideas to the analogous conflict that may occur within a clinical interaction. I draw upon their recognition of the importance of contributory expertise and interactional expertise in providing legitimate knowledge. I also draw upon Wynne's idea of the 'negotiation of meanings' as an important element of the clinical interaction. To resolve potential conflicts between patient and physician before they develop into 'non-adherence', I propose the implementation of a new epistemological framework that recognizes legitimate knowledge offered by the patient as well as the physician. By situating this patient expertise framework within the paradigm of patient-centred medicine, and by assuming the goal of medical treatment to be treatment of suffering, patient expertise becomes centralized as a means of determining the nature of patient suffering. Two aspects of the patient's tacit knowledge - the body aspect and the meaning aspect - both of which are context-dependent and directly accessible only to the patient, are thus recognized as knowledge essential to the success of the interaction. The physician's role becomes that of both medical expert and possessor of 'interactional expertise', by which the physician recognizes and includes patient expertise in the treatment decision. By recognizing and incorporating the negotiation of meanings into the development of a treatment plan, this epistemological model of patient expertise should prevent cases of non-adherence based on disagreement.

Using systematized tacit knowledge to prioritize implementation challenges in existing maternal health programs: implications for the post MDG era

Strategic priority setting and implementation of strategies to reduce maternal mortality are key to the post Millennium Development Goal (MDG) 2015 agenda. This article highlights the feasibility and the advantages of using a systematized tacit knowledge approach, using data from maternal health program personnel, to identify local challenges to implementing policies and programs to inform the post MDG era. Communities of practice, conceived as groups of people sharing professional interests, experiences and knowledge, were formed with diverse health personnel implementing maternal health programs in Mexico and Nicaragua. Participants attended several workshops and developed different online activities aiming to strengthen their capacities to acquire, analyze, adapt and apply research results and to systematize their experience and knowledge of the actual implementation of these programs. Concept mapping, a general method designed to organize and depict the ideas of a group on a particular topic, was used to manage, discuss and systematize their tacit knowledge about implementation problems of the programs they work in. Using a special online concept mapping platform, participants prioritized implementation problems by sorting them in conceptual clusters and rating their importance and feasibility of solution. Two hundred and thirty-one participants from three communities of practice in each country registered on the online concept mapping platform and 200 people satisfactorily completed the sorting and rating activities. Participants further discussed these results to prioritize the implementation problems of maternal health programs. Our main finding was a great similarity between the Mexican and the Nicaraguan general results highlighting the importance and the feasibility of solution of implementation problems related to the quality of healthcare. The use of rigorously organized tacit knowledge of health personnel proved to be a feasible and useful tool for prioritization to inform implementation priorities in the post MDG agenda.

Operationalizing Heedful Interrelating: How Attending, Responding, and Feeling Comprise Coordinating and Predict Performance in Self-Managing Teams

Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes.

Recapturing the history of surgical practice through simulation-based re-enactment

This paper introduces simulation-based re-enactment (SBR) as a novel method of documenting and studying the recent history of surgical practice. SBR aims to capture ways of surgical working that remain within living memory but have been superseded due to technical advances and changes in working patterns. Inspired by broader efforts in historical re-enactment and the use of simulation within surgical education, SBR seeks to overcome some of the weaknesses associated with text-based, surgeon-centred approaches to the history of surgery. The paper describes how we applied SBR to a previously common operation that is now rarely performed due to the introduction of keyhole surgery: open cholecystectomy or removal of the gall bladder. Key aspects of a 1980s operating theatre were recreated, and retired surgical teams (comprising surgeon, anaesthetist and theatre nurse) invited to re-enact, and educate surgical trainees in this procedure. Video recording, supplemented by pre- and post-re-enactment interviews, enabled the teams' conduct of this operation to be placed on the historical record. These recordings were then used to derive insights into the social and technical nature of surgical expertise, its distribution throughout the surgical team, and the members' tacit and frequently sub-conscious ways of working. While acknowledging some of the limitations of SBR, we argue that its utility to historians - as well as surgeons - merits its more extensive application.

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"Staining is the Best Policy". Visualization in the work of Paul Ehrlich. For nearly all of his life, the biomedical scientist Paul Ehrlich dedicated himself to work on dyes and staining at the interface between so-called color-chemistry and histopathology. The article begins by sketching out the field of histopathology at the junction of pathological anatomy, microtechniques, and the development of chemical dyes in the early 1870s when Ehrlich began his training as a medical student. The article explores Ehrlich's work staining first tissue and blood, and then pathogens and vital staining in the 1880s. In the late 1880s and 1890s, Ehrlich experimented with dyes as therapeutic agents. Staining made the invisible visible, revealing cell structures, pathogens, or vital physiological processes within the cell itself. The article shows how visualization became an essential - albeit laborious and painstaking - element in the epistemic process of Ehrlich's work. The production of histological specimens required special skills acquired through extensive practice, especially in the techniques of visualization, manipulation, observation, and tacit understanding. These practices were needed because it was increasingly necessary to produce objective results once the various techniques of visualization came to be assessed within a discourse on objectivity. Visualization itself became an epistemic object and was ultimately "more important than the subject matter itself".

Understanding through experience: information, experience and understanding in clinical rehabilitation practice

PURPOSE

According to ethical theories of patient autonomy, patients need information and understanding to make their own, autonomous choices. The aim of this article is to describe strategies used by clinical rehabilitation teams to develop patients' understanding and promote their autonomy.

METHOD

Individual semi-structured interviews were conducted with the patient, the nurse, the physiotherapist and the physician of three institution based rehabilitation teams. Analytic procedures described by Strauss and Corbin were applied, identifying categories by their properties and dimensions.

RESULTS

The analysis revealed how practitioners recognized that patients needed experience with practical challenges in order to understand their clinical conditions properly. Practitioners disclosed information related to the individual patient's experience with his or her clinical condition. In order to make information relevant to the individual patient's experience of possibilities and limitations, information was disclosed in discussions of these experiences, rather than in abstract verbal explanations. Patients needed to understand their situation to make autonomous choices for their future lives.

CONCLUSIONS

In clinical rehabilitation, patients and practitioners agree that adequate understanding cannot be achieved by verbal information alone, and that patients need to experience essential aspects of their physical possibilities and limitations.

IMPLICATIONS FOR REHABILITATION

Patients need an adequate understanding of their injuries or diseases to be able to make autonomous choices. In clinical rehabilitation teams, practical and bodily experiences are recognized as crucial for patients to develop such understanding. Rehabilitation practitioners may effectively enhance a patient's understanding and autonomy by disclosing information as part of discussions of the patient's own experiences.

Clinical judgement and the medical profession

OBJECTIVES

Clinical judgment is a central element of the medical profession, essential for the performance of the doctor, and potentially generating information also for other clinicians and for scientists and health care managers. The recently renewed interest in clinical judgement is primarily engaged with its role in communication, diagnosis and decision making. Beyond this issue, the present article highlights the interrelations between clinical judgement, therapy assessment and medical professionalism.

METHODS

Literature review and theory development.

RESULTS

The article presents different methodological approaches to causality assessment in clinical studies and in clinical judgement, and offers criteria for clinical single case causality. The article outlines models of medical professionalism such as technical rationality and practice epistemology, and characterizes features of professional expertise such as tacit knowledge, reflection in action, and gestalt cognition.

CONCLUSIONS

Consequences of a methodological and logistical advancement of clinical judgment are discussed, both in regard to medical progress and to the renewal of the cognitive basis of the medical profession.