How medical practice evolves: Learning to treat failing hearts with an implantable device

In this article we propose that medical practice evolves as a result of progress along three different pathways: improvement in the ability to develop effective medical technologies, learning in medical practice, and advances in biomedical scientific understanding of disease. The relative importance of these three pathways varies from case to case, and often they interact strongly. More specifically, we argue here that in cases of therapeutic innovation where a new medical technology is involved the advance in medical practice is driven largely by the ability to develop and use effective medical artifacts and the interactive sequence among these interdependent pathways often starts with what is learned in practice and not in science. While we state this argument in general, we develop it in detail in a longitudinal and contextual case study of the emergence and evolution of a treatment for advanced heart failure based on an implantable device, the Left Ventricular Assist Device (LVAD). Our findings show that an essential aspect of the evolution of the LVAD therapy is collective and cumulative learning that requires experience that only can be gained through the actual use of LVADs. We discuss the theoretical and policy implications that follow from our understanding of how medical practice evolves for research on the evolution of medical practices and new medical technologies, and policies about the evaluation of rapidly moving medical practices and clinical research involved in their advancement.     

Job Analysis for Lkensure and Certfication Exams: Science or Politics?

How might empirical j o b analysis give the appearance of science to a flawed public policy? How do “political” factors have an impact on the development of licensure tests? What are areas for future research and for improvement of prevailing practices in licensure and certification testingy?     

Metacognition and Self-Regulated Learning Constructs

Demographic variables, findings from the Metacognitive Awareness Inventory (Schraw & Dennison, 1994), the Learning Strategies Survey (Kardash & Amlund, 1991), and the Motivated Strategies for Learning Questionnaire (Pintrich, Smith, Garcia, & McKeachie, 1991), as well as accuracy ratings of test performance, were examined in 2 studies. Findings indicated convergence of self-report measures of metacognition, significant correlations between metacognition and academic monitoring, negative correlations between self-reported metacognition and accuracy ratings, and positive correlations between metacognition and strategy use and metacognition and motivation. Limitations of the studies and implications for theory development and future research are discussed.     

Is Criminology Out-of-Date? A Research Note on the Use of Common Types of Data

There is a need to explore trends in data use by researchers in criminology to assess the limitations of the knowledge base in the discipline. The current study explores the use of data published in three top criminology journals over a 10-year period to review: (1) data types (primary, secondary, or both), (2) the age of the data, and (3) whether scholars using data at least a decade old mention it as a limitation. The study found that the time dimension of data varied by publication source. A heavy reliance on secondary data was observed across all journals. Studies using only secondary data tended to have older data on average when compared to other data types. A majority of articles using data at least a decade old did not mention it is a shortcoming. The paper concludes by discussing advantages and disadvantages of relying on secondary data within the discipline of criminology.     

ALLEVIATING TRANSFER SHOCK: CREATING AN ENVIRONMENT FOR MORE SUCCESSFUL TRANSFER STUDENTS

Community college students transferring to a 4-year college or university face a variety of challenges. Social and academic issues can pose potential hurdles to graduating with a bachelor's degree for these students. Community colleges and 4-year institutions must work closely together to create more efficient and effective partnerships for students transitioning through the higher education system. This article makes suggestions for community college staff and faculty members to help transfer students successfully transition into university life and complete a bachelor's degree.