Only problems that cannot be solved without representational changes can be regarded as pure insight problems; others are classified as pseudo-insight problems. Existing studies using neuroimaging...

This study uses a rational ethical decision-making framework to examine the influence of moral intensity (potential harm and social pressure) on whistleblowing intention and behaviour using organisational commitment as a moderator. A scenario was developed, and an online questionnaire was used to conduct an empirical analysis on the responses of 533 participants. The mean age and years of work experience of the respondents were 31 and 8.2 years, respectively. The results show, first, that while moral intensity is correlated with whistleblowing (...) intention, only the potential harm is positively correlated with such intention. Second, potential harm and social pressure differentially affect whistleblower choice of using an internal or external channel. Third, organisational commitment has a moderated mediation effect among moral intensity, whistleblowing intention and behaviour. Fourth, whistleblowers may be grouped into four conceptual types: indifferent, rebel, mature and spoil. Finally, theoretical and managerial implications of the findings are discussed. (shrink)

Co-creativity focuses on how individuals produce innovative ideas together. As few studies have explored co-creativity using standardized tests, it is difficult to effectively assess the individual’s creativity performance within a group. Therefore, this study aims to develop a platform that allows two individuals to answer creativity tests simultaneously. This platform includes two divergent thinking tasks, the Straw Alternative Uses Test and Bottle Alternative Uses Test, and Chinese Radical Remote Associates Test A and B, which were used to evaluate their open-and (...) closed-ended creative problem-solving performance. This platform has two modes: single-player mode and paired-player mode. Responses from 497 adults were collected, based on which the fluency, flexibility, and originality of divergent thinking were measured. This study also developed a computer scoring technique that can automatically calculate the scores on these creativity tests. The results showed that divergent thinking scores from computer-based calculation and manual scoring were highly positively correlated, suggesting that the scores on a divergent thinking task can be calculated through a system that avoids time-consuming, uneconomical manual scoring. Overall, the two types of tests on this platform showed considerable internal consistency reliability and criterion-related validity. This advanced application facilitates the collection of empirical evidence about co-creativity. (shrink)

Multiple versions of the Chinese Remote Associates Test have been developed. Thus far, all CRATs have employed verbal stimuli; other forms of stimuli have not yet been used. In this context, the present study compiled a Chinese Visual Remote Associates Test that conforms to the Chinese language and culture based on a picture naming database. The developed CVRAT has two versions, CVRAT-A and CVRAT-B, each comprising 20 test questions. A typical CVRAT question consists of three stimuli pictures, requiring respondents to (...) propose a target word that is semantically associated with all the pictures. When compiling the CVRAT, this study first selected target words, sifted through stimuli words and corresponding pictures, and analyzed pilot test questions. After compilation, their reliability and validity were examined. The results showed that the CVRAT had moderate internal consistency reliability, good criterion-related validity for the Chinese Word Remote Associates Test, Chinese Radical Remote Associates Test, Chinese Compound Remote Associates Test, insight problem-solving, as well as acceptable discriminant validity for fluency, flexibility, and originality of a divergent thinking test. In other words, CVRAT can effectively measure remote associative capability and provides a figural creativity test that facilitates the understanding of different kinds of remote associations. (shrink)

Moral issues have been included in the studies of consumer misbehavior research, but little is known about the joint moderating effect of moral intensity and moral judgment on the consumer’s use intention of pirated software. This study aims to understand the consumer’s use intention of pirated software in Taiwan based on the theory of planned behavior (TPB) proposed by Ajzen (Organizational Behavior and Human Decision Processes, 50, 179, 1991). In addition, moral intensity and moral judgment are adopted as a joint (...) moderator to examine their combined influence on the proposed research framework. The results obtained from this Taiwan case reveal that the antecedent constructs proposed in the TPB model–an individual’s attitude and subjective norms toward using pirated software, and perceived behavioral control to use pirated software–indeed have positive impacts on the consumer’s use intention of pirated software. In addition, the joint moderating effect of moral intensity and moral judgment is manifested in the consumer’s use intention of pirated software. The results of this study not only could substantiate the results of consumer misbehavior research, but also could provide some managerial suggestions for Taiwanese government authorities concerned and the related software industries devoted to fighting pirated software. (shrink)

Moral issues have been included in the studies of consumer misbehavior research, but little is known about the joint moderating effect of moral intensity and moral judgment on the consumer's use intention of pirated software. This study aims to understand the consumer's use intention of pirated software in Taiwan based on the theory of planned behavior proposed by Ajzen. In addition, moral intensity and moral judgment are adopted as a joint moderator to examine their combined influence on the proposed research (...) framework. The results obtained from this Taiwan case reveal that the antecedent constructs proposed in the TPB model–an individual's attitude and subjective norms toward using pirated software, and perceived behavioral control to use pirated software–indeed have positive impacts on the consumer's use intention of pirated software. In addition, the joint moderating effect of moral intensity and moral judgment is manifested in the consumer's use intention of pirated software. The results of this study not only could substantiate the results of consumer misbehavior research, but also could provide some managerial suggestions for Taiwanese government authorities concerned and the related software industries devoted to fighting pirated software. (shrink)

The Fear of COVID-19 Scale (FCV-19S) is a new one-dimensional scale used to measure fear of an individual about the COVID-19. Given the seriousness of the COVID-19 situation in China when our study was taking place, our aim was to translate and examine the applicability of the FCV-19S in Chinese students. The sample used for validation comprised 2,445 Chinese students. The psychometrical characteristics of the Chinese FCV-19S (FCV-19S-C) were tested using Rasch analysis. Principal component analysis (PCA) proved the unidimensional structure (...) of the model. Both infit and outfit mean square (MNSQ) values (0.69–1.31) and point-measure correlations (0.82–0.86) indicated a good model fit. Person-item separation and reliability values indicated good reliability of the scale. The person-item map revealed an acceptable level of match between the persons and the items. Differential item functioning of the FCV-19S-C showed no differences with respect to age or gender. FCV-19S-C scores were significantly associated with anxiety, stress, depression, ego-resilience, and general health. The FCV-19S-C was proven to be effective in measuring fear of Chinese students about the COVID-19. (shrink)

Phenomenographic research about teachers’ conception of teaching has consistently revealed that teachers’ conception of teaching influence their classroom practices, which in turn shape students’ learning experiences. This paper reports teachers’ conceptions of teaching with regards to the use of interactive spherical video-based virtual reality in Chinese descriptive composition writing. Twenty-one secondary teachers in Hong Kong involved in an ISV-VR-supported Chinese descriptive writing program participated in this phenomenographic study. Analyses of the semi-structured interviews establish seven conception categories that are specifically related (...) to the use of ISV-VR for descriptive Chinese composition writing: offering students more observational opportunities; improving students’ writing skills; promoting students’ learning participation and motivation; shifting learning from teacher-centric to student-centric, enhancing collaborative learning among students; cultivating students’ positive values and moral character, and shaping students’ self-identity as “writers.” The concurrent and convenient access to the ISV-VR resources was for the teachers an enriched and supportive environment for them to cultivate students’ writer identity. In addition, it was discovered that the structural relationships of the conceptions may be better organized along three axes of continuum: conception’s orientation, teaching attention locus, and understanding of writing. These categories form a hierarchy from skill-oriented to community-oriented, and finally to identity-oriented conception. The findings may provide researchers and practitioners with novel insight into the teaching of composition writing in the contexts of L1 acquisition supported by virtual reality technology. (shrink)

There is controversy as to whether children with developmental language disorder (DLD) and those with high-functioning autism plus language impairment (HFA-LI) share similar language profiles. This study investigated the similarities and differences in the production of Chinese negative sentences by children with DLD and children with HFA-LI to provide evidence relevant to this controversy. The results reflect a general resemblance between the two groups in their lower-than-TDA (typically developing age-matched) performance. Both groups encountered difficulties in using negative markers, which suggests (...) that they might be impaired in feature agreement. Slight differences were detected between the two groups. Specifically, children with DLD experienced difficulties with the agreement on the feature [+telic] and that on the feature [+dynamic], while children with HFA-LI had difficulties with the agreement on the feature [+dynamic] and that on the feature [−dynamic]. This study supports the idea of a common symptomatology for the two disorders. More importantly, it suggests that these two disorders, DLD and HFA-LI, are not altogether the same in terms of language impairment. This paper concludes that general labels should not be simply attached to any children with language disorders. Instead, atypical language is very worthy of further analysis in the categorization of language disorders. (shrink)

Most neuroimaging research in stroke rehabilitation mainly focuses on the neural mechanisms underlying the natural history of post-stroke recovery. However, connectivity mapping from resting-state fMRI is well suited for different neurological conditions and provides a promising method to explore plastic changes for treatment-induced recovery from stroke. We examined the changes in resting-state functional connectivity (RS-FC) of the ipsilesional primary motor cortex (M1) in 10 post-acute stroke patients before and immediately after 4 weeks of robot-assisted bilateral arm therapy (RBAT). Motor performance, (...) functional use of the affected arm, and daily function improved in all participants. Reduced interhemispheric RS-FC between the ipsilesional and contralesional M1 (M1-M1) and the contralesional-lateralized connections were noted before treatment. In contrast, greater M1-M1 functional connectivity and disturbed resting-state networks were observed after RBAT relative to pre-treatment. Increased changes in M1-M1 RS-FC after RBAT were coupled with better motor and functional improvements. Mediation analysis showed the pre-to-post difference in M1-M1 RS-FC was a significant mediator for the relationship between motor and functional recovery. These results show neuroplastic changes and functional recoveries induced by RBAT in post-acute stroke survivors and suggest that interhemispheric functional connectivity in the motor cortex may be a neurobiological marker for recovery after stroke rehabilitation. (shrink)

This paper explores the linkage between electoral systems and candidate selection methods by analyzing two innovations of CSMs in Taiwan and Japan: polling primary and kobo, respectively. With an assumption that partiesno-finding’ conclusion in some previous large-N studies on the linkage between electoral systems and choices of CSMs. Additionally, our findings highlight the importance of institutional factors, such as electoral systems, in explaining CSM reforms in a comparative perspective.

The paper explores the influence of greenwash on green trust and discusses the mediation roles of green consumer confusion and green perceived risk. The research object of this study focuses on Taiwanese consumers who have the purchase experience of information and electronics products in Taiwan. This research employs an empirical study by means of the structural equation modeling. The results show that greenwash is negatively related to green trust. Therefore, this study suggests that companies must reduce their greenwash behaviors to (...) enhance their consumers’ green trust. In addition, this study finds out that green consumer confusion and green perceived risk mediate the negative relationship between greenwash and green trust. The results also demonstrate that greenwash is positively associated with green consumer confusion and green perceived risk which would negatively affect green trust. It means that greenwash does not only negatively affect green trust directly but also negatively influence it via green consumer confusion and green perceived risk indirectly. Hence, if companies would like to reduce the negative relationship between greenwash and green trust, they need to decrease their consumers’ green consumer confusion and green perceived risk. (shrink)

The high turnover of nurses has become a global problem. Several studies have proposed that nurses’ perceptions of the ethical climate of their organization are related to higher job satisfaction and organizational commitment and thus lead to higher organizational citizenship behaviors. This study uses hierarchical regression to understand which types of ethical climate, facets of job satisfaction, and the three components of organizational commitment influence different dimensions of organizational citizenship behaviors. Questionnaires were distributed to 450 nurses, and 352 usable questionnaires (...) were returned. The findings of the article suggest that hospitals can increase organizational citizenship behaviors by influencing an organization’s ethical climate, job satisfaction, and organizational commitment. Hospital administrators can foster within organizations, the climate types of caring, law and code and rules climate, satisfaction with coworkers, and affective commitment and normative commitment that increase organizational citizenship behavior, while preventing organizations from developing the type of instrumental climate and continuance commitment that decreases it. (shrink)

A core feature of drug-resistant epilepsy is hyperexcitability in the motor cortex, and low-frequency repetitive transcranial magnetic stimulation is a suitable treatment for seizures. However, the antiepileptic effect causing network reorganization has rarely been studied. Here, we assessed the impact of rTMS on functional network connectivity in resting functional networks and their relation to treatment response. Fourteen patients with medically intractable epilepsy received inhibitive rTMS with a figure-of-eight coil over the vertex for 10 days spread across two weeks. We designed (...) a 6-week follow-up phase divided into four time points to investigate FNC and rTMS-induced timing-dependent plasticity, such as seizure frequency and abnormal interictal discharges on electroencephalography. For psychiatric comorbidities, the Hamilton Depression Scale and the Hamilton Anxiety Scale were applied to measure depression and anxiety before and after rTMS. FNC was also compared to that of a cohort of 17 healthy control subjects. The after-effects of rTMS included all subjects that achieved the significant decrease rate of more than 50% in interictal epileptiform discharges and seizure frequency, 12 patients with the reduction rate above 50% compared to the baseline, as well as emotional improvements in depression and anxiety. In the analysis of RSNs, we found a higher synchronization between the sensorimotor network and posterior default-mode network in epileptic patients than in healthy controls. In contrast to pre-rTMS, the results demonstrated a weaker FNC between the anterior DMN and SMN after rTMS, while the FNC between the aDMN and dorsal attention network was greater. Importantly, the depressive score was anticorrelated with the FNC of the aDMN-SMN, which was markedly different in the good and bad response groups treated with rTMS. Based on the vertex suppression by rTMS, it is possible to achieve temporary clinical efficacy by modulating network reorganization in the DMN and SMN for patients with refractory epilepsy. (shrink)

Because no previous literature discusses the determinants of green product development performance, this study develops an original framework to fill the research gap. This study explores the influences of green dynamic capabilities and green transformational leadership on green product development performance and investigates the mediation role of green creativity. The results demonstrate that green dynamic capabilities and green transformational leadership positively influence green creativity and green product development performance. Besides, this study indicates that the positive relationships between green product development (...) performance and their two antecedents—green dynamic capabilities and green transformational leadership—are partially mediated by green creativity. It means that green dynamic capabilities and green transformational leadership can not only directly affect green product development performance positively but also indirectly affect it positively via green creativity. Hence, companies have to increase their green dynamic capabilities, green transformational leadership, and green creativity to enhance their green product development performance. (shrink)

Various countries have alternative pathway policies for 2-year community college graduates to articulate to 2-year university study, forming a “2+2” pathway. However, few studies have explored university staff members’ perceptions of this “2+2” transfer pathway and their understanding of transfer students’ transition experiences. This descriptive qualitative study addressed this research gap. Forty-two academic and supporting staff participated in the focus group interviews. Specifically, the study explored the assets and challenges of the “2+2” pathway from the university staff perspective in Hong (...) Kong. The articulation pathway and TSs are highly recognized for their prior learning, academic performances, and the value of the second chance. However, while the university staff were sympathetic to the challenges filling these transfer pathways, their offering of help was limited by government funding and policies restrictions. It is recommended that policies should be established at government and university levels to recognize and tackle TSs’ unique needs to alleviate their heavy workloads through better articulation between community college and university studies. Improving articulation will allow TSs time for social involvement in university life and thus enhance their mental well-being. (shrink)

A reciprocal relation has been identified between teacher emotion and teacher professional identity. However, the underlying mechanism explaining this complex interaction remains underexamined. Moreover, limited attention has been paid to the emotional dimension of student-teachers' development of professional identity during university coursework. To bridge this gap, the present study explores how student-teachers' emotions reciprocally interact with their professional identities, drawing data from questionnaires, reflections, and interviews with students taking courses related to language teaching in a teacher-training university. Both quantitative and (...) qualitative data delineated the intertwined trajectories of student-teachers' emotional experiences and the development of professional identity in the learning process of becoming teachers. Mainly triggered by course-related factors, student-teachers experienced a wide array of emotions, of which the polarity and intensity were determined and mediated by their goals and actions deriving from their professional identities. Those aroused emotions, in turn, signaled the developmental process of professional identity and promoted or hindered their emerging identities. This paper concludes with some implications for initial teacher education programs. (shrink)

In this paper, an active frequency control strategy of wind turbines based on model predictive control is proposed by using the power margin of wind turbines operating in load shedding mode. The frequency response model of the microgrid system with the load shedding of the wind turbines is used to predict the output power and system frequency deviation of the wind turbine. According to the prediction information, the output power control signal of the model predictive controller in the wind turbine (...) can be optimized. On this basis, a wind turbine active participation frequency control strategy based on model predictive control is designed by rolling prediction and optimization. The wind turbine power control signal after the strategy is used to adjust the output power of the wind turbine and balance the change of the active power of the system to reduce the frequency deviation. (shrink)

This study investigated students? perceptions of their own and their peers? academic dishonesty (AD), their reasons for this dishonesty, their achievement goals, and their willingness to report AD (WRAD) within a Chinese cultural context. The results identified students? belief that their peers had a greater likelihood of engaging in AD and had more motivation to do so than did the students themselves. Gender and academic major did not affect students? WRAD. However, students were significantly more willing to report classmates than (...) friends. In terms of the participants? self-perceptions and peer perceptions concerning motivations for AD, more female students cited the lack of penalties as the reason for their own and their peers? AD, whereas male students more frequently cited their lack of attention to schoolwork as the reason for their own AD. In contrast to students in the social sciences, business students more frequently cited inadequate capabilities as the reason for their AD, and engineering students more frequently attributed their AD to self-interest. Multiple regression analysis demonstrated that three motivations for AD (opportunism, inadequacy, and self-promotion) could positively predict AD, whereas mastery-approach goals could negatively predict AD. (shrink)

This study attempts to investigate the relationships among the ethical beliefs of Chinese consumers and orientations based on attitudinal attributes: materialism and moral philosophies (idealism and relativism). In addition, this study examines Chinese consumers' ethical beliefs in relation to five selected demographic characteristics (gender, age, religion, family income and education). Based on this exploratory study of 284 Chinese consumers, the following statistically significant findings were discovered. First, Chinese consumers regard that a passively benefiting activity is more ethical, but actively benefiting (...) from an illegal or a questionable activity is unacceptable. Second, the two dimensions of passively benefiting and no harm/no foul can be used to distinguish the consumers who endorse higher levels of idealism or relativism. Third, Chinese consumers with a high level of materialism are more likely to actively benefit from illegal and questionable activities, and the passively benefiting actions. Finally, the more ethical Chinese consumers seem to be younger, be religious, and have a lower family income. (shrink)

Peer assessment is employed as one fundamental practice of classroom-based assessment in terms of its learning-oriented and formative nature. The exercise of peer assessment has multiple and additional benefits for student learning. However, research into the learning processes in peer assessment is scarce both in theory and in practice, making it difficult to evaluate and pinpoint its value as a tool in assessment as learning. This study focuses both on the learning process and outcome through assessment activities. We set out (...) with three goals in mind: to examine students' assessment performance in context, to evaluate its impact on student progress, and to illuminate teachers on organizing assessment activities. Three specific research questions are answered in this study: How do student raters perform in the process of PA in an advanced English class? To what extent do assessment activities influence the students' speaking ability? What are students' perceptions of PA regarding its benefits and caveats? A total of 29 undergraduate students participated in two assessment activities on argumentative speaking. Many-Facet Rasch Model analysis was conducted to measure the rater effects both at the group level and the individual level. Bias/interaction analyses were performed to diagnose rater behavior in different contexts including the rating session, speaking session, and peer assessment vs. self-assessment. Questionnaire and semi-structured interview data were also collected to explore factors and strategies that could interfere with PA as AaL. Results show that students exhibited stable rating behavior and made progress in argumentative speaking in all dimensions, including delivery, organization, and language use. They are more stringent with themselves than with peers although there is one rare case with a bias against peers. Participants acknowledged the benefits of PA but also shared reasonable concerns in practice. This study validated the feasibility and the effectiveness of PA for student learning. Discussion on findings and guidelines for effective implementation of PA as AaL are provided. (shrink)

BackgroundPrehospital delay is associated with non-modifiable factors such as age, residential region, and disease severity. However, the impact of psychosocial factors especially for job burnout on prehospital decision delay is still little understood.MethodThis internet-based survey was conducted between 14 February 2021 and 5 March 2021 in China through the Wechat platform and web page. Self-designed questionnaires about the expected and actual length of prehospital decision time and the Chinese version of Maslach Burnout Inventory-General Survey, Type D Personality Scale-14, and Social (...) Support Rating Scale were applied. A total of 1,039 general participants with a history of perceptible but tolerable body discomfort were included.ResultsThe top six reasons for prehospital decision delay were: endure until self-healing, too busy to ask for leave, process for seeing a doctor too complicated, too tired after work, worry about the expenditure, and fear of being identified as with serious problem. The univariate analyses revealed that older age, type D personality, job burnout, and worrying about expenditure were associated with prolonged prehospital decision time, while engaged in medical-related job and with more social support would shorten the delay. The multivariate analysis using logistic regression model with forward selecting method showed that age [per 10 years, odds ratio 1.19, p 7 days). Mediating effects were analyzed by using bias-corrected percentile bootstrap methods. Social support was found partially mediated the relationship between the determinants and prehospital decision time. The partial mediating effect of social support accounted for 24.0% of the total effect for job burnout and 11.6% for worrying about expenditure.ConclusionPsychosocial factors have a non-negligible impact on prehospital decision delay. The crucial part of prehospital decision delay may be the lack of motivation inside. Job burnout and lack of social support, as two commonly seen features in the modern world, should be given enough consideration in disease prevention and treatment. (shrink)

BackgroundThe prognosis of patients undergoing lung cancer treatment might be influenced by mental health status. Resilience is one of the important predictors to reflect the mental health status. It has been shown that patients with higher levels of social support, self-care self-efficacy, and positive coping have greater resilience. This study aimed to determine the mediating role of self-efficacy and positive coping in the relationship between social support and psychological resilience in patients with lung cancer.MethodThis is a cross-sectional study that was (...) conducted in in the oncology departments and thoracic surgical wards of four tertiary hospitals in Hunan Province, China, between November 2016 and November 2017. Three hundred and three patients who were undergoing treatment for lung cancer volunteered their participation in the study. Participants completed questionnaires, including the Chinese version of the Perceived Social Support Seale Scale, the Chinese version of Strategies Used by People to Promote Health Scale, and the Chinese version of the Connor-Davidson Resilience Scale.ResultsMediation analysis indicated that self-care self-efficacy and social support partially mediate the effect of social support on resilience. Direct paths from social support to self-efficacy, self-efficacy to positive coping, positive coping to psychological resilience, self-efficacy to psychological resilience, and social support to psychological resilience were significant. The indirect paths from social support to self-efficacy and self-efficacy to psychological resilience were also significant. The chain mediation from social support to self-efficacy, self-efficacy to positive coping, and positive coping to resilience were significant.ConclusionSelf-efficacy and positive coping play an important role in the relationship between social support and resilience in patients receiving cancer treatment. Social support not only directly influenced psychological resilience but also indirectly influenced psychological resilience through self-efficacy and positive coping. (shrink)

Recently, teacher emotions have become the focus of research in teacher education. Teacher emotions not only affect teachers themselves but also have an impact on their students. However, pre-service teachers’ emotions have been neglected. This study is based on a qualitative analysis of online emotional diaries related to emotional experience expression by 120 Chinese pre-service teachers before, during, and after teaching practice. The results in this study show three characteristics of pre-service teachers’ emotional experiences: the overall positive emotions are higher (...) than negative emotions; “caring” and “nervous” are the most typical emotions and variability in emotional experience across gender and internship schools. Then, it is surprising that pre-service teachers’ emotional trajectories are complex and dynamic, positive emotions are decreasing, and negative emotions increase as time goes by. Finally, from the perspective of emotional experience sources, organizational factors affect the emotional experience, personal factors, and background factors. (shrink)

To understand the gaps between current bioethics education and the requirements of practicing nurses, a semistructured questionnaire was used to invite the directors of nursing departments at all 82 teaching hospitals in Taiwan to participate in this survey. The response rate was 64.6%. Through content analysis we obtained information about previous bioethical training, required themes and content, recommended teaching strategies, and difficulties with education and its application. The results suggest that Taiwanese nursing personnel need to be instilled with both self-cultivation (...) of morality and mental cultivation to acquire nursing virtues and the right attitudes toward bioethical issues. Good communication skills to prevent damage to the harmonious relationships between patients, their families and medical team members, policies that support the provision of systematic formal knowledge of ethics, small group training, and clarification of values were also shown to be important in bioethics education. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)