A number of ways of taxonomizing human learning have been proposed. We examine the evidence for one such proposal, namely, that there exist independent explicit and implicit learning systems. This combines two further distinctions, between learning that takes place with versus without concurrent awareness, and between learning that involves the encoding of instances versus the induction of abstract rules or hypotheses. Implicit learning is assumed to involve unconscious rule learning. We examine the evidence for implicit learning derived from subliminal learning, (...) conditioning, artificial grammar learning, instrumental learning, and reaction times in sequence learning. We conclude that unconscious learning has not been satisfactorily established in any of these areas. The assumption that learning in some of these tasks is predominantly based on rule abstraction is questionable. When subjects cannot report the “implicitly learned” rules that govern stimulus selection, this is often because their knowledge consists of instances or fragments of the training stimuli rather than rules. In contrast to the distinction between conscious and unconscious learning, the distinction between instance and rule learning is a sound and meaningful way of taxonomizing human learning. We discuss various computational models of these two forms of learning. (shrink)

This commentary addresses three points. First, it is argued that the common coding principles, as developed in the target article, may supplement rather than replace stage views of human information processing. Second, the issue of the properties of an event code is briefly discussed. It is concluded that much remains to be specified so as to allow critical tests. Finally, the question of the limits of common coding is raised. It may be particularly relevant to direct perception and action coupling (...) but less useful for the analysis of cognitive skills. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

A number of ways of taxonomizing human learning have been proposed. We examine the evidence for one such proposal, namely, that there exist independent explicit and implicit learning systems. This combines two further distinctions, (1) between learning that takes place with versus without concurrent awareness, and (2) between learning that involves the encoding of instances (or fragments) versus the induction of abstract rules or hypotheses. Implicit learning is assumed to involve unconscious rule learning. We examine the evidence for implicit learning (...) derived from subliminal learning, conditioning, artificial grammar learning, instrumental learning, and reaction times in sequence learning. We conclude that unconscious learning has not been satisfactorily established in any of these areas. The assumption that learning in some of these tasks (e.g., artificial grammar learning) is predominantly based on rule abstraction is questionable. When subjects cannot report the rules that govern stimulus selection, this is often because their knowledge consists of instances or fragments of the training stimuli rather than rules. In contrast to the distinction between conscious and unconscious learning, the distinction between instance and rule learning is a sound and meaningful way of taxonomizing human learning. We discuss various computational models of these two forms of learning. (shrink)

The aim of this article is to generate knowledge about parents’ participation in life-and-death decisions concerning their very premature and/or critically ill infants in hospital neonatal units. The question is: what are parents’ attitudes towards their involvement in such decision making? A descriptive study design using in-depth interviews was chosen. During the period 1997-2000, 20 qualitative interviews with 35 parents of 26 children were carried out. Ten of the infants died; 16 were alive at the time of the interview. The (...) comparative method (grounded theory) was used to analyse the data. The analysis was carried out continuously and in parallel with data collection. Six categories were revealed by the analysis: indecision and uncertainty (ambivalence); information and communication; participate, but do not decide; seeming to be included; the parents’ child; and individual consideration. The findings appear to indicate that parents agree that they should not have the final word in decisions concerning their infants’ future life or death. Such a responsibility would put too heavy a burden on parents who lack the medical knowledge and the professional experience needed to make such a decision, and would be likely to lead to them experiencing strong feelings of guilt. The findings show that parents should be well informed and listened to during the whole decision-making process. Their primary concern was how nurses and physicians communicate with parents who are experiencing a crisis, and how this serious information is presented. (shrink)

An increasing number of European research projects return, or plan to return, individual genomic research results (IRR) to participants. While data access is a data subject’s right under the General Data Protection Regulation (GDPR), and many legal and ethical guidelines allow or require participants to receive personal data generated in research, the practice of returning results is not straightforward and raises several practical and ethical issues. Existing guidelines focusing on return of IRR are mostly project-specific, only discuss which results to (...) return, or were developed outside Europe. To address this gap, we analysed existing normative documents identified online using inductive content analysis. We used this analysis to develop a checklist of steps to assist European researchers considering whether to return IRR to participants. We then sought feedback on the checklist from an interdisciplinary panel of European experts (clinicians, clinical researchers, population-based researchers, biobank managers, ethicists, lawyers and policy makers) to refine the checklist. The checklist outlines seven major components researchers should consider when determining whether, and how, to return results to adult research participants: 1) Decide which results to return; 2) Develop a plan for return of results; 3) Obtain participant informed consent; 4) Collect and analyse data; 5) Confirm results; 6) Disclose research results; 7) Follow-up and monitor. Our checklist provides a clear outline of the steps European researchers can follow to develop ethical and sustainable result return pathways within their own research projects. Further legal analysis is required to ensure this checklist complies with relevant domestic laws. (shrink)

In the original target article (Shanks & St. John 1994), one of our principal conclusions was that there is almost no evidence that learning can occur outside awareness. The continuing commentaries raise some interesting questions, especially about the definition of learning, but do not lead us to abandon our conclusion.

This article gives a survey of results of research concerning effects of public policy in the Netherlands. This survey is preceded by a summary of some important American projects.The Dutch research reported concerns effects of educational and housing policy on income distribution, effects of sururbanization policy, participation policy, and still other policies.In both countries the dominant conclusion is that the goals of public policy are at least partially realized by the means chosen. However, the conclusion that the welf are state (...) is totally f ailing would go to f ar.Research concerning effects of public policy is still rare. Moreover, it is clear that some goals are realized at least in part by the chosen means.When public policy appears not to be effective, this can be explained from several factors : the contents of policy and the underlying theory, the policy process, the society, the research, and a view which is toonarrow because it takes only short term effects of one particular policy program into account. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

_For centuries medicine was predominantly a tradition-based "trade" until the introduction of science transformed it into an intellectually rigorous discipline. That transformation contributed heavily to the dominance in medical education of the learning of biomedical concepts ("knowing that") over learning how to translate that knowledge into clinical performance ("knowing how"). The recent emergence of performance-oriented educational initiatives suggests, however, that the balance between these two complementary approaches is changing, a change that has been referred to as "the Flexnerian revolution of (...) the 21 ^st century." Problem-based learning, learning the practice of evidence-based medicine, and learning to use clinical guidelines are among the important initiatives designed to develop high-level performance in the care of individual patients. Initiatives in which learners acquire skill in changing the performance of care systems are also being widely implemented. These trends have received important formal support through recent changes in residency training accreditation standards. Although it is too early to assess the impact of these initiatives or to know whether they will develop further, medical education is unlikely to reach its full potential unless it successfully comes to grips with the challenges of understanding, teaching, and measuring performance._. (shrink)

My first article, back in 1989! Thanks, forever, Ralph McInerny. Here I take issue with John F.X. Knasas, a strong supporter of the existential Thomism of Etienne Gilson and Joseph Owens. Knasas's desire to sequester Thomas away from allowing the discipline of natural philosophy to arrive at a fully immaterial reality through its proper demonstrative methods seemed to me to be at odds with Thomas's text.

Study with reference to philosophy of Joseph F. Fletcher on christian ethics.

Father Owens suggests the outlines of a renewed Thomist attack on the post-Cartesian metaphysical questions and positions which would take advantage of the "analogical," "Platonic" and "existentialist" interpretations of St. Thomas' thought.--R. F. T.