Clinical teaching self-efficacy positively predicts professional fulfillment and negatively predicts burnout amongst Thai physicians: a cross-sectional survey.

BACKGROUND: Clinician teachers (physicians who teach in clinical settings) experience considerable psychological challenges in providing both educational training and patient care. This study aimed to determine the prevalence of physician burnout and professional fulfillment, and to identify internal and external factors associated with mental health outcomes among Thai clinician teachers working in non-university teaching hospitals. METHOD: A one-time online questionnaire was completed by physicians at 37 governmental, non-university teaching hospitals in Thailand, with 227 respondents being assessed in the main analyses. Four outcomes were evaluated including burnout, professional fulfillment, quality of life, and intentions to quit. RESULTS: The observed prevalence of professional fulfillment was 20%, and burnout was 30.7%. Hierarchical regression analysis showed a significant internal, psychological predictor (clinical teaching self-efficacy) and external, structural predictors (multiple roles at work, teaching support), controlling for the background variables of gender, years of teaching experience, family roles, and active chronic disease, with clinical teaching self-efficacy positively predicting professional fulfillment (b = 0.29, p ≤.001) and negatively predicting burnout (b = - 0.21, p =.003). CONCLUSIONS: Results highlight the importance of faculty development initiatives to enhance clinical teaching self-efficacy and promote mental health among Thai physicians.

Teacher anger as a double-edged sword: Contrasting trait and emotional labor effects.

In contrast to teachers' positive emotions, such as enjoyment and enthusiasm, teachers' negative emotions and the regulation of negative emotions have received limited empirical attention. As the most commonly experienced negative emotion in teachers, anger has to date demonstrated mixed effects on teacher development. On the one hand, habitual experiences of anger (i.e., trait anger) exhaust teachers' cognitive resources and impair pedagogical effectiveness, leading to poor student engagement. On the other hand, strategically expressing, faking, or hiding anger in daily, dynamic interactions with students can help teachers achieve instructional goals, foster student concentration, and facilitate student engagement. The current study adopted an intensive daily diary design to investigate the double-edged effects of teachers' anger. Multilevel structural equation modeling of data from 4,140 daily diary entries provided by 655 practicing Canadian teachers confirmed our hypotheses. Trait anger in teachers was found to impair teacher-perceived student engagement. Daily genuine expression of anger corresponded with greater teacher-perceived student engagement; daily faking anger impaired perceived student engagement, and daily hiding anger showed mixed results. Moreover, teachers tended to hide anger over time, and were reluctant to express anger, genuine or otherwise, in front of their students. Finally, genuine expression and hiding of anger had only a temporary positive association with teacher-perceived student engagement, with student rapport being optimal for promoting sustained observed student engagement.

Harnessing imaging tools to guide immunotherapy trials: summary from the National Cancer Institute Cancer Imaging Steering Committee workshop.

As the immuno-oncology field continues the rapid growth witnessed over the past decade, optimising patient outcomes requires an evolution in the current response-assessment guidelines for phase 2 and 3 immunotherapy clinical trials and clinical care. Additionally, investigational tools-including image analysis of standard-of-care scans (such as CT, magnetic resonance, and PET) with analytics, such as radiomics, functional magnetic resonance agents, and novel molecular-imaging PET agents-offer promising advancements for assessment of immunotherapy. To document current challenges and opportunities and identify next steps in immunotherapy diagnostic imaging, the National Cancer Institute Clinical Imaging Steering Committee convened a meeting with diverse representation among imaging experts and oncologists to generate a comprehensive review of the state of the field.

Predicting Research Productivity in STEM Faculty: The Role of Self-determined Motivation.

How are university faculty members in STEM disciplines motivated to conduct research, and how does motivation predict their success? The current study assessed how multiple types of self-determined motivation predict research productivity in a sample of 651 faculty from 10 US institutions. Using structural equation modeling, the basic psychological needs of autonomy and competence predicted autonomous motivation (enjoyment, value) that, in turn, was the strongest predictor of self-reported research productivity. Using negative binomial regression, autonomous motivation was the strongest predictor of faculty publications and citations, with a one-standard deviation increase in autonomous motivation (approximately a half response option on a 1-5 Likert scale) corresponding to an 11.63% increase in publications and a 22.57% increase in citations over a three-year period. Occupational and social-environmental background variables (e.g., research percentage on contract, career age, balance, collegiality), as well as controlled motivation (guilt, rewards), had comparatively limited predictive effects. These results are of relevance to higher education institutions aiming to support scholarly productivity in STEM faculty in identifying specific beneficial and detrimental aspects of faculty motivation that contribute to measurable gains in research activity.

Randomized Phase II Study of PET Response-Adapted Combined Modality Therapy for Esophageal Cancer: Mature Results of the CALGB 80803 (Alliance) Trial.

PURPOSE: To evaluate the use of early assessment of chemotherapy responsiveness by positron emission tomography (PET) imaging to tailor therapy in patients with esophageal and esophagogastric junction adenocarcinoma. METHODS: After baseline PET, patients were randomly assigned to an induction chemotherapy regimen: modified oxaliplatin, leucovorin, and fluorouracil (FOLFOX) or carboplatin-paclitaxel (CP). Repeat PET was performed after induction; change in maximum standardized uptake value (SUV) from baseline was assessed. PET nonresponders (< 35% decrease in SUV) crossed over to the alternative chemotherapy during chemoradiation (50.4 Gy/28 fractions). PET responders (≥ 35% decrease in SUV) continued on the same chemotherapy during chemoradiation. Patients underwent surgery at 6 weeks postchemoradiation. Primary end point was pathologic complete response (pCR) rate in nonresponders after switching chemotherapy. RESULTS: Two hundred forty-one eligible patients received Protocol treatment, of whom 225 had an evaluable repeat PET. The pCR rates for PET nonresponders after induction FOLFOX who crossed over to CP (n = 39) or after induction CP who changed to FOLFOX (n = 50) was 18.0% (95% CI, 7.5 to 33.5) and 20% (95% CI, 10 to 33.7), respectively. The pCR rate in responders who received induction FOLFOX was 40.3% (95% CI, 28.9 to 52.5) and 14.1% (95% CI, 6.6 to 25.0) in responders to CP. With a median follow-up of 5.2 years, median overall survival was 48.8 months (95% CI, 33.2 months to not estimable) for PET responders and 27.4 months (95% CI, 19.4 months to not estimable) for nonresponders. For induction FOLFOX patients who were PET responders, median survival was not reached. CONCLUSION: Early response assessment using PET imaging as a biomarker to individualize therapy for patients with esophageal and esophagogastric junction adenocarcinoma was effective, improving pCR rates in PET nonresponders. PET responders to induction FOLFOX who continued on FOLFOX during chemoradiation achieved a promising 5-year overall survival of 53%.

Exploring relations between teacher emotions, coping strategies, and intentions to quit: A longitudinal analysis.

Although previous research has indicated that emotions have a substantial impact on teacher well-being, research is lacking concerning the relationships between teachers' emotions, coping strategies, and quitting intentions. This current five-month, two-wave longitudinal study investigated the relations between these variables in a sample of 1086 Canadian teachers (female: 81.3%; Mage = 42). Results from cross-lagged analyses revealed that teachers' trait emotions corresponded with coping strategies and that trait emotions and coping strategies both corresponded with intentions to quit the teaching profession. Mediational latent change analyses further showed that baseline levels of teachers' anxiety corresponded with greater emotion-focused disengagement coping that, in turn, led to stronger intentions to quit the teaching profession. Finally, decreases in teachers' anxiety over time additionally corresponded with decreases in disengagement coping. Limitations and practical implications concerning the importance of providing meaningful support to teachers for reducing anxiety, improving coping, and reducing quitting intentions are discussed.

The impact of physician support on skin self-examination among melanoma patients: A serial mediation model with self-efficacy and intentions to perform skin exams.

OBJECTIVE: Melanoma is the most lethal of skin cancers; however, survival rates are excellent if the tumor is detected early. Clinical practice guidelines for melanoma follow-up care recommend regular skin self-examination (SSE) for individuals at high risk for melanoma. The current analyses tested whether self-efficacy for SSE and intention to perform SSE mediate the relationship between physician support for SSE and SSE behavior among a sample of melanoma patients. METHODS: We ran a serial mediation model on a cross-sectional sample of melanoma patients (n = 154) drawn from an observational study with longitudinal follow-up. RESULTS: Self-efficacy and intention to perform SSE sequentially mediated the relationship between physician support and SSE behaviors (ß = .31, t(152) = 3.61, p < .001 without mediators versus ß = .11, t(150) = 1.50, p = .14 with mediators), as supported by a significant total indirect effect (ß = .21, [95 % CI = .08-.35]). CONCLUSION: Self-efficacy for SSE and intention to perform SSE together explain the link between perceived physician support for SSE and the practice of SSE. PRACTICE IMPLICATIONS: Physician communication about the importance of SSE plays an important role in encouraging patient adherence to SSE recommendations and, thus, supporting early detection efforts.

Self-efficacy, procrastination, and burnout in post-secondary faculty: An international longitudinal analysis.

To address the present research gap on relations between motivational beliefs, self-regulation failure, and psychological health in post-secondary faculty, the present study used associative latent growth modeling to longitudinally examine relationships between self-efficacy, procrastination, and burnout (emotional exhaustion) in faculty internationally. Findings from 3,071 faculty participants (70% female, 69 countries) over three time points (5-6 month lags) showed greater self-efficacy at baseline to correspond with lower procrastination and burnout, and procrastination to be positively related to burnout (intercepts). Growth analyses additionally revealed stronger relations between increases in self-efficacy, procrastination, and burnout over time (slopes). Supplemental cross-lagged analyses provided causal evidence of burnout as an antecedent of self-efficacy and procrastination, underscoring intervention and policy efforts to address overwork and exhaustion in post-secondary faculty.

The Berlin Social Support Scales: Validation of the Received Support Scale in a Canadian sample of patients affected by melanoma.

The purpose of this study was to examine the reliability and validity of the Received Support Scale of the Berlin Social Support Scales in a Canadian sample of English and French language melanoma patients (N = 137). Participants received a skin self-examination education and completed self-report questionnaires. Exploratory factor analyses, reliability analyses, and independent samples t-tests were conducted. Findings support the unidimensionality of the Received Support Scale of the Berlin Social Support Scales. The psychometric similarities of the French and English versions of the scale, its strong internal consistency, as well as its convergent and discriminant validity support the use of the Received Support Scale of the Berlin Social Support Scales in patients with melanoma.

Colorectal Cancer:: Imaging Conundrums.

Progressive technological advancements in imaging have significantly improved the preoperative sensitivity for the detection of very small foci of regionally- or hematogenously-metastatic colorectal cancer. Unfortunately, this information has not translated to continued linear gains in patient survival, and might even result in the false-positive upstaging of some cases: these are two conundrums in the imaging of colorectal cancer. Both conundrums might be resolved by the widespread use of real-time imaging guidance during operative procedures. This might open the way for the widespread use of fluorodeoxyglucose PET/CT for the initial staging of patients with colorectal cancer.

Technology, attributions, and emotions in post-secondary education: An application of Weiner's attribution theory to academic computing problems.

As technology becomes increasingly integrated with education, research on the relationships between students' computing-related emotions and motivation following technological difficulties is critical to improving learning experiences. Following from Weiner's (2010) attribution theory of achievement motivation, the present research examined relationships between causal attributions and emotions concerning academic computing difficulties in two studies. Study samples consisted of North American university students enrolled in both traditional and online universities (total N = 559) who responded to either hypothetical scenarios or experimental manipulations involving technological challenges experienced in academic settings. Findings from Study 1 showed stable and external attributions to be emotionally maladaptive (more helplessness, boredom, guilt), particularly in response to unexpected computing problems. Additionally, Study 2 found stable attributions for unexpected problems to predict more anxiety for traditional students, with both external and personally controllable attributions for minor problems proving emotionally beneficial for students in online degree programs (more hope, less anxiety). Overall, hypothesized negative effects of stable attributions were observed across both studies, with mixed results for personally controllable attributions and unanticipated emotional benefits of external attributions for academic computing problems warranting further study.

A Systematic Review of Teachers' Causal Attributions: Prevalence, Correlates, and Consequences.

The current review provides an overview of published research on teachers' causal attributions since 1970s in the context of theoretical assumptions outlined in Weiner's (2010) attribution theory. Results across 79 studies are first examined with respect to the prevalence of teachers' interpersonal causal attributions for student performance and misbehavior, as well as intrapersonal attributions for occupational stress. Second, findings showing significant relations between teachers' attributions and their emotions and cognitions, as well as student outcomes, are discussed. Third, an overview of results showing the prevalence and implications of teachers' causal attributions to be moderated by critical background variables is also provided. Finally, observed themes across study findings are highlighted with respect to the fundamental attribution error and the utility of Weiner's attribution theory for understanding how teachers' explanations for classroom stressors impact their instruction, well-being, and student development.

Examining the accuracy of students' self-reported academic grades from a correlational and a discrepancy perspective: Evidence from a longitudinal study.

The present longitudinal study examined the reliability of self-reported academic grades across three phases in four subject domains for a sample of 916 high-school students. Self-reported grades were found to be highly positively correlated with actual grades in all academic subjects and across grades 9 to 11 underscoring the reliability of self-reported grades as an achievement indicator. Reliability of self-reported grades was found to differ across subject areas (e.g., mathematics self-reports more reliable than language studies), with a slight yet consistent tendency to over-report achievement levels also observed across grade levels and academic subjects. Overall, the absolute value of over- and underreporting was low and these patterns were not found to differ between mathematics and verbal subjects. In sum, study findings demonstrate the consistent predictive utility of students' self-reported achievement across grade levels and subject areas with the observed tendency to over-report academic grades and slight differences between domains nonetheless warranting consideration in future education research.

A comparison of FLT to FDG PET/CT in the early assessment of chemotherapy response in stages IB-IIIA resectable NSCLC.

BACKGROUND: The aim of this study was to compare the percentage change in 18F-fluorothymidine (FLT) standard uptake value (SUV) between baseline and after one cycle of chemotherapy in patients categorized by RECIST 1.1 computed tomography (CT) as responders or non-responders after two cycles of therapy. Change in 18F-fluorodeoxyglucose (FDG) uptake was also compared between these time points. Nine patients with newly diagnosed, operable, non-small cell lung cancer (NSCLC) were imaged with FDG positron emission tomography/CT (PET), FLT PET/CT, and CT at baseline, following one cycle of neoadjuvant therapy (75 mg/m2 docetaxel + 75 mg/m2 cisplatin), and again after the second cycle of therapy. All patients had a biopsy prior to enrollment and underwent surgical resection within 4 weeks of post-cycle 2 imaging. RESULTS: Between baseline and post-cycle 1, non-responders had mean SULmax (maximum standard uptake value adjusted for lean body mass) increases of 7.0 and 3.4% for FDG and FLT, respectively. Responders had mean decreases of 44.8 and 32.0% in FDG and FLT SULmax, respectively, between baseline and post-cycle 1 imaging. On post-cycle 1 imaging, primary tumor FDG SUL values were significantly lower in responders than in non-responders (P = 0.016). Primary tumor FLT SUL values did not differ significantly between these groups. Using the change from baseline to post-cycle 1, receiver-operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.94 for FDG and 0.78 for FLT in predicting anatomic tumor response after the second cycle of therapy. CONCLUSIONS: Fractional decrease in FDG SULmax from baseline to post-cycle 1 imaging was significantly different between anatomic responders and non-responders, while percentage changes in FLT SULmax were not significantly different between these groups over the same period of time.

Validation of the English and French versions of the Brief Health Care Climate Questionnaire.

Patient autonomy is a central value in medicine and critical component of adherence to medical advice. This article reports on a validation of the 6-item version of the Health Care Climate Questionnaire (HCCQ), a measure of autonomy support in health care settings, in a sample of 242 melanoma patients. The HCCQ showed excellent internal consistency (α = .91), structural validity (Tucker-Lewis index = .99; comparative fit index = .99; root mean square error of approximation = .06, 90 per cent confidence interval (.00, .11); standardized root mean square residual = .02; χ2 (8, N = 235) = 13.99, p = .08) and construct validity (92.31% of hypothesized correlations with other measures confirmed). Acceptable 3-month test-retest reliability was observed (r = .55, p < .001; intraclass correlation coefficient (A, 1) = .54, p < .001). The French version was found equivalent to the English version.

Teachers' goal orientations: Effects on classroom goal structures and emotions.

BACKGROUND: Prior research has shown teachers' goal orientations to influence classroom goal structures (Retelsdorf et al., 2010, Learning and Instruction, 20, 30) and to also impact their emotions (Schutz et al., 2007, Emotion in education, Academic Press, Amsterdam, the Netherlands). However, empirical research evaluating possible causal ordering and mediation effects involving these variables in teachers is presently lacking. AIM: The present 6-month longitudinal study investigated the relations between varied motivational, behavioural, and emotional variables in practising teachers. More specifically, this study examined the reciprocal, longitudinal relations between teachers' achievement goals, classroom goal structures, and teaching-related emotions, as well as cumulative mediational models in which observed causal relations were evaluated. SAMPLES: Participants were 495 practising teachers from Canada (86% female, M = 42 years). METHODS: Teachers completed a web-based questionnaire at two time points assessing their instructional goals, perceived classroom goal structures, achievement emotions, and demographic items. RESULTS: Results from cross-lagged analyses and structural equation modelling showed teachers' achievement goals to predict their perceived classroom goal structures that, in turn, predicted their teaching-related emotions. CONCLUSIONS: The present results inform both Butler's (2012, Journal of Educational Psychology, 104, 726) theory on teachers' achievement goals and Frenzel's (2014, International handbook of emotions in education, Routledge, New York, NY) model of teachers' emotions in showing teachers' instructional goals to both directly predict their teaching-related emotions, as well as indirectly through the mediating effects of classroom goal structures.

Attributions of Responsibility and Blame for Procrastination Behavior.

The present study examined the relationship between procrastination, delay, blameworthiness, and moral responsibility. Undergraduate students (N = 240) were provided two scenarios in which the reason for inaction (procrastination, delay), the target (self, other), and the outcome (positive, negative) were manipulated, and students were asked to rate the moral responsibility and blameworthiness of the agent. Results indicated that individuals who procrastinated were seen as more morally responsible and blameworthy than those who experienced delay. More specifically, after a negative outcome, procrastination was associated with more moral responsibility, whereas delay was associated with less moral responsibility. After a positive outcome, individuals perceived procrastination as deserving of less moral responsibility, and delays as associated with more moral responsibility. Finally, a three-way interaction showed that participants rated procrastination that resulted in failure as deserving of responsibility when engaged in by others as opposed to oneself.

Encouraging Realistic Expectations in STEM Students: Paradoxical Effects of a Motivational Intervention.

College students in STEM (science, technology, engineering, mathematics) disciplines are increasingly faced with highly competitive and demanding degree programs and are at risk of academic overconfidence. Following from theory and research highlighting the psychological and developmental risks of unrealistic expectations, the present exploratory study evaluated the longitudinal effects of a motivational intervention encouraging college students in STEM degree programs (N = 52) to consider the importance of downgrading one's expectations in response to academic setbacks. Contrary to study hypotheses, the results showed intervention participants to report significantly higher expectations and optimism on post-test measures administered 4 months later, no significant gains in emotional well-being or achievement goal orientations, and lower GPAs over five subsequent semesters. These paradoxical effects underscore the need for additional larger-scale research on the nature of students' responses to potentially ego-threatening motivational programs in STEM disciplines so as to minimize achievement deficits at the expense of preserving motivational resources.

Smiling on the Inside: The Social Benefits of Suppressing Positive Emotions in Outperformance Situations.

Although expressing positive emotions is typically socially rewarded, in the present work, we predicted that people suppress positive emotions and thereby experience social benefits when outperformed others are present. We tested our predictions in three experimental studies with high school students. In Studies 1 and 2, we manipulated the type of social situation (outperformance vs. non-outperformance) and assessed suppression of positive emotions. In both studies, individuals reported suppressing positive emotions more in outperformance situations than in non-outperformance situations. In Study 3, we manipulated the social situation (outperformance vs. non-outperformance) as well as the videotaped person's expression of positive emotions (suppression vs. expression). The findings showed that when outperforming others, individuals were indeed evaluated more positively when they suppressed rather than expressed their positive emotions, and demonstrate the importance of the specific social situation with respect to the effects of suppression.