Collective Efficacy as a Mediator of the Trustworthiness - Performance Relationship in Computer-Mediated Team-based Contexts.

The current study investigated the role of trustworthiness perceptions at the individual level and collective efficacy at the team level on team performance in computer-mediated teams using multi-level structural equation modeling (MSEM). It was hypothesized that trustworthiness perceptions and collective efficacy would predict team performance, and collective efficacy would partially mediate the trustworthiness - performance relationship in computer-mediated teams. Sixty-four teams (five participants each) engaged in a computer-mediated task across two experimental sessions. Trustworthiness measured after session 1, collective efficacy measured after sessions 1 and 2, and team performance measured of sessions 1 and 2 were used to build the MSEM. The half longitudinal model for assessing mediation was used to examine the influence of trustworthiness perceptions on performance through collective efficacy over time. Results demonstrated support for the hypothesized model, such that trustworthiness perceptions demonstrated indirect effects on performance through collective efficacy. These findings extend past research by identifying an emergent mechanism by which trustworthiness is important for team performance in computer-mediated teams.

The effect of stress on learning in surgical skill acquisition.

BACKGROUND: An excessive level of stress and anxiety in medical education can have a negative impact on learning. In particular, the interaction between attending surgeons and trainees in the operating room could induce stress on trainees that is counterproductive, especially if the teaching style or feedback is unduly harsh or critical. AIM: To characterize the effects of stress resulting from attending-trainee interaction during surgical skill acquisition. METHODS: Forty medical students learned to perform the FLS pattern-cutting task for the first time in one of four scenarios. In the control condition, no mentor was present. In the three experimental conditions, participants were observed, encouraged, or criticized by an expert surgeon. RESULTS: Task performance, as well as physiological and subjective indicators of stress, were measured. Taking both speed and accuracy into account, participants who were criticized performed the worst on the task, and those who were encouraged performed best. Physiological and subjective measures indicated that the criticized participants experienced the highest level of stress and anxiety. CONCLUSION: Even though providing constructive criticism to trainees is inevitable during the course of teaching, an exceedingly critical and negative mentoring style by attending physicians could be detrimental to trainees' acquisition of surgical skills.

The influence of neuroticism, extraversion and openness on stress responses.

The present research moved beyond focusing on negative dispositions to investigate the influence of positive aspects of personality, namely extraversion and openness, on stress responses including appraisals, affect and task performance. Challenge appraisals occur when stressor demands are deemed commensurate with coping resources, whereas threat appraisals occur when demands are believed to outweigh coping resources. We examined the unique influence of personality on stress responses and the mediating role of appraisals. Personality was assessed, and then participants (N = 152) were exposed to a validated math stressor. We found unique effects on stress responses for neuroticism (high threat and negative affect and low positive affect), extraversion (high positive and low negative affect) and openness (high positive and low negative effect and better performance). Mediation analyses revealed that neuroticism indirectly worsened performance, through threat appraisals, and that openness indirectly increased positive affect through lower threat. These findings highlight the importance of investigating multiple aspects of personality on stress responses and provide an avenue through which stress responses can be changed-appraisals. Only by more broad investigations can interventions be tailored appropriately for different individuals to foster stress resilience.

The dynamic nature of the stress appraisal process and the infusion of affect.

Very little is known about the process in which people reappraise a stressful environment or the factors that may influence this process. In the current study, we address the several limitations to previous research regarding stress reappraisals and explore the role of affect on this process. A total of 320 participants (mean age = 20 years, 60% male) completed an increasingly demanding team-based coordination task. Mood and stress appraisals were assessed at three time points using self-report surveys during four different waves of data collection. The longitudinal design enabled us to assess primary and secondary reappraisals (change in appraisals during the experiment), task-irrelevant affect (affect assessed prior to experiment participation), and task-relevant affect (change in affect experienced during the experiment). Guided by the Transactional Theory of Stress, we argue that the relationship between primary reappraisal and secondary reappraisal is an accurate representation of a dynamic stress appraisal process. We found that participants were more likely to engage in the stress appraisal process when they experienced less task-irrelevant positive affect and greater task-relevant positive affect. Both task-irrelevant and task-relevant negative affect were not found to influence the stress appraisal process.

Diagnosing premenstrual dysphoric disorder: the reliability of a structured clinical interview.

Premenstrual dysphoric disorder (PMDD), a diagnosis included for further study in the DSM-IV-TR (American Psychiatric Association 2000), lacks a structured interview. The reliability of a Structured Clinical Interview for DSM-IV-TR-Defined PMDD (SCID-PMDD) was assessed with 96 participants who spanned the full range of premenstrual problems. All individual SCID-PMDD items had high inter-rater agreement, and the overall reliability of diagnosis was high (kappa = 0.96). The SCID-PMDD provides a structured, sensitive, and reliable measure of the symptoms and impairment criteria for PMDD.

Promoting colorectal cancer screening in public health outreach campaigns.

OBJECTIVE: Research on public outreach campaigns is presented. BACKGROUND: One study examines the effects of instruction design on adherence to cancer self-screening instructions. A second study examines the effect of persuasive announcements on increasing screening campaign participation. METHOD: The first study examined adherence to screening (operationalized as returning results for evaluation) given standard instructions, or one of three other versions: persuasive, human factored, or a combination of the two.The second study investigated combining persuasion with a campaign announcement to increase participation (operationalized as picking up a test kit). RESULTS: The first study found that among first-time participants, the persuasive and human-factored instructions evoked higher result return rates than did the standard. The second study found that participation was significantly increased by adding persuasion to the campaign announcement. CONCLUSION: Enhancing motivation and reducing cognitive barriers increase adherence to test instructions and increase participation. APPLICATION: These are simple, cost-effective strategies that increase adherence to cancer screening in public outreach campaigns,which may reduce cancer-specific mortality.

A field test of the effects of instruction design on colorectal cancer self-screening accuracy.

A field experiment tested whether instruction design improves accurate adherence to instructions for medical do-it-yourself tests like the Fecal Occult Blood Test (FOBT). As part of an outreach campaign, 16,073 participants received FOBTs with instructions that were (i) human factored, (ii) motivational, (iii) human factored/motivational combined, or (iv) the standard used in the past. Among all test results returned (N = 2483), only the human factors instructions reduced errors in filling out result cards. However, after post-validating result cards that had errors, the human-factored, motivational and merged instructions reduced errors. The present findings show that medical instructions designed with human factors and persuasion principles increase accurate adherence. These design principles provide simple and cost-effective ways to increase test taking accuracy and FOBT effectiveness. Better screening instructions can improve the chances of detecting colorectal cancer early, which may help to decrease cancer mortality.

Matching health messages to monitor-blunter coping styles to motivate screening mammography.

This study examined whether providing messages matched to women's monitor-blunter coping styles is effective in encouraging mammography utilization. Female callers to a cancer information hotline were assessed at the end of their regular telephone call and classified as monitors or blunters. A randomly assigned message promoting mammography utilization, tailored for monitors or blunters, was delivered on the telephone, and a similarly tailored brochure and refrigerator magnet were mailed to participants immediately after their call. Women were telephoned 6 and 12 months later to determine whether they had obtained a mammogram. Messages matched to a woman's monitor-blunter coping style encouraged mammography after 6 months more effectively than mismatched messages and were significantly more effective for blunters but not for monitors.

Message framing and pap test utilization among women attending a community health clinic.

In a randomized experiment, women (N = 441) watched either a loss- or gain-framed video emphasizing the prevention or detection functions of the Pap test to test the hypothesis that loss- and gain-framed messages differentially influence health behaviors depending on the risk involved in performing the behavior. As predicted, loss-framed messages emphasizing the costs of not detecting cervical cancer early (a risky behavior) and gain-framed messages emphasizing the benefits of preventing cervical cancer (a less risky behavior) were most persuasive in motivating women to obtain a Pap test.

Matching health messages to information-processing styles: need for cognition and mammography utilization.

The use of tailored health communications has become a favored technique for persuading individuals to engage in health behaviors, such as screening mammography. This experiment examined the impact of tailoring persuasive health communications to one aspect of individuals' information-processing styles, that of the need for cognition (NFC), the enjoyment of thinking deeply about issues. To determine whether messages matched to an individual's NFC are more influential than mismatched messages, 602 women who called the Cancer Information Service (CIS) of the National Cancer Institute were asked to participate in an experiment at the end of their service call. They were assigned randomly to receive 1 of 2 phone messages promoting mammography use and a similarly tailored pamphlet 1 month later. Messages matched to an individual's NFC were better at motivating mammography 6 months later among high-NFC women. After controlling for prior mammography utilization, age, worry, intentions, perceived norms, suggestions to get a mammogram, and marital status, the interaction between participant NFC and message type also approached statistical significance. The differential influence of these brief, tailored communications diminished after 12 months, however.

A source of error in self-reports of pap test utilization.

The prevention and early detection of cervical cancer is achieved through women's regular use of Pap tests. Ascertaining adherence to Pap screening guidelines is often based on self-report, which may be unreliable. This study examined the reliability of Pap test self-reports and one potential source of error in them. We predicted that women having any gynecological examination (other than Pap tests) would falsely report having had a Pap test more often than women who had not experienced gynecological procedures. We compared self-reported Pap test utilization with medical records among 161 low-income women. Women with no Pap test in their medical record but who had experienced other gynecological procedures falsely reported a Pap test significantly more often than those women who actually received a Pap test or who had not received any gynecological procedure. Confusion over what type of gynecological procedures these women received could result in their under-utilization of Pap tests. Further, these findings question the validity of study findings based only on self-reported outcomes.