Cognitive control level of action for analyzing verbal reports in educative clinical simulation situations.

BACKGROUND: Several methods and theoretical frameworks have been proposed for efficient debriefing after clinical simulation sessions. In these studies, however, the cognitive processes underlying the debriefing stage are not directly addressed. Cognitive control constitutes a conceptual link between behavior and reflection on behavior to apprehend debriefing cognitively. OBJECTIVES: Our goal was to analyze cognitive control from verbal reports using the Skill-Rule-Knowledge model. This model considers different cognitive control levels from skill-based to rule-based and knowledge-based control. DESIGN: An experiment was conducted with teams of nursing students who were confronted with emergency scenarios during high-fidelity simulation sessions. SETTINGS: Participants' descriptions of their actions were asked in the course of the simulation scenarios or during the debriefing stage. PARTICIPANTS: 52 nursing students working in 26 pairs participated in this study. METHODS: Participants were divided into two groups: an "in situ" group in which they had to describe their actions at different moments of a deteriorating patient scenario, and a "debriefing" group, in which, at the same moments, they had to describe their actions displayed on a video recording. In addition to a cognitive analysis, the teams' clinical performance was measured. RESULTS: The cognitive control level in the debriefing group was generally higher than in the in situ group. Good team performance was associated with a high level of cognitive control after a patient's significant state deterioration. CONCLUSIONS: These findings are in conformity with the "Skill-Rule-Knowledge" model. The debriefing stage allows a deeper reflection on action compared with the in situ condition. If an abnormal event occurs as an adverse event, then participants' mental processes tend to migrate towards knowledge-based control. This migration particularly concerns students with the best clinical performance. Thus, this cognitive framework can help to strengthen the analysis of verbal reports.

Door-in-the-Face and But-You-Are-Free: Testing the Effect of Combining Two No-Pressure Compliance Paradigms.

According to Howard's proposal of chaining compliance techniques and based on the proximity of interpretation of their effects, this study aimed to test a combination of two paradigms: a door-in-the-face request that makes a high-cost request before the target request and the but-you-are-free request that adds an evocation of freedom to the request. Two experiments were conducted (N = 120 and 1,292) to promote donations to non-profit organizations. There were four conditions. Participants were approached according to the door-in-the-face procedure, to the but-you-are-free procedure, to a combination of both of them, or directly in a control condition. There was an increase of compliance rates in experimental conditions compared to the control condition and an increase in the average amount donated in the combination condition compared to the control condition in the second study. Results are discussed in terms of responsibility and guilt mechanisms, and future developments are proposed.

A pedestrian's smile and drivers' behavior: When a smile increases careful driving.

INTRODUCTION: Research has reported that smiles facilitate social relationships. However, the effect of a smile on driving behavior has received less interest. METHOD: This study attempts to evaluate how a pedestrian's smile influences an oncoming driver's behavior. In the first part of our study, male and female research assistants waiting at several pedestrian crossings were asked to smile or not at oncoming drivers. RESULTS: It was found that a smile increases the number of drivers who stop. The same effect was observed when the pedestrian tries to cross outside the pedestrian crossing. Finally, this study shows that motorists drive slower after they see a pedestrian smile, suggesting that a smile can induce a positive mood. PRACTICAL APPLICATIONS: This leads to motorists stopping more readily and driving more carefully. These results also suggest that pedestrians may increase their own safety by using appropriate nonverbal signals toward drivers.

Promising reciprocity: When proposing a favor for a request increases compliance even if the favor is not accepted.

Research has reported that reciprocity is an important social norm in relationships. In previous studies on reciprocity, participants' behavior was examined after receiving a favor from someone. In a series of field studies, we examined the effect of a statement that proved that a solicitor was someone who respected this principle. Confederates solicited participants for money or a cigarette in exchange for stamps or money, respectively. It was found that the participants complied more readily with the request in the promised favor condition, but most of them refused to take the promised favor. We conclude that individuals were led to help those who respected the putative norm of reciprocity in their social interaction.

The effect of priming with a love concept on blood donation promise.

This field study on blood donor behavior tests the effectiveness of semantic priming on donor intention and commitment. Using face-to-face interactions, participants were primed with the concept of love and solicited to promise blood to the French National Blood Bank. Results showed a significant effect on willingness to donate blood and on donor commitment. The relatively simple and easily implemented technique used in this study could be of interest in improving performance of recruitment and retention campaigns.

Words as environmental cues: the effect of the word "loving" on compliance to a blood donation request.

In a field setting, students (N = 3600) on different campus locations were solicited to give blood during a special one-day drive. Solicitations were made through face-to-face interactions. The solicitors wore a white T-shirt with different inscriptions: no inscription, Loving = Helping, Donating = Helping. Results showed that, when compared to the no inscription condition, the number of donors increased when the solicitor-confederates wore the T-shirt Loving = Helping whereas no effect was found when the confederates wore the T-shirt Donating = Helping. The activation spreading theory is used to explain these results. The practical application of these results for blood donation drives and other health-related fundraising events is explored.

Mimicry and helping behavior: an evaluation of mimicry on explicit helping request.

Research found that mimicry behavior led to increased helping behavior toward the mimicker and is associated with higher positive evaluation of the mimicker. Furthermore, studies on helping behavior focused only on implicit helping behavior, whereas no experimental study on explicit helping request was tested. An experiment was carried out in which a female student-confederate mimicked or not mimicked a participant during a discussion about paintings and, after that, solicited the participant for a written feedback about an essay. It was found that mimicry increased compliance to the confederate's request.

Similarity and social interaction: when similarity fosters implicit behavior toward a stranger.

People interact more readily with someone whom they think they have something in common with. At a pedestrian crossing, confederates asked participants for the time and, in one condition, said she/he had the same watch as the participant. The amount of time that participants lingered near a confederate was used as the dependent variable. Participants in the similarity condition spent significantly more time near the confederate than when no similarity was manipulated. The results showed that similarity fosters implicit behavior, adding to the growing body of data on the positive effects of similarity and its role in social interaction.

Improving medication adherence by using practitioner nonverbal techniques: a field experiment on the effect of touch.

Though the positive effect of touch on compliance has been widely reported in the social psychology literature, a new evaluation has been made in a health setting. Six general practitioners were instructed to touch (or not) their patients on the forearm for 1-2 s. Patients who suffered from mild pharyngitis were solicited by the practitioners at the end of the consultation for a verbal promise to take the antibiotic medication as prescribed. One week later, patients were contacted at home to determine the number of pills that had been taken and to evaluate the practitioner. Touch increased medication adherence in both male and female patients, but was associated with a greater increase in male patients. It was also found that practitioners were perceived to be more concerned about their patients by those in the touch condition. Practitioner competence appeared to be slightly higher in the touch condition. The theoretical implications of this positive effect of tactile contact are discussed and the practical interest for practitioners is highlighted, showing how this nonverbal technique could help them to increase the medication adherence of their patients.