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New Study Suggests That Fatigue is Most Detrimental for the Narrative Mind

I'm one of the authors on a new study by Dr. Mustafa Ozkaynak's research team, which looks at how emergency department (ED) nurses change their decision-making process when they become fatigued. In a previous paper , we found that fatigue was common in ED nurses, particularly toward the end of their work shift, and that nurses' fatigue was more often characterized as physical rather than mental or emotional -- in other words, this really represented being physically tired  at the end of the day, not being burned-out or depressed. Nevertheless, physical fatigue has important effects on nurses' decision-making in the ED. Based on nurses' qualitative reports, fatigue has mixed effects on their clinical performance. Nurses said that they definitely cut corners when they were tired, for example in terms of documentation in the electronic health record. They felt that they were less careful about double-checking things, and might be more likely to make snap decisions. We...
Recent posts

How Should We Now Talk About Vaccines?

Vaccines have emerged as a hot topic for Federal policy-making this year -- in particular, the positions and beliefs that last year would have been called "vaccine hesitancy" -- and that's the topic I am revisiting this week. Accordingly, t his seems like a good time to state that I write this blog as an individual scholar and a concerned American citizen, not directly as part of my faculty assignment at the University of Colorado. (Nobody in academia will be surprised that what actually counts for my annual review is peer-reviewed journal articles, and that public-facing communication is viewed as a potential distraction!) I greatly appreciate the university as an environment for my research, and the laws of the Regents of the University of Colorado that support free speech and academic freedom. But it's also important to note that my writing here is separate from my teaching and my funded research programs, and in no way reflects any official position of the univers...

What Years of Anxiety Taught Me About Balancing Two Minds

  Guest post by Dr. Britt Ritchie, DNP, PMHNP-BC   First, a huge thank-you to Dr. Paul Cook for inviting me to contribute here. Paul was my Division Chair when I worked at the University of Colorado (CU) as an assistant professor. During that time, he saw me at one of my most vulnerable points—grappling with anxiety so intense it almost made me abruptly quit my job. I knew it was social anxiety—the kind of fear marked by an overwhelming sense of being judged, embarrassed, or humiliated in front of others—but knowing the label didn’t make it any easier to manage in the moment. Because of that shared history, it feels especially fitting to write about my experience lecturing during my time at CU through the lens of Paul’s Two Minds Theory. I can still picture the lecture hall—the rows of students, the humming projector, the fluorescent lights that were both too hot and too bright. On paper, I was prepared. I had spent hours rehearsing, editing slides, and reviewing notes. ...

Self-Determination Theory Through the Lens of Two Minds

  Self-determination theory  (SDT) is a framework for understanding human motivation. It gained a great deal of popularity as a possible explanation for the effects of motivational interviewing  (MI), although MI's primary creator William Miller has said that his understanding of MI is atheoretical . It is certainly the case that MI came about long before SDT was used to explain it. And it's also true that SDT was an established model with its own body of research before it was ever linked to MI. But Stephen Rollnick, Miller's co-author in his most important works on MI, has specifically said that he considers SDT to provide the theoretical explanation for MI's success. Deci and Ryan (2000) propose six "mini-theories" or propositions that together make up SDT: 1. intrinsic motivation  is a strong predictor of behavior, and is related to feelings of competence and autonomy. The intrinsic/extrinsic motivation distinction is an old one in psychology, reflecting ...

New Article Finds Different Effects of Protective versus Adverse Childhood Events

In a new article , my former nursing honors student Linda Driscoll Powers wrote about the measurement properties of a survey called PACES -- standing for Positive and Adverse Childhood Experiences Survey -- developed by Dr. Laurie Leitch. The instrument combines items from the widely used ACEs (Adverse Childhood Experiences) measure with a set of protective factors such as having a supportive family, having a positive relationship with an adult outside the family, or belonging to social groups like a team or a church. ACEs items have been found to predict a variety of health outcomes in adulthood , either directly or by way of social support , but positive childhood experiences are under-studied .  Besides having satisfactory psychometric properties (a stable factor structure, good internal consistency reliability, no evidence of response bias), the PACES items split cleanly into two independent subscales, one measuring positive experiences and the other measuring negative ones. ...

Is AI Out to Get Us?

 I wrote earlier this year about a disturbing report on the prospects of self-improving artificial intelligence (AI) models deciding to take over the world. Much of the fear around AI relates to something called the "alignment problem," which simply means that an AI model might have goals incompatible with human flourishing -- or in some dystopian scenarios, with human life itself. A classic example of this line of thought is the "paper clip problem," in which a superintelligent AI is tasked with making paper clips. Eventually every resource in the world -- including human beings -- becomes just another obstacle for it to overcome in its goal of transforming the entire universe into paper clips. So far, that's not the danger -- AI models don't have that level of direct control over the physical world (yet). But a couple of new developments in the past few months do  suggest that AI models are pursuing goals different from what their human designers might w...

Prototypes and Willingness: The Theory of Planned Behavior Revisited

  You may recall my blog post from last year on the Theory of Planned Behavior (TPB) , titled "in praise of a failed model." My evaluation of this model was that it accurately describes the Narrative Mind, which does control intentions. But the ultimate goal of the TPB is to predict behavior, and the relationship between intentions and behavior is weak at best -- in fact, it is entirely attributable to the fact that when someone says they don't intend to do something, they probably won't do it. When they say they do intend to do it, their actual results are no better than chance, a result of the intention-behavior gap as described in Two Minds Theory.  The full TPB is shown in this diagram: Cognitive constructs like attitudes, subjective norms, and perceived behavioral control (i.e., self-efficacy) are Narrative-system phenomena, and they do indeed have relationships with each other and with intentions (which are also products of the Narrative Mind). Perceived behavi...