The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice‐based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt (...) “on the job.” We suggest that learning “on‐the‐job” is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the “invisible learning” which occurs as newly qualified nurses learn to delegate and supervise. (shrink)

Psychologists have traditionally approached phenomenology by describing perceptual states, typically in the context of vision. The control of actions has often been described as 'automatic', and therefore lacking any specific phenomenology worth studying. This article will begin by reviewing some historical attempts to investigate the phenomenology of action. This review leads to the conclusion that, while movement of the body itself need not produce a vivid conscious experience, the neural process of voluntary action as a whole has distinctive phenomenological consequences. (...) The remainder of the article tries to characterise this phenomenology. First, the planning of actions is often conscious, and can produce a characteristic executive mode of awareness. Second, our awareness of action often arises from the process of matching what we intended to do with what actually happened. Failures of this matching process lead to particularly vivid conscious experience, which we call 'error awareness'. These features of action phenomenology can be directly related to established models of motor control. This allows an important connection between phenomenology and neuroscience of action. Third, whereas perceptual phenomenology is normally seen as caused or driven by the sensory stimulus, a much more fluid model is required for phenomenology of action. Several experimental results suggest that phenomenology of action is partly a post hoc reconstruction, while others suggest that our awareness of action represents an integration of several processes at multiple levels of motor processing. Fourth, and finally, studies of the phenomenology of action, unlike those of perception, show a strong linkage between primary awareness and secondary awareness or self-consciousness: awareness of action is specifically and inextricably awareness of my action. We argue that the concepts of agency and of proprioaction are fundamental to this linkage. For these reasons, action represents a much more promising field than perception for attacking the problematic question of the relation between primary and secondary consciousness. Some promising directions for future research are indicated. (shrink)

The control of action has traditionally been described as "automatic". In particular, movement control may occur without conscious awareness, in contrast to normal visual perception. Studies on rapid visuomotor adjustment of reaching movements following a target shift have played a large part in introducing such distinctions. We suggest that previous studies of the relation between motor performance and perceptual awareness have confounded two separate dissociations. These are: (a) the distinction between motoric and perceptual representations, and (b) an orthogonal distinction between (...) conscious and unconscious processes. To articulate these differences more clearly, we propose a new measure of motor awareness, based on subjects' ability to reproduce the spatial details of reaching movements they have just made. Here we focus on the dissociation between motor awareness and perceptual awareness that may occur when subjects make rapid visuomotor adjustments to reaching movements following a target shift. In experiment 1, motor awareness was dissociated from perceptual awareness of a target shift during reaching movement. Participants' reproduction of movement endpoints following visuomotor adjustment was independent of whether they saw the target shift or not. Experiment 2 replicated this result, and further showed that neither motor awareness nor motor performance were disrupted by TMS over the parietal cortex. The neural mechanisms underlying motor awareness, and the implications for theories of consciousness, are discussed. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

In Foreign Native, RW Johnson looks back with affection and humour on his life in Africa. From schooldays in Durban -- fresh off the boat from Merseyside -- to later years as an academic, director of the Helen Suzman Foundation and formidable political commentator, he has produced an entertaining and occasionally eye-popping memoir brimming with history, anecdote and insight. Johnson charts his evolution from enthusiastic, left-leaning Africanist to political realist, relating the episodes that influenced his intellectual worldview, (...) including time spent among the exiled liberation movements in London during the 1960s, a sojourn in newly independent Guinea and more recent forays into Zimbabwe. There are wonderful stories, some hilarious, others filled with pathos, about the multitude of characters Harold Strachan, Tom Sharpe, Ronnie Kasrils, Helen Suzman, Frederik van zyl Slabbert, among many others that he met along the way. Perceptive, critical and full of verve, Foreign Native is leavened with a deep humanity that makes it a pleasure to read. (shrink)