This study aimed to develop cross-domain deep learning courses of artificial intelligence in vocational senior high schools and explore its impact on students’ learning effects. It initially adopted a literature review to develop a cross-domain SPOC-AIoT Course with SPOC and the Double Diamond 4D model in vocational senior high schools. Afterward, it adopted participatory action research and a questionnaire survey and conducted analyses on the various aspects of the technology acceptance model by SmartPLS. Further, this study explored the impact on (...) the effects of deep learning and knowledge-ability learning of artificial intelligence after 16 weeks of course teaching among 36 Grade I students from the electrical and electronic group of a vocational senior high school. This study revealed that the four stages of the SPOC-AIoT Teaching Mode of the Double Diamond 4D model may effectively guide students to learn AIoT knowledge and skills. Based on the technology acceptance model, the analysis of learning and participation in SmartPLS indicated that this model conformed to the academic fitness requirements of the overall model. After learning with the SPOC-AIoT Teaching Mode, the learning effects of students in AIoT have been significantly improved to a positive aspect. Finally, some suggestions were put forward to promote the development of the SPOC-AIoT Teaching Mode Course in the future. (shrink)

Building on research that analyzes how social relations and networks shape the Chinese market, this article asks a less-studied question: How is the market changing guanxi? The authors trace the transformation of guanxi from communal, kin-based ties to a cultural metaphor with which diverse individuals build flexible social relationships in late-socialist China. As a “generalized particularism,” this cultural metaphor provides something analogous to the culture of civility in Western societies. The authors discuss the political potential of guanxi in terms of (...) its dual tendency toward the “publicization” and “privatization” of power. The development of guanxi civility suggests the diverse cultural origins of civility and serves as a reminder of the particularistic roots in the universalistic assumption of Western civility. (shrink)

Elite domination is recognized as a significant downside of “linking social capital,” but its remedies are under-theorized and scarcely documented. Addressing this gap, we argue that bonding or bridging ties characterized by strong reflexivity, awareness of the state’s symbolic violence, and rich cultural resources for cross-fertilization serve as countervailing mechanisms against unresponsive linking ties. If bonding and bridging ties lack these characteristics, even when those ties are numerous, they are unlikely to challenge unresponsive linking ties. Our theoretical argument is substantiated (...) through a three-village comparison in Taiwan during the post-Typhoon Morakot reconstruction period, where linking ties among most disaster areas, state agencies, and large NGOs were deployed to promote elite agendas. Based on forty-five in-depth interviews, our findings suggest that in Namaxia, where all three features identified in our framework were absent in bonding and bridging ties, grassroots resistance against unresponsive linking ties largely failed. In Jialan, bonding networks displayed strong social reflexivity, but neither bonding nor bridging ties cultivated awareness of the state’s symbolic violence or cultural resources for cross-fertilization. The village only partially succeeded in challenging unresponsive linking ties. In Ali, where local bonding and bridging networks developed all three features mentioned above, the village successfully transformed unresponsive linking ties. The conceptual delinking of network homogeneity/heterogeneity and exclusivity/inclusivity in this study bears broader implications for social capital theories. (shrink)

Scholars have established that cultural codes and styles of expression in civil society must be recognized as informal mechanisms of exclusion, calling into question the possibility of the Habermasian normative ideal of the public sphere. This article joins theoretical discussions of how to remedy this problem. Going beyond Alexander's model of "multicultural incorporation" and borrowing from Sewell's theory of the duality of structure, we develop a theoretical framework of code hybridization to conceptualize how civil society participants achieve civil solidarity amid (...) multiple, potentially contradictory cultural legacies. Code hybridization is a process whereby social actors not only incorporate the cultural codes of subordinate groups into the public sphere, but in doing so also potentially transform dominant codes. We conceptualize code hybridization in terms of three analytic steps: enlargement of the terrains of signification; reinterpretation of codes; and mixing of schemas. The resulting hybridized schemas and frameworks are particularly useful cultural tools for developing visions of civil inclusiveness for young, unstable civil societies. Using a brief comparative study of the representation of women in political cartoons in Hong Kong and Taiwan, we offer a concrete example of code hybridization—a process linking the codes of liberty and caring while producing alternative and more inclusive narratives during moments of political agitation. (shrink)

Schizophrenia is considered as a self-disorder with disordered local synchronous activation. Previous studies have reported widespread dyssynchrony of local activation in patients with SZ, which may be one of the crucial physiological mechanisms of SZ. To further verify this assumption, this work used a surface-based two-dimensional regional homogeneity approach to compare the local neural synchronous spontaneous oscillation between patients with SZ and healthy controls, instead of the volume-based regional homogeneity approach described in previous study. Ninety-seven SZ patients and 126 HC (...) were recruited to this study, and we found the SZ showed abnormal 2dReHo across the cortical surface. Specifically, at the global level, the SZ patients showed significantly reduced global 2dReHo; at the vertex level, the foci with increased 2dReHo in SZ were located in the default mode network, frontoparietal network, and limbic network ; however, foci with decreased 2dReHo were located in the somatomotor network, auditory network, and visual network. Additionally, this work found positive correlations between the 2dReHo of bilateral rectus and illness duration, as well as a significant positive correlation between the 2dReHo of right orbital inferior frontal gyrus with the negative scores of the positive and negative syndrome scale in the SZ patients. Therefore, the 2dReHo could provide some effective features contributed to explore the pathophysiology mechanism of SZ. (shrink)

Anti-intellectualists claim that knowledge-how requires at least a corresponding ability or performance success that includes non-intellectual components. They argue that an insistence on the close relationship between knowledge-how and performance success is needed to account for our intuitions on the practical aspects of knowledge-how. In this paper, we examine three main anti-intellectualist proposals for what constitutes performance success, those of Hawley, Noë, and Kumar, and argue that all of them are non-informative in a practical manner. We further point out that (...) the problem of non-informativeness is dominant in anti-intellectualism. (shrink)

There has been some research conducted regarding nurses’ career success aimed at exploring its influencing factors, but there is no research on the mechanism of self-identity on the career success of infection control nurses. In order to further explore the formation mechanism of career success of nurses, we conducted our study using the Kaleidoscope Career Model to explore the chain-mediating effects of cognitive emotion regulation and social support between self-identity and career success. Five hundred forty-seven infection control nurses from nine (...) different hospitals participated in the study and completed questionnaires on the self-identity, cognitive emotion regulation, social support, and career success scales. The results from structural equation modeling reveal that self-identity has a positive effect on positive emotion regulation and social support and a negative impact on negative emotion regulation. Positive emotion regulation has a positive effect on social support. All antecedents have a positive impact on career success except negative emotion regulation, which has a negative one. Bootstrap analysis shows that the relationship between self-identity and career success is partially mediated by the chain of cognitive emotion regulation and social support. Overall, our research sheds light on the mechanism of self-identity on career success of nurses. Theoretical and practical implications are discussed. (shrink)

AimOur study aimed to investigate the effect of social responsibility on the subjective well-being of volunteers for COVID-19 and to examine the mediating role of job involvement in this relationship.BackgroundNowadays, more and more people join volunteer service activities. As we all know, volunteer work contributes to society without any return. Volunteers often have a strong sense of social responsibility and reap subjective well-being in their dedication. Although research shows that social responsibility will drive them to participate in volunteer work actively, (...) it is less clear whether job involvement will impact their subjective well-being.MethodsThe data were collected in the precaution zone in Shanghai, China, from April to May 2022. A sample of 302 volunteers for COVID-19 completed the social responsibility scale, subjective well-being scale and job involvement scale in the form of an electronic questionnaire on their mobile phones. A structural equation model was adopted to verify the research hypotheses.ResultsSocial responsibility was significantly and positively related to volunteers’ subjective well-being and job involvement. Job involvement fully mediates the relationship between volunteers’ social responsibility and subjective well-being.ConclusionSocial responsibility is critical to predicting volunteers’ subjective well-being. Job involvement plays an intervening mechanism in explaining how social responsibility promotes volunteers’ subjective well-being. (shrink)

The hierarchically nested structure is widely observed in a broad range of real systems, encompassing ecological networks, economic and trade networks, communication networks, among many others. However, there remain statistical challenges of the prevalence of nestedness. In response to this problem, we focus on the effect of incomplete information and the inputted matrix size, the role of network density and degree sequences, and the relevance of degree-degree correlation to conduct systematic research on the significance of the nested structure according to (...) multiplex world trade networks. Firstly, the nested structure can observe significantly when suffering incomplete information and varying inputted matrix size. Secondly, to analyze the role of network density and degree sequences in nested structure, we use “swappable rows, swappable columns” null model which conserves the network size and density, and “fixed in-degree, fixed out-degree” null model which not only preserves the network size and density but also keeps node degree to do randomization tests of nestedness. The randomizations of two null models remark that most nested structures are not determined by network density and degree sequences but closely related to them. Finally, we investigate degree-degree correlation in nested networks, and the results show that the nested structure is negatively related with degree-degree correlation of the network. Following the empirical analysis train of thought, we argue that nestedness is still a unique feature of the network. (shrink)

Balancing Change and Tradition in Global Education Reform is an invaluable resource for policymakers, faculty, students, and anyone interested in how decisions made about the education system ultimately affect the quality of education, educational access, and social justice.

This cross-sectional study, which included men aged 20–40 years, aimed to determine the relationships among type D personality, depressive symptoms and lower urinary tract symptoms in young men. An internet-based questionnaire was administered, and General demographics, International Prostate Symptom Scores, Type D Scale-14 scores, and Depression and Somatic Symptom Scale scores were analyzed. A total of 3,127 men were included; of these, 762 reported moderate/severe lower urinary tract symptoms, and 1,565 met the criteria for type D personality. Men with type (...) D personality had significantly higher body mass index and total and sub-scores for the International Prostate Symptom Score and Depression and Somatic Symptom Scale. Furthermore, the type D personality group had a higher prevalence of lower urinary tract symptoms, particularly voiding symptoms. Univariate analysis revealed that all parameters, except for body mass index, were significant predictors of moderate/severe lower urinary tract symptoms. Multivariate analysis showed that age >30 years, type D personality, and depressive and somatic Depression and Somatic Symptom Scale sub-scores were independent predictors of moderate/severe lower urinary tract symptoms. Regarding Type D Scale-14 subscales, social inhibition, rather than negative affectivity, impacted moderate/severe lower urinary tract symptoms. Mediation analysis revealed that depressive symptoms mediated the relationship between type D personality and lower urinary tract symptoms. This study established correlations between type D personality, depressive symptoms, and lower urinary tract symptoms. As previous studies suggested that patients with type D personality are less likely to consult and adhere to treatment, and are at higher risk for depression, urologists should therefore actively recognize patients with TDP. (shrink)

In this paper, according to the perspective of customers and products, by using clustering analysis and association rule technology, this paper proposes a cross-marketing model based on an improved sequential pattern mining algorithm, where an improved algorithm AP is applied. The algorithm can reduce the time cost of constructing a projection database and the influence of the increase of support on the algorithm efficiency. The improved idea is that when the first partition is used to generate the projection database, the (...) number of itemsets in the projection database is sorted from small to large, and when the second partition is used, the sequence patterns are generated directly from the mined sequence patterns, so as to reduce the construction of the database. The experimental results show that this method can quickly mine the effective information in complex data sets, improve the accuracy and efficiency of data mining, and occupy less memory consumption, which has good theoretical value and application value. (shrink)

We have been using feather development as a model for understanding the molecular basis of pattern formation and to explore the roles of homeoproteins, retinoids and adhesion molecules in this process. Two kinds of homeobox (Hox) protein gradients in the skin have been identified: a ‘microgradient’ within a single feather bud and a ‘macrogradient’ across the feather tract. The asynchronous alignment of different Hox macrogradients establishes a unique repertoire of Hox expression patterns in skin appendages within the integument, designated here (...) as the ‘Hox codes of skin appendages’. It is hypothesized that these Hox codes contribute to the phenotypic determination of skin appendages. High doses of retinoic acid cause a morphological transformation between feather and scale, while low doses of retinoic acid cause an alteration of the axial orientation of skin appendages. We have tested the ability of molecules directly involved in the feather formation process to mediate the action of the Hox codes, and surmise that adhesion molecules are potential candidates. Using specific Fabs to suppress the activity of adhesion molecules, we have found that L‐CAM is involved in the formation of the hexagonal pattern, N‐CAM is involved in mediating dermal condensations, tenascin is involved in feather bud growth and elongation, and integrin β‐1 is essential for epithelial‐mesenchymal interactions. More work is in progress to fully understand the molecular pathways regulating the feather formation process. (shrink)

Meta-analytical research has demonstrated the benefits brought by telecommuting to wellbeing. However, we argue that such a setup in the course of the coronavirus disease pandemic exerts negative effects. On the basis of conservation of resources theory, this study determined how telecommuting depletes wellbeing through obstructing psychological detachment from work. Moreover, we incorporated family interfering with work and family–work enrichment as moderators that can buffer the negative effect of telecommuting on psychological detachment from work. Time-lagged field research was conducted with (...) 350 Chinese employees, and findings largely supported our theoretical hypotheses. The elevated level of telecommuting results in minimal psychological detachment from work, which then leads to low wellbeing. Meanwhile, the negative effect of the extent of telecommuting on psychological detachment from work is reduced by family interfering with work. These findings extend the literature on telecommuting and psychological detachment from work through revealing why teleworkers present negative feelings during the pandemic. (shrink)

Problematic smartphone use is an expanded public health heed that requires more study to clarify the influence elements of different populations. The aim of this study was to investigate the relationship between smartphone use, and sleep quality, self-perceived health, and exercise participation in university students. A total of 1,575 Taiwanese undergraduate students from 7 universities participated in the study. Three questionnaires were completed by the study individuals. The results show the overall PSU rate was 11.8%. Average smartphone users were more (...) likely to feel in good health, better sleep quality and less unsatisfactory exercise participation than those who were problematic smartphone users. Multiple logistic regression analysis indicated that PSU, low weekly exercise frequency, and poor sleep quality were significant indicators of poor self-perceived health. We concluded that both low physical activity and PSU did have negative impacts on self-perceived health and sleep quality for undergraduate students. (shrink)

This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to cultural relativism by (...) construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)

This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to cultural relativism by (...) construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)

This study introduces visual cognition into Lithium-ion battery capacity estimation. The proposed method consists of four steps. First, the acquired charging current or discharge voltage data in each cycle are arranged to form a two-dimensional image. Second, the generated image is decomposed into multiple spatial-frequency channels with a set of orientation subbands by using non-subsampled contourlet transform. NSCT imitates the multichannel characteristic of the human visual system that provides multiresolution, localization, directionality, and shift invariance. Third, several time-domain indicators of the (...) NSCT coefficients are extracted to form an initial high-dimensional feature vector. Similarly, inspired by the HVS manifold sensing characteristic, the Laplacian eigenmap manifold learning method, which is considered to reveal the evolutionary law of battery performance degradation within a low-dimensional intrinsic manifold, is used to further obtain a low-dimensional feature vector. Finally, battery capacity degradation is estimated using the geodesic distance on the manifold between the initial and the most recent features. Verification experiments were conducted using data obtained under different operating and aging conditions. Results suggest that the proposed visual cognition approach provides a highly accurate means of estimating battery capacity and thus offers a promising method derived from the emerging field of cognitive computing. (shrink)

This study provides an overview of social media usage among researchers in Malaysia and examines factors affecting their use for science communication. The online questionnaire gathered the opinions of 425 researchers from over 20 science disciplines. The descriptive analysis highlighted usage preferences for 10 commonly used social media, while statistical analysis in particular MANOVA and correlation analysis, identified significant factors influencing researchers’ social media use. Up to 62% of respondents believe that social media is more effective in reaching the public, (...) compared to other media. WhatsApp, Facebook, YouTube, Google Scholar, and ResearchGate are routinely used or perceived as beneficial to use. However, Twitter, Instagram, WordPress, and LinkedIn are seldom used because they are less preferred for science communication. Seniority, perceived importance, and perceived credibility are significantly correlated with both intention and actual use. Meanwhile, age and experience are significantly correlated with actual use, but not the intention. Researchers are likely to post and share more on social media if they believe that science communication is important or if they are credible enough to present a scientific consensus. This study offered important insights into the perceptions, concerns, and factors influencing their use for science communication. By determining the perceptions, concerns and motivators affecting researchers, the findings shed light on effective ways to promote researchers’ use of social media to communicate scientific knowledge. (shrink)

In the paper, several data reduction techniques for machine learning from big datasets are discussed and evaluated. The discussed approach focuses on combining several techniques including stacking, rotation, and data reduction aimed at improving the performance of the machine classification. Stacking is seen as the technique allowing to take advantage of the multiple classification models. The rotation-based techniques are used to increase the heterogeneity of the stacking ensembles. Data reduction makes it possible to classify instances belonging to big datasets. We (...) propose to use an agent-based population learning algorithm for data reduction in the feature and instance dimensions. For diversification of the classifier ensembles within the rotation also, alternatively, principal component analysis and independent component analysis are used. The research question addressed in the paper is formulated as follows: does the performance of a classifier using the reduced dataset be improved by integrating the data reduction mechanism with the rotation-based technique and the stacking? (shrink)

In his 1987 article “Indeterminacy, Empiricism and the First Person”, John Searle argues that we actually know what we mean; therefore, W. V. O. Quine’s thesis of the indeterminacy of translation must be wrong. In this paper, I will try to identify the mistakes in Searle’s criticism of Quine’s story. I will argue that Quine’s indeterminacy thesis can be construed as containing two theses- that is, the immanent indeterminacy and the transcendent indeterminacy. With these two indeterminacies in mind, Quine’s indeterminacy (...) thesis will still remain tenable even if we actually know what we mean. (shrink)

In his 1987 article “Indeterminacy, Empiricism and the First Person”, John Searle argues that we actually know what we mean; therefore, W. V. O. Quine’s thesis of the indeterminacy of translation must be wrong. In this paper, I will try to identify the mistakes in Searle’s criticism of Quine’s story. I will argue that Quine’s indeterminacy thesis can be construed as containing two theses- that is, the immanent indeterminacy and the transcendent indeterminacy. With these two indeterminacies in mind, Quine’s indeterminacy (...) thesis will still remain tenable even if we actually know what we mean. (shrink)

The purpose of this study was to develop and empirically test a model for predicting the key factors affecting nurses’ behavioral intention to use mobile learning. We explored behavioral intention from users’ perspectives by applying an extended unified theory of acceptance and use of technology model with the addition of information quality, system quality, technostress, and satisfaction. We conducted a survey of the district and regional hospitals in central Taiwan. Data were derived from 434 respondents. Structural equation modeling was applied (...) to analyze the causal effects of 15 hypothesized predictive factors. We determined that satisfaction, social influence, performance expectancy, facilitating conditions, and effort expectancy positively impacted nurses’ behavioral intention to use m-learning. In addition, technostress was a negative antecedent of effort expectancy. Information quality and system quality had significantly positive effects on satisfaction, performance expectancy, and effort expectancy. This study provides hospital managers with a reference when assessing future developments and informs approaches to promote m-learning. (shrink)

As social entrepreneurial intention has received increasing attention from scholars and practitioners, no clear conclusions have been drawn regarding antecedent or external factors that influence social entrepreneurial intention. This study aims to develop a structural model to shape the social entrepreneurial intention of business administration students, which involves the theory of planned behavior, social capital, individual environmental responsibility, and individual absorptive capacity. Furthermore, this study regards potential absorptive capability as a multi-dimensional construct of a higher-order structure. The participants were students (...) from business administration colleges/universities in Taiwan. The empirical data from 969 participants were analyzed using Smart PLS 3.0 to obtain the results. The results revealed that: social capital had a significant positive effect on attitudes and subjective norms; attitudes, subjective norms, individual environmental responsibility, and realized absorptive capability had a positive effect on social entrepreneurial intention; however, social capital and potential absorptive capability had a negative effect. The results were discussed, and some specific recommendations for practitioners of business administration education were proposed. (shrink)

本书对儒家“内圣外王之道”的探索,注重以儒家经典为依据,以传统范畴为线索,按照儒家“内圣外王之道”的实际内容及其内在逻辑确立本书的理论架构。.

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)