With the creation of the European Higher Education Area, universities are undergoing a significant transformation that is leading towards a new teaching and learning paradigm. The competencies approach has a key role in this process. But we believe that the competence approach has a number of limitations and weaknesses that can be overcome and supplanted by the capabilities approach. In this article our objective is twofold: first, make a critical analysis of the concept of competence as it is being (...) used in higher education, identifying its limitations and weaknesses; and second, present the potential of the capabilities approach for higher education and review its complementarity to the competence approach.We begin with a brief characterisation of the capabilities approach and its implications for education. Then we examine some implications of the competencies approach in higher education and the reasons that led us to choose the DeSeCo proposal for comparison with the capability approach. We then go on to compare the two approaches, addressing 1) the aims of education and 2) the concept of competence and capability. Finally, we address the implications of incorporating the capabilities approach in learning and teaching in higher education. (shrink)

The central theme in the discussion of how education about religion can, and should, be developed in pluralistic societies concerns challenges and opportunities involving intercultural religious education (RE). One example is Robert Jackson’s report Signposts, commissioned by the Council of Europe, in which various aspects of intercultural competence are captured and made visible regarding a religious didactic context. Here, different dimensions of what can be described as ‘ethical competence’ appear to be central. In this article, the interpretive approach, strongly connected (...) with Jackson, is considered to be in need of a development of a theoretical framing of forceful strategies for handling ethical challenges taking place in multicultural, multireligious and multi-confessional classrooms. It is argued that such strategies will depend on a careful analysis of the concept of ethical competence. A theoretical platform for the argument is presented with reference to James Rest’s analysis of ethical competence, which is shown to be relevant to an examination of how the concept of ethical competence can contribute to the development of strategies for teaching intercultural RE. As a basis for this examination, the Danish, Finnish and Norwegian syllabuses for compulsory school RE are analysed regarding how they express conceptions of ethical competence. This selection shaped the curricular arena of the investigation as being non-confessional, whilst simultaneously, more or less explicitly, resting on a shared historical Protestant anchorage. This twofold interpretation is shown to allow for an analysis of ethical competence, in relation to which an identification of certain prerequisites for developing strategies for teaching intercultural RE is possible. (shrink)

Harvey Siegel argues that minimum competency testing (MCT) is incompatible with strong sense critical thinking. His arguments are reviewed and contrasted with positions held by John E. McPeck and Michael Scriven. Siegel's arguments seem directed against the prevailing form of MCT. However, alternative formats which allow for the aggregate and context-sensitive nature of critical thinking are not doomed to the arbitrariness Siegel finds. MCT may be a legitimate and useful means for furthering critical thinking as one of (...) our educational ideals. (shrink)

This critical review accomplished two main tasks: first, the article provides scope for identifying the most common conceptions of moral competence in the scientific literature, as well as the different ways to measure this type of competence. Having moral judgment is the most popular element of moral competence, but the literature introduces many other elements. The review also shows there is a plethora of ways to measure moral competence, either in standardized tests providing scores or other non-standardized tests. As (...) a second task, the article reflects critically on the general use of the idea of moral competence. Results suggest that this idea functions as what philosopher Bernard Williams would have called a thin ethical concept. Thin concepts are not problematic in and of themselves if they are used as linguistic shorthand, however, there may be shortcomings in the literature on moral competence because the idea is not rooted in more substantive views or theories in a way that is both clear and coherent. (shrink)

Analysis of Competing Hypotheses (ACH) promises a relatively objective and tractable methodology for ranking the plausibility of competing hypotheses. Unlike Bayesianism, it is computationally modest. Unlike explanationism, it appeals to minimally subjective judgments about relations between hypotheses and evidence. Yet the canonical procedures for ACH allow a certain kind of instability in applications of the methodology, by virtue of supporting competing rankings despite common evidential bases and diagnosticity assessments. This instability should motivate advocates of ACH to focus their efforts toward (...) creating structured methods for individuating items of evidence. (shrink)

Should the `irrational' refusal to consent to ECT of a depressed patient who knows he is thought to be ill, knows that his doctor believes ECT will help him and knows that he is being asked to decide, be respected or overridden? The author of the first paper, an American bioethicist argues that the refusal should be overridden in the interests of fostering the autonomy of the patient by overcoming the impediment to that autonomy which major depression represents. A philosopher (...) and a psychiatrist respond and an editorial discusses the issues. (shrink)

Natalie Stoljar posits that those who have internalized oppressive norms lack normative competence, which requires true beliefs and critical reflection. A lack of normative competence makes agents nonautonomous, according to Stoljar. This framework is thereby meant to address what she calls the “feminist intuition”—the intuition that oppressive norms are incompatible with autonomy. On my view, however, Stoljar’s normative competence account of autonomy is subject to a worrying problem. Her account misattributes nonautonomy to those who perpetrate the oppression, making those (...) who are oppressed and those who oppress count as equally nonautonomous. I argue that this is implausible and demonstrate in this paper that we can establish an asymmetry of autonomy between those who oppress others and those who are made the target of oppression. (shrink)

When education is jointly managed by a workplace and academia, causal mechanisms in the culture, structure and agency of these two contexts may unintentionally generate discourse that conveys conflicting messages for learners regarding some of the priorities of the profession. Using the concepts of culture, structure and agency as they are used in critical realism to analyse the discourse generated in two teaching and learning contexts (a radiography division in a university and a radiography workplace in a large state (...) tertiary academic hospital), this paper attempts (i) to identify possible causal mechanisms that generated discourse concerning the role and value of writing competency for radiographers, such that this discourse possibly influenced learners not to be motivated to improve their writing competency to their lecturers’ satisfaction; and (ii) to suggest what practices and influences might successfully generate an alternative emancipatory discourse. Drawing on Margaret Archer’s (1995) morphogenetic approach, the paper argues that the radiography lecturers have the primary agency to address this unsatisfactory situation, as it is through their interaction – both as a team and with other relevant stakeholders – that an alternative emancipatory discourse may be generated. (shrink)

An important consideration which runs through the adjudication process in each dimension is that of insight vs. blindness. Whether it is a question of deciding if one description is a persuasive critique of another, or which of two rivals is more adequate empirically, or which is a more plausible and convincing narrative, one is always involved in assessing how far and how much each of the accounts permits us to see. The centrality of this notion certifies the inescapably hermeneutical character (...) of social description adjudication. It precludes the possibility of a decision-procedure, but not of rationality. The alternative to a canonical method of description adjudication is not relativism but hermeneutics. ;My argument for a hermeneutical approach to social description adjudication is made largely via consideration of a series of examples. I look at a collection of rival accounts of the same portion of social reality and at the process of choosing between them. I consider the sorts of reasons and arguments that might be advanced for preferring one to another and I evaluate them. The descriptions I look at are accounts of the French Revolution of 1848 and they include Karl Marx's Eighteenth Brumaire of Louis-Bonaparte, Victor Hugo's Napoleon the Little, Gustave Flaubert's Sentimental Education and the works of two recent twentieth century social historians. ;I show that these descriptions are complexes of at least three analytically distinct components: critical, empirical and narrative. I show, therefore, that the choice between them can be made from at least three corresponding standpoints. But I also argue that these three dimensions are not independent of one another; each, rather, presupposes the others and none is foundational with respect to the others. Adjudicating between competing social descriptions, then, turns out to be a complex non-canonical process of weighing the relative merits within each dimension. ;I counterpose to the decision-procedure model of social description adjudication a hermeneutical model. I show that good and convincing reasons for preferring one social description or historical interpretation to another need not be strictly derivable from or translatable into a set of universal rules capable of being formulated independently of and in advance of the consideration of the particular case. I show, rather, that rational adjudication between competing social descriptions consists in creative rule-transcending judgment akin to Aristotelian phronesis or Kantian reflective judgment. ;It is often presupposed that choices between competing theories, interpretations, actions or whatever qualify as rational just in case they result from the application of some decision-procedure. I take issue with this assumption when what is at stake is choosing between competing descriptions of social reality. I argue that there is not and cannot be a decision-procedure governing such choices, but that such choices may nonetheless be rational and intersubjectively defensible. (shrink)

Designed specifically for the educational needs of RN to BSN students This is a unique, innovative professional nursing ethics textbook designed specifically for the educational needs of RN to BSN students. Written by experts in the field, it discusses ethical concepts geared to the licensed nurse who has spent several years in practice but is learning high-level concepts and applications. The text addresses different areas of professional practice and is rich with case studies illustrating clinical scenarios involving ethical awareness and (...) decision-making. The book fulfills the necessary criteria for the AACN Essentials for Baccalaureate Education and the QSEN and ISOM competencies. Clear and concise, the text relates content to the nurse’s current practice and professional development without extraneous information typically included in other texts. Progressing from simple to complex, chapters build on previous practice experience to focus on ethical decision-making in a variety of practice environments. The book incorporates a “four boxes” decision-making model and addresses essential communication skills, how to recognize and resolve moral distress, and the role of an ethics committee. It discusses common ethical issues likely to be encountered and ethical practice as it relates to quality and safety. Case Study Dilemmas that include evidence-based research provide the opportunity to apply ethical decision-making principles. QSEN application principles are also featured in each chapter, and interactive exercises and questions and PowerPoints provide further opportunity for critical thinking. Key Features: Addresses the specific needs of students in the RN to BSN course Fulfills AACN Essentials, IOM Competencies, and QSEN KSAs Builds upon previous practice experience of RN to BSN students Discusses ethical decision-making in a variety of practice environments Includes Case Study Dilemmas to apply ethical decision-making principles. (shrink)

. Revisioning the Fifth Element. Can critical realism reconcile competence and Bildung for a more sustainable twenty-first-century education? Journal of Critical Realism: Vol. 18, Sustainability, Interdisciplinarity and Transformative change: A Critical Realist Response to the Crisis System, pp. 402-419.

This monograph contrasts two prominent models of education, Competence-Based Education (CBE), more recent and currently dominant in most school systems around the world, and Bildung-Oriented Education (BOE), once the basis of the school systems of Northern Europe. CBE is assessment-oriented and interprets learning as the acquisition of clearly definable and allegedly measurable competences, and is supported by supranational organisations, such as the OECD, which approach education from the perspective of human capital theory. BOE is instead teaching-oriented and characterises learning (...) holistically as aimed at the progressive articulation of a meaningful ‘big picture’ in the student’s mind. Emerged in Northern Europe under the influence of the ideals of the Enlightenment and Neo-Humanism of individual and collective autonomy and responsibility, BOE was subsequently enriched with a hermeneutical approach to teaching and socio-political objectives of emancipation and solidarity originating within Critical Theory. The book first analyses CBE and argues that, in spite of its celebrated ‘scientificity’, it is internally incoherent and unreliable, contributes to structural forms of oppression and injustice, can foster social pathologies, and fails to provide students with the kind of intellectual autonomy they need as both human beings and citizens of our complex post-industrial societies. Then, it introduces BOE and articulates and defends an updated version of it from objections raised by critical theorists, poststructuralists and postcolonial thinkers. It argues that BOE is a coherent and flexible model of education that endows students with autonomy and responsibility, can reduce structural forms of oppression and injustice, and can heal social pathologies. (shrink)

ABSTRACTAchievements are among the things that make a life good. Assessing the plausibility of this intuitive claim requires an account of the nature of achievements. One necessary condition for achievement appears to be that the achieving agent acted competently, i.e. was not just lucky. I begin by critically assessing existing accounts of anti-luck conditions for achievements in both the ethics and epistemology literature. My own proposal is that a goal is reached competently, only if the actions of the would-be-achiever make (...) success likely, and that this is the reason why she acts that way. (shrink)

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about (...) social issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. (shrink)

The critical realist and Bourdieusian conceptions of action fundamentally disagree on a number of fronts: the synthetic versus dualistic relationship between structure and agency; the social nature of the self/body; the link between morphogenesis and reflexivity. Despite these differences, this article argues that re-reading Bourdieu’s theories with attention to some of the core tenets of critical realism (emergence, the stratification of reality, and conjunctural causality) can provide insights into how the habitus is capable of reflexivity and social change. (...) In particular, this article reworks Bourdieu’s theory of habitus by suggesting that social selves are always situated at the intersection of multiple and competing social locations (or field positions) and that the habitus itself is always layered. Reflexivity arises from horizontal disjunctures (between field positions) and vertical disjunctures (across temporal sedimentation). (shrink)

In philosophical semantics, a distinction has been proposed between inferential and referential lexical semantic competence. The former accounts for the relationship of words to the world, the latter for the relationship of words among themselves. Recent neuroscience research suggests that the distinction might be actually neurally implemented. That is, that inferential and referential abilities might be underpinned by two functionally independent cognitive architectures, with partly different neural realizations. This hypothesis is consistent with brain patient data, supporting the notion of a (...) functional double dissociation between inferential and referential abilities, and with neuroscience data, suggesting that inferential and referential abilities are underpinned by at least partly different regions of the human brain. The principal aim of this article is to provide the first comprehensive and critical review of the empirical evidence in favour of such hypothesis. (shrink)

As a supplement to other volumes in the Thinker’s Guide Library, this book provides a framework by which to assess the integration of critical thinking into an educational system The critical thinking competency standards articulated in this guide serve as a resource for teachers, curriculum designers, administrators and accrediting bodies.

I criticize Herbert Simon 's argument for the claim that complex natural systems must constitute decomposable, mereological or functional hierarchies. The argument depends on certain assumptions about the requirements for the successful evolution of complex systems, most importantly, the existence of stable, intermediate stages in evolution. Simon offers an abstract model of any process that succeeds in meeting these requirements. This model necessarily involves construction through a decomposable hierarchy, and thus suggests that any complex, natural, i.e., evolved, system is constituted (...) by a decomposable hierarchy. I argue that Stuart Kauffman's recent models of genetic regulatory networks succeed in specifying processes that could meet Simon 's requirements for evolvability without requiring construction through a decomposable hierarchy. Since Kauffman's models are at least as plausible as Simon 's model, Simon 's argument that complex natural systems must constitute decomposable, mereological or functional hierarchies does not succeed. (shrink)

Abstract:The concept of competency (or competence) entered educational policy by the end of last century. Due to this concept’s background in recruitment and because of its generic character, many definitions have been given, but so far no unified, transparent, and consistent definition has come forward. The concept of competency has also reached art education. Due to the “artistic” character of this domain of learning, this concept seems to be a powerful instrument to describe the types of behavior and learning goals (...) that are typical for this domain and for the related ways of thinking, working, and learning. This article gives a critical overview of what is seen as typical for what competency refers to in the domain of (art) education. A new definition of competency is presented that covers both the productive and the receptive domains of learning in visual art education. The constituent elements of this definition are discussed in detail. The analysis is broadened to include aspects of human cognition and behavior that can be considered as typical for visual art education, such as the aesthetic experience and its moral dimension. (shrink)

In this chapter, I explore moral competence as a central condition on moral responsibility. I distinguish two main conceptions. On the first, a morally competent agent is someone who knows right from wrong. On the second, a morally competent agent is someone who responds aptly to reasons. These two conceptions merit separate treatment as they offer different insights on how and why moral competence might be compromised. This distinction is of particular relevance since the chapter critically examines a standard assumption (...) stating that whenever a mental disorder impacts moral competence, it decreases its scope (on the first conception) or precision (on the second). In close conversation with the memoir literatures on bipolar disorder, autism and schizophrenia, I argue that moral competence may also be affected by what looks like increases in scope or precision; moreover, neither impact – decrease or increase – necessarily undermines moral competence in and of itself; oftentimes, either could enhance it in a reliable way. Finally, by critically revisiting the ecological or scaffolding approach to moral responsibility, I show that moral competence is best understood as a practical way of knowing right from wrong embedded in daily routines and habits, and irreducible to propositional understanding or intellectual skills. (shrink)

This book argues that the mainstream view and practice of critical thinking in education mirrors a reductive and reified conception of competences that ultimately leads to forms of epistemic injustice in assessment. It defends an alternative view of critical thinking as a competence that is normative in nature rather than reified and reductive. This book contends that critical thinking competence should be at the heart of learning how to learn, but that much depends on how we (...) understand critical thinking. It defends an alternative view of critical thinking as a competence that is normative in nature rather than reified and reductive. The book draws from a conception of human reasoning and rationality that focuses on belief revision and is interwoven with a Bildung approach to teaching and learning: it emphasises the relevance of knowledge and experience in making inferences. The book is an enhanced, English version of the Italian monograph Epistemologia dell’Educazione: Pensiero Critico, Etica ed Epistemic Injustice. (shrink)

The American Society for Bioethics and the Humanities (ASBH) issued its Core Competencies for Health Care Ethics Consultation just as it is becoming ever clearer that secular ethics is intractably plural and without foundations in any reality that is not a social–historical construction (ASBH Core Competencies for Health Care Ethics Consultation , 2nd edn. American Society for Bioethics and Humanities, Glenview, IL, 2011 ). Core Competencies fails to recognize that the ethics of health care ethics consultants is not ethics in (...) the usual sense of a morally canonical ethics. Its ethics is the ethics established at law and in enforceable health care public policy in a particular jurisdiction. Its normativity is a legal normativity, so that the wrongness of violating this ethics is simply the legal penalties involved and the likelihood of their being imposed. That the ethics of ethics consultation is that ethics legally established accounts for the circumstance that the major role of hospital ethics consultants is as quasi-lawyers giving legal advice, aiding in risk management, and engaging in mediation. It also indicates why this collage of roles has succeeded so well. This article shows how moral philosophy as it was reborn in the 13th century West led to the ethics of modernity and then finally to the ethics of hospital ethics consultation. It provides a brief history of the emergence of an ethics that is after morality. Against this background, the significance of Core Competencies must be critically reconsidered. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Stoics and Epicureans, while holding that all human beings are constitutively capable of achieving a fully coherent state of character, also maintain that failure to realize this capacity results in a radically un-structured and incoherent state of personality. This chapter examines the Stoic theory of the passions and explores the relationship between this theory and their view that human beings function as psychological wholes. It shows how an intense debate emerged in Hellenistic-Roman thought between Stoic and Platonic-Aristotelian ways of conceiving (...) emotions. It shows how this controversy underlies the critical presentation of the Stoic theory by Plutarch and Galen, and how it leads Galen to give a misleading account of the ideas about passions held by the Stoic thinkers Chrysippus and Posidonius. (shrink)

To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. (...) These are some of the reasons behind current movements to develop competency frameworks that can enhance cross‐disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care. (shrink)

This paper notes the critical response that the ‘competence movement’ has received from writers in philosophy of education and argues for a more positive assessment of what it offers in relation to: (i) the place of practical competence in a liberal education, (ii) the meritocratic principles underlying the competence movement, (iii) the ‘transparency’ of expectations in assessment, and even (iv) the element of practical competence in moral performance. It emphasises, however, that not all versions of ‘competence’ can be defended (...) in these terms and that this requires a more generic and cognitively laden concept of personal and professional competence. (shrink)

Critical aspects in the field of education are currently related to low levels of socioemotional competences and high rates of school dropouts. However, there are no standard practices or guidelines for helping countries to assess and train social and emotional competences. To overcome this limitation, the project Learning to be (L2B) aims to propose a comprehensive model of the assessment and development of social and emotional competences that bring together policymakers, researchers, teachers, school authorities and learners (...) from different participating countries: Finland, Italy, Latvia, Lithuania, Portugal, Slovenia, and Spain. The project attempts to create an international framework for regulating activities and supporting teachers working on the social and emotional competences of the students and to provide tools which can be used across countries. The aim of the paper is to describe how L2B has been developed in Spain by analyzing the contributions of the international framework and extracting the specific needs in the Spanish context. Specifically, we describe two products of the project: a) the process for creating a toolkit, a tool focused on creating activities and materials for helping teachers develop social and emotional competences of students and b) the results of an exploratory study in Spain in which social and emotional competences are assessed and compared to the international framework. First, we explain the definition of social and emotional competences used for creating the toolkit. Second, we analyze responses of Spanish students to questionnaires administered before applying the toolkit in the schools. The paper describes social and emotional competences in Spain and evaluates the overlap between relevant variables in Spain and those used for developing the toolkit, the international tool. Specific needs in Spain are discussed, as well as the contribution of the project for promoting the improved development of students’ social and emotional competences, improving learning outcomes and stronger social cohesion in schools and local communities, as well as the utility of the results for creating new educational policies. (shrink)

Diagnostic errors are more frequently a result of the clinician's failure to combine medical knowledge adequately than of data inaccuracy. Diagnostic reasoning studies are valuable to understand and improve diagnostic reasoning. However, most diagnostic reasoning studies are characterized by some limitations which make these studies seem more simple than diagnostic reasoning in real life situations actually is. These limitations are connected both to the failure to acknowledge components of knowledge used in clinical practice as well as to acknowledge the physician-patient (...) relationship's influence on clinical knowledge and on the reasoning process itself. In addition the modes of reasoning described in these studies frequently is oversimplified. In this paper three simplistic and competing models of diagnostic reasoning are analyzed and criticized, followed by an evaluation of two alternative models proposing a combined view. (shrink)

Habit plays a central role in Peirce's pragmatic account of human signification. What he means by meaning is, hence, fully intelligible only in reference to the role he accords to habit in this account. While the main focus of Peirce's critical attention is, especially in the mature articulation of his thoroughgoing pragmatism, upon deliberately acquired habits, it is reasonable to suggest that often his concern is actually with something broader in one sense and narrower in another than individual or (...) isolated habits. Any given disposition to act in certain ways in certain circumstances is taken by him to be an integral part of more or less integrated dispositions to act, feel, and even imagine: it is not taken to be operative apart from these other habits. In this sense, then, his concern is primarily with such integrated dispositions, not isolated habits. Thus, it is broader than the inattentive reader is likely to suspect. But, since those deliberately cultivated dispositions of rational agents that are at the center of Peirce's concerns are ones specifiable only in reference to some human practice such as experimental inquiry or everyday conversations, religious worship or artistic innovation, these dispositions are appropriately taken to be not simply habits in any way whatsoever but primarily habits to act in a competent or expert manner. More simply put, these deliberately cultivated dispositions are, in many instances, best conceived as competencies or expertise. While not all habits equip agents with expert or even competent ways of addressing the shifting demands of experiential situations (that is, while not all habits are instances of competence or expertise), all cases of competence and expertise are, at bottom, more or less harmoniously integrated clusters of flexible, nuanced, and alterable habits. Accordingly, any account of Peirce's conception of habit, especially as it pertains to his pragmatic theory of meaning, must bring into sharper focus the complex relationship among habits, competence, and expertise than Peirce and even his most imaginative expositors have done thus far. The aim of this paper is to push our investigation of the Peircean notion of human habituation in precisely this direction. Against an evolutionary background, the historical foreground of historically evolved and evolving practices will be sketched. Habits in their guise as competencies and expertise will then be seen in the context of such practices, with equal emphasis on initiation into a practice and the open-ended process of acquiring ever more refined expertise. (shrink)

This study offers a proposal about which competencies should be fostered in organizations to promote a culture in favor of sustainability in line with Pope Francis' encyclical letter Laudato Si. As a result, seven main competencies are proposed, with their interpretation in the light of the encyclical letter, and some suggestions on how to implement them in organizations are presented. The competencies are systemic vision, critical thinking, capacity for dialog, inclusion, proper use of goods, creativity, and spirituality. In addition, (...) the study offers a discussion of the relevance of these competencies in today's business context. This study offers a novelty with respect to other theoretical proposals on competencies for sustainability since it includes competencies that require an authentic concern for other people and for a vision of the human being open to transcendence, thus breaking with instrumentalism and technocratic paradigm that underlies other proposals. In this way, it also offers a new key to interpreting the integral ecology proposed by Pope Francis, which goes beyond other approaches to sustainability in that it includes not only the person–nature relationship but also the person–person and person–transcendence or person–God relationships. The conclusions of this theoretical research can be especially useful for those who intend to promote a culture of sustainability inspired by the Catholic Social Teaching, also making use of the knowledge and good practices of competency-based management. (shrink)

WINDSOR C, DOUGLAS C and HARVEY T. Nursing Inquiry 2012; 19: 213–222 Nursing and competencies — a natural fit: the politics of skill/competency formation in nursingThe last two decades have seen a significant restructuring of work across Australia and other industrialised economies, a critical part of which has been the appearance of competency based education and assessment. The competency movement is about creating a more flexible and mobile labour force to increase productivity and it does so by redefining work (...) as a set of transferable or ‘soft’ generic skills that is transportable and is the possession of the individual. This article sought to develop an analysis of competency based clinical assessment of nursing students across a bachelor of nursing degree course. This involved an examination of a total of 406 clinical assessment tools that covered the years 1992–2009 and the three years of a bachelor degree. Data analysis generated three analytical findings: the existence of a hierarchy of competencies that prioritises soft skills over intellectual and technical skills; the appearance of skills as personal qualities or individual attributes; and the absence of context in assessment. The article argues that the convergence in nursing of soft skills and the professionalisation project reform has seen the former give legitimacy to the enduring invisibility and devaluation of nursing work. (shrink)

Several bioethicists have recently advocated the force-feeding of prisoners, based on the assumption that prisoners have reduced or no autonomy. This assumed lack of autonomy follows from a decrease in cognitive competence, which, in turn, supposedly derives from imprisonment and/or being on hunger strike. In brief, causal links are made between imprisonment or voluntary total fasting and mental disorders and between mental disorders and lack of cognitive competence. I engage the bioethicists that support force-feeding by severing both of these causal (...) links. Specifically, I refute the claims that VTF automatically and necessarily causes mental disorders such as depression, and that these mental disorders necessarily or commonly entail cognitive impairment. Instead, I critically review more nuanced approaches to assessing mental competence in hunger strikes, urging that a diagnosis of incompetence be made on a case-by-case basis—a position that is widely shared by the medical community. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in (...) nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)

The importance of developing cultural competence among healthcare professionals is well recognized. However, the widespread reports of insensitivity and deficiencies in care for culturally diverse patients illuminate the need to review how cultural competence development is taught, learnt and applied in practice. Unless we can alter the ‘hearts and minds’ of practising nurses to provide the care that they know they should, culturally insensitive care will continue operating in subtle ways. This paper explores the ideas behind nurses’ actions and omissions (...) when caring for culturally diverse patients and proposes the need to examine cultural competence development through a moral reasoning lens. Examining cultural competence development through a moral reasoning lens can help empower nurses, whilst nurturing commitment and courage to providing quality care that meets the needs of culturally diverse patients. The model of morality provides a framework that explores how moral motivation and behaviour occur and can provide a vehicle for critically examining the knowledge, skills and attitudes required to provide culturally responsive care. (shrink)

This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals’ formation of choices. In response to this problem, I will present a brief overview of Diana Meyers’s account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This (...) account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical ‘self-reading’. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills. (shrink)

Definition of the problemThe upcoming reforms according to the specifications of the Master Plan 2020 provide for a competency-oriented restructuring of medical studies. This article aims to develop perspectives on how teaching ethics in medical studies can be more strongly oriented at building competencies. In this way, it pursues the goal of making the concept of competency more tangible for medical ethics and usable for the design of medical ethics education.ArgumentsWe understand competencies as dispositions for actions that enable problem solving. (...) By transferring the concept of moral intelligence to the moral actions of physicians in patient care, we specify five ethical–moral competencies that must be present for morally appropriate, ethically reflected actions by future physicians: (1) the ability to form a professional moral compass, (2) the willingness to align oneself with professional ethical norms and values, (3) the ability to perceive moral dimensions of medical action, (4) the ability to make moral judgments based on ethical considerations about the right action, and (5) the willingness to realize ethically justified action. We illustrate their importance for teaching medical ethics using the example of teaching clinical ethics in medical studies.ConclusionOur conceptualization of moral–ethical competencies can be used to design concrete courses in a competency-oriented way. Our approach could be applied analogously to other areas of teaching ethics in health care. (shrink)

Amphibian metamorphosis is a post‐embryonic process that systematically transforms different tissues in a tadpole. Thyroid hormone plays a causative role in this complex process by inducing a cascade of gene regulation. While natural metamorphosis does not occur until endogenous thyroid hormone has been synthesized, tadpoles are competent to respond to exogenous thyroid hormone shortly after hatching. In addition, even though the metamorphic transitions of individual organs are all controlled by thyroid hormone, each occurs at distinct developmental stages. Recent molecular studies (...) suggest that this competence of premetamorphic tadpoles to respond to the hormone and the developmental stage‐dependent regulation of tissue‐specific transformations are determined in part by the levels of thyroid hormone receptors and the concentrations of cellular free thyroid hormone. In addition, at least two genes, encoding a cytosolic thyroid hormone binding protein and a 5‐deiodinase, respectively, are likely to be critical players in regulating cellular free thyroid hormone concentrations. This review discusses how all of these molecuar components coordinate to induce amphibian metamorphosis in a correct spatial and temporal manner. These studies provde us with general clues as to how and why tissues become competent to respond to hormonal signals. (shrink)

France and New Caledonia are currently involved in an ongoing debate surrounding the independence of the latter from the former that will lead to referenda in 2018–2022. The main stakeholders in the negotiation process are France, the Caldoche population of the island agglomeration and its Kanak inhabitants. Most critical discourse studies analyse texts as expressions of power entrenched in monologues. In this paper, however, the debate between the social actors is seen as a plurilogue. The study argues that the (...) dominant interactants propagate a rhetoric of unity and homogeneity, aiming to further marginalise the Kanak people and other minority groups in New Caledonian society by rendering them invisible. It further argues that the French political power aims to persuade the other groups to accept the reality of a common destiny as a given truth. The paper combines Systemic Functional Linguistics and Pragma-dialectics, and incorporates postcolonial and poststructuralist perspectives into a critical study of discourse samples, taken from a larger corpus of French data, across various genres and registers. The analysis reveals that the French rhetoric of unity is built upon Republican principles inherent to neo-colonialist ideology. It also shows that the French rhetoric is being reproduced by local settler interactants, based on values that pertain to Caldoche nationalist ideology. Both French and Caldoche ideologies are in discord with Kanak socialist ideology. By exposing the existing power inequalities the study does not only contribute to defending the Kanak minority discourse, but also emphasises the rights for recognition and self-determination of the Kanak indigenous people of New Caledonia. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention, and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; and coordination of law-based public health actions; and information.This action agenda offers options for consideration by those responsible for (...) or interested in ensuring that public health professionals, their legal counsels, and relevant partners understand the legal framework in which they operate and are competent in applying legal authorities to public health emergency preparedness.Competencies are critical to an individual's ability to make effective legal response to all-hazards public emergencies. (shrink)

Physician-assisted death (PAD) of patients whose suffering does not stem from terminal conditions has become more prevalent during the last few decades. This paper is focused on decision-making competence for PAD, specifically in situations in which PAD is related solely to psychiatric illness. First, a theoretical analysis presents the premises for the argument that competence for physician-assisted death for psychiatric patients (PADPP) should be determined based on a higher threshold in comparison to the required competence for conventional medical interventions. Second, (...) the higher threshold for decision-making competence for PADPP is illustrated. Third, several real PADPP cases are critically discussed, as an illustration to decision-making competence evaluations that would not have met the higher standard. Finally, a short summary of practical suggestions regarding the assessment of decision-making competence for PADPP is presented. Psychiatrists are called to address the ethical, legal, societal and clinical challenges related to PADPP and should be prepared for its probable expansion. (shrink)

We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.

This article examines the ‘integrated conception of competence’ as conceived by Paul Hager and David Beckett and suggests that its characterization in terms intended to distance it from behaviouristic and reductionist notions of competence is not sufficient to differentiate it from other models. Taking up Hager and Beckett’s idea that competence must be inferred from behaviour, it is suggested that this indicates how the integrated conception is more properly distinguished by virtue of the method used rather than what it is (...) that is assessed. Drawing on the work of Wittgenstein and Donald Davidson, it is argued that it is possible to discern two logically distinct methodological approaches to competence assessment, allowing a clear distinction to be made between the integrated conception and the kind of approach which predominates in the UK’s framework of vocational qualifications. While the latter is shown to be rightly criticized for its deficiencies, in contrast the integrated conception is seen to suggest a methodological approach that is capable of acknowledging the full richness of occupational practice. (shrink)

Competency has become a key concept in education in general over the last four decades. This article examines the development of the competency‐based movement with a particular focus on the significance it has had for nursing education. Our hypothesis is that the competency movement can only adequately be understood if it is analyzed in relation to the broad societal transformation of the last decades—often summarized under the catchword neoliberalism—and with it the emergence of managerial models for Human Resource Management (HRM) (...) for the reorganization of social services. Classical professions, which were characterized under welfarism by an esoteric knowledge based on ethical norms, have now become marketable commodities that can be evaluated in the same way as other commodities. We want to underline that while this development is still under way, it is the concept of competency that was the decisive political instrument enabling this profound change. With the widespread implementation of competency‐based education that now governs nursing knowledge, the development of a critical, oppositional perspective becomes more challenging, if not entirely impossible. We will be focusing primarily on nursing education in Canada, although we maintain that it has relevance for nursing internationally. (shrink)

This article argues that what was understood as democracy in the eighteenth century differs fundamentally from modern democracy. While modern democratic states take locally born or naturalized personhood as the criterion of citizenship, eighteenth-century advocates of democracy demanded proof of political competence to allow participation in politics. While the requirement of competence to engage in any activity is not unreasonable, if defined, as it was by most Enlightenment thinkers, as a combination of independence, cultural standing and wealth, it is clearly (...) elitist. Enlightenment criticisms of birth and status as criteria of political standing should not be mistaken for demands for broadly inclusive, modern conceptions of equality and democracy. Rather, most Enlightenment thinkers and publicists, fully aware of the implications of widespread and debilitating poverty, expressed reservations about granting the ‘people’ an effective role in politics. Far from being ‘radical’, Enlightenment political theory called for the replacement of an elitism based on status and privilege with an elitism of ability and wealth. (shrink)

This article examines two currently disputed issues regarding public policy for mentally retarded people. First, questions are raised about the legal tradition of viewing mental competence as an all-or-nothing attribute. It is argued that recently developed limited competence and limited guardianship laws can provide greater freedom for retarded people without sacrificing needed protection. Second, the question of who should act paternalistically for retarded people incapable of acting for themselves is examined. Rothman's claim that special formal advocates are the best representatives (...) for retarded people is discussed and criticized. It is argued that parents, professionals and legal advocates should share decision-making authority on behalf of those who are incompetent. (shrink)