Reflexivity

反身性
  • 文章类型: Journal Article
    背景:一系列证据表明,临床接触中隐含偏见的存在如何对提供者与患者的沟通产生负面影响,护理质量,最终导致健康不平等。反身实践已被探索为一种识别和解决医疗保健提供者隐含偏见的方法。包括医学生。在洛桑医学院,2019年引入了一个临床综合模块,旨在使用反身性和定位性方法提高学生对医疗实践中性别偏见的认识.这项研究的目的是描述医学生发现的性别偏见,分析他们的类型,临床接触期间出现的地点和模式。它进一步探讨了立场如何支持学生反思社会地位如何调节他们与患者的关系。
    方法:作为教学活动的一部分,医学生通过回答电子作品集中的问题,分别反映了特定临床中的性别偏见。问卷包括一个关于位置性的部分。我们定性分析了学生的作业(n=76),应用主题分析框架。
    结果:医学生识别并描述了在临床遭遇的不同时刻发生的性别偏见(回忆(即患者病史),体检,鉴别诊断,最终管理)。他们将这些偏见与更广泛的社会现象联系在一起,例如性别分工或围绕性和性别的陈规定型观念。分析学生对他们的位置如何影响他们与患者的关系的反思,我们发现,建议的练习揭示了医学文化发展过程中的一个主要矛盾:中立和客观的禁令消除了患者的社会和文化背景,阻碍了对性别偏见的理解。
    结论:性别偏见存在于临床咨询的不同步骤中,并且植根于更广泛的性别社会表征。我们进一步得出结论,应该向学生明确追求客观性与社会现实之间的紧张关系,因为它是医疗实践的组成部分。
    BACKGROUND: An array of evidence shows how the presence of implicit bias in clinical encounters can negatively impact provider-patient communication, quality of care and ultimately contribute to health inequities. Reflexive practice has been explored as an approach to identify and address implicit bias in healthcare providers, including medical students. At the Lausanne School of Medicine, a clinically integrated module was introduced in 2019 to raise students\' awareness of gender bias in medical practice using a reflexivity and positionality approach. The purpose of this study is to describe the gender bias that were identified by medical students, analysing their types, places and modes of emergence during a clinical encounter. It further explores how positionality supported students\' reflection on the way in which social position modulates their relationship to patients.
    METHODS: As part of the teaching activity, medical students individually reflected on gender bias in a specific clinical encounter by answering questions in their electronic portfolio. The questionnaire included a section on positionality. We qualitatively analysed the students\' assignments (n=76), applying a thematic analysis framework.
    RESULTS: Medical students identified and described gender biases occurring at different moments of the clinical encounter (anamnesis (i.e. patient history), physical exam, differential diagnosis, final management). They causally associated these biases with wider social phenomena such as the gendered division of labour or stereotypes around sexuality and gender. Analysing students\' reflections on how their position influenced their relationship with patients, we found that the suggested exercise revealed a major contradiction in the process of medical enculturation: the injunction to be neutral and objective erases the social and cultural context of patients and impedes an understanding of gender bias.
    CONCLUSIONS: Gender biases are present in the different steps of a clinical consultation and are rooted in broader gendered social representations. We further conclude that the tension between a quest for objectivity and the reality of social encounters should be made explicit to students, because it is constitutive of medical practice.
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  • 文章类型: Journal Article
    背景:生活经验研究人员利用他们的生活和生活经验来引导或指导研究。他们的个人经历与研究课题相关,因此他们必须管理他们的健康和医疗保健经验与研究的相互作用,人口,和他们使用的数据,以及作为研究人员的更普遍的挑战。生活经验研究人员除了对他们的能力进行查询之外,还必须应对这些困境,由于与交叉性和认知不公正有关的问题。这证明了更好地了解生活经验研究人员的经验的动机,并根据他们的喜好和需求制定适当和个性化的监督。
    方法:Q方法用于识别一系列与身份相关的问题,这些问题会影响英国博士研究期间的生活经验研究人员。这些问题以54个陈述的形式呈现给18个生活经验研究人员,作为在监督中探索的主题优先考虑。
    结果:发现生活经历研究人员可以在反向因子分析后分为三个不同的因素:因素1:增强我的身份,技能,增长,因素2:探索我与研究的情感和关系联系,因素3:在实际和情感上导航我的生活和职业经历。研究结果表明,可能有三种类型的生活经验研究人员,每个人都有不同的监督需求,表明种群是异质的。
    结论:该研究发现了对生活经验研究人员需求的更深入理解,并根据研究人员的个人需求及其对监督的偏好强调了个性化监督的重要性。这些发现加强了将临床维度纳入监督以支持所有生活经验研究人员需求的重要性。
    BACKGROUND: Lived experience researchers draw on their lived and living experiences to either lead on or inform research. Their personal experiences are relevant to the research topic and so they must manage the interplay of their health and healthcare experiences with the research, population, and data they work with, as well as the more general challenges of being a researcher. Lived experience researchers must navigate these dilemmas in addition to queries over their competency, due to issues relating to intersectionality and epistemic injustice. This justifies a motivation to better understand the experiences of lived experience researchers and develop appropriate and personalised supervision based on their preferences and needs.
    METHODS: Q methodology was used to identify a collection of identity-related issues that impact lived experience researchers during PhD research in the context of the UK. These issues were presented in the form of 54 statements to 18 lived experience researchers to prioritise as topics to explore in supervision.
    RESULTS: It was found that lived experiences researchers could be grouped into three distinct factors following an inverted factor analysis: Factor 1: Strengthening my identity, skills, growth, and empowerment; Factor 2: Exploring the emotional and relational link I have with the research and Factor 3: Navigating my lived and professional experiences practically and emotionally. The findings suggest that there may be three types of lived experience researchers, each with different needs from supervision, suggesting the population is heterogeneous.
    CONCLUSIONS: The research identified a deeper understanding of the needs of lived experience researchers and highlights the importance of personalised supervision according to the individual needs of the researcher and their preferences for supervision. The findings reinforce the importance of integrating a clinical dimension into supervision to support the needs of all lived experience researchers.
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  • 文章类型: Journal Article
    公共政策的共同生产包括汇集技术专家,从业者,和有该政策经验的人合作和深思熟虑地共同设计它。共同生产可以利用不同的方式来了解和评估政策领域的观点,以增强决策的合法性和有效性。本文认为,研究人员的自反性对于在道德和认识论上充分利用共同生产至关重要。通过反思我们的定位,habitus,和偏见,我们可以对我们如何影响研究设计获得新的见解,数据的生产和分析,和交流发现。这种反思性有助于破坏研究和决策不足的权力动态,帮助实现共同生产对民主化实践的激进潜力,赋予公民权力,使研究更加相关。我们通过与英国国家反贫困慈善机构Turn2us合作,对我们的工作进行了分析,共同产生了在财务困境中蓬勃发展的理论,从而证明了反身性的价值。在当今英国推进联合生产的实际现实中,我们对反身性的倡导进行了背景化。
    Coproduction of public policy involves bringing together technical experts, practitioners, and people with lived experience of that policy to collaboratively and deliberatively codesign it. Coproduction can leverage different ways of knowing and evaluative perspectives on a policy area to enhance the legitimacy and efficaciousness of policymaking. This article argues that researcher reflexivity is crucial for getting the most out of coproduction ethically and epistemically. By reflecting on our positionality, habitus, and biases, we can gain new insights into how we affect the research design, production and analysis of data, and communication of findings. This reflexivity helps to disrupt power dynamics that underly research and policymaking, helping to realise the radical potential of coproduction to democratise practice, empower citizens, and make research more relational. We demonstrate the value of reflexivity through an analysis of our work coproducing a theory of thriving in financial hardship in partnership with the UK national anti-poverty charity Turn2us. We contextualise our advocacy for reflexivity within the practical realities of advancing coproduction in the UK today.
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  • 文章类型: Journal Article
    在本文中,我们借鉴了一个启发式探究的例子-(重新)想象成为一名物理治疗师:一种现象学方法-来说明反身性和代表性在物理治疗研究结果中的作用以及它们可能对推动职业发展的意义。物理治疗中的定性研究倾向于通过使研究人员偏见公开来承认反身性作为客观性的途径,然而,关于数据表示的争论(研究人员关于如何在文本中表示数据的决策)几乎没有特色。这与其他领域的定性研究形成对比,包括其他卫生专业,其中代表事项(即,知识是如何传达的)经常被辩论和质疑。自反性,事实上,不仅仅是透明的。连同代表,反身性有助于在研究中定位参与者和研究人员的声音。本文描述的启发式探究提供了有关学习成为物理治疗师的新见解;它挑战了物理治疗实践中有关护理的假设,并改变了第一位研究人员的身份和实践。这些见解是通过反身性和代表性之间的协同作用产生的,我们认为,物理治疗研究有机会通过更认真地对反身性和代表性的承诺而变得更加广阔。
    In this paper, we draw on an example of heuristic inquiry - (Re)imagining becoming a physiotherapist: a phenomenological approach - to illustrate the role that reflexivity and representation can play in physiotherapy research outcomes and the meaning they might have for moving the profession forward. Qualitative research in physiotherapy tends to acknowledge reflexivity as a route to objectivity by making researcher biases overt, yet the debate about data representation (a researcher\'s decision-making about how data are represented in a text) barely feature. This contrasts with qualitative research in other fields, including other health professions, where matters of representation (i.e., how knowledge is conveyed) are routinely debated and contested. Reflexivity, in fact, is much more than being transparent. Together with representation, reflexivity helps to position both the voices of participants and researchers within the research. The heuristic inquiry described in this paper offers new insights about learning to be a physiotherapist; it challenged assumptions about care in physiotherapy practice and it changed the first researcher\'s identity and practice. These insights were generated through the synergies between reflexivity and representation, and we argue that physiotherapy research has an opportunity to be more expansive by taking a commitment to reflexivity and representation more seriously.
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  • 文章类型: Journal Article
    在本文中,作者开发了一种精神分析临床推理模型,作为推理过程,通过该过程,分析治疗师能够理解临床材料。从Bion的函数理论开始,作者认为,“功能”可以被认为是一个条件-动作序列,分析治疗师通过执行概念或反思操作,隐含地使用该序列来响应材料中某些元素的配置。调查分析治疗师在日常实践中使用的主要功能家族,作者使用了基于理论上异质参与者的监督会话的人际过程回忆程序。制定了共识程序来识别操作,阐明底层功能,并将功能分组到家庭中。确定了十二个功能家族,这些功能家族似乎被分析治疗师所使用,无论他们的思想流派如何。作者称他们为精神分析临床推理的“操作员”。根据运营商模型,精神分析临床推理的过程包括使用来自不同家庭的功能将操作链接在一起。在这个过程中,“临床推理风格”的特定集合似乎交织在一起。为研究开辟了不同的途径,临床实践,和训练。
    In this paper, the authors develop a model of psychoanalytic clinical reasoning as the inferential process by which analytic therapists are able to arrive at an understanding of the clinical material. Starting from Bion\'s theory of functions, the authors propose that a \"function\" can be thought of as a condition-action sequence that analytic therapists implicitly use to respond to certain configurations of elements in the material by executing conceptual or reflective operations. To investigate the main families of functions that are used by analytic therapists in everyday practice, the authors used an interpersonal process recall procedure based on supervision sessions from a theoretically heterogeneous group of participants. A consensual procedure was developed to identify operations, spell out the underlying functions, and group functions into families. Twelve families of functions were identified that appear to be used by analytic therapists regardless of their schools of thought. The authors call them the \"operators\" of psychoanalytic clinical reasoning. According to the operators model, the process of psychoanalytic clinical reasoning consists in the chaining together of operations using functions from different families. A specific collection of \"clinical reasoning styles\" seems to be interwoven in this process. Different avenues open up for research, clinical practice, and training.
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  • 文章类型: Journal Article
    从失败的创新中学习对于成功的创新至关重要。这种创新框架的理论基础是反身性,变革性的遗忘,智能失败该框架提出了“变革性治理”的定义,即创建结构性股权的治理。在COVID-19大流行后重建经济的政府寻求公平的绿色转型;性别化,结构,可持续,从实施的对性别问题有敏感认识的应对措施(以下称为政策创新)中学习。本文认为,变革性实践,信仰,值,假设,政策,系统学习是危机后转型的补充。目的是通过分析COVID-19实践和消除政策创新信念,促进对能源政策创新治理失败的系统学习,值,和不具有变革性的假设。我问:性别平等,结构公平,和绿色变革是COVID-19政策创新吗?该研究的方法是定性的,位于建构主义研究范式内。它使用反身主题分析,结合创新的编码政策叙事和变革性的索引匹配技术,确定变革性干预措施中的差距。该研究包括从开发署收集的58项政策创新(n=58),毕马威,政府报告,新闻从撒哈拉以南非洲人口最多的三个国家闪现:埃及,尼日利亚,和南非。研究发现,政策创新在性别方面是不公平的,结构,和可持续性,而衍生的变革途径是公平和性别变革的,结构上的变革性,绿色变革。变革性政策方法背后的基本原理反映了关键领域的系统性失败:市场动态,研究和开发,绿色转型政策创新者可以为实施变革性能源政策的创新治理调整变革性途径。为了满足多重脆弱和脆弱身份的需求,衍生的大流行后框架是一个交叉计划,有10个政策学习支柱。该计划包括当地能源转型和加强能源正义部分,例如能源行业的本地化,社区力量,和社会规范,包括Ubuntu,翻译为“我是,因为我们是。“重新参与全球供应链需要调整南南贸易关系的战略。
    Learning from innovations that fail is imperative for innovations that succeed. The theoretical underpinnings for this innovative framing are reflexivity, transformative unlearning, and intelligent failure. This framework proposes a definition of \"transformative governance\" as governance that creates structural equities. Governments rebuilding their economies after the COVID-19 pandemic seek equitable green transformations; that are gendered, structural, and sustainable, learning from the implemented gender-sensitive responses (hereafter referred to as policy innovations). This paper argues that transformative practices, beliefs, values, assumptions, policies, and systematic learnings are complementary to post-crisis transformations. The aim is to promote systematic learnings from innovation governance failure regarding energy policy through the analysis of COVID-19 practices and the unlearning of policy innovation beliefs, values, and assumptions that are not transformative. I ask: how gender-equitable, structurally equitable, and green-transformative were the COVID-19 policy innovations? The study\'s approach is qualitative and situated within the constructivist research paradigm. It uses reflexive thematic analysis combined with innovative coded policy narrative and a transformative index-matching technique, to identify the gap within transformative interventions. The study included 58 policy innovations (n = 58) collected from the UNDP, KPMG, government reports, and news flashes from the three most populous nations in sub-Sahara Africa: Egypt, Nigeria, and South Africa. The study found that policy innovations were inequitable in terms of gender, structure, and sustainability whereas the derived transformative pathways are equitable and gender-transformative, structurally transformative, and green-transformative. The rationales behind a transformative approach to policy reflect the systemic failures across key areas: market dynamics, research and development, and green transformation. Policy innovators can align transformative pathways for innovative governance that implements transformative energy policy. To address the needs of multiple fragile and vulnerable identities, the derived post-pandemic framework is an intersectional plan with 10 policy learning pillars. The plan includes local energy transformation and reinforcement of energy justice components, such as the localization of the energy industry, community power, and social norms, including Ubuntu, which translates to \"I am because we are.\" Reengagement in global supply chains requires South-South trade relations to be restrategized.
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  • 文章类型: Journal Article
    本文旨在为进化和复杂性经济学框架中的期望和信念逆转分析做出贡献。它根据反身性的概念来进行分析,借鉴乔治·索罗斯关于金融市场反身性的想法,并展示了一个金融周期如何表达相互作用反馈效应的系统模式的模型。本文将此分析发展为从自反经济主体的行为得出的异质期望集之间的复杂相互作用。周期中的正反馈阶段和负反馈阶段是有区别的,并且与该周期的繁荣和萧条阶段相关联。代理人的信念和判断是他们期望的基础,以及在不确定的情况下,这些信念和判断是如何变化的,并受到突然逆转的影响,这些逆转可以在“明斯基时刻”中表现出来。“论文认为,代理人的信念逆转是由于他们对繁荣和上升中的因果过程的误解,一种误解,反映了他们倾向于以负反馈模式而不是积极反馈模式进行因果关系思考。
    This paper aims to contribute to the analysis of expectations and belief reversals in a evolutionary and complexity economics framework. It formulates its analysis in terms of the concept of reflexivity, drawing on the ideas regarding reflexivity in financial markets of George Soros, and lays out a model of how a financial cycle expresses a systematic pattern of interacting feedback effects. The paper develops this analysis as a complex interaction between sets of heterogeneous expectations derived from the behavior of reflexive economic agents. Positive and negative feedback phases in a cycle are distinguished and associated with boom and bust stages of that cycle. A central role is played by agents\' beliefs and judgments underlying their expectations, and how those beliefs and judgments in uncertain circumstances are changeable and subject to abrupt reversals which can manifest themselves in \"Minsky moments.\" The paper argues that agents\' belief reversals result from their misconceptions about causal processes in booms and upswings, a misconception that reflects their tendency to think causally in terms of negative feedback patterns rather than positive ones.
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  • 文章类型: Journal Article
    本文考察了日惹年轻创意工作者的反身实践,印度尼西亚,在COVID-19期间。自2020年3月以来,COVID-19大流行在印度尼西亚群岛引发了一系列无情和重叠的危机。在印度尼西亚的城市中心,艺术和创意部门是受大流行严重影响的主要经济部门之一。COVID-19意味着的不仅仅是收入和生计的损失。流动性限制,取消演出,场馆关闭,所有这些都需要失去连接,机遇,和创意出口。然而,尽管条件不确定,年轻的创意工作者为了在日常生活中生存而保持反身的创造力。在与日惹年轻创意工作者的访谈和焦点小组讨论的基础上,我们发现了三种基于时间性的反身实践模式:等待,做某事并重新学习,这代表了年轻的创造性工作者的积极反应,表现为在一个以定期破裂为特征的大流行时代,在等级和异质文化领域中,与各种可能性的实际和矛盾的关系。对以下数据的分析有助于有关大流行时期年轻创意工作者的反身性和习性的文献。
    This article examines reflexive practice among young creative workers in Yogyakarta, Indonesia, during COVID-19. Since March 2020, the COVID-19 pandemic has unleashed a series of relentless and overlapping crises across the Indonesian archipelago. In urban centres across Indonesia, the arts and creative sectors are among the key economic sectors severely afflicted by the pandemic. COVID-19 implies a lot more than the loss of income and livelihoods. Mobility restrictions, gig cancellations, venue closures, all entail the loss of connections, opportunities, and creative outlets. Yet despite such uncertain conditions, young creative workers remain reflexively creative in order to survive in everyday life. Building upon interviews and focus-group discussions with young creative workers in Yogyakarta, we found three modes of temporality-based reflexive practice: waiting, doing something and re-learning, which represent young creative workers\' active responses manifested in the practical and contradictory relationship to the diverse possibilities within hierarchical and heterogenous cultural fields in a pandemic era characterised by regular ruptures. The analysis of the data below contributes to the literature on reflexivity and habitus among young creative workers in a time of pandemic.
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  • 文章类型: Journal Article
    本文研究了最近的一项研究项目,该项目探索了在冠状病毒大流行期间毕业的苏格兰5最后一年社会工作学生的生活经历。该项目使用Photovoice作为主要的数据收集方法,随后是一个3小时长的在线焦点小组,参与者和研究人员合作确定主题以进行进一步分析。研究结果表明,虽然参与者通过照片和字幕收集的数据对每个参与者来说都是高度个人化的,有反复出现的主题将所有这些主题联系在一起,这些主题被广泛地确定为;(DIS)连接,关闭和身份-所有这些都在收集数据后在虚拟焦点小组中进行了详细讨论。本文主要关注该研究采用的Photovoice方法,以及该方法如何成为参与式研究的有效方法。本文还重点介绍了大流行如何影响参与者身份从学生转变为专业人士之间的过渡时期。这项研究遵循参与行动研究的原则,这意味着参与者和研究人员共同努力培养和分析收集到的数据,这里讨论的发现反映了这一合作过程。在撰写这份报告时,许多新的研究,关于流行病对我们集体心理健康影响的报告和预测每天都在出现,因此希望这个项目将作为一个小时间戳,说明流行病如何影响苏格兰的这一小群学生,并纪念他们的故事,为他们创造了一个持久的空间,让他们在不断增加的新闻轰炸中被听到。
    This article examines a recent research project that explored the lived experiences of 5 final year social work students in Scotland who graduated during the coronavirus pandemic. The project used Photovoice as the primary data collection method, followed by a 3 hour long online focus group where the participants and the researcher worked collaboratively to identify themes for further analysis. The findings demonstrated that while the data collected by participants through the photographs and captions were highly personal to each participant, there were recurring themes that connected all of them which were identified broadly as; (dis)connection, closure and identity - all of which were discussed in great detail in a virtual focus group after the data was collected. This article focusses predominantly on the Photovoice method adopted for the study and how this was an effective method for participatory research. This article also focusses on how the pandemic affected the transitionary period between the participants\' identity shift from students to professionals. This study followed the principles of Participatory Action Research which meant that participants and the researcher worked together to cultivate and analyse the data collected and the findings that are discussed here reflect this collaborative process. As this report is being written, numerous new studies, reports and predictions as to the pandemics impact on our collective mental health emerge daily and so it is hoped that this project will serve as a small time stamp as to how the pandemic impacted this small group of students in Scotland and will honour their stories, creating a lasting space for them to be heard among the ever-increasing bombardment of news.
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  • 文章类型: Journal Article
    长期以来,学者们一直在努力解决不平等的权力关系如何影响国际社会工作知识的创造和流通。我概述了一个强大的后殖民理论框架,以阐明全球知识和权力的复杂性,并扩展了考虑此类认知正义问题的可能性。利用我自己与尼泊尔服务提供商的研究,我建议三种分析策略在国际社会工作研究中应用后殖民见解:反身性,批判性语篇分析,和后殖民翻译。后殖民理论和策略为社会工作研究人员的理解提供了支持,生成,并传播可以破坏殖民地假设的知识。
    Scholars have long grappled with the ways in which unequal power relations influence the creation and circulation of international social work knowledge. I outline a robust postcolonial theoretical framework to elucidate complexities of global knowledge and power and extend possibilities for considering such questions of epistemic justice. Drawing on my own research with service providers in Nepal, I suggest three analytic strategies to apply postcolonial insights in international social work research: reflexivity, critical discourse analysis, and postcolonial translation. Postcolonial theory and the strategies provided support social work researchers to comprehend, generate, and disseminate knowledge that can disrupt colonial assumptions.
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