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)

Medical-legal partnership (MLP) is an intervention embedding legal professionals within a clinical setting to address patients’ health harming legal needs (HHLN). While much of the literature focuses on the role of the lawyer in the partnership, less is understood about the role of the clinician. Data were collected about MLP medical champions from workshop attendees at an MLP conference held by the Solomon Center at Yale Law School, a leader in health law. From the 107 concepts collected at the workshop, (...) 40 mechanisms by which the medical champion can best serve an MLP were identified and ranked by expert MLP champions, using a Delphi method. Medical champions’ relations with the legal team and with direct patient care were of high priority, in contrast with their role in larger scale advocacy. The findings from this study provide evidence that medical champions are a cornerstone of MLPs as they understand clinical workflows, are aware of patient population needs, and can support the multi-disciplinary MLP team to address HHLN. By gaining a deeper understanding of the potential responsibilities and actionable steps that a medical champion can undertake, it is possible to mitigate the challenges faced by MLPs and enhance their implementation and longevity. (shrink)

Background The growing incorporation of telenursing into the conventional healthcare system has raised urgent ethical and legal questions concerning the scope and standards of nursing practice. As nursing expands beyond traditional in-person care into digitally mediated environments, the lack of a legal framework in South Korea presents challenges to protecting patient rights and ensuring professional accountability. Aim This study aims to support the development of a regulatory framework for telecare nursing by identifying and prioritizing key legislative challenges affecting professional autonomy (...) and ethical care delivery. Research design A two-round Delphi technique was employed. Participants and research context A panel of twelve experts in nursing, health law, and digital health, each with over ten years of professional experience, participated. An initial set of 16 legislative items was developed through content analysis of legal documents and guidelines and reviewed by two subject-matter experts. Through iterative expert consultation, the item pool was refined and expanded to 24 statements for use in the Delphi process. Ethical considerations The study was approved by the institutional review board. Informed consent was obtained, and confidentiality was maintained throughout. Results Eight items met all consensus criteria (necessity and feasibility ≥4.0; ≥80% agreement), including data security, documentation standards, identity verification, nurse certification, and informed consent. Seven ethically significant items such as scope of practice, liability, and reimbursement lacked feasibility consensus, suggesting major implementation barriers. Nine items were considered lower priority. The panel also highlighted three preparatory tasks: building public consensus, forming a multistakeholder steering committee, and legally recognizing nursing roles in telecare. Conclusions Legislative priorities for ethical telecare were identified, though feasibility gaps indicate challenges to implementation. Legal frameworks should uphold ethical principles while supporting information governance, patient-centeredness, and professional empowerment. These findings offer timely guidance for integrating telecare into nursing practice and enhancing patient trust. (shrink)

Disagreement among experts is a central topic in social epistemology. What should an expert do when confronted with the different opinion of an epistemic peer? Possible answers include the steadfast view (holding to one’s belief), the abstemious view (suspending one’s judgment), and moderate conciliatory views, which specify criteria for belief change when a peer’s different opinion is encountered. The practice of Delphi techniques in healthcare, medicine, and social sciences provides a real-life case study of expert disagreement, where disagreement is (...) gradually transformed into consensus. An analysis of Delphi shows that moderate conciliatory views are descriptively more adequate than rival views. However, it also casts doubt on whether the debate in social epistemology is explanatory relevant vis-à-vis real life cases of expert disagreement, where consensus replaces truth, and acceptance is more explanatorily relevant than belief. (shrink)

Background Managerial ethical principles and behaviours guide the roles, duties, responsibilities, behaviours, and relationships of nurse managers in healthcare institutions. Research objectives The aim of this study was to establish the managerial ethical principles and behaviours for nurse managers. Research question What are the managerial ethical principles and behaviours for nurse managers? Research design The Delphi method, one of the qualitative research methods, was used in this study. The Delphi process consisted of two rounds. Data were collected by (...) e-Delphi technique. Participations 42 experts were included in the first Delphi round and 39 in the second Delphi round. These experts consisted of nurse managers, academicians studying in the field of ethics and nursing management. Ethical considerations Participation in the study was voluntary and informed consent of the experts was obtained before the study. Approval was obtained from the ethics committee of the university at which the researcher worked (Approval date: 24.07.2020, Decision No: 2020/12-16). Findings At the end of the Delphi rounds, eight managerial ethical principles and 29 ethical behaviours of these principles were identified. The distribution of these behaviours and principles were: justice (six behaviours), equality (two behaviours), honesty (two behaviours), fairness (two behaviours), responsibility (eight behaviours), confidentiality (two behaviours), clarity (two behaviours), and humanity (five behaviours). Conclusion These managerial ethical principles and behaviours are intended to guide nurse managers when providing nursing services but should be updated accordingly in line with changing conditions and developments. (shrink)

BackgroundFear of cancer recurrence is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research.MethodsMembers of the International Psycho-oncology Society Fear of Cancer Recurrence Special Interest Group were invited to participate in an online Delphi study. Research domains identified in (...) Round 1 were presented and discussed at a focus group to consolidate the domains and items prior to presentation in further survey rounds aimed at gaining consensus on research priorities of international significance.ResultsThirty four research items were identified in Round 1 and 33 of the items were consolidated into six overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2, and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further four research items were identified by panelists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panelists. Given the high levels of consensus and stability between rounds, no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panelists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions was the third highest priority identified.ConclusionThe findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment are based on a flexible approach based on symptom severity and can be delivered within routine clinical care were identified as research areas to prioritize. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need. (shrink)

Background Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. Methods We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas (...) of agreement among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item’s mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. Results Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. Conclusions Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research. (shrink)

There are no remains of the wood frame of the Temple of Apollo, built in Delphi during the 4th century BC, neither are there any blocks with hollows for supporting the beams. In contrast, the construction accounts mention wooden pieces in a number of extracts and report work on the upper parts of the monument. This article examines these inscriptions, with three main objectives: to determine the destination and function of the wooden pieces; to analyse the technical vocabulary; and (...) to establish the chronology of work in the upper parts of the temple. In addition to being a study focused on Delphic architecture, the corpus used contributes to the characterization of carpentry techniques and the knowledge of how monumental architectural projects were carried out in ancient Greece. (shrink)

Senior lecturers/lecturers in mental health nursing (11 in round one, nine in round two, and eight in the final round) participated in a three-round Delphi study into the teaching of health care ethics (HCE) to students of nursing. The participants were drawn from six (round one) and four (round three) UK universities. Information was gathered on the organization, methods used and content of HCE modules. Questionnaire responses were transcribed and the content analysed for patterns of interest and areas of (...) convergence or divergence. Findings include: the majority (72.8%) of the sample believed that insufficient time was allocated to the teaching of HCE; case studies were considered a popular, although problematic, teaching method; the ‘four principles’ approach was less than dominant in the teaching of HCE; and virtue ethics was taught by only 36.4% of the participants. The Delphi technique proved adequate and worth while for the purposes of this study. Further empirical research could aim to replicate or contradict these findings, using a larger sample and recruiting more university departments. Reflection is required on several issues, including the depth and breadth to which ethics theory and, more controversially, meta-ethics, are taught to nursing students. (shrink)

Use of the drill in Archaic sculpture : the technique of the running drill. In most works treating the techniques of ancient Greek sculpture, the date of appearance of the running drill varies between the beginning of the second half of the 5th c. and the third quarter of the 4th c. B. C. No mention of a use in the Archaic period is made and the technical definitions are often unclear, going as far as confusing the tool with (...) the manner of its use. The study of tool marks, undertaken within the framework of research on the techniques of Archaic Greek sculpture, shows that the running drill appears to have been in use toward the middle of the 6th c. at Samos, then in a more sustained manner at the end of the 6th and the beginning of the 5th c. at the Athenian Akropolis and at Delphi. (shrink)

Executives in business and government seek to leverage artificial intelligence (AI), the biggest driver of technological change, to inform decision-making. The intelligence behind AI comes from machine learning (ML) algorithms applied to large datasets. The goal of this research is to investigate the adage that while humans are fallible, computers are impartial with no implicit bias. Toward this purpose, the author used the Delphi research technique to achieve these three objectives: (1) identify and categorize the sources of flaws (...) in algorithm design; (2) validate a framework for auditing AI-powered systems; and (3) propose strategies for resolving the sources and mitigating the flaws in algorithm design. The paper begins with a concise theoretical framework for algorithm design to familiarize the readers with the science of ML algorithms. Next, the author describes the research methodology including population and sample of the study. The findings of the Delphi study are presented in three sections that correspond with the three objectives of this investigation. A discussion of the findings is enhanced with supporting evidence from existing literature of unintended undesirable societal impacts of flaws in algorithm design in fields like education, healthcare, criminal justice, human resource management, and financial services. The expected outcome is cautious use of AI by decision-makers—employing AI while being aware of its limitations and shortcomings. (shrink)

There appears to be a widespread belief that the social sciences during the 1950s and 1960s can be characterized by an almost unquestioned faith in a positivist philosophy of science. In contrast, the article shows that even within the narrower segment of Cold War social science, positivism was not an unquestioned doctrine blindly followed by everybody, but that quite divergent views coexisted. The article analyses two ‘techniques of prospection’, the Delphi technique and political gaming, from the perspective of (...) a comprehensive set of ideas attributed to ‘positivism’. Both techniques were developed in the early 1950s by researchers at the RAND Corporation, a Californian think tank with tight relations to the US Air Force. Despite the closeness of origin, the two techniques show considerable differences in their basic epistemologies. The article thus concludes that more important than positivism in uniting US Cold War social science was the shared sense of urgency and of the potential of social science to put decision-making in foreign policy on a rational basis. In this sense, as far as the Cold War social sciences were of a piece, they were made so by the sense of danger and urgency of action evoked by the image of the Iron Curtain. (shrink)

BackgroundStructured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or (...) not stating how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.MethodsThe ACCORD (ACcurate COnsensus Reporting Document) project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration (E&E) document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.DiscussionThe ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes. (shrink)

Engineering ethics education is a complex field characterized by dynamic topics and diverse students, which results in significant challenges for engineering ethics educators. The purpose of this paper is to introduce a systematic approach to determine what to teach and how to teach in an ethics curriculum. This is a topic that has not been adequately addressed in the engineering ethics literature. This systematic approach provides a method to: (1) develop a context-specific engineering ethics curriculum using the Delphi (...) class='Hi'>technique, a process-driven research method; and (2) identify appropriate delivery strategies and instructional strategies using an instructional design model. This approach considers the context-specific needs of different engineering disciplines in ethics education and leverages the collaboration of engineering professors, practicing engineers, engineering graduate students, ethics scholars, and instructional design experts. The proposed approach is most suitable for a department, a discipline/field or a professional society. The approach helps to enhance learning outcomes and to facilitate ethics education curriculum development as part of the regular engineering curriculum. (shrink)

SMEs are the driving force of economies. However, they face challenges that affect their long-term survival, such as developing ethical business environments. Business ethicsrelated research is underdeveloped in SMEs, thus limiting our understanding of business ethics in SMEs. The purpose of this qualitative study was to investigate how business ethics is conceptualised in SMEs, using the Delphi Technique. In SMEs, business ethics is viewed as doing the right thing, having integrity, being transparent, trustworthy, and behaving responsibly towards internal (...) and external parties. The contribution of this article is that business ethics is perceived as upholding quality, being transparent and trustworthy. (shrink)

Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given (...) to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)

About ten years ago, I participated in a consensus process on migraine nomenclature. Participants used a modified Delphi technique to explore their views about what migraine is. Candidate concepts included an illness, disease, syndrome, condition, disorder, or susceptibility. Initially, there was a wide range of views about which concept best fits our concept of migraine. Migraine—in common with many psychiatric disorders—is poorly understood by neuroscience. On scientific grounds, participants thought that "susceptibility" and "syndrome" describes our current knowledge well. (...) However, participants were concerned that terms like "susceptibility" and "syndrome" could lead to migraine not... (shrink)

The application of artificial intelligence (AI) in financial investments has transformed investment decision-making by providing customized investment solutions and advanced predictive analytics. However, using AI in financial investment is accompanied by critical concerns surrounding data bias, market volatility, lack of transparency, and ethical concerns, resulting in investment-related stress. The present study identifies and examines the important factors impacting stress in financial investment due to the application of artificial intelligence. Using a Delphi technique and Social Network Analysis utilizing UCINET (...) software, nine factors were determined, including perceived loss of control, reduced human interaction, algorithm bias, and over-reliance on AI. This research explored the interrelationships and cascading effect of these identified factors on stress, and key stress-inducing factors like transparency issues, decision fatigue, perceived loss of control, and over-reliance on AI are determined as critical factors affecting investor behavior. The findings highlight the significance of addressing psychological and technological challenges through user education, enhanced transparency, and ethical AI practices to maximize investor trust and confidence. This study offers important implications for policymakers, financial institutions, and academics. By addressing the underlying stressors, stakeholders can design equitable, efficient, and user-friendly AI systems that stimulate a more positive and inclusive investment environment. (shrink)

Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given (...) to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs ; 2) Deputy chief provincial coroners ; 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting. Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)

This study aims to conduct awareness research in Turkey on how the internal audit function follows/will follow to manage the risks encountered in the digital transformation process and to present suggestions as a result of this research. In the doctoral thesis, the two-phase Delphi technique was used. In the first phase, semi-structured interviews were conducted with 13 participants: academics, internal auditors working in public, independent auditing institutions, and law-making institutions. This stage constitutes the qualitative part of the study. (...) As a result of the interviews, in the second stage, the survey form consisting of 65 statements was presented to the participants and their opinions were taken. The second and third phases constitute the quantitative part of the study. In this study, semi-structured interviews, which are the first phase of the study, are presented. As a result of the study, it was found that the participants were aware of the effects of digital transformation on internal audit and that the institutions had expectations from the internal audit function within the framework of the consultancy role in the digital transformation process. (shrink)

The “Radiography of the Teaching of University Entrepreneurship in Mexico” is situated within the context of the necessity to comprehend and enhance the pedagogical practices associated with entrepreneurship in Mexican universities. This context encompasses a global examination of entrepreneurship and its prevailing trends, as well as a detailed analysis of the entrepreneurial landscape in Mexico. The principal objective of this study is to conduct a comprehensive examination of the pedagogical approaches employed in higher education institutions (HEIs) in Mexico with regard (...) to the teaching of entrepreneurship. The objective is to establish a unified approach to entrepreneurship teaching, identify the most effective pedagogical tools for fostering an entrepreneurial mindset, and disseminate the requisite technical knowledge among educators to facilitate their integration into the classroom. The methodology employed begins with a review of secondary sources to provide a detailed overview of the global and Mexican entrepreneurship landscapes, as well as the current state of entrepreneurship education in higher education institutions (HEIs). In conclusion, the Delphi technique is employed to conduct interviews with experts directly involved in the teaching of entrepreneurship in various HEIs, with the objective of collecting and synthesizing their opinions on the subject matter. The research yielded a “Teaching Model of Entrepreneurship in the University,” which is based on the identified approaches, models, and methodologies. The teacher plays a pivotal role in the teaching of entrepreneurship in higher education institutions (HEIs). The findings indicate that in Mexico, the probability of success or opportunity for entrepreneurs is significantly influenced by the material conditions of the individual, which are shaped by their social stratum and geographical location. Furthermore, data indicates that all HEIs endeavor to impart instruction on entrepreneurship. However, due to significant disparities between private and public institutions, smaller or more remote ones may lack the capacity and resources to do so effectively. Therefore, this results in heterogeneity in the teaching of entrepreneurship, which could condition the chances of success for those wishing to become entrepreneurs. Consequently, the necessity was identified for all entrepreneurship teachers in HEIs in Mexico to be able to achieve a robust and comprehensive process of teaching entrepreneurship, whereby students can develop their entrepreneurial skills at an early stage, as well as the creation of companies at a later stage. (shrink)

Objective: Bullying of school-aged children is not new and has been well-established as a common and serious problem in society. The aim of the current study is to explore the nature of cyberbullying in a sample of Jordanian adolescents. Method: The study used the quantitative approach and opted for the Delphi Technique, an online survey of adolescents, and an interview-based research approach following with the reviewing of the responses in order to identify the trends and nature of cyberbullying (...) in a sample of Jordanian adolescents. The population sample consists of adolescents from two private schools in Jordan in the Middle East. The combined Adolescents sample of both schools totals approximately 6,000 students. Results: The results of this study reveal that significant numbers of adolescents are sending or receiving sexually explicit photos. The results also suggested that prevalence rates are high in four main categories of cyberbullying. Also, there is a difference in gender and educational level as females are subjected to more incidences of cyberbullying, and 4th grades students have a more significant value of cyberbullying involvement. Conclusion: It is essential to activate the role of the media and education systems in training youths about the risks of cyberbullying to improve adolescent feelings about the value of treating others well and engaging in objective cultural dialogue with them, as well as the strategies for avoiding it. (shrink)

Background and rationale Clinicians often encounter a variety of ethical challenges in their routine clinical practice, and it varies across healthcare and cultural settings of their practice. Despite of this, there are no clear-cut available guidelines concerning the right course of action in a given ethically challenging situation. A validated instrument that could capture the health care providers’ (HCP’s) viewpoints in this regard is lacking from Indian settings. Thus, the current study aimed at developing an instrument to assess the HCP’s (...) perspective regarding different ethically challenging situations encountered in the Indian settings. Methods The questionnaire was developed by involving 15 medical experts. A mixed-method approach, Delphi-technique, and online survey were used for item generation and validation. Results The questionnaire comprised of 11 items (accounts 57% variance; having an α = 0.68) representing four factors: health-resource constraints, medical responsibility of the HCP, obtaining patients/family members’ consent for the treatment, and treatment beyond the standard protocol. The gender and clinical disciplines of the participants were related to their level of endorsement for various domains of the ECCS-Q. Conclusions Ethical challenges in the clinical practice fall in different clusters. The clinicians’ course of action in such situations have many socio-demographic and professional determinants. Future studies are warranted to investigate these phenomena. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six (...) chapters and 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

Efforts to reform medical education have emphasized the need to formalize instruction in medical ethics. However, the discipline of medical ethics education is still searching for an acceptable identity among North American medical schools; in these schools, no real consensus exists on its definition. Medical educators are grappling with not only what to teach (content) in this regard, but also with how to teach (process) ethics to the physicians of tomorrow. A literature review focused on medical ethics education among North (...) American medical schools reveals that instruction in ethics is considered to be vitally important for medical students. Agreement by medical educators on a possible core curriculum in ethics should be explored. To develop such a curriculum, deliberative curriculum inquiry by means of a targeted Delphi technique may be a useful methodology. However, the literature reveals that medical curricular change is notoriously slow. General implications for medical ethics education as a discipline are discussed. (shrink)

Background The recent proliferation of health care report cards, especially in cardiac care, has occurred in the absence of an ethical framework to guide in their development and implementation. An ethical framework is a consistent and comprehensive theoretical foundation in ethics, and is formed by integrating ethical theories, relevant literature, and other critical information (such as the views of stakeholders). An ethical framework in the context of cardiac care provides guidance for developing cardiac report cards (CRCs) that are relevant and (...) legitimate to all stakeholders. The purpose of this study is to develop an ethical framework for CRCs. Methods Delphi technique – 13 panelists: 2 administrators, 2 cardiac nurses, 5 cardiac patients, 2 cardiologists, 1 member of the media, and 1 outcomes researcher. Panelists' views regarding the ethics of CRCs were analyzed and organized into themes. Results We have organized panelists' views into ten principles that emerged from the data: 1) improving quality of care, 2) informed understanding, 3) public accountability, 4) transparency, 5) equity, 6) access to information 7) quality of information, 8) multi-stakeholder collaboration, 9) legitimacy, and 10) evaluation and continuous quality improvement. Conclusion We have developed a framework to guide the development and dissemination of CRCs. This ethical framework can provide necessary guidance for those generating CRCs and may help them avoid a number of difficult issues associated with existing ones. (shrink)

Rapid advances in the domain of science and technology are having an unprecedented effect upon the provision of higher education in universities throughout the world, the pace of change often being so fast as to make planning for the development of the “classroom of the future” an extremely difficult task. The Mobile Multimedia University (MMU) project, a collaborative action between four leading UK based research facilities, has been established to investigate these issues. Included amongst its aims is the use of (...) novel research methodologies to determine the factors which will influence the shape and form of future education provision, and thus the distribution of knowledge to society, such as mobility, telecommunications and multimedia services. This paper describes the use of a Delphi survey in predicting the technological trends and innovations which will affect university education in the near future. It describes the theory underpinning the Delphi method, illustrating this with examples of how such a technique has been successfully used in the past. It then details the specific application of the Delphi approach within the current MMU research project, detailing the preliminary results and discussing the implications of these findings for the future of universities and other institutes of higher education. (shrink)

Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

This chapter reviews research from psychological science on the conditions under which groups make optimal judgements, a subject area often called “wisdom of crowds”. It concludes that good judgements are more likely when the members of a group are selected for expertise, there is cognitive diversity among the members, they make independent judgements which are then aggregated and there is opportunity for sharing information and discussion. When the methods that scientists use to establish deliberative consensus are evaluated against these conditions, (...) none meet them all, but some (Delphi studies and nominal group technique) are better than others. (shrink)

This chapter describes the range of methods that have been used for determining deliberative consensus. These are Delphi studies, the nominal group technique, surveys of experts, systematic analysis of conclusions in the peer-reviewed literature, consensus conferences and expert working groups. There are also emerging methods which are not yet in common use: scientific citation networks, prediction markets and artificial intelligence.

Purpose This study aims to explore the association between internet addiction and problem behaviours on social networking sites (SNS) using the general strain theory (Agnew, 1992). Design/methodology/approach Using the purposive sampling method, a survey was conducted, which collected data from 414 college students studying in two public universities in South Australia. The Delphi method was used to develop the questionnaire used for the survey. Findings 'Results of this research indicated a significant association between internet addiction and problem behaviours on (...) SNS. Respondents who had engaged in problem behaviours on SNS had high internet addiction test scores (Young, 1998). On the basis of this finding, the present research argues that the general strains associated with the suffering of newly emerging challenges such as internet addiction might contribute to victimisation and deviant and problem behaviours on SNS in specific and possibly in cyberspace in general. Research limitations/implications Results of the present study need to be interpreted cautiously due to many limitations it has. This research is a cross-sectional study, which might not adequately explain the associations between internet addiction and problem behaviours on SNS. Longitudinal studies involving larger samples might have added significant value to this study. The present study uses purposive sampling technique, which has limited its generalizability, and its findings may not be generalised to large populations. Originality/value Limited information is available pertaining to the association between problem behaviours on SNS and internet addiction. The present study is a pioneering effort, which argues that rapid popularity of SNS is likely to increase internet addiction and the frustration of not getting proper treatment for their internet addiction might lead to deviant behaviours on SNS. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Plato on the Rhetoric of Philosophers and SophistsMichael SvobodaPlato on the Rhetoric of Philosophers and Sophists by Marina McCoy New York: Cambridge University Press, 2008. vii + 212 pp. $74.00, hardcover.With her new book, Marina McCoy, an assistant professor of philosophy at Boston College, succeeds in opening up new lines of inquiry into Plato’s formative engagement(s) with rhetoric: first, by involving other Platonic dialogues in the ongoing interrogations (...) of the Gorgias and Phaedrus and, second, by patiently considering the implications of the different accounts of sophists and philosophers that result. These new investigations are aided by the diverse disciplinary voices with which Marina McCoy herself converses—works by classicists, critics, philosophers, political theorists, and rhetoricians, works taken from a wide range of journals. In her interpretation of the Gorgias, for example, one encounters the names one would expect from a thorough and up-to-date review of these different literatures: Arieti, Dodds, Fussi, Gordon, McComiskey, Nightingale, Saxonhouse, and Yunis. Thus, Plato scholars from both rhetoric and philosophy will find much of interest in this book.McCoy provides a clear overview of her project in her introduction (1–22). In separate readings of the Apology, Protagoras, Gorgias, Republic, Sophist and Theaetetus, and Phaedrus, three interrelated claims are presented and developed: first, consistently distinguishing the philosopher from the sophist was a difficult challenge for Plato—and for the ancient Athenians; second, Plato’s conception of philosophy includes “important rhetorical dimensions,” and third, Plato ultimately differentiates the philosopher [End Page 191] from the sophist on the basis of character (3). To substantiate these claims, the dramatic and historical elements of Plato’s dialogues are interpreted in tandem with their explicit arguments. McCoy notes that the experience of reading the dialogues often reproduces the psychological tensions captured by them. In other words, Plato uses rhetorical techniques to cause his readers both to question philosophy and to engage in it as they do so (7). At the same time, McCoy recognizes that the terms of these discussions were hotly contested: “The Greek mindset at the time of Plato is one of passionate interest in the nature, power, and danger of logos : terms such as philosophia, rhetorike, sophist, and rhetor become part of the weaponry in the battle” (11). By attending to these elements in the seven dialogues examined in the following six chapters, McCoy seeks to show that philosophy is better defined as an interaction of souls than as a collection of analytical techniques, that the approach of Plato’s Socrates “relies more on phronesis and kairos than techne ” (15).These broad claims are immediately tested in the second chapter of the book, “Elements of Gorgianic Rhetoric and the Forensic Genre in Plato’s Apology ” (23–55). Here McCoy further develops two observations about the Apology. First, Socrates’ claims to the contrary, the Apology actually incorporates a number of elements common in forensic speeches at the time of his trial: a standard speech structure, arguments from probability ( eike ), and portrayal of character ( ethopoioa ) (26, 40). But perhaps more provocatively, second, in the Apology Plato seems to allude to Gorgias’ In Defense of Palamedes ; both speeches portray their speakers as public benefactors who cannot have committed the crimes of which they are accused but who nonetheless cannot defend themselves effectively under the conditions of their trial (32–39). When McCoy then calls our attention to the historical elements in the Apology —the life and death of Chaerophon, the role played in Athenian culture and politics by the oracle at Delphi, and the rules governing testimony—we must consider the possibility that Socrates may successfully be using rhetorical techniques, not to win his juror’s favor but to confuse and challenge them. Thrown off their moral balance, McCoy argues, his jurors might be led to question themselves. “Socrates’ risky choice to appeal to the oracle story forces each juror to make a choice: he must decide whether Socrates’ philosophical activity is a moral and even religious virtue” (51). In and through the Apology, Plato may be doing something very similar for his readers: “If Gorgias’ Encomium of Helen is a forensic piece disguised as [an] encomium, perhaps Plato’s Apology... (shrink)

Although construct measurement is critical to explanatory research and intervention efforts, rigorous measure development remains a notable challenge. For example, though the primary theoretical model for understanding health disparities among sexual minority (e.g., lesbian, gay, bisexual) adolescents is minority stress theory, nearly all published studies of this population rely on minority stress measures with poor psychometric properties and development procedures. In response, we developed the Sexual Minority Adolescent Stress Inventory (SMASI) with N = 346 diverse adolescents ages 14–17, using a (...) comprehensive approach to de novo measure development designed to produce a measure with desirable psychometric properties. After exploratory factor analysis on 102 candidate items informed by a modified Delphi process, we applied item response theory techniques to the remaining 72 items. Discrimination and difficulty parameters and item characteristic curves were estimated overall, within each of 12 initially derived factors, and across demographic subgroups. Two items were removed for excessive discrimination and three were removed following reliability analysis. The measure demonstrated configural and scalar invariance for gender and age; a three-item factor was excluded for demonstrating substantial differences by sexual identity and race/ethnicity. The final 64-item measure comprised 11 subscales and demonstrated excellent overall (α = 0.98), subscale (α range 0.75–0.96), and test–retest (scale r > 0.99; subscale r range 0.89–0.99) reliabilities. Subscales represented a mix of proximal and distal stressors, including domains of internalized homonegativity, identity management, intersectionality, and negative expectancies (proximal) and social marginalization, family rejection, homonegative climate, homonegative communication, negative disclosure experiences, religion, and work domains (distal). Thus, the SMASI development process illustrates a method to incorporate information from multiple sources, including item response theory models, to guide item selection in building a psychometrically sound measure. We posit that similar methods can be used to improve construct measurement across all areas of psychological research, particularly in areas where a strong theoretical framework exists but existing measures are limited. (shrink)

Separate and Dominate is Delphy's manifesto, lambasting liberal hypocrisy and calling for a fluid understanding of political identity that does not place different political struggles in a false opposition. She dismantles the absurd claim that Afghanistan was invaded to save women, and that homosexuals and immigrants alike should reserve their self-expression for private settings. She calls for a true universalism that sacrifices no one at the expense of others. In the aftermath of the Charlie Hebdo massacre, her arguments appear more (...) prescient and pressing than ever.--Provided by publisher. (shrink)

By bringing feminist science studies scholar Donna J. Haraway’s A manifesto for cyborgs (1985) and Situated knowledges (1988) in line with contemporary critical new materialist thought (see Colman & Van der Tuin, 2024; Dolphijn & Van der Tuin, 2012; Geerts, 2022), this critical pedagogical and philosophical think piece tackles the problematic of Anthropocenic disruptions of the planetary biosphere for critical pedagogies and higher education (also see Carstens, 2016). It additionally encourages its readers to think through their own pedagogical conceptions and (...) praxes by means of irruptive (Geerts & Carstens, 2024; Koro-Ljungberg, 2015) selfreflection- stimulating questions. Our situated – and thus limited and open-ended – response to this all-encompassing Anthropocenic crisis is rooted in a rethinking of Harawayan cyborgian and situated knowledges and the critical pedagogical lessons drawn from the latter. Rereading Haraway’s work through contemporary critical new materialist and related scholarship reveals that it already contained an ecofeminist onto-epistemological shift toward more-than-human agency and relationality. This shift has major consequences for all things critical pedagogical and educational, as our pedagogical thinking-doings are deeply embedded in today’s crisis-ridden lifeworld. This rereading exercise furthermore underlines the necessity of an updated critical new materialist pedagogical praxis for learning and teaching, inspired by Harawayan ecofeminism, that takes the entanglements between human, dehumanised, and more-than-human actors seriously. (shrink)

Fascism, according to the Deleuzo-Guattarian perspective and new materialist viewpoints, can be conceived of in terms of desire. In mediating desire’s pure flows, the schizoanalytical programme attempts to bypass what Deleuze calls ‘the strange detour of the other’ (B, 356). In this respect, concepts developed in Gilles Deleuze and Félix Guattari’s Capitalism and Schizophrenia cycle are critical to the project of the problematic of desire, the other and (neo-)fascism. In this chapter, we explore how Deleuzo-Guattarian anti-fascist concepts, such as the (...) Body without Organs (BwO), together with new materialist approaches towards vital materialism, may help us to ‘keep an eye on all that is fascist, even [the fascist] inside us’ (TP, 165). Such a critical-creative analysis, we argue, is needed to distinguish contemporary vitalist new materialisms from so-called Lebensphilosophien (philosophies of life) and frame the rise of neoliberal capitalism-supported regimes of neo-fascism. (shrink)

Les femmes mariées restent gouvernées par les hommes qui en attendent un travail domestique ménager, culturel, social, et sexuel. La famille reste oppressive pour les femmes. Patriarcat et capitalisme sont deux systèmes d’oppression distincts. Partout, et pas seulement dans le capitalisme, le travail ménager est fait par les femmes gratuitement et obligatoirement, parfois par des domestiques qu’il faut tout de même contrôler. La hiérarchie entre les hommes et les femmes reste admise, car elle est héritée du passé. Les femmes continuent (...) de s’autosacrifier quand il faut partager au sein de la famille. (shrink)

This essay argues for a transversal posthumanities-based pedagogy, rooted in an attentive ethico-onto-epistemology, by reading the schizoanalytical praxes of Deleuzoguattarian theory alongside the work of various feminist new materialist scholars.

This intra-view explores a number of productive junctions between contemporary Deleuzoguattarian and new materialist praxes via a series of questions and provocations. Productive tensions are explored via questions of epistemological, ontological, ethical, and political intra-sections as well as notions of difference, transversal contamination, ecosophical practices, diffraction, and, lastly, schizoanalysis. Various irruptions around biophilosophy, transduction, becomology, cartography, power relations, hyperobjects as events, individuation, as well as dyschronia and disorientation, take the discussion further into the wild pedagogical spaces that both praxes have (...) in common. -/- . (shrink)

Whether we are said to be living in the Anthropocene, the Capitalocene, or are witnessing the start of the Chthulucene, as feminist science studies scholar Donna J. Haraway (2016) would describe the current post-anthropocentric era, there is a demonstratable need for affective, entangled, transversal forms of thinking-doing today. Writing this editorial almost a year after the COVID-19 pandemic erupted, and that as inhabitants of Belgium and South Africa—countries with complex ongoing capitalist-colonial legacies, socio-political presents, and heavily but also differently hit (...) by said pandemic—we more than ever feel that these are times of entwined crisis, chaos, and hardship, overflowing with cravings for pedagogical-philosophical responses that are affirmative, productive, and future-oriented. Reactions that are moreover part theory, part praxis, counter the nihilistic, and are future-focused while still grounded in the present, as to not defer responsibilities to future times (see Geerts & Carstens, 2019). (shrink)

Our current era of crisis and neo-fascist revanches (see Lawtoo 2019) is rife with desires-driven mimesis, and more specifically, mimetic resentment or conflictual copycat behaviour. Traditionally conceptualised in relation to ressentiment, mimetic resentment (see Nietzsche [1887]2006; Girard [1961]1965, [1977]1992, and [1978]1987) is seldom analysed as a somatechnical phenomenon that meshes the corporeal and the technological (Sullivan 2005; Pugliese and Stryker 2009; Sullivan and Murray 2011), involving pre-personal and affective micropolitics, as well as social and environmental macropolitical characteristics. This article therefore (...) seeks to map out resentment's contemporary somatechnics by attending to its violence-engendering micropolitics in addition to the macrolevels of the permacrisis times it is said to be operating in. The burgeoning environmental crisis that is currently unfolding against the backdrop of these permacrisis times furthermore indicates that such a mapping exercise must consider both the micro- and macropolitical nuances of how zoē/bios classifications and resultant gaps between non/human actors are created and sustained. Finding such a nuanced eco-focused framework in Deleuzoguattarian philosophy (see Deleuze [1969]1990; Deleuze and Guattari [1980]2005; Guattari [1989]2000 and [1992]2002), as well as contemporary critical new materialist thought (see Cooper 2008; Braidotti 2013; Haraway 2016; and Yusoff 2018), we first examine these permacrisis times before presenting a critical cartography (Braidotti [1994]2011; Deleuze and Guattari [1980]2005) of the contours of mimetic resentment's violent micro- and macropolitical somatechnics, to then explore several eco-focused Deleuzoguattarian and critical new materialist pathways that could lead us out of the spiralling vortex of violence that characterises this time of planetary trouble. (shrink)