Effective decisions and their verbal justification

Recent experimental work on human control of complex systems has drawn attention to the discrepancy that may exist between the person's reported knowledge of the system and their ability to control it. Sometimes people act correctly but cannot answer questions about what they are doing; sometimes they can say verbally what they should do (perhaps having had verbal instruction in the right answers), but still do not do it. This discrepancy is of major practical importance, for example in designing training programmes or in eliciting expert knowledge for incorporation in a mechanical 'expert system'. It is also puzzling for psychological theory, as it rules out certain plausible models of the functioning of the brain. This paper considers what mechanisms are still possible.     

Microenterprise in health care and health education

Over the last decade, development aid has increasingly used a more collaborative model, with donors and recipients both contributing ideas, methods and goals. Though many examples of collateral aid projects exist in agriculture, business administration and banking, few have found their way into health care and health education, a typically donor-dominated model. The following case report describes a collateral project in health care education. This case report analyzes data-inducing project proposals, personal interviews and project reports obtained through standard archival research methods. The setting for this joint project was the collaboration between international nongovernmental (NGO) aid foundations and the faculty of a major sub-Saharan African Medical School's Department of Anesthesia. The initial goal of this project was to improve record keeping for all anesthetic records, both in the operating theatres and outside. Analysis of the data was performed using ethnographic methods of constant comparative analysis. The purpose of the analysis was to critically evaluate both the goals and their results in the Department of Anesthesiology. The findings of this analysis suggested that results included not only quality assurance and improvement programs in the department but also advances in the use of critical incidents as teaching tools, hospital-wide drug and equipment utilization information and the initiation of an outreach program to district hospitals throughout the country for similar projects.