Demystifying Research for Medical and Healthcare Students. John L. Anderson. Читать онлайн. Newlib. NEWLIB.NET

Автор: John L. Anderson
Издательство: John Wiley & Sons Limited
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Жанр произведения: Медицина
Год издания: 0
isbn: 9781119701385
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in American history, there was a near obsession with finding ways of making factory production more efficient. ‘Time and motion’ studies were rife. An early pioneer in this was Henry Ford who, in 1913, introduced the ‘assembly line’ in his car factories in which the work – cars being assembled – was brought to the workers in assembly lines rather that the workers having to move from car to car, thus cutting the time it took to complete the assembly of a Model T Ford car from 12 hours to 2.5 hours. As Henry Ford said, ‘Walking is not a paying operation’ (cited in Tuckett 1976). So, the initial experiments in the Hawthorne works were aimed at finding things which improved workers' productivity. A special production room – the bank‐wiring room – was set up so that workers could do their work in ‘laboratory’ conditions. Observers sat in and watched what was going on. The work involved wiring boards of electrical circuits. The finished circuit boards were then placed in a tub. These could be counted as a measure of productivity and workers could be paid according to the numbers of circuit boards they completed.

      The first variable to be studied was the lighting – would workers be more productive in higher/lower levels of light? So, the lighting level was increased. And productivity increased. Lighting levels were lowered; productivity increased. Cleaning the workplace, removing obstacles, and changing the working positions all seemed to increase productivity. Shortening the working day increased output. Returning to the original hours increased output. Other variables were experimented with. The results were that changing a variable usually resulted in increases in production – even when the change was back to the original condition! Output seemed to slump when the experiment was ended. Note that there is some controversy about this – no one has been able to identify the original data. Thus, Richard Nisbett has described the Hawthorne effect as ‘a glorified anecdote’. But, if that is what it is, I think it is an illustrative one. However, it is still used in Social Psychology as an example of compliant behaviours during experimental situations. The most controversial of these were the experiments conducted by Milgram where experimental participants were instructed to carry on giving electric shocks to supposed ‘subjects’ in a phoney experiment, even though the gauges showed lethally high levels of electric shocks! And Zimbardo, who set up a mock prison setting then allocated roles of ‘guards’ and ‘prisoners’ to participants – with astounding results! (Read these – you will be shocked [no pun intended] and amazed at what people will do when they think they are taking part in an experiment!)

      So, the ‘Hawthorne Effect’ is a term we use to describe a tendency in some people to try to do their best when they are taking part in experiments. It may be that the whole experimental situation, and the attention that they receive from the researchers, results in changes in their behaviour.

      I first came across the term in 1971 at a conference in Aberdeen on research into doctor–patient communication. One presenter mentioned in her work that she had taken steps to avoid the ‘Hawthorne Effect’. This stunned everybody there – ‘What's that?’ ‘Have you heard of it?’ Then, after some considerable digging, someone came up with the answer, ‘It's the bank wiring room experiments!’ All of us had read about them in our undergraduate psychology or sociology courses and referred to them as ‘the bank wiring room experiments’. This immediately prompted a tendency for conference participants to refer to spurious jargon terms to try to catch each other out! (I sometimes wonder if we ever grow up!) Of course, in medicine, the ‘Hawthorne Effect’ is known as and is referred to as … that's right, the ‘Placebo Effect’.

      For further reading on this topic, try Fox, Brennan, and Chasen (2008), Kolata (1998), Landsberger (1958), Levitt and List (2011), and McCarney, Warner, and Iliffe, et al. (2007).

       When placed in a shuttle box, an experimentally naïve dog, at the onset of the first electric shock, runs frantically about until it accidentally scrambles over the barrier and escapes the shock. On the next trial, the dog, running frantically, crosses the barrier more quickly than on the preceding trial; within a few trials it becomes very efficient at escaping, and soon learns to avoid shock altogether. After about fifty trials the dog becomes nonchalant and stands in front of the barrier; at the onset of the signal for shock it leaps gracefully across and never gets shocked again.

       A dog that had first been given inescapable shock showed a strikingly different pattern. This dog's first reactions to shock in the shuttle box were much the same as of a naïve dog; it ran about frantically for about thirty seconds. But then it stopped moving; to our surprise, it lay down and quietly whined. After one minute of this we turned the shock off; the dog had failed to cross the barrier and had not escaped from shock. On the next trial, the dog did it again; at first it struggled a bit, and then, after a few seconds, it seemed to give up and to accept the shock passively. On all succeeding trials, the dog failed to escape. This is the paradigmatic learned‐helplessness finding. (Seligman, 1975).

A photograph of Shuttlebox design.

      Seligman demonstrated from this and later work on human subject that learned helplessness saps the motivation to initiate responses; disrupts the ability to learn; and produces emotional disturbance. That is, it has three levels of effect:

       motivational

       cognitive

       emotional.

      He went on to show how this effected people in real life and that this could even be implicated in depression and death. Read his book Learned Helplessness: On Depression, Development, and Death (1975); in addition to being educational, it is a thoroughly good read!