DOI: 10.31038/PSYJ.2023523

Summary

In Cameroon, the number of people with disabilities is estimated at nearly two million nine hundred and ten thousand (2,910,000). Thus, a little over 5% of the population of Cameroon suffers from at least one disability [1]. These alarming figures lead us to consider the issue of children’s disability and its impact on the health of their parent(s). Certain types of disability cause more suffering to caregivers and relatives than to the disabled person. Within the framework of our activities in clinical psychology with associations of parents of children living with disabilities, through clinical interviews with parents of children with Down syndrome and autism, we have observed that many of these parents present various forms of psychopathology related to the disability of their children: affective disorders, depressive anxiety disorders, acute stress, behavioral disorders, PTSD, etc. We wondered how to deal with these suffering parents. To answer this question, we administered the SPRINT (a recent traumatic event assessment scale) to parents of children with disabilities whose discourse highlighted their experience with their different child as traumatic. This evaluation allowed us to set up therapeutic projects with EMDR (Eye Movement Desensitization Reprocessing). Through a reading of seven clinical cases followed in Yaoundé, Cameroon, we were able to verify that EMDR psychotherapy is a useful care tool for the management of parents of different children in pain. For most of the cases, the first EMDR session was very satisfactory. The results obtained were astonishing: 04 parents saw their VOC (truth scale) rise to 7 and their SUD (suffering scale) drop to 2 at the end of the first EMDR session. For the 03 other parents, the VOC rose progressively over the course of the sessions to reach 7 at the sixth session with an economic SUD at 1, due to their sometimes traumatic childhood experiences.

Keywords

Disability, Child with a disability, Psychopathology, EMDR, PTSD, SUD, VOC

Disability and Society

Society is a group of men and women who are united by nature or by laws. These laws differ from one sphere to another. Thus, what is seen as taboo in one society may be normal in another. However, there are common features between societies with regard to the concept of norm. This norm is applied to each individual who, for the most part, is subjected to it without any choice. Those who deviate from this pre-established norm are considered a problem, a social case. It is in this logic that the person living with a disability fits in. “Disability” is used here as an umbrella term for impairments, activity limitations and participation restrictions that represent the negative aspects of the interaction between a person (with a condition) and contextual factors (personal and environmental). Disability is neither a purely biological nor a purely social phenomenon” [2]. A person with a disability is therefore a person with physical, mental, or sensory incompetencies that affect their activities of daily living and limit their actions in society. The concept of disability can be defined in several ways depending on the culture and society. In so-called Western societies, disability is seen as incapacity, a lack. However, it should be noted that the concept of disability has evolved in these societies with the scientific progress of the 19th century because it was not always so. In African society, disability is still considered by most people as a curse to be got rid of. In most regions of Cameroon, disability is seen and understood as something mystical, supernatural. With the mixing of populations, a slight evolution of mentalities, the advent of ICTs, and access to education, this conception is changing. 5.4% of the population in Cameroon suffer from at least one type of disability. Sensory impairments (3.6%) are the most frequent, due to (2.2%) for visual impairments and (1.6%) for hearing impairments, followed by motor impairments (1.2%) which are mainly deformities of the lower or upper limbs [3]. According to the same survey, “the proportion of people with disabilities is higher in rural areas (6%) than in urban areas (4%) and “this proportion increases steadily with age, from just over 1% among children aged 0-4 years to 6% among people aged 25-49 years and reaches 19% among those aged 50 years or more.”

Disability and Its Manifestations

Disability is an impairment that limits the subject in the efficient performance of his or her actions. According to the WHO, “disability is universal”. According to the INS and ICF International survey, it is defined as “a disadvantage resulting from an impairment or disability, which limits or prevents the individual concerned from performing a role that is normal for him or her, taking into account age, gender, and social and cultural factors”. The number of people with disabilities is estimated to be over one billion people, including about 15% of the world’s population in general, and in turn, one in seven people [4].

Disability generates clinical manifestations that are often poorly understood. Whether sensory, motor, mental or social, disability always poses a societal problem. The lack of expression of positive emotions by parents towards their children with disabilities is a striking modality of the functioning of families with a child with a disability in Cameroon. Today, many families or parents want to give the maximum to their disabled child. Unfortunately, they face several difficulties or sufferings that can put them at a disadvantage; among others; the gaze of the other, the mourning of the idealized child, the fear of reliving the same experience and the inadequacy of our environment in terms of infrastructure. Whether it is sensory, motor, mental or social, disability almost always poses a problem of social integration. The emotional suffering of families with regard to their children with disabilities is a striking feature of the functioning of families with a child with a disability in Cameroon. In our different actions carried out with the parents of disabled people, we noticed that several parents had psychological illnesses linked to their child’s disability. We wondered if the non-acceptance of a child’s disability could lead to a psychological illness? What can be done to help them? What types of psychotherapies would best respond to their suffering? From these questions arise a series of hypotheses among which the following one. Following a high SPRINT score in these parents, we can use EMDR therapy to treat them and especially to control the impact of the suffering during therapy.

The term disability has several definitions depending on the model (medical and social). Medically, it is defined as an incapacity, a deficiency, a lack, whereas socially, it is defined as an inadequacy. It is for this reason that the WHO, taking into account these two models, defines a disabled person as “any person whose physical or mental integrity is temporarily or permanently impaired, either congenitally or as a result of age or accident, so that his or her autonomy, ability to attend school or to hold a job are compromised. The French law of February 11, 2005 [5] on equal rights and opportunities, participation and citizenship of people with disabilities provides a simpler definition of disability. According to this law, disability is “any limitation of activity or restriction of participation in society suffered in his or her environment by a person due to a substantial, lasting or permanent impairment of one or more physical, sensory, mental, cognitive or psychic functions, a multiple disability or a disabling health disorder. Disability is a social notion rather than a medical one because the person living with a disability needs to move in a society to consider himself as an important being. In short, the term disability refers to the difficulty that an individual encounters in interacting with his or her environment and that is caused by an impairment that results in a permanent or non-permanent inability to access, express, understand or apprehend.

In Cameroon, the population of people living with a disability is estimated at nearly 10% of the 18 million inhabitants [6], a percentage that has doubled in four years since the INS and ICF International survey. To understand the psychological situation of this part of the population, we must invoke the psychology of disability, which condenses the entirety of the psychological needs and experiences of the person with a disability as well as those around them, without ignoring the characteristics related to their life phases. It allows for a better understanding of the needs, adaptation problems and significant interference according to the types of disability situations (motor, sensory, psychological or mental). To make this field of investigation more concrete, let’s look at the role of a psychologist.

The Psychologist in Question

The psychologist is a health professional whose role is to offer the individual a place to listen, to speak, and to maintain confidentiality in order to identify conflicts. He is trained in the psychological analysis of the individual, but also in the analysis of factors internal or external to the individual that influence this psychological functioning. He is an expert in conscious and unconscious psychological functioning. His analysis allows him to understand what is going on in the individual at the cognitive, affective and behavioral levels, contextual and social. To perfect this, he has the appropriate methods, tools and techniques. His essential skills are: psychological evaluation (audits, diagnoses, counseling, training, orientation), clinical interviewing, psychological support, therapeutic management. In this panoply of skills, there is one that allows the specialist to work directly with the patient or individual with a mental health problem.

The clinical psychologist is the one who works at the bedside of the individual. He promotes mental health through prevention, care and reintegration or professional orientation. He/she assesses the people who make a request in order to determine the nature, causes and potential effects of the distress (emotional, physical, social) felt by the person or group. He intervenes in order to prevent, treat and address psychopathologies, emotional conflicts, and skill deficits at the root of the dysfunction. He therefore intervenes for the promotion of health. It is in this movement that the clinician is training in psychotherapy. One of these revolutionary therapies is called EMDR

What is EMDR?

EMDR psychotherapy is a fairly new therapeutic intervention that aims to provide relief to patients with post-traumatic stress disorder by helping them to let go of traumatic memories. EMDR (Eye Movement Desensitization and Reprocessing) is a therapy developed in the late 1980s by Francine Shapiro [7]. With the aim of reducing the emotional charge linked to traumatic events, EMDR thus becomes a powerful tool for “cognitive restructuring”. It is a therapy that is currently used to effectively treat a wide variety of psychological disorders resulting from traumatic memories, including anxiety disorders, depression, stress and trauma [8]. But especially in Post-Traumatic Stress Disorder (PTSD). Shapiro’s theory stipulates that the information linked to the trauma is stored in a fragmented manner (images, sounds, smells, places, events, etc.) in the brain and that these different fragments are not linked together, which prevents the integration of the trauma into the memory. It presents a specific information processing system, which deals with traumatic memories, called Adaptive Information Processing (AIT), so that during the course of our existence, certain information is not processed, and therefore not memorized, which means that it is constantly present in our memory. This dysfunctional information remains unresolved and constitutes dysfunctional memory networks; their voluntary or involuntary recall is unpleasant and painful, and the emotion can arise unexpectedly as soon as the environment recalls the circumstances of the traumatic event. They are the source of various disorders such as intrusive thoughts and images, nightmares, fears, untimely startles, phobias… The objective of the therapy is to promote the transfer of information between the emotional and cognitive brains in order to stop the disorders.

The EMDR Procedure

EMDR combines several methods already used by other approaches. In particular: CBT (cognitive and behavioral therapies), psychodynamic therapies and Ericksonian hypnosis. It consists of eight essential phases: the patient’s life history and treatment planning (collection of anamnestic data, the most distant or most recent memories), the preparation of the patient (targeting plan in agreement with the patient), the evaluation (preparation phase for cognitive associations for the TAI), thedesensitization (bilateral stimulation), settling (positive cognition reinforcement), body scanning, closing and re-evaluation.

When life episodes generate too much emotional disturbance, whether they are small traumas (being humiliated as a child, witnessing violent arguments from one’s parents, etc.), or large traumas (rape, accident, attack, earthquake…), the information processing system is blocked. This leads to the following consequences: post-traumatic stress disorder, depressive, anxiety or eating disorders, drug addiction, various physical disorders… EMDR is based on a neurological model in which the alternating stimulation of the cerebral hemispheres re-establishes a process of re-connecting the elements of information processing (emotional, cognitive, physical) disconnected by the traumatic event. In other words, the adaptive process of information processing could be reactivated by the bilateral stimulations. Once reactivated, this system would process the traumatic material in an accelerated manner. Thanks to this system, negative emotions are neutralized and adaptive information arises spontaneously. EMDR makes it possible to establish a connection between the memory network that contains the traumatic memory and the memory networks that carry the adaptive, incorporated experiences that have meaning for the individual and constitute psychological resources.

The Principle of EMDR Therapy

After having had an initial clinical interview with the patient, the therapist verifies the patient’s problematic using a scale of his or her choice, after which he or she must respect the above-mentioned steps. The patient identifies a representative image of the most disturbing dysfunctional target memory, gives the negative cognition of himself, finds a positive cognition of the same register with a verification scale, identifies the emotions linked to the target, the related body sensations, and above all situates the suffering, the disturbance linked to the event on a scale. The cognitive evaluation of the target dysfunctional memory is done on a subjective scale and the degree of distress in relation to the target memory is evaluated throughout the desensitization phase. During this desensitization phase, the patient returns to the image from the beginning by making a kind of cognitive association, while simultaneously making eye movements from left to right in order to follow the therapist’s hand movements, which act as a dual-action stimulus (either in front of the eyes, on the knees, on the shoulders or beside the ears). After each series of SBA (bilateral stimulation) the patient is asked to report the associative information that was elicited during the EMDR session, the instruction given to the patient is either to move the eyes from left to right, to listen to the sounds produced by the hand, to listen to the vibrations produced by the tapping… at a regular rhythm, while thinking of elements of a traumatic memory.

The EMDR Session

Each classic EMDR session lasts between 45 and 90 minutes. The EMDR treatment begins with a preparation. It is important for the therapist to diagnose the type of trauma (simple, psychic poisoning or complex). The therapist also helps the patient to develop resources, not only to improve his or her relationship with himself or herself and others, but also to facilitate the treatment of the trauma. EMDR allows the brain to reprocess the emotional information in order to remove the trauma from the nervous system. Before beginning the EMDR treatment, the therapist follows the above-mentioned steps. In this way, he/she offers the patient a safe therapeutic space that will allow him/her toto confront the origin of his suffering and especially to take refuge in a comfort zone in case of abreaction.

As Martine Gercault [9] puts it so well Once the foundations of the work have been established, the practitioner will help the patient to locate and represent as accurately as possible the origin of the target event, to feel in his or her body the perceptions, emotions and sensations that are linked to it. While the thoughts and affects surface, the psychotherapist sweeps his or her hand in front of the patient’s face and the patient follows rhythmically with his or her eyes”. The reprocessing of a trauma can take from one to several sessions. To reprocess a traumatic episode, the psychotherapist invites the patient to focus on his or her memory, by being in contact with its sensory elements (visual, auditory, olfactory, kinesthetic, gustatory…), with the beliefs and negative emotions generated. The therapist then initiates a series of alternating bilateral left and right stimulations (30 seconds to a few minutes) of eye movements, sounds or tactile stimulations. As free associations of ideas emerge, the patients reprocess the different information linked to the memory, integrating them into their memory network in a functional, adapted manner. Between each series, the therapist asks the patient to take a deep breath and to share what came to mind during the stimuli. These successive and quite brief series of bilateral movements continue until the emotions are neutralized and the emotional scars of the past are emptied of their traumatic charge. When the traumatic memory is thought of again without emotional discomfort and associated with positive thoughts, the therapist moves on to the next phase. The traumatic memories lose their negative emotional charge, thus ending the suffering and negative reactions. It may happen that during a session, the patient experiences strong emotions; it may also happen that between sessions such emotions resurface, as well as other memories, as in any form of psychotherapy. In the end, the patient experiences an improvement in the emotional disturbance related to the memory being treated, and a calming. Through this process, images, perceptions and memories that were negatively encoded in the emotional brain are reprocessed and lose their dramatic intensity. The past adversity is replaced by the uniqueness of the event.

Procedure for the Parent Survey

The first step taken was to contact the heads of the associations we had identified for our investigation (WellbeingAfrica, an association of parents of children with disabilities that works for the rights of vulnerable people), the Little Prince and the Moabi [P²M], an association of parents of children living with disabilities whose main mission is the empowerment of people with Down’s syndrome and other disabilities). Having obtained the various appointments, we organized ourselves for the meeting with the targeted parents. Once on site, after a detailed explanation of the object of our research, we were allowed to “arrange” an appointment with the parents concerned. On the day of the meeting, we first proceeded with a sort of interactive discussion with all the parents present. The purpose was to give them all the explanations related to the research and to the importance of their participation, especially for their well-being.

After this collective meeting phase, which lasted about 20 minutes, each parent was taken individually in a more private setting of the institution (consultation room or office set up on site). There, we would conduct a clinical interview with the parent to ensure that he or she met the inclusion criteria for our sample. As a reminder, these criteria were: being a parent (father or mother) since birth, having denial of their child’s disability, having a psychological disorder related to their child’s disability, and especially having a high SPRINT score, willingly agreeing to take an active part in therapy… Once these conditions were met, we asked the parent to ask any questions he or she might have about our study. After these preliminary steps we would then make a well-framed appointment for the preparation of the actual therapy.

Post-Traumatic Stress Disorder (PTSD) Clinic

Post-traumatic stress disorder (PTSD) affects people who have experienced trauma caused by violence, disability, accident, natural disaster or war, or degrading treatment. How society views the trauma. Lack of support or negative behaviours of those around them (criticism, blame, lack of understanding and empathy, or hostile, controlling, intrusive or stressful behaviours) aggravate the symptoms. Victims feel painfully judged by others. Support from others is very important. Trauma-related thoughts made by the victim herself.

A set of symptoms can develop in a person following a confrontation with an intense stressful event (loss of an object) that would involve serious injuries or a feeling of helplessness. Such situations sometimes trigger strong anxieties, chills, sweating, trembling; and psychic sides such as dreams, flashbacks and sometimes avoidance of similar situations. The positive symptoms are: reliving, avoidance, negative alterations, neurovegetative disorders. These symptoms cause significant suffering in the person, leading to an alteration in their social and professional functioning, and many other important areas. Thus, the patient’s entire functioning may be turned towards the trauma and its memory. Victims will tend to avoid thoughts and conversations that remind them of the traumatic event, as well as places, situations and people that may remind them of the original situation. Their interests and relationships gradually diminish.

Presentation of the Cases

Case PS

PS is a young married woman of 35 years old, of Catholic religion, of Bamileke ethnicity. Her schooling level is that of the 4th grade. She carries out an informal activity that is very common among women in Cameroon, known as “bayamselam,” which consists of buying food products in bulk at the end of the fields to transport them to the city markets and sell them in retail. She is the third of five siblings and her 15-year-old disabled child is schizophrenic. During the interview, she appeared very distressed. She was born in 2003 in Yaoundé, the first of five children of PS, including one girl and four boys.

Case M

M is a young Cameroonian woman, 42 years old, of Bulu ethnicity, with a BTS level of education and unemployed. She is the first of two girls. She is the mother of J who was born on May 31, 1997. He is the only child of M and suffers from an autistic spectrum disorder.

Case E

E was born 55 years ago to a Christian protestant family in the Sanaga Maritime. She has a CEPE. She is a housewife, married and mother of five children, herself the fifth of seven children. She is the mother of Y, born in 2007 in Yaoundé, the fourth of her five children. 02 girls and 03 boys, she attends a local special school, she has a mental retardation.

Case T

T is a 48 year old housewife. Of the Foulbé ethnic group, she is Muslim, without school education, she is married and mother of seven children. She is the sixth of nine children. She is the mother of J, born in 2007, who is the first of these 07 children, of which 03 are girls and 04 are boys. He has been in the special SIL for three consecutive years.

Case X

X was born 45 years ago and is of Douala ethnicity. Catholic, with a literary baccalaureate, he is a service provider. He is the first of three siblings, including two boys and a girl. X is the father of K who was born in 1998. He would suffer from an autism spectrum disorder.

Case P

P is a 30 year old Gabonese, of Fang ethnicity, catholic, he holds a BEPC, he is a military man by profession and single with two children, he is the second of three siblings. He is the father of B who was born in 2002 in Yaoundé, the first of 02 boys and he is being trained in a specialized school in the area. He has been suffering from schizophrenia for two years.

Case Z

Z is a 38 year old housewife, of Bulu ethnicity, from the evangelical church, with no school education. An only child, she is married and has three children. The disabled child is the third of 8 years old, autistic, and attends an inclusive school in the area.

Analysis of the Data Collected during EMDR Therapy

Seven parents were recruited on the basis of individualized clinical interviews among the parents of children with disabilities, including five (05) mothers and two (02) fathers from associations of parents of children with disabilities in Yaounde. Before starting the therapy, we made sure of the type of trauma that each parent might have, because the arrival of the disabled child could be just the trigger for the suffering. After each session, we administered a Stressful Event Rating Scale (SPRINT) to the parent to assess the effectiveness of EMDR therapy. By doing this, we were able to treat all seven parents according to their individual schedules, over a period of 2 months, with an average of 5 sessions of 60-90 minutes each (Table 1).

Table 1: Analysis of the data collected during EMDR therapy

An insecure family context, a feeling of guilt related to a probable negligence during the pregnancy and the development of the disabled child, stereotypes, accusations and stigmatizations coming from the entourage, lack of projection in the future, feeling of devaluation, the look of others, the physical manifestations are the elements that emerge from the discourse of the different parents.

Clinical Case PS

For EMDR therapy, we need 08 phases: the life history of the subject, the assessment, the desensitization, the reinforcement of positive cognition, the body scan, the future scenario, the closure and the reassessment.

Clinical Aspects of the Test

The relationship with the clinician being well established, PS presents her apprehensions, suspects at the beginning of the manipulation as she declares “I trust you docta, even as I don’t know what I’m getting into, this doesn’t seem catholic to me, looking from left to right there scares me”. In spite of this, she lends herself to the game and respects all the instructions given for the good progress of the EMDR therapy.

The encounter with the therapy device immediately provokes a movement of surprise in PS. She smiles when I explain the course of the session. Regarding the eye movements, she said to me: “Docta, excuse me, but I am going to laugh”. This observation is recurrent with EMDR patients, because it is different from what they expect, not only do we not only do active listening or give them advice, but we also ask them to make eye movements, and to verbalize what comes to their mind during desensitization.

The Subject’s Life Story

PS is a young woman of 35 years old, of Catholic religion, of Bamiléké ethnicity. Her school level is that of the 4th grade. She is the third of five siblings and her 15-year-old disabled child has schizophrenia. Her score on the SPRINT test by Connor & Davidson 1997, translated by F. Mousnier – Lompré 2014 is 18. We made a targeting plan and listed 02 targets: The first is a conflict with her father because she never felt loved by him. The second is her child’s disability. With her permission, we started the therapy with the current situation, which is her child’s disabling illness.

Assessment of the Situation

The elements of the therapy are: the image which is the haunting voice of her daughter in crisis, the negative cognition “I am a bad mother”, the positive cognition “I am a good mother”, the VOC equals 2, the emotions are crying and sadness, the SUD equals 9 and as body sensation the pain in the throat and the heart palpitations.

Desensitization

This phase is marked by bilateral stimulations, breathing movements and especially by adaptive information processing (AIT). PS’s speech reveals an increased suffering following her daughter’s diagnosis. She revisits her childhood, her friends, her family, her marriage, in short, all the important elements of her life and notes a major fact that justifies her discomfort. Her behavior when she was young, she says in these terms: “I see myself with my brother making fun of people with a physical handicap, especially the neighbor’s son who had a limp”, “I can’t live with a handicap or put up with a person with a handicap”. As the therapy progressed, she understood that she did not have the right to decide for anyone, that life had its elements that she had to accept and deal with, that she had regained her values and, above all, that she had found meaning in all the efforts she had made since her daughter’s diagnosis, in all the appeals she had had to make for the child’s well-being, and, above all, that she had been a good mother because she had not abandoned her child in her situation of psychological illness. When the SUD drops to 1 economic, we move on to phase 5.

Reinforcement of Positive Cognition

We just check the positive cognition that she gave at the beginning namely “I am a good mother”, when the VOC goes up to 7, we go to phase 6.

The Body Scan

In a relaxing atmosphere, we go over all the parts of her body, always coming back to the disturbing image that we no longer name in this phase. We just say to him, thinking back to the starting image, and especially to the negative cognition that you stated at the beginning, we are going to do an examination of your whole body starting from the head, the neck… to the toes. The instruction is simple: every time she recently feels a knot, a pinch, a pain, an affect in any part of her body, she reports it to us and we desensitize. She has reported pain in her throat and neck and each time we ask her after the desensitization: “what came to mind”, until we get zero pain or manifestations in the body. Once the VOC is verified, we change phase.

The Closing

After having informed Mrs. PS that we will soon stop the session, we say to her: “you have worked well today, I encourage you to note down everything that appears in the meantime, you can report them to me at our next session”.

Reassessment

This session allows us to make a small evaluation of the previous one in order to desensitize the new elements if there are any. After six sessions, we have allowed Mrs. PS to have another look (admiring) on her child.

Results

The action of EMDR is based on the association of psychological and neurological processes. This technique allows the patient to revisit a traumatic event. This therapeutic action is understood as an information processing therapy during which the patient recounts the traumatic event by means of its cognitive, affective and physiological characteristics while concentrating visually, audibly on bilateral movements of an external stimulus until the psychological distress evoked by the traumatic memories diminishes or disappears (Shapiro, 2001).

We have experienced this in the seven parents who, after just two months of care, regained the smile they thought was lost forever. For most of the cases, the first EMDR session was very satisfactory for the parents because 4 of them saw their VOC rise to 7 and their SUD drop to 2. For the other 03 parents, the VOC rose progressively during the sessions to reach 7 at the sixth session with an economic SUD because of the sometimes traumatic experience of these parents.

Discussion

Contrary to other types of therapy which are all equally effective, EMDR has the particularity of not expecting patients to verbalize and perform precise tasks which will constitute the action of the treatment received. The effects of EMDR are less prolonged than cognitive and behavioral therapies, which facilitates the rapid recovery of parents who cannot feel good just by verbalizing their suffering. The main advantage of EMDR lies in the brevity of the application of this technique. Indeed, when properly indicated, it acts directly and shows positive effects in the first session. EMDR has been used in randomized controlled studies with a waiting list where placebo control groups show a definite therapeutic effect [10].

Conclusion

Our work highlights the action of EMDR therapy on the psychological problems of parents of disabled children. For these parents at the end of the therapies, each parent, who at the beginning felt a fair amount of suffering at the sight of his or her disabled child, found himself or herself satisfied with his or her life and, above all, found qualities to be amplified in order to consolidate each of his or her different child’s achievements. The results are very satisfactory.

The treatment is essentially psychosomatic and global. It would be interesting to verify the stability of the results in a few years by observing the parents concerned over the years. In the field of brief and effective therapies, EMDR is one more tool that seems promising.

We did this study in 2019, to check the sustainability of the therapy, we did an evaluation three months for each one after stopping the therapy and one year after. The advantage was that we stayed in contact with the parents in question.

References

1. BUCREP (2010, April 22) Results presentation report.
2. World Health Organization (2012) World report on disability. WHO. Disabilities and rehabilitation.
3. Institut National de la Statistique & ICF International (2012) Cameroon Demographic and Health Survey and Multiple Indicators (EDS-MICS) 2011. INS and ICF International.
4. World Health Organization (2016) WHO draft global disability action plan 2014-2021: better health for all people with disabilities. WHO.
5. Vernet O (2006) Law for equal rights and opportunities, participation and citizenship of people with disabilities. La lettre de l’enfance et de l’adolescence 64(2): 105-110.
6. Von Bernuth E, Gelfert L (2014) The social situation of the disabled person in Cameroon.https://vhandicap.net/La-situation-sociale-de-la.html
7. Shapiro F (2001) Eye movement desensitization and reprocessing basics principlex, protocols and procedures. US Guilford press. [crossref]
8. Lohr JM, Lilienfeld SO, Tolin DF, Herbert JD (1999) Eye movement desensitization and reprocessing: An analysis of specific versus nonspecific treatment factors. Journal of AnxietyDisorders 13(1-2): 185-207. [crossref]
9. Gercault M (2014) My father away, Amazon.
10. Bradley R, Greene J, Russ, E, Dutra L, Westen D (2005) A multidimensional meta-analysis of psychotherapy for PTSD. American journal of Psychiatry 162(2): 214-227. [crossref]

DOI: 10.31038/PSYJ.2023522

Abstract

The study reported here investigates the response to ideas about bullying, these ideas emerging from the interaction of a young, eight-year old researcher with an artificial intelligence system (Idea Coach). The program permits the researcher to suggest the topic (bullying), uses the AI Idea Coach to create sets of 30 questions about bullying, requires to the research to select four questions, lets the AI suggest 15 answers to each question, requiring the researcher to select four of the answers for each question. The program then combined the answers (elements) into small combinations, comprising 2-4 elements, each respondent of the group (110 individuals, ages 15-26) evaluating a totally unique set of 24 combinations (vignettes). Deconstruction of the vignettes based upon the response ‘makes sense’ reveal three different mind-sets, focusing on WHO is a likely bully, How to STOP a likely bully and less clearly but still emerging, the reason WHY person is a bully, respectively. The approach shows the feasibility of AI as an enhancer of critical and creative thinking, empowering students as young as eight years able to begin doing high-level, original scientific research, in a systematized, programmed fashion.

Introduction

This paper is part of a series of research studies conducted by young students, enrolled in elementary and in middle school, with the dual goal of teaching students how to think critically while at the same time working with them as researchers to explore issues of social relevance. A glance at the literature reveals that virtually all research is executed by professionals, occasionally junior professionals such as graduate students, but far more often by young and middle-aged professionals, following the structure of academic research. Even when the topic involves the experience of young people, such experience is analyzed through the ‘trained’, perhaps biased eye of the professional, who brings along a career of studies. The study of the experience follows the time-hallowed practices of the scientific method, although the ‘immediacy’ of the experience cannot be tapped because the researcher is not a young person.

Almost 80 years ago, the radio and television personality Art Linkletter starred in a show called House Party, starting in 1945 and ending in 1969. As described by Wikipedia. The host would begin a conversation by posing a question about life topics to a child, who usually responds with their own innocent, often comedic perspectives on the various topics…. In the show’s first inception, it would sometimes flash back to the 1950s and 1960s show Art Linkletter’s House Party, with Cosby joined onstage by Art Linkletter, that show’s host, to introduce the vintage clips. It would show kids (of the time), their same comedic reactions to whatever Linkletter would ask or say to them…

The foregoing quote suggests that we may learn a great deal about the way children think about the world, although it is clear that a great deal of this learning is second-hand, with the researcher observing the behavior, and commenting on it. In recent years authors Deitel, Moskowitz and Rappaport have collaborated to create a system whereby anyone can be a researcher, at least for the type of research known as Mind Genomics. The idea behind Mind Genomics is that by showing people combinations of ideas and measuring their response, one can learn what specific aspects of these ideas drive the behavior, viz., the aspects to which people pay attention. Rather than asking people to say what is important to them about a topic (viz., open ended question), or ask people to rate importance of different ideas, one idea at a time, Mind Genomics assumes that people will find it more ‘natural’ to respond to combinations of ideas. The rationale for this assumption is that in the world of everyday experience people evaluate combinations of features, rather than one single feature at a time.

Bullying

The topic of bullying is becoming increasingly important [1-3]. It may be that the availability of video technology on smartphones to record one’s bullying efforts has become a stimuli to become a hero. Bullying on the internet has been shown to be responsible for teen and child suicides [4,5]. Those are just the most serious cases.

The emerging science of Mind Genomics may help us understand what young people think is important. The study reported here is unique because it was set up by young researchers, in elementary schools (3^rd grade; Ciara) and in middle school (8^th grade; Cledwin). The study objective was to explore aspects of bullying from the point of view of the younger researcher, using Mind Genomics augmented with AI, in the form of Idea Coach. Idea Coach helped the researcher both learn about the issues involved in bullying, and to take an active role providing new-to-the-world knowledge about these issues.

The Mind Genomics approach has been previously discussed in a variety of papers [6,7]. Three previous studies have appeared featuring the efforts of these young researchers [8,9]. The objective of the studies is to deal with a serious topic, framed not so much by an experienced adult researcher as is usually the case but rather a research effort framed by a young mind. Often the types of questions intriguing the young researcher may well differ from the questions intriguing an older researcher. We almost never heard from the young researcher, and from young respondents. The study reported here and its companion studies allow us a peek into the mind of the younger researcher, and the response to test stimuli by respondents of the appropriate age.

Method

Mind Genomics studies follow a now-standard approach, using templated inputs and automated, rapid analyses. The almost automated approach exemplifies the vision of author Moskowitz to create a system which allows anyone to become a researcher (democratization), coupled with the goal of accelerated knowledge development (efficiency), and with the vision of creating large-scale databases of aspects of ordinary life, doing so in a simple, inexpensive, iterative, and world-wide manner (industrial-scale knowledge development). The Mind Genomics program itself is called BimiLeap, short for Big Mind Learning App. The program can be accessed by anyone with access to the Internet, at www.BimiLeap.com.

Step 1 – Identify the Specific Topic

This sounds simple, and eventually is simple. The novice researcher often thinks in generalities, not in specifics.

Step 2 – Create Four Questions Regarding the Topic of the Study

The respondent is allowed to choose any questions, as long s the questions tell a story about the topic. It is at this point that Mind Genomics proceeds to structure the way the researcher approaches the problem. The first encounter with requiring the researcher to ask a question can be frightening, and certainly off-putting. Most novice researchers freeze up at this point, perhaps shocked by the directness of the question. The most common initial reaction at this point is a sense of discomfort, and in some cases that discomfort simply ends the effort, with the researcher.

For the researchers who cannot think of questions, there is the associated AI feature, Idea Coach. The researcher simply writes a short paragraph, really 1-3 sentences, and Idea Coach returns with 10-30 questions. Idea Coach can be invoked several times, either with the same paragraph or with different paragraphs. Each time Idea Coach will return with a set of somewhat different questions. Table 1 shows a run of Idea Coach, prompted by the researcher request ‘Help me create questions about bullying.’

Table 1: Thirty questions emerging from Idea Coach, based upon the request to ‘tell me some questions to ask about bullying in school’.

Once the researcher selects the four questions, the next step requires the research to provide four answers to each question, specifically phrases which paint word pictures. Once again the researcher can either come up with answers, and/or work with the Idea Coach. For each ‘run’ of Idea Coach, comprising answers to a question, Idea Coach emerges with approximately 15 phrases which answer the question. This step in the process is much easier, simply because many people find it easier to answer questions than to pose questions. Answering questions relies on memory and experience. Posing questions relies more on critical thought because the researcher is going into a void, rather than filling the void under the direction of a question.

The process in Mind Genomics has been simplified, allowing the researcher to write the question to describe the topic, use Idea Coach to present 30 questions (and repeat as desired), select four questions, edit those questions when desired, and finally put in answers and have Idea Coach fill in the missing answers. In all cases the researcher is free to override the Idea Coach effort, whether overriding consists of editing the question/answer or even providing a new question/element based upon one’s insight.

Once the researcher has used Idea Coach to create questions, such as those shown in Table 1, the researcher select questions and/or adds in questions of one’s own. These questions are automatically inserted into the template. The researcher is then prompted to provide four answers to each question. The Idea Coach can provide answers to each question, providing 15 answers for each question for each ‘run’ of the Idea Coach. The researcher need only select four answers, or fewer answers, providing other answers as desired. The answers can be edited, as they were in this study, generally edited for simplicity, and recognizing the nature of the project. In this study the answers were edited by introducing the sub-topic, followed by a colon, and then followed by the text. In this way the element would end up ‘making sense’ in the format of Mind Genomics, wherein one element was presented atop another, not connected with each other, but part of the vignette.

Table 2 presents the four questions selected from the 30 questions at the start of the study. These questions may or may not have appeared in Table 1 for the simple reason that each iteration of Idea Coach produces different sets of questions. Table 2 also presents the four answers to each question.
 

Table 2: The four questions and the four answers to each question

Once the questions and answers are selected, the Mind Genomics program creates combinations of elements. These combinations are called vignettes. A vignette comprises a minimum of two elements, and a maximum of four elements. The structure of the vignette is specified by a layout called an experimental design. The experimental design for Mind Genomics was created to ensure the following properties:

1. Every respondent evaluates exactly 24 vignettes
2. The 24 vignettes are set up so that each of the 16 elements appears exactly five times and is absent 19 times.
3. A vignette has either two, or three or four elements.
4. A vignette can have at most one element from a question, often has no elements from a question, and never has more than one element from a question. This property is important. It is a bookkeeping feature which ensures that a single vignette can never have two different pieces of information of the ‘same type’. The problem becomes obvious when instead of the elements selected here, the elements are prices and brands. In the latter case we want to ensure that a single vignette can have at most one price, not two prices, which would be self-contradictory.
5. The underlying experimental design ensures that the 16 elements are statistically independent of each other. This statistical independence and the specific nature of the design allow the researcher to use statistical modeling (OLS, ordinary least-squares regression) to relate the presence/absence of the 16 elements to the dependent variable. Usually the dependent variable is the rating assigned, a simple transform of the assigned rating, or response time (the time elapsed between the presentation of the vignette to the respondent and the respondent’s rating, captured by the program).
6. A special feature of the experimental design is that it is permuted [10,11]. The permutation means that the underlying mathematical structure is maintained, but each respondent evaluates different combinations. From the practical point of view, the permutation means that the research ends up covering a lot more of the underlying ‘design space’. Rather than having to have a good idea of the ‘right test stimuli’, viz., the right test combinations, and then test those ‘right combinations’, the permuted design tests many more combinations. The patterns in the data emerge more powerfully when the large design space is explored, rather than when one focuses on what ‘thinks’ to be a promising area.

Study Execution on the Internet

The actual study is run in a straightforward fashion, using the Mind Genomics program, www.BimiLeap.com. The program both guides the set-up of the study, as well as executes the study. Once the researcher has set up the study, the next step is to ‘order’ respondents. Traditionally, this process has been arduous, typically because over the past decades respondent participation has dropped. The simple reasons are that people are busy, but also one can scarcely do anything in the commercial world without a sweetly phrased request inquires whether the person would be willing to complete a short survey about the experience. One or two such requests are acceptable, but one can expect resistance, despite the motto of the Marketing Research Association that ‘Your Opinion Counts.’

To remedy the issue of difficulty in recruiting respondents, the BimiLeap program contains a built-in facility to both issue invitations (links to the study), or to pay for respondents, specifying these respondents by a set of screens showing qualifications. The paid request is immediately sent to the associated ‘on-line panel provider’, Luc.id, which aggregates respondents, and provides the necessary respondents in a short period of time, perhaps an hour or so for 100 qualified respondents. This speed means that the entire study can be set up in 30 minutes or less, and executed in 90 minutes or less for 100 easy-to-find respondents. The result is a study executed form start to finish within the space of two or two and a half hours.

The actual study begins with a short introduction about the project, a set of classificaiton questions (age and gender fixed, and then a no/yes question of having been bullied in school). The respondent then proceeds to the actual evaluation of the 24 vignettes. The orientation is short, providing almost no substantive information. The objective is for the orientation to simply introduce the topic. The actual information is presented in the vignettes, the combinations of the elements. Table 3 below presents the orientation sentence, the rating question, and the five answers comprising a Likert scale.

Table 3: The orientation sentence, the rating question and the five point rating scale

Initial Analyses – Frequency of Selected Ratings by Groups of Respondents

Mind Genomics studies generate a great deal of data. We can approach the analyses in at least two different ways. The first way is to look for different patterns of responses, recognizing that we are dealing with different vignettes across all 110 respondents or 2680 vignettes, without the test stimuli having any cognitive meaning at all, other than being test stimuli, the responses to which are being measured.

Following the foregoing analysis, we can examine the frequency of ratings by groups. The first set of groups include the Total Panel, the genders, the ages, the groups who say they were bullied before versus not bullied before. The second set of groups is the mind-sets, individuals who think similarly to each other. We look at the 110 respondents divided into two mutually exclusive mind-sets and then three mutually exclusive mind-sets. Finally we look at the position of the vignette during the sequence of 24 vignettes (first to fourth quarter), and at the vignettes rated quickly (< 3 seconds) versus at the vignettes rated slowly (>= 3 seconds).

Table 4 shows the frequencies. There are occasional differences of 8% or more, especially for the ratings of ‘makes sense’ (5 and 4). There are a few differences for ‘makes no sense’ (1 and 2), and very few for ‘don’t know’. We conclude from Table 4 that there are differences in the measure ‘makes sense’, but beyond that deliberate overlooking of the cognitive meaning hampers our knowledge. It will be with the knowledge of what the elements ‘mean’ that we will make progress.

Table 4: Frequency of ratings assigned by the different, identifiable groups of respondents or vignettes. The numbers in the first three columns of each row should add to 100%.

How Elements Drive Ratings of ‘Makes Sense’ and ‘Doesn’t Make Sense’

The previous section considering the frequency of ratings showed that simply measuring responses to test stimuli suggests some differences among groups, although one would be hard pressed to learn more about the process of decision making. Fortunately, the cognitive richness of the test stimuli, viz., the simple statement, can be used by the researcher to reveal what the respondent may ‘think’ about a topic, even when the respondent herself or himself cannot articulate the rules by which the respondent makes a simple decision. Indeed, quite often exit ‘comments’ by respondents participating in a Mind Genomics study end up with the respondent insisting that it was impossible to ‘find the right answer that was deemed appropriate’ and that much of the answering felt like ‘guessing’ rather than like a reasoned rating.

A deeper analysis of the ratings shows, time after time, that there is a clear set of rules that can be inferred by the pattern of ratings, but only when the ratings themselves can be related to the presence/absence of the specific messages in the vignettes. That is, the pattern of ratings themselves fail to provide information as Table 4 above suggests. Yet, as the remaining tables in this paper will reveal, there are clear, consistent, and interpretable patterns, especially when we bring to bear the combination of OLS (ordinary least squares) regression, coupled with cluster analysis to identify similar behaving groups in the population.

OLS regression, colloquially known as ‘curve fitting’, relates a dependent variable to one or more independent variables. For our study, the regression equation is written as:

Dependent variable = k₀ +k₁(A1) + k₂(A2) … k₁₆(D4)

In words, the expected value of the dependent variable (e.g., Makes Sense, Top2, Rating 54) is the sum of 17 numbers. The first number, k0, is the additive constant. It is the expected the top of the dependent variable (e.g., Top2, Makes Sense) in the absence of elements. Of course, all 24 vignettes evaluated by each respondent comprised a minimum of two elements and a maximum of four elements, so the case of a vignette without elements is hypothetical. Yet, the additive constant (also called the intercept by statisticians) is estimated, and is considered to be a correction factor. We can use it as a baseline, from which all elements either add or subtract. The additive constant is usually high when the dependent variable is ‘Top2, Makes Sense’, and usually low when the dependent variable is ‘Bot2, Does not make sense’.

The regression analysis returns with positive coefficients and with negative coefficients. For our analysis we will present only the positive coefficients of magnitude +2 or higher. The blank spaces in the tables of coefficients actually have numbers, negative or zero coefficients, but in the interest of discerning the pattern we are primarily interested in the positive coefficients. In actuality, presenting the positive and negative coefficients clouds the results.

The top portion of Table 5 presents the positive coefficients for the Top2, viz., for the Total panel, two genders, three ages, and the first six versus the last six vignettes in the set of 24 vignettes. The additive constants are all high, but the highest for the younger respondents, ages 15-18 (additive constant 83) and ages 19-21 (additive constant 78). This is noteworthy. It says something about the proclivity of younger respondents to agree with the statements about bullying, especially since respondents ages 22-26 show a much lower value (additive constant 61). It is important to recognize that this type of granular information could not have emerged from conventional research, and may not have been recognized without the use of OLS regression.

Table 5: Parameters of the models for ‘Make Sense’ (Top 2), and for ‘Does Not Make Sense’ for self-defined groups, and for first and last test orders.

Moving now to the granular level of elements, we see many empty cells. These cells belong to elements which failed to drive a perception of agreement beyond the general proclivity to agree evidenced by the additive constant. What strikes us as noteworthy is that the majority of strong performing elements occur in the columns devoted to order of testing. There seem to be two types of elements, those which desensitize with exposure, and those which sensitize with exposure. The magnitude of the effect can be dramatic, especially when we see that the additive constants are virtually equal (63 for vignettes 1-6; 61 for vignettes 19-24).

Sensitizing elements (stronger tor vignettes 19-24, weaker for vignettes 1-6)

To stop bullying: Encourage students to speak up if they witness bullying.

To stop bullying: Bullying should be discussed openly and regularly, both in class and in assemblies.

Desensitizing elements (stronger for vignettes 1-6, weaker for vignettes 19-24)

Likely bully: People who are unhappy with themselves

Likely bully: People who are insecure

Likely bully: People who have mental health issues

When the analysis is reversed, focusing now on what does not make sense (BOT2), Table 5 suggests a different picture. As expected, the additive constants are quite low, hovering around 20. In turn, a low additive constant ends up allowing a variety of elements to emerge. Table 5 shows the greater number of low coefficients. Worthy of note are the three element responded to strongly by the youngest group of respondents, ages 15-18. Here are the elements which do not make sense to them:

Reason others bully: They want to make someone else feel bad

Reason others bully: They’re mean

Victims feel: Powerless

Table 5 gives us somewhat of a sense of the mind of the respondent. We find some messages to be strong, most messages to be weak. One hypothesis which emerges is that people may differ from each other in part of their life histories. For our study of bullying, a question which comes to mind is whether having been bullied (or at least answering YES on the up-front classification questionnaire) reveals itself in the pattern of responses to the elements.

Table 6 shows the parameters of the equations developed from the 38 respondents who said that they were bullied versus the parameters of the equation developed from the 72 respondents who said they were not bullied.

Table 6: Parameters of the models for ‘Make Sense’ (Top 2), and for ‘Does Not Make Sense’ for those who reported that were bullied versus not bullied.

There are some differences, not in the additive constant (baseline), but in the elements. Those who said that they were bullied find more elements to ‘make sense’ than those who said that they were not bullied. In terms of not making sense, those who were not bullied find more elements not to make sense.

Mind-Sets

A foundational principle of Mind Genomics is that for the world of the everyday there are differences in the way that people make decisions. These differences emerge in the granular level of the everyday, not necessarily in a way which sets one person apart from others. Researchers might call these individual differences, often recognizing that they could end up being a vexatious source of variability, hindering the signal, but signifying nothing. In contrast, Mind Genomics processes this variability through clustering respondents on the patterns of their coefficients for their models. The clustering uses all 16 coefficients for the respondent, viz, positive coefficient, 0’s, and negative coefficients, the latter two coefficients not shown in the tables. The method k-means clustering, uses as a distance measure the value (1-Pearson correlation between the corresponding sets of 16 coefficients for two people [12]).

The k-means program extracted two mind-set and three mind-sets, using the coefficients relating the presence absence of the elements to the ratings of ‘make sense’ (viz., Top3) The 110 sets of coefficients were used for in the k-means, with the additive constant not included Table 6 presents the non-zero coefficients, first for TOP2 (Makes sense), and for BOT2 (makes no sense).

The two-mind set solution suggest one group one group focusing on WHO is a likely bully, and a second group focusing on HOW TO STOP a bully. The three mind-set solution distinguishes among WHO is a likely bully from How to STOP a likely bully, and less clearly but still emerging from the reason WHY person is a bully.

It is remarkable that in the face of such a complex task, respondents are able to focus on what is important to them. It is even more remarkable when we see that only with clustering the responses do these groups emerge clearly, in a way that could not possibly be biased (Table 7) [13].

Table 7: Parameters of the models for ‘Make Sense’ (Top 2), and for ‘Does Not Make Sense’ for two and three mind-sets extracted from the coefficients using k-means clustering.

Discussion and Conclusions

The extensive literature on the topic of bullying has been created by adults, for adults, using the behavior of children towards each other. The inevitable effect of the research effort and the published result is to describe and explain the behavior of children as a combination of anthropology, sociology, and psychology. The researcher sits on the outside, observing the behavior, or talking to those involved in the behavior. Afterwards, the researcher translate the personal experience of the children into ‘adult, science-speak’, replete with statistics when relevant. Of course research ethics do not permit the researcher to induce bullying as part of an experiment, requiring observation and storytelling, rather than experimentation.

It is obvious that young researchers can construct simple questionnaires, and by administering these questions to the correct people the young researcher can learn a lot about the world from the point of view of other people. One need only look at the exercise of interviewing someone older about one or another life experience, the type of research that schools use to introduce students to the research process. Within that framework, the Mind Genomics study reported here presents the way people think about bullying. The data could be reported in that fashion.

The important activities of the Mind Genomics efforts occur at the start, when the study is designed and the questions/answer are developed, and at the end, when the results are analyzed. The Mind Genomics approach, modified by adding a coaching feature, enables the younger researcher to investigate topics in great depth, doing work which by virtue of the coaching and templating becomes valuable. When looking at the execution of the study, and the results, it would be hard to believe that the author of the study is a grade school student. That is precisely the point. The student has now done professional level research. The topics might be thought about initially by the mind of a grade school student, but quickly the execution and the results bring the student to a higher degree of understanding of the topic. It is the mind of the grade school student which frames the topic and selects the question. It is the research approach, the AI coaching, and finally the easy to read results emerging from powerful but ‘hidden’ analyses, which end up helping the student to get excited at the prospect of discovery, and accelerate the process of self-education.

References

1. Bradshaw CP (2015) Translating research to practice in bullying prevention. American Psychologist 70: 322-332. [crossref]
2. Dake JA, Price JH, Telljohann SK, Funk JB (2003) Teacher perceptions and practices regarding school bullying prevention. Journal of School Health 73: 347-355. [crossref]
3. Evans CB, Fraser MW, Cotter KL (2014) The effectiveness of school-based bullying prevention programs: A systematic review. Aggression and Violent Behavior 19: 532-544. [crossref]
4. Craig W, Boniel-Nissim M, King N, Walsh SD, Boer, M, et al. (2020) Social media use and cyber-bullying: A cross-national analysis of young people in 42 countries. Journal of Adolescent Health 66: S100-S108. [crossref]
5. Sedgwick R, Epstein S, Dutta R, Ougrin D (2019) Social media, internet use and suicide attempts in adolescents. Current Opinion in Psychiatry 32: 534. [crossref]
6. Moskowitz HR, Gofman A, Beckley J, Ashman H (2006) Founding a new science: Mind Genomics. Journal of Sensory Studies 21: 266-307.
7. Porretta S, Gere A, Radványi D, Moskowitz H (2019) Mind Genomics (Conjoint Analysis): The new concept research in the analysis of consumer behaviour and choice. Trends in Food Science & Technology 84: 29-33.
8. Mendoza, CL, Mendoza CI, Rappaport S, Deitel J, Moskowitz HR (2023) Empowering Young Researchers: Understanding the mind of prospective aides regarding elderly clients.
9. Mendoza CI, Mendoza CL, Rappaport S, Deitel J, Moskowitz HR (2023) Empowering Young Researchers: Exploring and understanding responses to the jobs of home aide for a young child.
10. Mendoza CL, Mendoza CI, Rappaport S, Deitel J, Moskowitz HR (2023) Empowering young researchers to think critically: Exploring reactions to the ‘inspirational charge to the newly-minted physician.
11. Gofman A, Moskowitz H (2010) Isomorphic permuted experimental designs and their application in conjoint analysis. Journal of Sensory Studies 25: 127-145.
12. Likas A, Vlassis N, Verbeek JJ (2003) The global k-means clustering algorithm. Pattern Recognition 36: 451-461.
13. Hardy MA (1993) Regression with Dummy Variables. Sage.

DOI: 10.31038/PSYJ.2023521

Abstract

The study is part of a program set up to encourage young researchers (age < 18) to learn to think critically. The process shows the young researcher how to systematize aspects of daily life, create a database of specifics, and then explore the perception of these aspects by real people, using templated experimental designs and real ‘experiments’ on the web through a purpose-built application (www.BimiLeap.com). In this study respondents evaluated unique sets of 24 combinations (vignettes), each vignette presenting 2-4 statements which might have come from a ‘charge’ given to medical students and new doctors. Deconstruction of the response to these combinations at the level of individual respondents using regression analysis revealed which statements were perceived to be ‘important,’ which were perceived to be ‘memorable, which were both, etc. Cluster analysis of the individual coefficients from respondents revealed three mind-sets emerging, based upon the pattern of messages perceived to be important: MS1 – Dealing with the stress of the practice of medicine, MS2 – Dealing with difficult patients, MS3 – Aware of what is important to the patient.

Introduction

Empowering through Templated Experimental Design

This paper deals with the way a young researcher (Cledwin Mendoza) conceives of the way a medical school might inspire its students or give a ‘charge’ to a new doctor [1-4]. The topic of inspirational addresses given by senior professionals to newly-minted-professionals is of interest to middle school and high school students. It is their introduction to the world, a world about which they are curious, and excited to enter. The literature has publications on exhortations to the doctor, but virtually nothing from the vantage point of young people to whom the world of professionalism is both experienced but at the same time shrouded in mystery, the world of adulthood.

In this series of papers entitled ‘Empowering young researchers,’ we aim to look at the world of the everyday through the lens of the young researcher, in this case a junior high school student who is aware of the world, interested in the world, but whose sole experience is personal interactions with doctors, what he reads, and what he might see in the media. The research in this paper was designed and carried out using a new science, Mind Genomics. The objective of the research was to explore how ordinary people think medical students would react to inspirational and descriptive phrases regarding their teachings and ethical issues. The study is reported in the spirit of Mind Genomics, specifically a study of an everyday experience (the lecture or charge to a medical student), with the objective of learning what might be the inspiring messages and what might be the messages heard but soon forgotten.

Today’s computer technology allows people to do complex clerical tasks, often quite simply, by following a template. The template ensures that the person does the correct actions for each task, checks that the material is ready, and moves forward. As a consequence, the template ensures that the process will not run into a problem, at least in terms of the structure of the activity. Furthermore, what could be a complex, involved task might well become easy as the person filling out the template becomes conversant with the different steps. What could have been a boring, repetitive task may remain boring, but can be executed flawlessly over time. And, most of all, the learning to complete the template in general is fairly quick, although the material fitting into the template may itself be difficult.

Imagination about the Everyday

The history of science will show the increasing sophistication of the questions asked. From Aristotle who could only observe the world around and make conjectures, we move along to the world of experiments, where the notion was to understand how one variable ‘covaried’ with another variable, but more important, how one variable drove the other variable, viz., causation. As one readily recognizes today, the best experiments occur when the researcher is trying to understand how ‘nature’ works, searching doggedly in many cases for the rules of nature. At the same time there is the world of social science, the study of people, their social structures, motives, behaviors and so forth. Philosophers since Plato and Aristotle, and presumably many before them, were interested in why people behave the way they do. One never, however, feels that one can create a massive database about the many different aspects of people, at least in the social sciences.

Test Stimuli: Collaboration between the Researcher and AI (Idea Coach)

Mind Genomics works by creating a ‘bank’ of ideas (elements), presenting combinations of these elements to a respondent, having the respondent read and rate each combination on a fixed Likert scale, and then deconstructing the ratings to discover the contribution of each element. The process is mechanical once the elements are created. It is the creation of the elements which often stymies the researcher, leading to the abandonment of the project, or leading to an untenable delay in the project until ‘everything is just right’, everyone agrees with the choice of elements, etc. In the end, the task of creating the elements simply frightens many researchers, regardless of their experience or seniority.

The Mind Genomics template requires that the researcher select four questions which ‘tell a story’. For each question, the researcher is required to provide four answers. In the end, the raw material comprises the underlying story, knitting tighter the four specific questions, and the sixteen answers. Experience over three decades, since the early 1990’s, suggests that it is at this point in the process when many promising projects are simply abandoned by hopeful but frustrated researchers. The reasons for abandoning the project are not relevant, other than to say that there seems be a lowered tolerance for frustration in today’s researcher, and a belief that one should ‘know’ the answer, and select the ‘correct’ elements. Not being sure of ‘correct elements’ suffices to stop forward progress. Many researchers apparently suffer from “open-ended question anxiety.”

To remedy the problem, the Mind Genomics templated recently has been upgraded to incorporate Idea Coach, a user-friend tool based in OpenAI [5]. In the templated process, the researcher begins by providing the four questions. The researcher who would like ‘guidance’ chooses the Idea Coach button on the template form. The researcher then writes in a few sentences about the topic. Using that information, Idea Coach returns with up to 30 questions, from which the researcher can choose up to four. In the case where the questions do not all meet the researcher’s expectation, the researcher choose some, and repeats the Idea Coach effort, either with the same input (leading to a set of 30 questions, many of which are new), or with different input. The researcher ends up selecting four questions, some from AI, perhaps some from oneself, and can edit/polish before proceeding.

Table 1 shows the four questions. The Idea Coach was given the following background to the project:

Table 1: The four questions and the four answers (elements) for each question

We created this study to see what important precautions young doctors need to face in the medical world. Also to help young doctors so they don’t make a serious mistake.

It is important to keep in mind that the formulation of the question comes from the mind of a young person, a middle-school student. The question is simple, direct, and not formulated in the typical manner that has become the pattern of today’s science. The question is one ‘about the world,’ in the naïve yet profound way that could only be asked by a young person. As the data will show, this type of questioning can lead to profound, powerful, and actionable results, as well as be a part of an easy-to-construct corpus of knowledge about the mind of people facing everyday life.

The quality of the questions shown in Table 1 come from the nature of the Open AI. The researcher’s task is made much easier. The task now morphs from trying to think about good questions to reading questions and selecting those which make sense for one’s project.

After the AI and researcher have collaborated to create/select the four questions, the BimiLeap templated system moves to acquiring four answers to each question. Once again the Idea Coach helps in this task, but requires the deeper involvement of the researcher. For the case of questions, Idea Coach required questions needing very little editing. Not so with the answers. Idea Coach returns with statements. These statements comprise the answers but the statements must be edited. For example, consider element A1. Idea Coach returned with the second part of the element, specifically ‘They need to have a passion for helping people and a strong interest in science and medicine.’ The BimiLeap program for Mind Genomics would be better when the sentence is given an ‘orientation’, such as the word ‘Required’. The authors changed the elements, inserting the orientation word(s), so that the elements were more meaningful. A good analogy to this is the placement of items in a menu under the proper headings (appetizer, main course, etc.,) rather than just having the food on the menu.

The second thing to note about the elements is that they are long, and well-crafted. Virtually all users of the BimiLeap program have commented on the fact that the questions, but more importantly the answers, move beyond what they might have generated had they been instructed to think about the elements, and do research to find elements. This up-front work, possibly taking hours and days, and often leading to frustration in the wake of progress seemingly out of one’s grasp, now takes approximately 20 to 30 minutes, with potentially far better results.

The final thing to note is that hitherto a long, arduous, and often frustrating effort to create questions literally from one’s mind is now replaced by a far more pleasant, intriguing learning experience. The researcher no longer has to feel alone in the effort to come up with questions and answers, but rather now engages in a focused experience of discovering and choosing. In some respects the creation of the elements evolves into its own learning experience, enjoyed by the researcher, with a motivating power to drive exploration of just-learned ideas. What was a difficult moment in the design of a Mind Genomics experiment now becomes perhaps the first learning experience. The Idea Coach, and AI, moves away from a simple aide to become a teacher who reveals new dimensions of a topic to a researcher deeply focused on the topic. Ideas that were not even in the ken of the researcher can now be explored in moments, as part of the research effort.

The History of Mind Genomics

Mind Genomics traces its history to three disciplines, psychophysics, statistics, and consumer research, respectively. Psychophysics is the oldest branch of experimental psychology, seeking to understand how to measure the internal perception of physical stimuli, such as the sweetness of sugar in a beverage. The origination of Mind Genomics can be traced to author Moskowitz’s studies as a graduate student in the Laboratory of Psychophysics in William James Hall, Harvard University, directed by the late Harvard professor, S.S. Stevens. During the latter part of Moskowitz’s tenure at Harvard, with a Ph.D. awarded for studies of taste mixture, it became obvious that the approach could be used to mix ideas, and obtain a measure of the mind in terms of responses to these ideas. The effort would have to wait until Moskowitz was safely ensconced as a scientist at the US Army Natick Laboratories, in Natick MA, where he could begin small scale studies of mixtures of ideas. The taste work would lead to the appreciation of human response mixtures as the relevant topic to explore, whether mixtures of ingredients, or mixtures of ideas [6,7].

Statistics, the second discipline, provides Mind Genomics with analytic tools. The history of science is often presented in terms of the researcher isolating all forms of extraneous noise, viz. unwanted variability, in order to study a phenomenon. We need only visit laboratories to see the apparatus used for these studies to get a sense of how proud the researcher is of the ability to study a phenomenon in ‘splendid isolation;, without the interfering noise. On the other hand, there are many effects where many variables interact with each other, and in the end produce a response. The traditional methods of isolating the variable and then studying the behavior of that variable simply cannot work. Rather, it is a matter of creating specific combinations, allowing the variables to interact, but at the same time allowing the researcher to measure the behavior of each variable, even though the variables are in a mixture. It is this discipline, statistics, specifically the area of experimental design, which constitutes the second foundation of Mind Genomics [8].

The third foundation of Mind Genomics is the world of consumer research, where the focus in on the complex, real-world stimulus, rather than on the artificially created world of the experimental psychologist. The consumer researcher focuses on what consumers are exposed to, how they react to situations which occur in everyday life. Consumer researchers are not attempting to understand the deep fundamentals of thinking and behaving, but rather interested in behavior in natural settings, dealing with responses to real test stimuli, or at least test stimuli which could be real.

The Test Stimuli

The foregoing history of Mind Genomics serves as an introduction to the nature of the test stimuli. The stimuli comprise combinations of elements, rather than single elements. The rationale is that only with combinations of elements can the test stimuli make sense, have ‘ecological validity.’ When we isolate the test elements, the 16 phrases shown in Table 1, instructing the respondent to rate each element, one at a time, we end up presenting the respondent with stimuli that are almost meaningless. Of course we are interested in the performance of each element, but it is very hard for the respondent to rate each element. It may be that the respondent and rate each element with the same mental rules, but more likely the respondent will end up shifting the mental criterion for the rating. That shift may be hard to imagine for these data, but easy to understand when we turn to elements which comprise brand name, price, nature of the product features, and location where the product is bought. When the rating sale is ‘interest in buying’, the respondent has a hard time using the same criterion. The data may look correct, but the reality is that during the course of evaluating the different types of elements the respondent may have shifted the criterion many time to be appropriate for the element.

To solve the foregoing problem, viz., of presenting ideas as simulating something real, Mind Genomics uses the power of experimental design to create combinations of elements. The experimental design for the 4×4 structure (four questions, four answers for each) comes up with 24 combinations. Within those 24 combinations, each of the 16 elements appears exactly five times, and is absent 19 times. A single vignette can have two, three, or four elements, but no more than one element from any question. The structure is set up so that the data from a single respondent can be analyzed by OLS (ordinary least squares regression), which as shown below, will reveal the individual level combination of every element to the response. Finally, the Mind Genomics design is set up so that each respondent sees different combinations. No respondents see the same combinations until the number of respondents exceeds 250. This property of different sets of 24 combinations created by the same mathematical scheme is called a permuted design structure.

The Orientation and Rating Scale

Mind Genomics studies are typically conducted with populations of respondents who are unfamiliar with the topic. They know that they will be reading and evaluating different combinations of messages, but have no idea that the combinations, also known as vignettes, will be created by experimental design. The respondent generally follows the instructions, doing what they are told. Thus, the simplest way to do the Mind Genomics experiment is to tell the respondent a little about the topic, viz., a sparse background, and then instruct the respondent to read the vignette and assign a rating using a defined rating scale.

Table 2 shows the instructions and the rating scale. The instructions are very simple. A principle of Mind Genomics is that it is more productive to provide a sparse orientation and let the individual elements in the vignette provide the necessary information about the topic. We follow this practice in our studies. Simplicity makes the task easy for a younger researcher because there needs to be very little deep knowledge behind the question.

Table 2: The orientation paragraph and the associated rating scale

The rating scale in Table 2 merits more discussion. The rating scale actually encompasses two scales, one for important, and the other for remembering. Each point on the five point scale corresponds to one possible combination of thinking something is important and remembering the speech. Another thing to observe is that ‘remembering’ is first, and ‘important’ is second. In this way the scale is ‘broken up’ forcing the respondent to read the scale, rather than just remember a place on the scale, or at least that is the intention.

In order to prepare the data for analysis, it was first necessary to transform the scale. Users of data find it very hard to look at either the mean on the scale (which is meaningless for our broken up scale), or the distribution of ratings on the five-point scale. A simpler way to do things is to transform the scale values to binary (0 or 100). For simplicity, we abbreviate the word “Rating,” with “R” and the rating number. For example, “Rating 1” is abbreviated “R1,” etc. This study features two sets of transformations, one dealing with importance, and the other dealing with memorability.

1a. Important and Remembered (R5 only transformed to 100, rest of ratings transformed to 0)

1b. Not Important (viz., Not Necessary) and Not Remembered (R1 only transformed to 100, rest of ratings transformed to 0)

2a. Important (R5, R4 only transformed to 100, rest of ratings transformed to 0)

2b. Remembered (R5, R2 only transformed to 100, rest of ratings transformed to 0)

2c. Not Important (viz., Not Necessary) (R1, R2 only transformed to 100, rest of ratings transformed to 0)

2d. Not Remembered (R1, R4 only transformed to 100, rest of ratings transformed to 0)

With this transformation it becomes easier to discover patterns. The combination of rating scale points into those denoting ‘important’ vs. ‘not important’ allow us to isolate specific elements driving the perception of importance. Similarly, the combination of rating scale points into those denoting ‘remembered’ vs. ‘not remembered’ allow us the same power to isolate specific elements that the respondents feel will be ‘remembered’ by the medical students or young doctors. Keep in mind, however, that this experiment is done among the population of young people, ages 19-40. The same experiment could be done easily among medical students to discover whether they feel the same way.

Analysis 1

Do Different, Identifiable Groups of Respondent Score the Vignettes the Same Way?

In the foregoing introduction to Mind Genomics we made the point that each respondent in the study evaluated a unique set of 24 vignettes. This means that when we look at the distribution of ratings, we must keep in mind that we are not looking at the different groups of people evaluating the same stimuli, but rather evaluating different stimuli of the same type.

At this point it is worth pointing out that stopping here, just looking at the pattern of responses without any deeper analysis, would not be wrong. Indeed, the researcher who stops here, and supports her or his conclusions of similar patterns with conventional statistics, e.g., tests of statistical difference, would be lauded for defending the conclusion of ‘similar patterns’ using well-accepted statistics. Yet, as we will see below, when we move to the development of ‘mind-sets’, the researcher will be afforded the far deeper opportunity to understand the topic, one provided by the up-front efforts to create the test vignettes using experimental design.

Table 3 shows the average ratings for the six newly created dependent variables, for the key subgroups. Table 3 suggests similar patterns of response. Were we to stop here, we would not know anything beyond the observation that the patterns of transformed ratings seems to be similar across the different groups. As the subsequent analyses will reveal, our observation might seem correct on the surface, but is wrong. We would not, however, realize that there are deeper patterns, some of which are radically different from each other.

The groups shown in Table 3 are:

1. Total
2. Gender (male, female)
3. Age (18-29 years old, 30-40 years old)
4. Vignettes rated rapidly (response time < = 3 seconds) vs. rated slowly (response time > 3 seconds)
5. Mind-Set emerging from clustering (Mind Set 1 of 3 Dealing with the stress of the practice of medicine; M2 of 3 Dealing with difficult patients; MS 3 of 3 Aware of what is important to the patient).

Table 3: Averages of six newly created transformed variables, by total panel and by key subgroups. The averages are computed based upon the original rating assigned to each of the vignettes seen by a member of the subgroup. The numbers can be treated like percentages.

Building Models (Equations) Relating the Elements to the Newly Created Transformed Variables

We now move to the heart of Mind Genomics, creating equations which show how each of the 16 elements contributes to the newly created variables. Our analysis will focus on five of the six variables, as we see at the top of Table 4. We will look at the transformed variables corresponding to the highest level of performance (important and remembered), the transformed variables corresponding to ‘important’, the transformed variable corresponding to ‘remembered’, and then the complementary transformed variables of ‘not important’ and ‘not remembered’. The next set of tables will present the parameters of these five transformed variable for each identifiable subgroup previously presented in Table 3. The results will reveal a deeper, far more organized world, one emerging clearly due to the underlying experimental design.

Table 4: Values of the additive constant for five dependent variables (columns) and different groupings of respondents and vignettes, respectively

The first step to build the equation is to create the database. The database can be thought of as a rectangular file, one row for each vignette. Recall that each respondent evaluated 24 vignettes, so this database comprises 24 rows for each respondent.

The columns of this database contain the relevant information:

Column 1 – The unique identification number for the respondent. It is sufficient to label the respondents with a sequential set of numbers, starting with 1, and continuing. The study comprises the data from 102 respondents.

Column 2 – Gender

Column 3 – Age

Up to now the data for a specific respondent has been repeated 24 times. We now turn to the data for a specific vignette.

Columns 4-19 correspond to the 16 elements, with each element having its own column. For example, column 4 is reserved for element A1, column 5 or element A2, and so forth. For a single row, each cell (4-19) will be given the value ‘0’ when the element is absent from that particular vignette, or given the value ‘1’ when the element is present in that particular vignette. Since the experimental design prescribe that each vignette will have 2-4 elements, and not more than one element from a question, the database will reflect the design by having the number ‘1’ in two, three, or four columns, and the number ‘0’ in the remaining columns. The rationale for this specific coding, so-called ‘dummy variable coding’ [9], is that the coding enables the regression program to estimate the contribution of each element when the element goes from ‘state =0’ to ‘state = 1’, viz., present.

Column 20 shows the order of presentation of the vignette for a respondent, with the value going from 1 (first vignette) to 24 (last vignette).

Column 21 shows the response time, defined as the number of seconds elapsing between the presentation of the vignette to the respondent and the response. The response time is measured to the nearest tenth of a second. The response time is an important measure in the world of consumer researcher, insofar as it may indicate the presence of different cognitive processes [10,11].

Column 22 shows the rating assigned to the specific vignette by the specific respondent.

Up to now, columns 1-22 were generated by the BimiLeap program, along with data acquired during the course of the experiment. The data can be used for analysis ‘as is’, but consumer researchers prefer to transform the data so that they can investigate different types of answers. There are five specific transformations of interest, focusing on five different aspects of the decision. Each one creates a new dependent variable that will be analyzed in depth.

1. R5: ‘important’ and ‘memorable’. Ratings of ‘5’ are converted to 100. Ratings 1-4 are converted to 0.
2. R54: ‘important’. Ratings ‘5’ and ‘4’ are converted to 100. Ratings 1-3 are converted to 0.
3. R52: ‘memorable’. Ratings ‘5’ and ‘2’ are converted to 100. Ratings 1,3, and 4 are converted to 0.
4. R12: ‘not important’. Ratings ‘1’ and ‘2’ are converted to 100. Ratings 3,4 and 5 are converted to 0.
5. R14: ‘not memorable.’ Ratings ‘1’ and ‘4’ are converted to 100. Ratings 2,3 and 5 are converted to 0
6. To prepare for the analysis by OLS (ordinary least-squares) regression the BimiLeap program adds a vanishingly small random number (<10^-5) to each transformed value. The random number does not affect the coefficients of the regression equation, but ensures that the dependent variable will possess some minimal variation across the vignettes for each individual respondent. This variability is necessary for the statistical calculations.
7. The equation or model is expressed by the simple formula: DV (dependent variable) = k₀ + k₁(A1) + k₂(A2) … k₁₆₍D4)
8. After the parameters of the OLS model for importance (R54) are calculated for each respondent and stored in a second database, that second database to be subsequently used by a clustering program. The clustering program [12], uses the 16 coefficients (k₁-k₁₆) as inputs to identify groups of respondents showing similar patterns of 16 coefficients The clustering program assigns each respondent to one of two clusters, based upon similar patterns, and then assigns each respondent to one of three clusters, again based upon similar patterns. The output is the assignment of each respondent to one of two ‘mind-sets’ or one of ‘three mind-sets.’ The assignment is done using strict mathematical criteria. However, the names assigned to the mind-sets or clusters are based upon the elements which are the strongest performers. This criterion is known as ‘interpretability.’

Clustering generates groups of two and three mind-sets, with the name of each mind-set chosen based on the strongest performing elements in the mind-set, viz., the elements with the highest positive coefficients. Taking the three mind-set-solution as an example, Mind Set 1 of 3 is Dealing with the stress of the practice of medicine, Mind Set 2 of 3 is Dealing with difficult patients, and Mind Set 3 of 3 is Aware of what is important to the patient.

9. Each respondent belongs to several different groups. The first group is Total Panel, viz., everyone. The second grouping divides into the respondent being a male or a female. The third grouping divides into the respondent into younger (ages 19-29) or older (ages 30-40). The fourth grouping divides the respondents by the mind-set to which they belong.
10. Up to now, the vignettes were assigned to groups based upon the characteristic of the respondent, viz., a gender. We can also look at the vignettes, rather than at respondents to create groups. The fifth groups divides the vignettes by those that were evaluated quickly (operationally defined as response time, <= 3 seconds) versus those that were evaluated slowly (operationally defined as response time > 3 seconds). We can also look at the data focusing our attention on the speed of the response to the particular vignette.

Steps 1-7 above create a database that is readily analyzed by standard regression methods. The approach here is OLS (ordinary least squares) regression. We begin with the additive constant, k₀, shown above as part of Step 6. To review, the equation in Step 6 has 16 coefficients (k₁-k₁₆) and the additive constant. The additive constant is a ‘baseline’, defined as the expected transformed value were the vignettes to comprise no elements at all. The underlying experimental design ensures that all vignettes will comprise at lest two elements and at most four elements. The additive constant has no physical meaning other than as an adjustment factors. We can use the additive constant as a ‘baseline’, giving us a sense of the likely percent of responses to be obtained for a given dependent variable (e.g., R54), in the absence of elements.

6. Table 4 shows the additive constant for each of the groups (rows), and for each of the five dependent variables (columns). For each group and for each dependent variable the additive constants have been shaded for those groups showing an 11 point or higher magnitude of difference between any two members of the group. The large magnitudes of differences in a group are most striking for the three mind-sets, viz., those groups create on the basis of different patterns of coefficients.

We now turn to the important elements for the five transformed dependent variables, showing only those elements which generate a coefficient of +5 or higher. The standard error for Mind Genomics coefficients varies from 4-6 for most studies with a base size of 100. Furthermore, when elements with coefficients of 4-5 or higher are separately investigated, they often turn out to be relevant to the topic. Consequently, and in the interest of Mind Genomics studies as being early-stage explorations, the cut-off level is set to about 4-5. In this project the cut-off level was set at 5, to follow the conventional practice. In addition, the very strong performing elements are shown in shaded cells, specifically those elements with coefficients of +10 or higher. Finally, each table presents three sets of elements, each set sorted in descending order of coefficient value. The first portion of the table presents the results for relevant elements (coefficient = 5+) for the total panel, gender and age. The second portion of the table presents the results for relevant elements for the three mind-sets. Finally, the third portion of the table presents the results for relevant elements for vignette-based groups (response time, order of testing).

Mind Genomics generates a great deal of data, much of which can be analyzed in depth for the simple reason that the elements themselves are ‘cognitively meaningful.’ That meaningfulness leads to the ability to discern general patterns, but then to evaluate the nuances of each element.

7. If we were to summarize the results from the data in Tables 5-9 we would emerge with the conclusion that the strong results emerge from the mind-set, rather than from the self-profiled demographics of the respondents (viz., age and gender), and rather than from the non-cognitive nature of the stimulus (viz., speed of responses, order of testing (first half vs. second half)).

Table 5: Strong performing elements (high coefficients) for ‘important and memorable, R5’



Table 6: Strong performing elements (high coefficients) for ‘important (R54)



Table 7: Strong performing elements (high coefficients) for ‘memorable’ (R52)



Table 8: Strong performing elements (high coefficients) for ‘not important’ (R12)



Table 9: Strong performing elements (high coefficients) for ‘not memorable’ (R14)



Discussion and Conclusions

Traditionally, the combination of young students and ‘science’ has been to repeat experiments that have been previously performed, experiments whose answers are known. The student’s task is to replicate the experiment in the proper manner, obtain the results, and present the process to the teacher. Success in such a case emerges from the combination of executing the study properly and getting the ‘right answer’. The approach has worked for decades, as generations of students went through the process, some emerging with the feeling that ‘science’ is for them, whereas others emerging with the feeling that this process is not at all for them. A century and more of scientific progress, and the emergence of the modern world with all its technology and ‘know-how’ testifies to the success of the traditional process to learn science.

The world has changed. One can scarcely spend a day reading newspapers or now more frequently looking at the material flooding forth from the web, to get a sense that the traditional methods of teaching and exciting students no longer work very well. Perhaps it is the ‘tyranny of the small screen’, a phrase author Moskowitz coined to describe the everyday scene of people, young and old, glued to their smartphones. Perhaps the phones are smart, but the people seem to be less smart, or less educated, if one is to believe the ongoing reports in both the academic press and in the popular press, respectively.

In this emerging world, how then can students be excited? The approach presented in this paper constitutes one way of exciting students through becoming researchers. Happily, there is very systematized thinking about the problems of the everyday, the world where ordinary people live, the world in which they experience the aspects of the quotidian, the daily, the routine. What then could happen if this daily world, so accessible to people, so very ordinary, could be magically transformed into a topic for true scientific investigation, research which not only teaches the student how to think, but actually creates a unique, valuable, indeed absolutely vital corpus of knowledge about the world. After all, the study just reported here, done in just a few hours, from beginning to end, produces unique to the world, valuable information. Most of all, this valuable information comes from the minds of young students, the senior researcher aged 13 (Cledwin), and the junior researcher aged 8 (Ciara), respectively. Their efforts, their curiosity, exploring the topic, produces unique to the world information, the beginning of a large corpus of knowledge on communications to students in the world of medicine.

There is much to do, more than a billion students around the world, many of them that could be considered the ‘raw material’ of our civilization. Right now the issue continues to be concern about their learning, that they are not learning properly, that their motivation is lagging, that their attention is increasingly on the small screen. Perhaps it is because they are not involved in learning, that learning has become the ceaseless repetition of facts to be ingested, converted to bits of memory, and regurgitated at the proper time, somewhat like the cow chewing its cud. Expressed that way, learning is for the very motivated, and perhaps those who cannot escape this onerous task. But, and this is the important point, what would happen if the students could participate in world-wide projects which create separate topic-specific databases about the everyday, using templated experimental design, and using artificial intelligence. The escape would be into education, not away from education into mindless gaming. One could only imagine a world where thousands of students could collaborate and even compete as they jointly build large scale databases about the minds of people in society regarding the different aspects of daily living. An example might be a large scale database about different aspects of teaching and learning mathematics, across 192 countries, across the entire range from say 3^rd grade to end of college, focusing on the many dozens different aspects of teaching and learning mathematics. This effort alone, with 192 countries x 10 aspects of learning mathematics creates a unique, valuable database. One could only imagine the pride of participation and learning for students world-wide who volunteer to participate in this effort. And, to finish, the opportunities are unlimited. Truly in this case ‘the appetite comes with the eating.’

References

1. Baruch JM (2017) Doctors as makers. Academic Medicine 92: 40-44. [crossref]
2. Kassirer JP (2000) Patients, physicians, and the internet: Coming generations of doctors are ready to embrace new technology, but few incentives now exist to encourage their older peers to do likewise. Health Affairs 19: 115-123.
3. Murtagh GM, Furber L, Thomas AL (2013) Patient-initiated questions: How can doctors encourage them and improve the consultation process? A qualitative study. BMJ Open 3: p.e003112.
4. Swennen MH, van der Heijden GJ, Boeije HR, van Rheenen N, Verheul FJ et al (2013) Doctors’ perceptions and use of evidence-based medicine: a systematic review and thematic synthesis of qualitative studies. Academic Medicine 88: 1384-1396. [crossref]
5. OpenAI (2023)
6. Moskowitz HR, Gofman A, Beckley J, Ashman H (2006) Founding a new science: Mind Genomics. Journal of Sensory Studies 21: 266-307.
7. Porretta, S, Gere A, Radványi D, Moskowitz H (2019) Mind Genomics (Conjoint Analysis): The new concept research in the analysis of consumer behaviour and choice. Trends in Food Science & Technology 84: 29-33.
8. Gofman A, Moskowitz H (2010) Isomorphic permuted experimental designs and their application in conjoint analysis. Journal of sensory studies 25: 127-145.
9. Suits DB (1957) Use of dummy variables in regression equations. Journal of the American Statistical Association 52: 548-551.
10. Lenzner T, Kaczmirek L, Lenzner A (2010) Cognitive burden of survey questions and response times: A psycholinguistic experiment. Applied cognitive psychology 24: 1003-1020.
11. Revilla M, Ochoa C (2015) What are the links in a web survey among response time, quality, and auto- evaluation of the efforts done? Social Science Computer Review 33: 97-114.
12. Likas A, Vlassis N, Verbeek JJ (2003) The global k-means clustering algorithm. Pattern Recognition 36: 451-461.