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Despite patient demand for sexual health discussions with their physicians, sexuality instruction in residency is often lacking. This exploratory quantitative study assessed the amount and usefulness of sexuality instruction received by a sample of medical residents, as well as the residents' self-perceived readiness regarding addressing sexuality issues. Data were obtained through a self-administered survey with 130 resident respondents. The majority reported receiving little/no formal sexuality instruction. Many indicated that additional sexuality instruction would be useful in their practice. Although the majority reported comfort discussing sexuality, they reported rarely/never initiating these discussions. Recommendations for changes in graduate medical education programming are provided.  相似文献   
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Researchers widely agree that learning history should involve more than learning historical facts and should include competencies of historical thinking. Various models of historical thinking view students' competency to take historical perspectives as a standard in history education. In this study we introduce a standardized measure for historical perspective taking (HPT) consisting of a short scenario set in the German Weimar Republic. We assessed students' HPT by using rating scales; our data were obtained in grammar schools from 170 German 10th graders. Latent class analyses identified three types of students with similar profiles of HPT. One was present-oriented and two showed more or less contextualized historical thinking. Students' history grades were connected to their HPT competency. We discuss limitations of the study and argue for further research on measures assessing students' historical thinking.  相似文献   
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Prior research on organizational routines in the ‘capabilities’ literature has either studied how new routines are created during an exploratory process of variation and selection or how existing routines are replicated during a phase of exploitation. Few studies have analyzed the life cycle of new routine creation and replication as an integrated process. In an in-depth case study of England’s Highways Agency, this paper shows that the creation and replication of a new routine across multiple sites involves four sequential steps: envisioning, experimenting, entrenching and enacting. We contribute to the capabilities research in two ways: first, by showing how different organizational levels, capabilities and logics (cognitive and behavioural) shape the development of new routines; and second, by identifying how distinct evolutionary cycles of variation and selective retention occur during each step in the process. In contrast with prior research on replication as an exact copy of a template or existing routine, our study focuses on the replication of an entirely new routine (based on novel principles) that is adapted to fit local operational conditions during its large-scale replication across multiple sites. We draw upon insights from adjacent ‘practice research’ and suggest how capabilities and practice studies may complement each other in future research on the evolution of routines.  相似文献   
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A critical analysis of the existing ranking systems of German and international horse sports could identify weak points with regard to their implicit evaluations of the horses’ performances. This study is aimed at developing a feasible and more performance-related valuation method and comparing it with the existing cumulative ranking systems of the German and international equestrian umbrella organizations. On the one hand, the modeling is based on a method using average points per competition; on the other hand, by considering additional points and drawbacks. We investigated a sample of 50 top-ranked jumping horses and monitored the differences towards the existing ranking systems. The modification proposed results in significant implications on the rankings. The validity in relation to the horses’ performance evaluation could be improved. As a consequence, the interests of different stakeholder groups are better served than before. It is recommended to further develop the existing ranking system accordingly and to analyze a more differentiated placing of points.  相似文献   
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