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In recent years a set of new ‘postempiricist’ approaches to public policy, drawing on discursive analysis and participatory deliberative practices, have come to challenge the dominant technocratic, empiricist models in policy analysis. In this book, Frank Fischer brings together this work for the first time and critically examines its implications for the field of public policy studies. He describes the theoretical, methodological and political dimensions of this emerging approach to policy research. The book includes a discussion of the social construction of policy problems, the role of interpretation and narrative analysis in policy inquiry, the dialectics of policy argumentation, and the uses of participatory policy analysis. After an introductory chapter, ten further chapters are arranged in four parts: Part I, Public Policy and the Discursive Construction of Reality (two chapters), introduces the re-emergence of interest in ideas and discourse. It then turns to the postempiricist or constructionist view of social reality, presenting public policy as a discursive construct that turns on multiple interpretations. Part II, Public Policy as Discursive Politics (two chapters), examines more specifically the nature of discursive politics and discourse theory and illustrates through a particular disciplinary debate the theoretical, methodological, and political implications of such a conceptual reframing of policy inquiry. Part III, Discursive Policy Inquiry: Resituating Empirical Analysis (four chapters), offers a postempiricist methodology for policy inquiry based on the logic of practical discourse, and explores specific methodological perspectives pertinent to such an orientation, in particular the role of interpretation in policy analysis, narrative policy analysis, and the dialectics of policy argumentation. Part IV, Deliberative Governance (two chapters), discusses the participatory implications of such a method and the role of the policy analyst as facilitator of citizen deliberation .

Critical policy studies, as illustrated in this handbook, challenges the conventional approaches of public policy inquiry. But it offers important innovations as well, in particular its focus on discursive politics, policy argumentation and deliberation and interpretive modes of analysis. This volume offers a compilation of critical work that assesses past developments and appraises emerging issues.

Simulation-based learning offers a wide range of opportunities to practice complex skills in higher education and to implement different types of scaffolding to facilitate effective learning. This meta-analysis includes 145 empirical studies and investigates the effectiveness of different scaffolding types and technology in simulation-based learning environments to facilitate complex skills. The simulations had a large positive overall effect: g = 0.85, SE = 0.08; CIs [0.69, 1.02]. Technology use and scaffolding had positive effects on learning. Learners with high prior knowledge benefited more from reflection phases; learners with low prior knowledge learned better when supported by examples. Findings were robust across different higher education domains (e.g., medical and teacher education, management). We conclude that (1) simulations are among the most effective means to facilitate learning of complex skills across domains and (2) different scaffolding types can facilitate simulation-based learning during different phases of the development of knowledge and skills.

Scripts for computer-supported collaborative learning (CSCL) offer socio-cognitive scaffolding for learners to engage in collaborative activities that are considered beneficial for learning. Yet, CSCL scripts are often criticized for hampering naturally emerging collaboration. Research on the effectiveness of CSCL scripts has shown divergent results. This article reports a meta-analysis about the effects of CSCL scripts on domain-specific knowledge and collaboration skills. Results indicate that CSCL scripts as a kind of socio-cognitive scaffolding can enhance learning outcomes substantially. Learning with CSCL scripts leads to a small positive effect on domain-specific knowledge (d=0.20) and a large positive effect on collaboration skills (d=0.95) compared to unstructured CSCL. Further analyses reveal that CSCL scripts are particularly effective for domain-specific learning when they prompt transactive activities (i.e., activities in which a learner's reasoning builds on the contribution of a learning partner) and when they are combined with additional content-specific scaffolding (worked examples, concept maps, etc.). Future research on CSCL scripts should include measures of learners' internal scripts (i.e., prior collaboration skills) and the transactivity of the actual learning process.

The study of public policy and the methods of policy analysis are among the most rapidly developing areas in the social sciences. Policy analysis has emerged to provide a better understanding of the policymaking process and to supply decision makers with reliable policy-relevant knowledge about pressing economic and social problems. Presenting a broad, comprehensive perspective, the Handbook of Public Policy Analysis: Theory, Politics, and Methods covers the historical development of policy analysis, its role in the policy process, and empirical methods. The handbook considers the theory generated by these methods and the normative and ethical issues surrounding their practice. Written by leading experts in the field, this book- Deals with the basic origins and evolution of public policy Examines the stages of the policy-making process Identifies political advocacy and expertise in the policy process Focuses on rationality in policy decision-making and the role of policy networks and learning Details argumentation, rhetoric, and narratives Explores the comparative, cultural, and ethical aspects of public policy Explains primary quantitative-oriented analytical methods employed in policy research Addresses the qualitative sides of policy analysis Discusses tools used to refine policy choices Traces the development of policy analysis in selected national contexts The Handbook of Public Policy Analysis: Theory, Politics, and Methods describes the theoretical debates that have recently defined the field, including the work of postpositivist, interpretivist, and social constructionist scholars. This book also explores the interplay between empirical and normative analysis, a crucial issue running through contemporary debates. HISTORICAL PERSPECTIVES The Policy Sciences at the Cross-Roads Promoting the Policy Orientation: Lasswell in Context Public Policy, Social Science and the State: An Historical Perspective POLICY PROCESSES Theories of the Policy Cycle Agenda Setting in Public Policy Policy Formulation: Design and Tools Implementing Public Policy Do Policies Determine Politics? An Analysis of Lowi's Policy Typology POLICY POLITICS, ADVOCACY, AND EXPERTISE A Guide to the Advocacy Coalition Framework Policy Communities Policy Analysis and Think Tanks POLICY DECISION MAKING: RATIONALITY, NETWORKS, AND LEARNING. Rationality in Policy Decision-Making Rational Choice in Public Policy: The Theory in Critical Perspective Taking Stock of Policy Networks: Do They Matter? Theories of Policy Learning: Agency, Structure, and Change DELIBERATIVE POLICY ANALYSIS: ARGUMENTATION, RHETORIC, AND NARRATIVES Deliberative Policy Analysis as Practical Reason: Integrating Empirical and Normative Arguments Rhetoric in Policy-Making: Between Logos, Ethos, and Pathos Narrative Policy Analysis COMPARATIVE, CULTURAL, AND ETHICAL PERSPECTIVES Comparative Public Policy Applied Cultural Theory: Tool for Policy Analysis Ethical Issues and Public Policy Public Policy and Democratic Citizenship: What Kinds of Citizenship Does Policy Promote? QUANTITATIVELY-ORIENTED POLICY METHODS Quantitative Methods for Policy Analysis The Use (and Misuse) of Survey Research in Policy Analysis Social Experiments and Public Policy Evaluation Research in Policy Analysis QUALITATIVE POLICY ANALYSIS: INTERPRETATION, MEANING, AND CONTEXT Qualitative-Interpretive Methods in Policy Research Qualitative Research and Public Policy Interpretation and Intention in Policy Analysis Context Sensitive Policy Methods POLICY DECISION TECHNIQUES Cost-Benefit Analysis Environmental Impact Assessment: Between Bureaucratic Process and Social Learning. Technology Assessment as Policy Analysis: From Expert Advice to Participatory Approaches Public Policy Mediation: From Argument to Collaboration COUNTRY PERSPECTIVES Policy Analysis in Britain Evolution of Policy Analysis in the Netherlands Policy Analysis and Evaluation in Sweden: Discovering the Limits of the Rationalistic Paradigm Policy Analysis in Germany Policy Analysis in India Policy Analysis in Korea: From Economic Efficiency to Public Participation

Facilitating diagnostic competences is an important objective of higher education for many professions. This meta-analysis of 35 empirical studies builds on a conceptual framework and investigates the role of problem-solving, scaffolding, and context to foster diagnostic competences in learners with lower and higher professional knowledge bases. A moderator analysis investigates which type of scaffolding is effective for different levels of learners’ knowledge bases, as well as the role of the diagnostic context. Instructional support has a moderate positive effect ( g =  .39; CI [.22; .56]; p  = .001). Diagnostic competences are facilitated effectively through problem-solving independent of the learners’ knowledge base. Scaffolding types providing high levels of guidance are more effective for less advanced learners, whereas scaffolding types relying on high levels of self-regulation are more effective for advanced learners.

Sirtuins are protein deacetylases regulating metabolism and stress responses. The seven human Sirtuins (Sirt1–7) are attractive drug targets, but Sirtuin inhibition mechanisms are mostly unidentified. We report the molecular mechanism of Sirtuin inhibition by 6-chloro-2,3,4,9-tetrahydro-1H-carbazole-1-carboxamide (Ex-527). Inhibitor binding to potently inhibited Sirt1 and Thermotoga maritima Sir2 and to moderately inhibited Sirt3 requires NAD ⁺, alone or together with acetylpeptide. Crystal structures of several Sirtuin inhibitor complexes show that Ex-527 occupies the nicotinamide site and a neighboring pocket and contacts the ribose of NAD ⁺ or of the coproduct 2’- O -acetyl-ADP ribose. Complex structures with native alkylimidate and thio-analog support its catalytic relevance and show, together with biochemical assays, that only the coproduct complex is relevant for inhibition by Ex-527, which stabilizes the closed enzyme conformation preventing product release. Ex-527 inhibition thus exploits Sirtuin catalysis, and kinetic isoform differences explain its selectivity. Our results provide insights in Sirtuin catalysis and inhibition with important implications for drug development.

Clinical reasoning theories agree that knowledge and the diagnostic process are associated with diagnostic success. However, the exact contributions of these components of clinical reasoning to diagnostic success remain unclear. This is particularly the case when operationalizing the diagnostic process with diagnostic activities (i.e., teachable practices that generate knowledge). Therefore, we conducted a study investigating to what extent knowledge and diagnostic activities uniquely explain variance in diagnostic success with virtual patients among medical students. The sample consisted of N  = 106 medical students in their third to fifth year of university studies in Germany (6-years curriculum). Participants completed professional knowledge tests before diagnosing virtual patients. Diagnostic success with the virtual patients was assessed with diagnostic accuracy as well as a comprehensive diagnostic score to answer the call for more extensive measurement of clinical reasoning outcomes. The three diagnostic activities hypothesis generation, evidence generation, and evidence evaluation were tracked. Professional knowledge predicted performance in terms of the comprehensive diagnostic score and displayed a small association with diagnostic accuracy. Diagnostic activities predicted comprehensive diagnostic score and diagnostic accuracy. Hierarchical regressions showed that the diagnostic activities made a unique contribution to diagnostic success, even when knowledge was taken into account. Our results support the argument that the diagnostic process is more than an embodiment of knowledge and explains variance in diagnostic success over and above knowledge. We discuss possible mechanisms explaining this finding.

Background Simulation-based learning with virtual patients is a highly effective method that could potentially be further enhanced by including reflection phases. The effectiveness of reflection phases for learning to diagnose has mainly been demonstrated for problem-centered instruction with text-based cases, not for simulation-based learning. To close this research gap, we conducted a study on learning history-taking using virtual patients. In this study, we examined the added benefit of including reflection phases on learning to diagnose accurately, the associations between knowledge and learning, and the diagnostic process. Methods A sample of N  = 121 medical students completed a three-group experiment with a control group and pre- and posttests. The pretest consisted of a conceptual and strategic knowledge test and virtual patients to be diagnosed. In the learning phase, two intervention groups worked with virtual patients and completed different types of reflection phases, while the control group learned with virtual patients but without reflection phases. The posttest again involved virtual patients. For all virtual patients, diagnostic accuracy was assessed as the primary outcome. Current hypotheses were tracked during reflection phases and in simulation-based learning to measure diagnostic process. Results Regarding the added benefit of reflection phases, an ANCOVA controlling for pretest performance found no difference in diagnostic accuracy at posttest between the three conditions, F (2, 114) = 0.93, p  = .398. Concerning knowledge and learning, both pretest conceptual knowledge and strategic knowledge were not associated with learning to diagnose accurately through reflection phases. Learners’ diagnostic process improved during simulation-based learning and the reflection phases. Conclusions Reflection phases did not have an added benefit for learning to diagnose accurately in virtual patients. This finding indicates that reflection phases may not be as effective in simulation-based learning as in problem-centered instruction with text-based cases and can be explained with two contextual differences. First, information processing in simulation-based learning uses the verbal channel and the visual channel, while text-based learning only draws on the verbal channel. Second, in simulation-based learning, serial cue cases are used to gather information step-wise, whereas, in text-based learning, whole cases are used that present all data at once.