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Family Systems Therapy

Published by Earl Donovan Modified over 9 years ago

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Presentation on theme: "Family Systems Therapy"— Presentation transcript:

Keys to Family Therapy The concept of the family is a “System.”

Collaborating with Families: Partnering for Success

Person-Centered Therapy Carl Rogers Chapter 4. The Case of Richard 48-year-old married Caucasian male Complains of symptoms of depression including a.

Copyright © Allyn & Bacon 2003 V. Classic Schools of Family Therapy, Part 1 Power Point presentation prepared by Leslie Barnes-Young, PhD, Francis Marion.

Theory Applied to Practice

Theory and Practice of Counseling and Psychotherapy Psych422 Chapter 5: Adlerian Therapy Theory and Practice of Counseling and Psychotherapy - Chapter.

Person-Centered Therapy

Social Work Practice With Groups

Family Systems PART SET Dr MargiAnne Isaia, MD MPH PCC-T DrAnneenthusiasticLife 12.

Recreational Therapy: An Introduction

DED 101 Educational Psychology, Guidance And Counseling

Fostering, Maintaining, and Repairing Relationships.

Family Systems Theory Chapter 11. The Case of Jean and Derril Jean 42-year-old divorced African American female Derril 12-year-old multiracial male Referred.

Attachment and Family Therapy Byng-Hall, J. (1999). Family therapy and couple therapy: Toward greater security. In J. Cassidy & P. R. Shaver (Eds.), Handbook.

Family Assessment and Interventions Chapter 15. Family A group of people connected emotionally, by blood or both that has developed patterns of interaction.

Interventions Systemic and Psychoeducational. Systemic interventions assume –Human problems are based in the systems where an individual functions. –Change.

Family Therapy A systemic approach.

Theory and Practice of Counseling and Psychotherapy Chapter 14

Copyright © 2005 Wadsworth Group. Brooks/Cole is an imprint of the Wadsworth Group, a division of Thomson Learning, Inc. Family Systems Therapy.

Theory and Practice of Counseling and Psychotherapy

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Extended Family Systems - PowerPoint PPT Presentation

Extended Family Systems

Membership: father and mother; sons and wives; daughters until married; ... this is intangible wealth amassed that promotes physical, emotional, ... – powerpoint ppt presentation.

• What is a Family?
• Joint Family Concepts
• Did Joint Family system exist throughout the World? Why it has Disintegrated?
• Benefits of Joint Family
• Nuclear Family and its Disadvantages
• Family is a social institution
• People descended from a common ancestor
• Primary social group
• Extended Family Multiple generations living under one roof with one kitchen.
• Other names
• Joint Family
• Nuclear Family disintegrated Extended Family.
• Membership Father and mother sons and wives daughters until married grandsons and wives granddaughters until married great grandsons and wives great granddaughters until married.
• Head of the family Father with support of mother. In the absence of the father, the most capable elder son with guidance of his mother and support of spouse. In the absence of the elder brother, a competent younger brother takes over.
• Distribution of duties The head of the family assigns members according to their abilities and availability. The mother is responsible for nurturance, clothing, household activities, gift giving and acceptance of gifts. She consults her daughters-in-law and wives of younger brothers and educates them for proper decision-making in her absence.
• Religious ceremonies The eldest son is to perform all these duties. His spouse joins him. Others share and cooperate as they are able.
• Basic principles
• Every member sees that others get the best and most of resources. Each person himself asks for the least, and last.
• All are willing to endure to relieve the others' burdens.
• No one owns anything. Each is a trustee for the joint family, extended family, society and the nation.
• Everyone's voice and opinion has value and importance.
• Everyone's conduct is such that intentions can never be questioned. This includes honoring the traditions and fulfilling spoken and unspoken expectations of the extended family, society at large and the venerable principles of Sanatana Dharma.
• 1 out of 6 children in America lives with only one parent, and the number of such households may well increase in the future.
• Under the circumstances, it is only fitting that a number of thoughtful men and women should continue to search for more stable, "new and improved" family models.
• According to Dr. Tripathi, the value of traditional value system and status of women got badly affected with the passage of time because of reasons like political and cultural invasions, urbanization, industrialization, changed socio-economic conditions, etc.
• These factors are ever growing industrialization, city based living and to a great extent modern education and construct of the contemporary social thinking itself.
• kula-kñaye praëaçyanti
• kula-dharmäù sanätanäù
• dharme nañöe kulaà kåtsnam
• adharmo'bhibhavaty uta
• With the destruction of the dynasty, the eternal family tradition is vanquished, and thus the rest of the family becomes involved in irreligion.
• In the system of the varëäçrama institution there are many principles of religious traditions to help members of the family grow properly and attain spiritual values. The elder members are responsible for such purifying processes in the family, beginning from birth to death. But on the death of the elder members, such family traditions of purification may stop, and the remaining younger family members may develop irreligious habits and thereby lose their chance for spiritual salvation. Therefore, for no purpose should the elder members of the family be slain.
• "Most joint families disintegrate when the elders lose moral authority," says Mr. A.V. Subba Rao, an advocate.
• Kali Yuga is the age of Quarrel and Hypocrisy
• Ecological and Environmental
• Psychological
• Joint families are like microcosms of an entire world. They are the first training grounds, where people learn interpersonal skills. People in joint families learn lessons of patience, tolerance, cooperation and adjustment. They also learn what it means to take collective responsibility. One for all and all for one.
• Speaking in support of the joint family system, Dr. Mona Khaitan, a professor of business in MassBay Community College, presented data suggesting the joint family system fares better economically. According to the National Family Health Survey of 1998-1999, while joint families form only 35 of the low income households, they form 53 of the high income households.
• Dr. Khaitan explained the better economic success of the joint family as it "enjoys the economies of scale the costs are lower than if two or three households were to be maintained, making for increased income."
• In addition to the economic advantage, Professor Khaitan advanced the idea of 'relational wealth', original proposed by late Professor Romesh Diwan of Rensselaer Polytechnic College in Troy, NY. This is intangible wealth amassed that promotes physical, emotional, intellectual, and psychic wellbeing of each individual.
• Joint Families May Be More Environmentally Sound Source http//timesofindia.indiatimes.com/cms.dl l/html/comp/ LONDON, ENGLAND, January 14, 2003 Living with mom and dad, rather than venturing out on your own may actually contribute to saving the planet.
• From an environmental stance, as the number of households with one, two, or three occupants increase, proportionately so too will energy consumption, land and water use and construction materials. Other experts, such as sociologists, agree that more households means more energy use.
• Liu calls the study a Wake-up Call!
• High divorce rates
• Working mothers Cannot spend time with Kids
• Security, education and Welfare of Children are not met properly.
• Raise in Oldage homes corresponds to raise in Nuclear families and Divorce rates
• The ageing India combined with a declining joint family system faces a crisis in social security for elderly. The government pension system has been converted from a defined benefit system to a Defined Contribution one. The mandatory schemes like Employees' Provident Funds Schemes cover a relatively small segment of the total work force. In all, more than 80 of the work force is not covered by any mandatory retirement/social security schemes.
• Prof. Vaidynathan
• IIM, Bangalore
• (Declining Joint Family Emerging crisis in Old Age)
• It is required for India to think of innovative products and systems to deal with the issues. Reverse mortgage on housing stock and converting huge stock of gold held by households by single premium pension products may help to some extent. But, it is equally important to stress on family values and savings based life style to face the long-term implications of the emerging crisis in the social security scene.
• School shoot-outs in US
• School violence in India
• Juvenile delinquency due to poor family structure
• Psychological effects of single child (no sibling) and Nuclear Family
• Crime rate connected with Nuclear Family system
• State expenditure on the Family insurance on Health
• Concept of Varna Sankara
• By the evil deeds of those who destroy the family tradition and thus give rise to unwanted children, all kinds of community projects and family welfare activities are devastated. --B.g 1.42
• Devayäné wished to marry him, but at first he refused to accept her because of her being a daughter of a brähmaëa. According to çästras, a brähmaëa could marry the daughter of a kñatriya but a kñatriya could not marry the daughter of a brähmaëa. They were very much cautious about varëa-saìkara population in the world.
• This Vedic social organization is very good in that it stops the promulgation of illicit sex life, or varëa-saìkara, which appears under different names in this present day. Unfortunately in this age although the father and mother are anxious to get their children married, the children refuse to get married by the arrangement of the parents. Consequently, the number of varëa-saìkara has increased throughout the world under different names.
• Nuclear family system has its own advantages, which exactly are not advantages but the ways out to the problems in joint family. The core strength of the nuclear family system lies in Fewer the members, lesser the problems.
• The problems commonly found in joint family system are automatically eradicated because there is no one to produce those problems, in case of nuclear families. This solution is achieved but at the cost of an ironic set of factors that do count.
• This set of factors and the results of those factors include
• Loneliness and Depression
• Sharing Joys and Grieves
• Development of Children
• Radical transformation of society as a whole. They believe that a "new man" and a "new woman" have to be created before a better family system can be devised.
• The prevailing social order preconditions everyone against achieving true happiness. They find human nature itself deformed by our present unhealthy civilization and therefore demand a "fresh start"
• The Conclusion should be clear
• MAKE VRNDAVAN VILLAGES
• -H.H.Bhakti Raghava Maharaj

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Why Republicans are calling Walz 'Tampon Tim' — and why Democrats embrace it

Rachel Treisman

Minnesota Gov. Tim Walz, pictured at a campaign rally in Philadelphia on Tuesday, is getting attention for a law he signed last year requiring public schools to provide free period products. Matt Rourke/AP hide caption

For more on the 2024 election, head to the NPR Network's live updates page.

Republican critics of Democratic vice presidential candidate Tim Walz have given him a new nickname: “Tampon Tim.”

After Vice President Harris announced her pick , Stephen Miller, a former adviser to former President Donald Trump, tweeted , “She actually chose Tampon Tim.” Chaya Raichik, who runs the far-right social media account Libs of TikTok, photoshopped Walz’s face onto a Tampax box.

#TamponTim pic.twitter.com/eBPyEOSWPC — Chaya Raichik (@ChayaRaichik10) August 6, 2024

“Tampon Tim is hands down the best political nickname ever,” tweeted conservative commentator Liz Wheeler. “It’s so… savagely effective. In one word tells you EVERYTHING you need to know about Tim Walz’s dangerous radicalism.”

The moniker refers to a law that Walz, the governor of Minnesota, signed last year, requiring public schools to provide menstrual products — including pads and tampons — to students in 4th through 12th grades.

The products are free for students, with the state paying about $2 per pupil to keep them stocked throughout the school year.

Takeaways from Tim Walz's introduction to the national stage

The law, which was the result of years of advocacy by students and their allies, took effect on Jan. 1, though students say the rollout has so far been smoother in some school districts than others .

It makes Minnesota one of 28 states (and Washington D.C.) that have passed laws aimed at giving students access to menstrual products in schools, according to the Alliance for Period Supplies.

The issue enjoys broad popular support: 30 states have eliminated state sales tax on menstrual products, and Trump himself signed a 2018 package that requires federal prisons to provide them.

But Republicans appear to be taking issue with the wording of the legislation, which says the products must be available “to all menstruating students in restrooms regularly used by students.”

Some Minnesota Republicans initially tried to limit the initiative to female-assigned and gender-neutral bathrooms, but were unsuccessful. Even the author of that amendment ultimately voted for the final version of the bill, saying his family members “felt like it was an important issue I should support.”

The bill’s inclusive language reflects that not all people who menstruate are women, and not all women get periods, which was important to those who lobbied for the legislation.

“It will make it more comfortable for everyone … then people can use whatever restroom they want without being worried,” Bramwell Lundquist, then 15, told MPR News last year.

But some in the Republican Party — which has increasingly promoted anti-transgender policies and rhetoric — see that aspect of the bill as a reason to attack Walz.

“Tim Walz is a weird radical liberal,” the MAGA War Room account posted on X, formerly Twitter. “What could be weirder than signing a bill requiring schools to stock tampons in boys' bathrooms?”

'Midwestern Nice' and 'Fun Dad' posts abound after Tim Walz is named VP pick

Trump campaign spokesperson Karoline Leavitt made a similar argument in a Tuesday appearance on Fox News .

“As a woman, I think there is no greater threat to our health than leaders who support gender-transition surgeries for young minors, who support putting tampons in men’s bathrooms in public schools,” she said. “Those are radical policies that Tim Walz supports. He actually signed a bill to do that.”

LGBTQ rights groups have cheered Walz’s selection and praised his track record, which includes a 2023 executive order making Minnesota one of the first states to safeguard access to gender-affirming health care, as dozens of states seek to ban it .

Walz, who once earned the title “ most inspiring teacher ” at the high school where he taught and coached football, hasn’t responded publicly to the “Tampon Tim” taunts. But he had strong words for his Republican opponents on Tuesday night.

“I'll just say it: Donald Trump and JD Vance are creepy and, yes, weird,” he tweeted , repeating the put-down he helped popularize in recent days. “We are not going back.”

Many on the left see “Tampon Tim” as a compliment

Democratic Minnesota Rep. Sandra Feist, the chief sponsor of the bill in the state House, sold it as a "wise investment" , explaining to her colleagues last year that “one out of every 10 menstruating youth miss school” due to a lack of access to menstrual products and resources.

She defended it again in a tweet on Wednesday morning, saying she was grateful to have partnered with Walz to address period poverty .

“This law exemplifies what we can accomplish when we listen to students to address their needs,” she wrote. “Excited to see MN representation at the top of the ticket!”

Feist ended the tweet with the hashtag #TamponTim.

Other Democratic figures have embraced both the hashtag and the policy behind it.

The case for free tampons and pads in schools

Many social media users responded that providing tampons in schools isn’t the bad thing that Republicans are making it out to be — and in fact, they see it as the opposite.

Former presidential candidate Hillary Clinton said it was “nice of the Trump camp to help publicize Gov. Tim Walz’s compassionate and common-sense policy,” adding, “Let’s do this everywhere.”

Former Georgia State Rep. Bee Nguyen said Walz, as a former teacher, understands how the lack of access to menstrual products impacts educational outcomes.

“This makes me an even bigger fan of Tampon Tim,” she added.

Nearly 1 in 4 students have struggled to afford period products in the United States, according to a 2023 study commissioned by Thinx and PERIOD. Experts say period poverty is more than just a hassle : It’s an issue of public and personal health, dignity and more.

The Minnesota students who lobbied for the bill testified last year about having to miss class because they were unable to afford menstrual products, being distracted from schoolwork and tests and feeling that adults didn’t take their concern seriously.

“We cannot learn while we are leaking,” high school student Elif Ozturk, then 16, told a legislative hearing in 2023. “How do we expect our students to carry this burden with them during the school day and still perform well? The number one priority should be to learn, not to find a pad.”

• menstrual products

Educators want a post-pandemic reset, overhaul of current system

by GEOFF HARRIS | The National Desk

WASHINGTON (TND) — Public school educators are calling for a post-pandemic reset. Four years after COVID-19 forced schools to close, educators want a system overhaul.

When it comes to teaching during the pandemic, Jennifer Steele wasn't just thrown into the mix as an educator at American University, but also as a parent whose kids go to public school in Virginia.

We were juggling all pieces of that. Teaching online, me at the university, and our kids learning online," Steele said.

She understands why educators are pushing for a reset as fears continue to grow that students could be left with developmental issues from lost learning time.

There may have been some skills that would have gotten covered in class that were hard to cover in remote or hybrid environments," Steele said.

As for how this reset would work, Steele believes improving teacher burnout starts with pay and working conditions.

Higher pay attracts teachers to high-need schools (and) keeps them there, but isn't the whole story. Working conditions and leader support matter a lot as well," said Steele.

To help curb the learning gap and improve chronic absenteeism, Douglas Harris with Tulane University said tutoring should be more readily available.

Assign a tutor, who, in a very targeted way, can try and get them up to speed on the things they're missing," Harris said.

As for what families can do, Harris said it's best to ask questions and get more involved.

So, parents should be asking teachers and school leaders at parent-teacher conferences and so on, 'How is my child really doing?'" said Harris.

According to the Pew Research Center, about half of Americans think the public education system is going in the wrong direction, with 82% saying it's been trending that way for the past five years.

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Portuguese students visit UD to learn about U.S. financial system

Article by Jen Hendrickson Photo by Maria Errico August 06, 2024

University of Lisbon students gain practical experience

From June 11-21, the University of Delaware’s building Alfred Lerner College of Business and Economics hosted about 30 master of finance students from the University Institute of Lisbon (ISCTE), who came to learn about stock trading and get a first-hand taste of the United States financial system. Much of the learning took place in the Geltzeiler Trading Center, which is set up to provide a similar experience as Wall Street trading floors, with real-time stock feeds, workstations and access to the Bloomberg trading terminal. Students also traveled to Washington, D.C., Philadelphia and New York.

The program, which Lerner has hosted many times since 2011, is managed by Paul Laux, a professor of finance and JP Morgan Chase senior fellow in the Lerner College. Laux and Mattias Fleckenstein, also a professor of finance, offered students sessions in machine-learning and smart beta trading; and hedge-fund arbitrage trading in the U.S. Treasury markets, respectively. Richard Jakotowicz, finance instructor, provided a hands-on introduction to the Bloomberg Terminal and trading.

It’s a chance to benefit and inspire a group of eager, smart students, Laux noted, while enhancing UD’s reputation in Europe at the same time.

During their trip, students got an insider’s perspective from Bloomberg’s Daniel Zelkin, Class of 2022 UD Lerner Finance alum, on using the Bloomberg Terminal for security research and a technical analysis perspective on trading with Brian Joyce, managing director of Nasdaq’s Market Intelligence Desk. The students each were awarded a certificate recognizing their work with Lerner’s professors over the previous days during the closing events on June 21.

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Family Systems Therapy

Oct 31, 2011

450 likes | 2.08k Views

Family Systems Therapy. Dr. Alfred Adler Dr. Murray Bowen Dr. Virginia Satir Dr. Carl Whitaker Dr. Salvador Minuchin Dr. Jay Haley Dr. Cloe’ Madanes (Haley). Basic Assumption. Serve a purpose for the family Conflict

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• human validation process model
• carl whitaker dr
• unmask pretense
• creates family
• extreme rules
• joint family therapy

Presentation Transcript

Family Systems Therapy Dr. Alfred Adler Dr. Murray Bowen Dr. Virginia Satir Dr. Carl Whitaker Dr. Salvador Minuchin Dr. Jay Haley Dr. Cloe’ Madanes (Haley)

Basic Assumption • Serve a purpose for the family • Conflict • Be a function of the family’s inability to operate productively • The Cause • Be handed down across generations

Primary Goal of Therapy • To bring about change in the family system, which is assumed to produce change in the individual members of that family unit…

Adlerian Family Therapy • Basic Assumption: Both parents and children become stuck in repetitive negative interactions, which become motivators for the type of behavior displayed by the entire family… • EX: Arguing, Tobacco & Alcohol Use, Trouble with authority, etc…

Family Power & Authority Decision Maker F F Decision Maker P 2 P 1 2 3 1 2 3 TYPICAL DYSFUNCTIONAL

Role of Therapist The role of the therapist is that of a “Collaborator” who actually seeks to join the family unit…

Goals of Adlerian Family Therapy • Unlock mistaken goals and interactional patterns • Engage parents in a learning experience and joint assessment • Of the family • Place emphasis on the family’s motivational patterns • What makes them tick • To initiate a reorientation of the family • Teach them new ways

Multi-Generational Family Therapy: Murray Bowen • Bowen the original developer of mainstream family therapy • A family can be best understood when it is analyzed from at least a three-generational perspective…

Basic Concept of Differentiation of Self & Triangulation • Differentiation of Self • The psychological separation of intellect and emotion and independence of self from others • Triangulation • Eliciting the support of a third party to lessen emotional tension between other family members Central To Therapy Model

Multi-Generational Goals • To change the individuals within the system • To end generation-to-generation transmission of problems by resolving emotional attachment • To lessen anxiety and relieve symptoms • To increase the individual member’s level of differentiation

Human Validation Process Model: Virginia Satir • Her approach emphasizes: • Communication • Emotional Experiencing • And, stresses the involvement of the therapist with a family The model is called: “Con-Joint Family Therapy”

Validation Process • Enhancement and validation of self-esteem • Family Rules • Congruence and openness in communication • Sculpting • Nurturing Triads • Family Mapping and Chronologies

Goals of Conjoint Therapy • Open Communication • Individuals are allowed to honestly report their perceptions • Enhancement of Self-Esteem • Family decisions are based on individual needs • Encouragement of Growth • Differences are acknowledged • Transforming extreme rules into useful and functional rules • Families have many spoken and unspoken rules

Experiential Family Therapy:Carl Whitaker This approach stresses: • Choice • Freedom • Self-Determination • Growth • Self-Actualization

Therapist Emphasis • Unmask pretense, create new meaning, and liberate family members • Techniques are secondary • Creates family turmoil

Phases of Family Therapy • Engagement • Involvement • Disentanglement

Goals of Experiential Family Therapy • Individual autonomy • Achieve more intimacy • Encourage free expression • Promote spontaneity, creativity, the ability to play, and the willingness to be “Crazy”

Structural Family Therapy:Salvador Minuchin • An approach to understanding the nature of the family, the presenting problem, and the process of change… • An approach that stresses action over insight…

Family Structure • Basic Family • Family Sub-Systems • Spousal sub-system • Mother/father sub-system • Sibling sub-system • Extended family sub-system

Strategic Family Therapy: Jay Haley • Focus is on solving problems in the present • Therapy is brief • Therapist designs strategies • Change results when family follows therapist directions

Goals of Therapy • Resolve presenting problem • Change Behavior • Shift family organization • Move family toward an appropriate stage of development

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• Open access
• Published: 06 August 2024

Assessing the interplay of presentation and competency in online video examinations: a focus on health system science education

• Phoomjai Sornsenee 1 ,
• Pawita Limsomwong 1 ,
• Polathep Vichitkunakorn 1 ,
• Supakorn Sripaew 1 ,
• Supinya Sono 1 ,
• Kanisorn Sungkaro 2 ,
• Theepat Wongkittithaworn 3 ,
• Thadakorn Tantisarasart 4 ,
• Pongphon Chuchuen 5 ,
• Katti Sathaporn 6 &
• Kwanchanok Chantaramanee 7  

BMC Medical Education volume  24 , Article number:  842 ( 2024 ) Cite this article

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The integration of Health System Science (HSS) in medical education emphasizes mastery of competencies beyond mere knowledge acquisition. With the shift to online platforms during the COVID-19 pandemic, there is an increased emphasis on Technology Enhanced Assessment (TEA) methods, such as video assessments, to evaluate these competencies. This study investigates the efficacy of online video assessments in evaluating medical students’ competency in HSS.

A comprehensive assessment was conducted on first-year medical students ( n  = 10) enrolled in a newly developed curriculum integrating Health System Science (HSS) into the Bachelor of Medicine program in 2021. Students undertook three exams focusing on HSS competency. Their video responses were evaluated by a panel of seven expert assessors using a detailed rubric. Spearman rank correlation and the Interclass Correlation Coefficient (ICC) were utilized to determine correlations and reliability among assessor scores, while a mixed-effects model was employed to assess the relationship between foundational HSS competencies (C) and presentation skills (P).

Positive correlations were observed in inter-rater reliability, with ICC values suggesting a range of reliability from poor to moderate. A positive correlation between C and P scores was identified in the mixed-effects model. The study also highlighted variations in reliability and correlation, which might be attributed to differences in content, grading criteria, and the nature of individual exams.

Our findings indicate that effective presentation enhances the perceived competency of medical students, emphasizing the need for standardized assessment criteria and consistent assessor training in online environments. This study highlights the critical roles of comprehensive competency assessments and refined presentation skills in online medical education, ensuring accurate and reliable evaluations.

Peer Review reports

In medical education, assessment extends beyond mere knowledge acquisition. It emphasizes the mastery of essential skills and the medical profession. [ 1 ] Among various approaches, competency-based assessment stands out, [ 2 ] as it encompasses the full range of knowledge, skills, and attitudes. [ 3 ] This approach focuses extensively on Health System Science (HSS), which is globally recognized as the third pillar of medical education. [ 4 ] HSS integrates systems thinking and the complexities of healthcare systems, equipping medical professionals to adeptly navigate and manage the socio-economic, political, and interpersonal factors influencing healthcare. [ 5 ] Furthermore, the cognitive domain is an integral facet of HSS, emphasizing Higher-Order Thinking (HOT) skills, such as critical thinking, problem-solving, and analytical reasoning. [ 6 , 7 ] These skills are crucial to effectively engaging with the broader constructs of HSS.

The challenges brought by the COVID-19 pandemic have reshaped traditional teaching and prompted a re-evaluation of existing assessment methods. [ 8 , 9 , 10 ] Global institutions, faced with the limitations of in-person interactions, have found it essential to transition to digital platforms. [ 10 ] This shift has highlighted the need for adopting Technology Enhanced Assessment (TEA) methods, which align well with the emerging online teaching environment. [ 11 , 12 ] In this new paradigm, it is crucial that TEA methods, especially online video assessments, effectively evaluate competencies for the digital age. However, their efficacy in specific areas like HSS remains under exploration.

Oral presentations, especially in online video formats, may offer unique insights into a student’s HOT capabilities, which are essential for HSS assessments. These evaluations could potentially elucidate core areas within HSS, such as systems thinking, health policy, and the social sciences. Previous studies hint at the efficacy of oral assessments in areas like social sciences [ 13 ] and professionalism. [ 14 ] However, the robustness and reliability of video-based oral presentations as an assessment tool warrant further investigation. Another consideration is the potential bias resulting from varying presentation skills. [ 15 , 16 ] Students with exemplary presentation skills may overshadow essential content gaps, while those less adept at presenting might not be duly acknowledged for their depth of HSS knowledge. To ensure fair and effective assessment, it is critical to carefully differentiate true competency from mere presentation prowess.

In this study, we investigate the effectiveness of online video assessments in capturing medical students’ competency in the HSS curriculum, focusing on topics like systems thinking, health policy, medical ethics, and social health determinants. Our research primarily aims to gauge score consistency across assessors. We employ the Interclass Correlation Coefficient (ICC) to measure inter-rater reliability and use Spearman’s Rho—a statistical method—to determine correlations among assessors. Alongside, we explore the relationship between foundational HSS competenies (C) and presentation skills (P) through mixed-effects modeling. Elucidating the interplay between C and P offers a nuanced perspective for HSS assessments.

Study design, setting, and participants

The study involved a comprehensive assessment of all first-year medical students ( n  = 10) enrolled in a newly developed curriculum integrating Health System Science (HSS) into the Bachelor of Medicine program in 2021. The curriculum aims primarily at two objectives. First, it seeks to provide comprehensive medical education enriched with HSS concepts. Second, it intends to attract students from rural areas, nurturing them with the hope they will return and serve their home communities, equipped with a deep understanding of the public health system.

Examination process

First-year medical students undertook three distinct exams, each designed to assess various dimensions and complexities of Higher-Order Thinking (HOT) skills within the Health System Science (HSS) curriculum. For a detailed breakdown of exam formats, materials, and timing, refer to Table  1 .

Exam 1 on Social Health Determinants (SDHs) : This exam assesses foundational HOT skills such as understanding, recall, and application, in addition to critical thinking and problem-solving. It integrates theoretical and practical elements to evaluate how students apply systems thinking to real-world health challenges.

Exam 2 on Health Care Policy : This exam focuses on deeper analytical and synthetic HOT skills, evaluating students’ abilities to critically engage with and construct reasoned arguments regarding health policy issues.

Exam 3 on Medical Ethics : Similarly, this exam tests the students’ ability to analyze, synthesize, and evaluate ethical dilemmas in medical practice, enhancing their understanding of the ethical frameworks essential to health system science.

Each exam incorporates elements of systems thinking, foundational to mastering HSS. The assessments were developed by an impartial educator and are conducted over a standardized 40-minute session, utilizing a Learning Management System (LMS) developed by the faculty of medicine.

Assessment technique and evaluation

After the three exams, students’ response videos were assessed by a panel of seven expert assessors specializing in medical education. The assessment process utilized a detailed rubric, designed to capture the depth and nuance of HOT as intended in each exam. This rubric, informed by the principles of HOT and HSS, combined a numerical scale (ranging from 1 to 10) with explicit descriptors for each score, providing clarity on performance expectations. This ensured evaluations were consistent and adequately represented the depth of student understanding in relation to the complexities integrated into the three exams. The training of our panel of assessors focused on the foundational principles of Health System Science (HSS) and the effective application of the assessment rubric. The initial session introduced the assessors to the rubric, highlighting its alignment with key HSS competencies such as systems thinking and value based care. This included a detailed explanation of the scoring system and performance standards.

The students were assessed based on two primary criteria. First , their competency skills were evaluated using the rubric formulated by the educational research team to capture the nuances of HOT. Second , their presentation skills were assessed, focusing on accuracy, clarity, and the effectiveness of their communication, drawing from criteria established in previous research. [ 16 ]

Statistical analysis and reliability assessment

Assessor Score Correlation : We utilized the Spearman rank correlation method to understand the interrelationships among assessor scores. Data for each of the three exams (Exams 1–3) are presented in tables, which display the Spearman’s rho coefficients for competency (C) scores and presentation (P) scores. A rho value near 1 signifies a strong correlation; a value between 0.5 and 0.75 indicates a moderate correlation; a value between 0.3 and 0.5 suggests a weak correlation; and a value close to 0 implies negligible correlation.

Reliability Estimation : The level of agreement among assessors was quantified using the Interclass Correlation Coefficient (ICC). Each ICC value was complemented with its respective 95% confidence interval. It is essential to note the interpretative context of the ICC values: those below 0.5 signify poor reliability; values ranging from 0.5 to 0.75 denote moderate reliability; values between 0.75 and 0.9 are indicative of good reliability; and values exceeding 0.9 are demonstrative of excellent reliability.

Relationship between Presentation and Competency : A jitter plot depicted individual student performances, with colors differentiating each assessor. A mixed-effects model was implemented to consider potential variability due to individual assessors. The model’s coefficient indicated the anticipated shift in competency relative to presentation skills.

Software and Packages : All analytical processes, from data visualization to heat map creation, were executed using R software, version 4.3.1 with packages. [ 17 , 18 , 19 , 20 ]

Our evaluation offers insights into both the correlation and reliability of assessments. The 10 participants, scores across the three exams were evaluated by seven expert assessors. Spearman’s Rho values, as illustrated in Tables  2 and 3 , indicate correlations for competency scores (C) and presentation scores (P). All correlations emerged as positive; however, there were discernible variations in strength from weak to strong for both competency and presentation scores across different assessors and exams. The Interclass Correlation Coefficient (ICC) values for C scores across exams were 0.42 (95% CI = 0.18–0.74) for Exam 1, 0.27 (95% CI = 0.09–0.61) for Exam 2, and 0.35 (95% CI = 0.12–0.68) for Exam 3. P scores for these exams were 0.44 (95% CI = 0.20–0.75) for Exam 1, 0.32 (95% CI = 0.12–0.66) for Exam 2, and 0.48 (95% CI = 0.24–0.78) for Exam 3. When considering the 95% confidence intervals for both competency and presentation scores, these ICC values suggest a range of reliability from poor to moderate.

Further exploration of the correlation between C and P scores across the three exams is depicted in Figs.  1 and 2 , and 3 , respectively. Each figure presents a jitter plot that highlights individual data points; different colors represent individual assessors. The overall mixed-effects model prediction is captured by a red dotted line, flanked by the 95% confidence interval (CI). For Exam 1, the model indicates a positive correlation between C and P scores with a coefficient of 0.16, but this is not statistically significant ( p  = 0.073). In contrast, both Exams 2 and 3 consistently showed statistically significant positive correlations between C and P scores, with all assessors reflecting this trend.

Jitter plot of exam 1 with individual assessor lines and mixed-effects model correlating competency and presentation scores

Jitter plot of exam 2 with individual assessor lines and mixed-effects model correlating competency and presentation scores

Jitter plot of exam 3 with individual assessor lines and mixed-effects model correlating competency and presentation scores

Medical education, especially in areas like HSS, has significantly evolved due to global trends. As digital platforms have surged in popularity, exacerbated by the COVID-19 pandemic, the emphasis on online assessments has grown. Our study, deeply rooted in HSS, sheds light on the broader challenges of online evaluations. Specifically, it underscores the balance required between content mastery and effective presentation in an environment where both are paramount.

One key finding from our study is the role of assessor calibration. Using statistical measures like ICC and Spearman’s rho, we observed a positive correlation in inter-rater reliability, accompanied by variations. It is imperative to recognize that our research’s primary objective was not solely to evaluate the efficiency of our rubric scores but to scrutinize the efficacy of our video assessment design for HSS. Prior studies support our conclusions, suggesting that rubric-based grading can have varying reliability. [ 21 , 22 , 23 ] Such deviations can arise due to factors including the content under examination, the adopted grading criteria, statistical evaluation methods, the nature of the test, and the number of involved assessors or participants. [ 21 , 24 ]

In addressing the challenges of evaluating complex topics such as healthcare politics and policies, our assessor training was tailored to enhance the use of a comprehensive rubric and objective assessment skills. The training included detailed reviews of HSS case studies and scenario-based exercises, emphasizing strategies to mitigate personal biases and maintain consistency across varied content. This approach helped ensure that all assessors were equipped to objectively assess responses, even in subjects prone to subjective interpretation. Upon deeper observation, we found that Exam 2 showed a lower correlation among scorers compared to Exams 1 and 3. This could be attributed to the content of Exam 2, which focused on healthcare politics and policies. Such policy-oriented topics can lead to varied interpretations among assessors, making it challenging to determine a universally acceptable answer. [ 25 ]

Our research underscores the crucial balance between competency and presentation skills. With the rise of digital platforms, the ability to articulate and communicate effectively has become indispensable for professional competency. [ 26 ] A related study, utilizing platforms like Zoom for assessments, aligns with our findings. [ 27 ] It emphasizes that when evaluating online, it is essential to distinguish domains like metacognition and creativity. Many evaluation methodologies prioritize oral presentation capabilities, relegating content knowledge to a secondary role. [ 14 , 15 , 28 ] In disciplines demanding HOT skills, such as HSS, merging these domains could potentially obscure the importance of specific competencies. Therefore, to ensure fair and effective assessments, it is vital to carefully differentiate between true competency and the enhancement effect of presentation prowess. This vigilance is crucial because exemplary presentation skills can sometimes overshadow gaps in content knowledge, while less polished presentation skills might lead to underestimation of a student’s understanding and competence. In response to this challenge, educational institutions should incorporate robust communication and presentation training modules into their curricula. [ 28 ] This would ensure that graduates are not only well-versed in their fields but also adept at articulating their knowledge.

Reflecting on our video assessment approach in HSS, the novel method we employed to understand the nexus between competency and presentation skills emerges as a strength. With the prevailing trend of transitioning to digital platforms in medical education, our insights stress the essence of both thorough content comprehension and proficient communication.

In our study, we employed a numeric scoring scale to quantify student performances, which provides precision and facilitates straightforward comparison. This method offers the advantage of detailed quantification, allowing for fine distinctions between levels of competency. However, it may introduce inconsistencies, especially when assessing complex competencies that require nuanced judgment. Alternatively, ordinal rating systems, which categorize performances into descriptive levels such as excellent, good, fair, or poor, can simplify assessments and potentially enhance consistency by more clearly delineating broad performance categories. Each system has its merits, with numeric scales offering granularity and ordinal scales providing clearer benchmarks. [ 29 ] This distinction underscores a key aspect of our current methodology and presents a valuable area for future research to explore the optimal balance between detailed quantification and categorical assessment in evaluating both competency and presentation skills in medical education.

In this study, we intentionally employed a diverse panel of seven expert assessors rather than the conventional use of two raters. This decision was guided by the aim to enhance the reliability and depth of our evaluations, particularly given the complex competencies involved in HSS. A larger panel allows for a more comprehensive range of perspectives on student performances, which is critical in a field where subjective judgment can significantly influence scoring. However, this approach can also introduce variability in scoring due to differences in each rater’s interpretation and emphasis, which might not be as pronounced with a smaller, more uniform panel. By using seven raters, we aimed to capture a broader spectrum of interpretations, which, while enriching the assessment, could also lead to increased score dispersion and affect the overall consistency of the results. This aspect of our methodology could have influenced the outcomes by either mitigating or exaggerating individual biases, thus impacting the inter-rater reliability as reported. To address these challenges, integrating AI technology could provide a valuable tool. Artificial intelligence can assist in standardizing evaluations by consistently applying predefined criteria, potentially reducing the variability introduced by multiple human assessors. [ 30 , 31 ] This hybrid approach, blending human insight with AI precision, represents a promising direction for future research, aiming to balance depth and reliability in complex competency assessments.

Considering the observed shift towards online assessments in medical education, this study sought to evaluate the efficacy of video assessments in measuring both competency and presentation skills within the Health System Science (HSS) framework. Our findings reveal positive correlations between these skills, indicating that effective presentation can enhance the perception of competency. However, variations in inter-rater reliability highlight the necessity for standardized assessment criteria and consistent assessor training. By implementing these strategies, educational institutions can ensure greater accuracy and reliability, which is crucial for accurately assessing student competencies in a digital learning environment. Thus, our study substantiates the importance of both thorough competency assessment and the enhancement of presentation skills in online medical education.

Data availability

The dataset analysed in the current study is available upon request from the corresponding author.

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Acknowledgements

We wish to thank the Department of Family Medicine and Preventive Medicine at Prince of Songkla University for supporting our research endeavors. Our gratitude is also extended to Assistant Professor Kanyika Chamniprasas, Vice Dean for Education, and Assistant Professor Supaporn Dissaneevate for their roles in creating and backing the health system reform curriculum for medical students, which contributed to this study.

No funding was received for this research.

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Phoomjai Sornsenee, Pawita Limsomwong, Polathep Vichitkunakorn, Supakorn Sripaew & Supinya Sono

Division of Neurosurgery, Department of surgery, Faculty of medicine, Prince of Songkhla University, Kho Hong, Hat Yai District, 90110, Songkhla, Thailand

Kanisorn Sungkaro

Division of Head and neck surgery, Department of otolaryngology, Faculty of medicine, Prince of Songkhla University, Kho Hong, Hat Yai District, Songkhla, Thailand

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Department of Anesthesiology, Faculty of medicine, Prince of Songkhla University, Kho Hong, Hat Yai District, 90110, Songkhla, Thailand

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Pongphon Chuchuen

Department of Psychiatry, Faculty of medicine, Prince of Songkhla University, Kho Hong, Hat Yai District, 90110, Songkhla, Thailand

Katti Sathaporn

Department of Emergency Medicine, Faculty of medicine, Prince of Songkhla University, Kho Hong, Hat Yai District, 90110, Songkhla, Thailand

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All authors made a significant contribution to the reported work. P.S., P.L. S.So., T.T., P.C, K.S., K.C. designed the study and obtained research ethics approval; P.S., P.V., S.Sr., K.S., and T.W., analysed and visualized the data; all authors interpreted the results, drafted, and revised the manuscript, and read and approved the final version of the manuscript.

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Correspondence to Phoomjai Sornsenee .

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This study was approved by the Human Research Ethics Committee (HREC), Faculty of Medicine, Prince of Songkla University, on March 12, 2022. (Approval Number: REC REC.65-114-9-1). HREC is official institute responsible for the ethical review and supervision of human research. The study was conducted in accordance with the Declaration of Helsinki. All participants and/or their legal guardian(s) provided electronic informed consent before participating in the study, in accordance with established procedures. All questionnaires were fully computerised by the researchers and anonymised to ensure confidentially.

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Sornsenee, P., Limsomwong, P., Vichitkunakorn, P. et al. Assessing the interplay of presentation and competency in online video examinations: a focus on health system science education. BMC Med Educ 24 , 842 (2024). https://doi.org/10.1186/s12909-024-05808-1

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What Kamala Harris has said so far on key issues in her campaign

As she ramps up her nascent presidential campaign, Vice President Kamala Harris is revealing how she will address the key issues facing the nation.

In speeches and rallies, she has voiced support for continuing many of President Joe Biden’s measures, such as lowering drug costs , forgiving student loan debt and eliminating so-called junk fees. But Harris has made it clear that she has her own views on some key matters, particularly Israel’s treatment of Gazans in its war with Hamas.

In a departure from her presidential run in 2020, the Harris campaign has confirmed that she’s moved away from many of her more progressive stances, such as her interest in a single-payer health insurance system and a ban on fracking.

Harris is also expected to put her own stamp and style on matters ranging from abortion to the economy to immigration, as she aims to walk a fine line of taking credit for the administration’s accomplishments while not being jointly blamed by voters for its shortcomings.

Her early presidential campaign speeches have offered insights into her priorities, though she’s mainly voiced general talking points and has yet to release more nuanced plans. Like Biden, she intends to contrast her vision for America with that of former President Donald Trump. ( See Trump’s campaign promises here .)

“In this moment, I believe we face a choice between two different visions for our nation: one focused on the future, the other focused on the past,” she told members of the historically Black sorority Zeta Phi Beta at an event in Indianapolis in late July. “And with your support, I am fighting for our nation’s future.”

Here’s what we know about Harris’ views:

Harris took on the lead role of championing abortion rights for the administration after Roe v. Wade was overturned in June 2022. This past January, she started a “ reproductive freedoms tour ” to multiple states, including a stop in Minnesota thought to be the first by a sitting US president or vice president at an abortion clinic .

On abortion access, Harris embraced more progressive policies than Biden in the 2020 campaign, as a candidate criticizing his previous support for the Hyde Amendment , a measure that blocks federal funds from being used for most abortions.

Policy experts suggested that although Harris’ current policies on abortion and reproductive rights may not differ significantly from Biden’s, as a result of her national tour and her own focus on maternal health , she may be a stronger messenger.

High prices are a top concern for many Americans who are struggling to afford the cost of living after a spell of steep inflation. Many voters give Biden poor marks for his handling of the economy, and Harris may also face their wrath.

In her early campaign speeches, Harris has echoed many of the same themes as Biden, saying she wants to give Americans more opportunities to get ahead. She’s particularly concerned about making care – health care, child care, elder care and family leave – more affordable and available.

Harris promised at a late July rally to continue the Biden administration’s drive to eliminate so-called “junk fees” and to fully disclose all charges, such as for events, lodging and car rentals. In early August, the administration proposed a rule that would ban airlines from charging parents extra fees to have their kids sit next to them.

On day one, I will take on price gouging and bring down costs. We will ban more of those hidden fees and surprise late charges that banks and other companies use to pad their profits.”

Since becoming vice president, Harris has taken more moderate positions, but a look at her 2020 campaign promises reveals a more progressive bent than Biden.

As a senator and 2020 presidential candidate, Harris proposed providing middle-class and working families with a refundable tax credit of up to $6,000 a year (per couple) to help keep up with living expenses. Titled the LIFT the Middle Class Act, or Livable Incomes for Families Today, the measure would have cost at the time an estimated $3 trillion over 10 years.

Unlike a typical tax credit, the bill would allow taxpayers to receive the benefit – up to $500 – on a monthly basis so families don’t have to turn to payday loans with very high interest rates.

As a presidential candidate, Harris also advocated for raising the corporate income tax rate to 35%, where it was before the 2017 Tax Cuts and Jobs Act that Trump and congressional Republicans pushed through Congress reduced the rate to 21%. That’s higher than the 28% Biden has proposed.

Affordable housing was also on Harris’ radar. As a senator, she introduced the Rent Relief Act, which would establish a refundable tax credit for renters who annually spend more than 30% of their gross income on rent and utilities. The amount of the credit would range from 25% to 100% of the excess rent, depending on the renter’s income.

Harris called housing a human right and said in a 2019 news release on the bill that every American deserves to have basic security and dignity in their own home.

Consumer debt

Hefty debt loads, which weigh on people’s finances and hurt their ability to buy homes, get car loans or start small businesses, are also an area of interest to Harris.

As vice president, she has promoted the Biden administration’s initiatives on student debt, which have so far forgiven more than $168 billion for nearly 4.8 million borrowers . In mid-July, Harris said in a post on X that “nearly 950,000 public servants have benefitted” from student debt forgiveness, compared with only 7,000 when Biden was inaugurated.

A potential Harris administration could keep that momentum going – though some of Biden’s efforts have gotten tangled up in litigation, such as a program aimed at cutting monthly student loan payments for roughly 3 million borrowers enrolled in a repayment plan the administration implemented last year.

The vice president has also been a leader in the White House efforts to ban medical debt from credit reports, noting that those with medical debt are no less likely to repay a loan than those who don’t have unpaid medical bills.

In a late July statement praising North Carolina’s move to relieve the medical debt of about 2 million residents, Harris said that she is “committed to continuing to relieve the burden of medical debt and creating a future where every person has the opportunity to build wealth and thrive.”

Health care

Harris, who has had shifting stances on health care in the past, confirmed in late July through her campaign that she no longer supports a single-payer health care system .

During her 2020 campaign, Harris advocated for shifting the US to a government-backed health insurance system but stopped short of wanting to completely eliminate private insurance.

The measure called for transitioning to a Medicare-for-All-type system over 10 years but continuing to allow private insurance companies to offer Medicare plans.

The proposal would not have raised taxes on the middle class to pay for the coverage expansion. Instead, it would raise the needed funds by taxing Wall Street trades and transactions and changing the taxation of offshore corporate income.

When it comes to reducing drug costs, Harris previously proposed allowing the federal government to set “a fair price” for any drug sold at a cheaper price in any economically comparable country, including Canada, the United Kingdom, France, Japan or Australia. If manufacturers were found to be price gouging, the government could import their drugs from abroad or, in egregious cases, use its existing but never-used “march-in” authority to license a drug company’s patent to a rival that would produce the medication at a lower cost.

Harris has been a champion on climate and environmental justice for decades. As California’s attorney general, Harris sued big oil companies like BP and ConocoPhillips, and investigated Exxon Mobil for its role in climate change disinformation. While in the Senate, she sponsored the Green New Deal resolution.

During her 2020 campaign, she enthusiastically supported a ban on fracking — but a Harris campaign official said in late July that she no longer supports such a ban.

Fracking is the process of using liquid to free natural gas from rock formations – and the primary mode for extracting gas for energy in battleground Pennsylvania. During a September 2019 climate crisis town hall hosted by CNN, she said she would start “with what we can do on Day 1 around public lands.” She walked that back later when she became Biden’s running mate.

Biden has been the most pro-climate president in history, and climate advocates find Harris to be an exciting candidate in her own right. Democrats and climate activists are planning to campaign on the stark contrasts between Harris and Trump , who vowed to push America decisively back to fossil fuels, promising to unwind Biden’s climate and clean energy legacy and pull America out of its global climate commitments.

If elected, one of the biggest climate goals Harris would have to craft early in her administration is how much the US would reduce its climate pollution by 2035 – a requirement of the Paris climate agreement .

Immigration

Harris has quickly started trying to counter Trump’s attacks on her immigration record.

Her campaign released a video in late July citing Harris’ support for increasing the number of Border Patrol agents and Trump’s successful push to scuttle a bipartisan immigration deal that included some of the toughest border security measures in recent memory.

The vice president has changed her position on border control since her 2020 campaign, when she suggested that Democrats needed to “critically examine” the role of Immigration and Customs Enforcement, or ICE, after being asked whether she sided with those in the party arguing to abolish the department.

In June of this year, the White House announced a crackdown on asylum claims meant to continue reducing crossings at the US-Mexico border – a policy that Harris’ campaign manager, Julie Chavez Rodriguez, indicated in late July to CBS News would continue under a Harris administration.

Trump’s attacks stem from Biden having tasked Harris with overseeing diplomatic efforts in Central America in March 2021. While Harris focused on long-term fixes, the Department of Homeland Security remained responsible for overseeing border security.

She has only occasionally talked about her efforts as the situation along the US-Mexico border became a political vulnerability for Biden. But she put her own stamp on the administration’s efforts, engaging the private sector.

Harris pulled together the Partnership for Central America, which has acted as a liaison between companies and the US government. Her team and the partnership are closely coordinating on initiatives that have led to job creation in the region. Harris has also engaged directly with foreign leaders in the region.

Experts credit Harris’ ability to secure private-sector investments as her most visible action in the region to date but have cautioned about the long-term durability of those investments.

Israel-Hamas

The Israel-Hamas war is the most fraught foreign policy issue facing the country and has spurred a multitude of protests around the US since it began in October.

After meeting with Israeli Prime Minister Benjamin Netanyahu in late July, Harris gave a forceful and notable speech about the situation in Gaza.

We cannot look away in the face of these tragedies. We cannot allow ourselves to become numb to the suffering. And I will not be silent.”

Harris echoed Biden’s repeated comments about the “ironclad support” and “unwavering commitment” to Israel. The country has a right to defend itself, she said, while noting, “how it does so, matters.”

However, the empathy she expressed regarding the Palestinian plight and suffering was far more forceful than what Biden has said on the matter in recent months. Harris mentioned twice the “serious concern” she expressed to Netanyahu about the civilian deaths in Gaza, the humanitarian situation and destruction she called “catastrophic” and “devastating.”

She went on to describe “the images of dead children and desperate hungry people fleeing for safety, sometimes displaced for the second, third or fourth time.”

Harris emphasized the need to get the Israeli hostages back from Hamas captivity, naming the eight Israeli-American hostages – three of whom have been killed.

But when describing the ceasefire deal in the works, she didn’t highlight the hostage for prisoner exchange or aid to be let into Gaza. Instead, she singled out the fact that the deal stipulates the withdrawal by the Israeli military from populated areas in the first phase before withdrawing “entirely” from Gaza before “a permanent end to the hostilities.”

Harris didn’t preside over Netanyahu’s speech to Congress in late July, instead choosing to stick with a prescheduled trip to a sorority event in Indiana.

Harris is committed to supporting Ukraine in its fight against Russian aggression, having met with Ukrainian President Volodymyr Zelensky at least six times and announcing last month $1.5 billion for energy assistance, humanitarian needs and other aid for the war-torn country.

At the Munich Security Conference earlier this year, Harris said: “I will make clear President Joe Biden and I stand with Ukraine. In partnership with supportive, bipartisan majorities in both houses of the United States Congress, we will work to secure critical weapons and resources that Ukraine so badly needs. And let me be clear: The failure to do so would be a gift to Vladimir Putin.”

More broadly, NATO is central to our approach to global security. For President Biden and me, our sacred commitment to NATO remains ironclad. And I do believe, as I have said before, NATO is the greatest military alliance the world has ever known.”

Police funding

The Harris campaign has also walked back the “defund the police” sentiment that Harris voiced in 2020. What she meant is she supports being “tough and smart on crime,” Mitch Landrieu, national co-chair for the Harris campaign and former mayor of New Orleans, told CNN’s Pamela Brown in late July.

In the midst of nationwide 2020 protests sparked by George Floyd’s murder by a Minneapolis police officer, Harris voiced support for the “defund the police” movement, which argues for redirecting funds from law enforcement to social services. Throughout that summer, Harris supported the movement and called for demilitarizing police departments.

Democrats largely backed away from calls to defund the police after Republicans attempted to tie the movement to increases in crime during the 2022 midterm elections.

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Who is Letsile Tebogo, the Botswana runner who won 200m over Noah Lyles at Paris Olympics?

Letsile Tebogo started pounding the “Botswana” on his jersey in celebration before even crossing the finish line. He had stunned the world at the 2024 Paris Olympics , winning the 200m and earning the gold medal over heavy favorite Noah Lyles of the United States.

Tebogo made all sorts of history by beating Lyles, who settled for the bronze medal, and silver medalist Kenny Bednarek. But for track and field enthusiasts, Tebogo's emergence wasn’t completely unexpected.

He has been a rising star for a few years, even drawing comparisons to Usain Bolt prior to his introduction to an international audience on Thursday. He also beat Lyles Wednesday in the 200m semifinals – the first race Lyles had lost in the 200m since the Tokyo Olympics – in a precursor to what Tebogo pulled off in the final.

Here’s what else you should know about Tebogo now that he’s known for dethroning Lyles in his signature event:

2024 PARIS OLYMPICS: Follow all of USA TODAY's Paris Games coverage here

How old is Letsile Tebogo?

Tebogo turned 21 years old on June 7.

Where is Letsile Tebogo from?

Tebogo was born in Kanye, Botswana, a village in the southern portion of the country. He moved to Botswana’s capital city, Gaborone, in the seventh grade.

Letsile Tebogo 200m history

By winning the gold medal at the 2024 Paris Olympics, Tebogo became the first Olympic gold medal winner from Botswana and the first runner from Africa to win the 200m final at the Olympic Games. In 2023, he became the first African to win a medal in the 100m at the world championships.

“Africans can be sprinters, too,” Tebogo declared to NBCSports.com in an interview before the Paris Games.  

LETSILE TEBOGO WINS THE MEN’S 200M FOR BOTSWANA! 🇧🇼 #ParisOlympics pic.twitter.com/jL9jm4bTKZ — NBC Olympics & Paralympics (@NBCOlympics) August 8, 2024

Letsile Tebogo dedicated 2024 Paris Olympics to his mother

Tebogo’s mother, Seratiwa, died in May from an illness and Tebogo said he dedicated his 200m gold medal win to her. Tebogo held up his shoe to the camera after the race, and it featured his mother’s birthdate on it. He also painted her initials on his nails. 

“I always think about her but I just try not to let it get into me that much and then just block it out and move forward,” Tebogo said last week.

"I believe there is a medal in these legs and it only needs the determination and the willpower to do it," he added. "I've had such a huge blow that affected me deeply so I'm still trying to get the confidence back into the body. It's not about injuries, it is all about my mum."

Letsile Tebogo 🇧🇼 dedicates his Olympic 200m GOLD 🥇 to his mother, Seratiwa Tebogo, who passed on in May this year after a brief illness. #Paris2024 #Olympics #Athletics pic.twitter.com/2Fh8iIH3JM — Track & Field Gazette (@TrackGazette) August 8, 2024

Bringing a piece of his mum with him at the Paris Olympics Letsile Tebogo 🇧🇼 with his Mum’s initials on his Nails 💅 He lost his mum in May this year. #OlympicGames pic.twitter.com/zh9On0F5jS — Lynne Wachira (@WachiraLynne) August 3, 2024

Letsile Tebogo-Usain Bolt comparison, explained

In 2022, at the U20 world championships in Columbia, Tebogo set a world junior record in winning the 100m gold medal in 9.91 seconds. He was far enough ahead in the final stretch that he turned around to gesture and smile at his nearest competitors. Tebogo later explained it was a tribute to Bolt as opposed to showboating.

"If somebody took it as disrespect, I'm really sorry," Tebogo said at the time, according to Reuters . "(It was so) everybody watching at home can enjoy the race – to remind them a little bit about what Usain Bolt did back in the day. He's my idol - the person I look up to."

The display quickly drew comparisons to Bolt on social media and Bolt even retweeted a post featuring Tebogo’s finish. 

Letsile Tebogo used to train without shoes

“I used to train without shoes,” Tebogo told NBCSports.com. “Shoes were more expensive and we couldn’t afford that because we lived with our extended family, so it was difficult for us to get things. [If you did], it would be as if you were the favored child, so things had to be equal. So I used to train without shoes in both football and athletics. I would wear a pair of old pants that one of my uncles used to wear back when he was in school. It was just a generational thing.”