Amnesia and future thinking: Exploring the role of memory in the quantity and quality of episodic future thoughts.

PubMed

Cole, Scott N; Morrison, Catriona M; Barak, Ohr; Pauly-Takacs, Katalin; Conway, Martin A

2016-06-01

To examine the impact of memory accessibility on episodic future thinking. Single-case study of neurological patient HCM and an age-matched comparison group of neurologically Healthy Controls. We administered a full battery of tests assessing general intelligence, memory, and executive functioning. To assess autobiographical memory, the Autobiographical Memory Interview (Kopelman, Wilson, & Baddeley, 1990. The Autobiographical Memory Interview. Bury St. Edmunds, UK: Thames Valley Test Company) was administered. The Past Episodic and Future Episodic sections of Dalla Barba's Confabulation Battery (Dalla Barba, 1993, Cogn. Neuropsychol., 1, 1) and a specifically tailored Mental Time Travel Questionnaire were administered to assess future thinking in HCM and age-matched controls. HCM presented with a deficit in forming new memories (anterograde amnesia) and recalling events from before the onset of neurological impairment (retrograde amnesia). HCM's autobiographical memory impairments are characterized by a paucity of memories from Recent Life. In comparison with controls, two features of his future thoughts are apparent: Reduced episodic future thinking and outdated content of his episodic future thoughts. This article suggests neuropsychologists should look beyond popular conceptualizations of the past-future relation in amnesia via focussing on reduced future thinking. Investigating both the quantity and quality of future thoughts produced by amnesic patients may lead to developments in understanding the complex nature of future thinking disorders resulting from memory impairments. We highlight the clinical importance of examining the content of future thoughts in amnesic patients, rather than only its quantitative reduction. We propose an explanation of how quantitative and qualitative aspects of future thinking could be affected by amnesia. This could provide a useful approach to understand clinical cases of impaired prospection. Systematic group investigations are required to fully examine our hypothesis. Although the current study utilized typical future thinking measures, these may be limited and we highlight the need to develop clinically relevant measures of prospection. © 2015 The British Psychological Society.

Counterfactual Reasoning Deficits in Schizophrenia Patients.

PubMed

Contreras, Fernando; Albacete, Auria; Castellví, Pere; Caño, Agnès; Benejam, Bessy; Menchón, José Manuel

2016-01-01

Counterfactual thinking is a specific type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Although it has been broadly studied in the general population, research on schizophrenia is still scarce. The aim of the current study was to further examine counterfactual reasoning in this illness. Forty schizophrenia patients and 40 controls completed a series of tests that assessed the influence of the "causal order effect" on counterfactual thinking, and the ability to generate counterfactual thoughts and counterfactually derive inferences from a hypothetical situation. Socio-demographic and clinical characteristics, as well as neurocognitive variables, were also examined. Compared to controls, the schizophrenia patients generated fewer counterfactual thoughts when faced with a simulated scenario. The pattern of response when assessing the causality effect of the order was also different between the groups, with the patients being more frequently unable to attribute any ordering of events than the control subjects. Additionally, the schizophrenia patients showed more difficulties when deriving normative counterfactual inferences from hypothetical social situations. None of the counterfactual reasoning measures was associated to any of the cognitive functions or clinical and socio-demographic variables assessed. A global impairment in counterfactual thinking characterizes schizophrenia patients. Because of the potential impact of such deficits on psychosocial functioning, targeting counterfactual reasoning for improvement might be considered in future treatment approaches.

Towards evidence-based critical thinking medicine? Uses of best evidence in flawless argumentations.

PubMed

Jenicek, Milos

2006-08-01

Uses of informal logic and critical thinking methodology are increasingly taught, learnt and advantageously applied in such diverse domains as law, the military, business, and education. Health sciences are also following this trend. However, production and critical appraisal of evidence as already practiced in Evidence-Based Medicine must be coupled with equally rigorous uses in order to ensure appropriate health problem understanding and decision-making. Making most proposals and decisions in medicine is the conclusion of an argumentation process that lies behind any communication between health professionals working with patients, performing research or sharing ideas about health problems, their interpretations and solutions with numerous stakeholders in public life. Modern critical thinking and decision making in medicine is not instantly mastered, but is instead a learnt experience as anything else in professional and social interactions. The modern argument as outlined, illustrated and applied to health problems in this essay is an extension of a previously established way of thinking in Evidence-Based Medicine. Ideally, health professionals, their patients and all other stakeholders should speak the same language and it is up to us to make this possible. Evidence and critical thinking - based medicine might be a solution. As modern critical thinkers, we are at the forefront and we must see to it that patients and professional and general communities benefit from this more so even than from other remarkable historical and current contributions to the well-being of those under our care.

76 FR 28308 - Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects-Criteria for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... quality levels (AQLs) for leaks and visual defects observed during FDA testing of medical gloves. The CPG... practices regulation (21 CFR 10.115). The CPG represents FDA's current thinking on the criteria for direct...

[Current situation and thinking of diagnosis and treatment in some types of thyroid cancer].

PubMed

Yang, X Y; Yu, Y; Li, D P; Dong, L

2017-04-07

As arising incidence of thyroid cancer, the treatment for thyroid carcinoma is becoming increasingly standardized. But there are different opinions on the treatment for some types of thyroid cancers, including the determination of operative opportunity, surgical method, and follow-up observation plan. There are mainly two categories of patients, namely the patients diagnosed as familial thyroid cancer mutation carriers through family screening, including medullary thyroid carcinoma and familial nonmedullary thyroid carcinoma, and the patients with thyroid microcarcinoma that can be observed after diagnosed by fine needle biopsy cytology. We will discuss current situation for the diagnosis and treatment of these patients.

A Review of Atmospheric Ozone and Current Thinking on the Antarctic Ozone Hole.

DTIC Science & Technology

1987-01-01

UNIVERSITY OF CALIFORNIA 0 A Review of Atmospheric ozone and Current Thinking on the Antartic Ozone Hole A thesis submitted in partial satisfaction of the...4. TI TLE (Pit 5,1tlfie) S. TYPE OF REPORT & PFRIOO COVERED A Review of Atmospheric Ozone and Current THESIS/DA/;J.At1AAU00 Thinking on the Antartic ...THESIS A Review of Atmospheric Ozone and Current Thinking on the Antartic Ozone Hole by Randolph Antoine Fix Master of Science in Atmospheric Science

NCI Think Tank Concerning the Identifiability of Biospecimens and “-Omic” Data

PubMed Central

Weil, Carol J.; Mechanic, Leah E.; Green, Tiffany; Kinsinger, Christopher; Lockhart, Nicole C.; Nelson, Stefanie A.; Rodriguez, Laura L.; Buccini, Laura D.

2014-01-01

On June 11 and 12, 2012, the National Cancer Institute (NCI) hosted a think tank concerning the identifiability of biospecimens and “omic” Data in order to explore challenges surrounding this complex and multifaceted topic. The think tank brought together forty-six leaders from several fields, including cancer genomics, bioinformatics, human subject protection, patient advocacy, and commercial genetics. The first day involved presentations regarding the state of the science of re-identification; current and proposed regulatory frameworks for assessing identifiability; developments in law, industry and biotechnology; and the expectations of patients and research participants. The second day was spent by think tank participants in small break-out groups designed to address specific sub-topics under the umbrella issue of identifiability, including considerations for the development of best practices for data sharing and consent, and targeted opportunities for further empirical research. We describe the outcomes of this two day meeting, including two complimentary themes that emerged from moderated discussions following the presentations on Day 1, and ideas presented for further empirical research to discern the preferences and concerns of research participants about data sharing and individual identifiability. PMID:23579437

Is Episodic Future Thinking Important for Instrumental Activities of Daily Living? A Study in Neurological Patients and Healthy Older Adults.

PubMed

Brunette, Amanda M; Calamia, Matthew; Black, Jenah; Tranel, Daniel

2018-06-11

Episodic future thinking is the ability to mentally project oneself into the future. This construct has been explored extensively in cognitive neuroscience and may be relevant for adaptive functioning. However, it has not been determined whether the measurement of episodic future thinking might be valuable in a clinical neuropsychological setting. The current study investigated (1) the relationship between episodic future thinking and instrumental activities of daily living (IADLs); and (2) whether episodic future thinking is related to IADLs over and above standard measures of cognition. Sixty-one older adults with heterogeneous neurological conditions and 41 healthy older adults completed a future thinking task (the adapted Autobiographical Interview), a performance-based measure of instrumental activities of daily living (the Independent Living Scales), and standard clinical measures of memory and executive functioning. Episodic future thinking significantly predicted IADLs after accounting for age, education, gender, and depression (increase in R2 = .050, p = .010). Episodic future thinking significantly predicted IADLs over and above executive functioning (increase in R2 = .025, p = .030), but was not predictive of IADLs over and above memory (p = .157). This study suggests that episodic future thinking is significantly associated with IADLs, beyond what can be accounted for by executive functioning. However, episodic future thinking did not predict IADLs over and above memory. Overall, there is limited evidence for the clinical utility of episodic future thinking. The findings suggest that an episodic future thinking task does not provide enough valuable information about IADLs to justify its inclusion in a clinical neuropsychological setting.

Counterfactual Reasoning Deficits in Schizophrenia Patients

PubMed Central

Castellví, Pere; Caño, Agnès; Benejam, Bessy

2016-01-01

Background Counterfactual thinking is a specific type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Although it has been broadly studied in the general population, research on schizophrenia is still scarce. The aim of the current study was to further examine counterfactual reasoning in this illness. Methods Forty schizophrenia patients and 40 controls completed a series of tests that assessed the influence of the “causal order effect” on counterfactual thinking, and the ability to generate counterfactual thoughts and counterfactually derive inferences from a hypothetical situation. Socio-demographic and clinical characteristics, as well as neurocognitive variables, were also examined. Results Compared to controls, the schizophrenia patients generated fewer counterfactual thoughts when faced with a simulated scenario. The pattern of response when assessing the causality effect of the order was also different between the groups, with the patients being more frequently unable to attribute any ordering of events than the control subjects. Additionally, the schizophrenia patients showed more difficulties when deriving normative counterfactual inferences from hypothetical social situations. None of the counterfactual reasoning measures was associated to any of the cognitive functions or clinical and socio-demographic variables assessed. Conclusions A global impairment in counterfactual thinking characterizes schizophrenia patients. Because of the potential impact of such deficits on psychosocial functioning, targeting counterfactual reasoning for improvement might be considered in future treatment approaches. PMID:26828931

Health care frames - from Virchow to Obama and beyond: the changing frames in health care and their implications for patient care.

PubMed

Sturmberg, Joachim P; O'Halloran, Di; Colagiuri, Ruth; Fernandez, Ana; Lukersmith, Sue; Torkfar, Ghazal; Salvador-Carulla, Luis

2014-12-01

Framing allows us to highlight some aspects of an issue, thereby bringing them to the forefront of our thinking, talking and acting. As a consequence, framing also distracts our attention away from other issues. Over time, health care has used various frames to explain its activities. This paper traces the emergence of various health care frames since the 1850s to better understand how we reached current ways of thinking and practicing. The succession of the most prominent frames can be summarized as: medicine as a social science; the germ theory of disease; health care as a battleground (or the war metaphor); managing health care resources (or the market metaphor); Health for All (the social justice model); evidence-based medicine; and Obama Care. The focus of these frames is causal, instrumental, political/economic or social in nature. All remain relevant; however, recycling individual past frames in response to current problems will not achieve the outcomes we seek. Placing the individual and his/her needs at the centre (the attractor for the health system) of our thinking, as emphasized by the World Health Organization's International Classification of Function framework and the European Society of Person Centered Health Care, may provide the frame to refocus health and health care as interdependent experiences across individual, community and societal domains. Shifting beyond the entrenched instrumental and economic thinking will be challenging but necessary for the sake of patients, health professionals, society and the economy. © 2014 John Wiley & Sons, Ltd.

System-level change in mental health services in North Wales: An observational study using systems thinking.

PubMed

Evans, S; Huxley, P J; Maxwell, N; Huxley, K L S

2014-06-01

To describe changes to mental health services using systems thinking. Structured standardized quality of life assessment (Manchester Short Quality of Life Assessment: MANSA) was used to establish service user priorities for changes to service provision (part of a process known as check in systems thinking). Current service performance in these priority areas was identified, and changes to service arrangements were planned, implemented and monitored by task and finish (T&F) groups (making use of a process known as flow in systems thinking). 81 MANSA assessments were completed at the check stage (by NM). Work finances and leisure activities emerged as service user priority areas for change, and T&F groups were established with representation of all sectors and service users. Ways to make improvements were observed, planned and implemented by T&F groups (the flow stage). The systems approach reveals how services and quality of life have been changed for patients in Wrexham. Further generalizable research is needed into the potential benefits of using systems thinking in mental health service evaluation. © The Author(s) 2013.

Learning to think like a nurse: stories from new nurse graduates.

PubMed

Etheridge, Sharon A

2007-01-01

One aim of nursing education is to help students learn to be beginning practitioners, which includes making clinical judgments that ensure patient safety. Clinical judgments often determine how quickly nurses detect a life-threatening complication, how soon patients leave the hospital, or how quickly patients learn to take care of themselves. However, current research shows that new graduates do not perform well when making clinical judgments, despite having graduated from accredited schools of nursing and passing the NCLEX examination. This descriptive, qualitative study examined the perceptions of recent nursing graduates about learning to make clinical judgments. Graduates with baccalaureate degrees in nursing were interviewed three times in 9 months to determine their perceptions of how they learned to think like nurses. The results of this study should be useful in identifying strategies to help new graduates make the transition from students to registered nurses.

TTaPP: Together Take a Pause and Ponder: A Critical Thinking Tool for Exploring the Public/Private Lives of Patients.

PubMed

Kuhnel, Leslie

2018-01-01

The broad use of social networking and user-generated content has increased the online footprint of many individuals. A generation of healthcare professionals have grown up with online search activities as part of their everyday lives. Sites like Facebook, Twitter, and Instagram have given the public new ways to share intimate details about their public and private lives and the lives of their friends and families. As a result, careproviders have the ability to find out more about their patients with just the tap of a key or the click of a mouse. This type of online searching for patient information is known as patient-targeted googling or PTG. This article provides an overview of the emergence of PTG, identifies the potential benefits and possible pitfalls of engaging in PTG, and explores current ethical frameworks that guide decisions about PTG. The article describes the development of a critical thinking tool developed by the Behavioral Health Ethics Committee at CHI Health, that can serve as a best-practice model for other hospitals and health systems. Called TTaPP (Together Take a Pause and Ponder), this tool is designed to help healthcare professionals across settings practice collaborative critical thinking skills as they consider the ethical questions of whether or not to engage in PTG. Finally, this article suggests areas for further study, including ways to prompt collaboration and appropriate documentation by maximizing electronic medical records systems, exploring the effectiveness of the TTaPP tool as a way to promote a culture of collaborative critical thinking practices, and the attitudes of patients and the public regarding PTG. Copyright 2018 The Journal of Clinical Ethics. All rights reserved.

Structural correlates of creative thinking in patients with bipolar disorder and healthy controls-a voxel-based morphometry study.

PubMed

Tu, Pei-Chi; Kuan, Yi-Hsuan; Li, Cheng-Ta; Su, Tung-Ping

2017-06-01

This study investigated the structural correlates of creative thinking in patients with bipolar disorder (BD) to understand the possible neural mechanism of creative thinking in BD. We recruited 59 patients with BD I or BD II (35.3±8.5 y) and 56 age- and sex-matched controls (HCs; 34±7.4 y). Each participant underwent structural magnetic resonance imaging and evaluation of creative thinking, which was assessed using two validated tools: the Chinese version of the Abbreviated Torrance Test for Adults for divergent thinking and the Chinese Word Remote Associates Test for remote association. Voxel-based morphometry was performed using SPM12. In patients with BD, divergent thinking positively correlated with the gray matter volume (GMV) in right medial frontal gyrus (Brodmann area [BA] 9), and remote association positively correlated with the GMV in the medial prefrontal gyrus (BA 10). In the HCs, divergent thinking negatively correlated with the GMV in left superior frontal gyrus (BA 8) and positively correlated with the GMV in the precuneus and occipital regions, and remote association positively correlated with the GMV in the hippocampus. Patients with BD were receiving various dosages of antipsychotics, antidepressants and mood stabilizer. These medications may confound the GMV-creative thinking relationship in patients with BD. Our findings indicate that medial prefrontal cortex plays a major and positive role in creative thinking in patients with BD. By contrary, creative thinking involves more diverse structures, and the prefrontal cortex may have an opposite effect in HCs. Copyright © 2017 Elsevier B.V. All rights reserved.

Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking.

PubMed

Dolansky, Mary A; Moore, Shirley M

2013-09-30

Over a decade has passed since the Institute of Medicine's reports on the need to improve the American healthcare system, and yet only slight improvement in quality and safety has been reported. The Quality and Safety Education for Nurses (QSEN) initiative was developed to integrate quality and safety competencies into nursing education. The current challenge is for nurses to move beyond the application of QSEN competencies to individual patients and families and incorporate systems thinking in quality and safety education and healthcare delivery. This article provides a history of QSEN and proposes a framework in which systems thinking is a critical aspect in the application of the QSEN competencies. We provide examples of how using this framework expands nursing focus from individual care to care of the system and propose ways to teach and measure systems thinking. The conclusion calls for movement from personal effort and individual care to a focus on care of the system that will accelerate improvement of healthcare quality and safety.

The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

PubMed

Maneval, Rhonda; Fowler, Kimberly A; Kays, John A; Boyd, Tiffany M; Shuey, Jennifer; Harne-Britner, Sarah; Mastrine, Cynthia

2012-03-01

This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear. Copyright 2012, SLACK Incorporated.

A data model that captures clinical reasoning about patient problems.

PubMed Central

Barrows, R. C.; Johnson, S. B.

1995-01-01

We describe a data model that has been implemented for the CPMC Ambulatory Care System, and exemplify its function for patient problems. The model captures some nuances of clinical thinking about patients that are not accommodated in most other models, such as an evolution of clinical understanding about patient problems. A record of this understanding has clinical utility, and serves research interests as well as medical audit concerns. The model is described with an example, and advantages and limitations in the current implementation are discussed. PMID:8563311

Relationship of Posttreatment Decentering and Cognitive Reactivity to Relapse in Major Depression

ERIC Educational Resources Information Center

Fresco, David M.; Segal, Zindel V.; Buis, Tom; Kennedy, Sydney

2007-01-01

Z. V. Segal et al. (2006) demonstrated that depressed patients treated to remission through either antidepressant medication (ADM) or cognitive-behavioral therapy (CBT), but who evidenced mood-linked increases in dysfunctional thinking, showed elevated rates of relapse over 18 months. The current study sought to evaluate whether treatment response…

Using Video-Reflexive Ethnography to Capture the Complexity of Leadership Enactment in the Healthcare Workplace

ERIC Educational Resources Information Center

Gordon, Lisi; Rees, Charlotte; Ker, Jean; Cleland, Jennifer

2017-01-01

Current theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. However, much healthcare leadership education focusses on the training and competence of individuals and little attention is paid to the interprofessional workplace and how…

Would a new definition and classification of nocturia and nocturnal polyuria improve our management of patients? ICI-RS 2014.

PubMed

Bosch, J L H Ruud; Everaert, Karel; Weiss, Jeffrey P; Hashim, Hashim; Rahnama'i, M Sajjad; Goessaert, An-Sofie; Aizen, Joshua

2016-02-01

The following is a report of the proceedings of the Nocturia Think Tank sessions of the annual International Consultation on Incontinence-Research Society, which took place September 22-24, 2014 in Bristol, UK. The report is organized into sections pertaining to the main topic of discussion focussing on the question as to whether a new definition and classification of nocturia and nocturnal polyuria would improve the outcome of management in our patients. First, discussions identified theoretical and practical shortcomings of current definitions. Secondly, the utility of several nocturnal polyuria definitions was tested in a real life population in relation to the symptom nocturia, in order to display weaknesses of these definitions. Thirdly, we explored in a clinical population the utility of bladder diary based parameters by asking the question: when nocturia improves, which of these parameters improve most? Based on the above explorations the Think Tank summarized elements of the current definitions that need reconsideration and suggests proposals for further research to reach more practical and more clinically meaningful definitions. © 2015 Wiley Periodicals, Inc.

Fit between Future Thinking and Future Orientation on Creative Imagination

ERIC Educational Resources Information Center

Chiu, Fa-Chung

2012-01-01

The purpose of the current study is to investigate the impact of future thinking, and the fit between future thinking and future orientation on creative thinking. In Study 1, 83 undergraduates were randomly assigned to three groups: 50-year future thinking, 5-year future thinking, and the present-day thinking. First, the priming tasks, in which…

Relationship between abstract thinking and eye gaze pattern in patients with schizophrenia.

PubMed

Oh, Jooyoung; Chun, Ji-Won; Lee, Jung Suk; Kim, Jae-Jin

2014-04-16

Effective integration of visual information is necessary to utilize abstract thinking, but patients with schizophrenia have slow eye movement and usually explore limited visual information. This study examines the relationship between abstract thinking ability and the pattern of eye gaze in patients with schizophrenia using a novel theme identification task. Twenty patients with schizophrenia and 22 healthy controls completed the theme identification task, in which subjects selected which word, out of a set of provided words, best described the theme of a picture. Eye gaze while performing the task was recorded by the eye tracker. Patients exhibited a significantly lower correct rate for theme identification and lesser fixation and saccade counts than controls. The correct rate was significantly correlated with the fixation count in patients, but not in controls. Patients with schizophrenia showed impaired abstract thinking and decreased quality of gaze, which were positively associated with each other. Theme identification and eye gaze appear to be useful as tools for the objective measurement of abstract thinking in patients with schizophrenia.

Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.

PubMed

Power, Tara E; Swartzman, Leora C; Robinson, John W

2011-05-01

Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effects of using the developing nurses' thinking model on nursing students' diagnostic accuracy.

PubMed

Tesoro, Mary Gay

2012-08-01

This quasi-experimental study tested the effectiveness of an educational model, Developing Nurses' Thinking (DNT), on nursing students' clinical reasoning to achieve patient safety. Teaching nursing students to develop effective thinking habits that promote positive patient outcomes and patient safety is a challenging endeavor. Positive patient outcomes and safety are achieved when nurses accurately interpret data and subsequently implement appropriate plans of care. This study's pretest-posttest design determined whether use of the DNT model during 2 weeks of clinical postconferences improved nursing students' (N = 83) diagnostic accuracy. The DNT model helps students to integrate four constructs-patient safety, domain knowledge, critical thinking processes, and repeated practice-to guide their thinking when interpreting patient data and developing effective plans of care. The posttest scores of students from the intervention group showed statistically significant improvement in accuracy. Copyright 2012, SLACK Incorporated.

Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway? ICI-RS 2015.

PubMed

Rademakers, Kevin; Drake, Marcus J; Gammie, Andrew; Djurhuus, Jens C; Rosier, Peter F W M; Abrams, Paul; Harding, Christopher

2017-04-01

The diagnosis of bladder outlet obstruction (BOO) in the male is dependent on measurements of pressure and flow made during urodynamic studies. The procedure of urodynamics and the indices used to delineate BOO are well standardized largely as a result of the work of the International Continence Society. The clinical utility of the diagnosis of BOO is however, less well defined and there are several shortcomings and gaps in the currently available medical literature. Consequently the International Consultation on Incontinence Research Society (ICI-RS) held a think tank session in 2015 entitled "Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway?" This manuscript details the discussions that took place within that think tank setting out the pros and cons of the current definition of BOO and exploring alternative clinical tests (alone or in combination) which may be useful in the future investigation of male patients with lower urinary tract symptoms. The think tank panel concluded that pressure-flow studies remain the diagnostic gold-standard for BOO although there is still a lack of high quality evidence. Newer, less invasive, investigations have shown promise in terms of diagnostic accuracy for BOO but similar criticisms can be levelled against these tests. Therefore, the think tank suggests further research with regard to these alternative indicators to determine their clinical utility. © 2017 Wiley Periodicals, Inc.

The Effect of Learning Styles, Critical Thinking Disposition, and Critical Thinking on Clinical Judgment in Senior Baccalaureate Nursing Students during Human Patient Simulation

ERIC Educational Resources Information Center

McCormick, Kiyan

2014-01-01

Simulated learning experiences using high-fidelity human patient simulators (HPS) are increasingly being integrated into baccalaureate nursing programs. Thus, the purpose of this study was to examine relationships among learning style, critical thinking disposition, critical thinking, and clinical judgment during high-fidelity human patient…

A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.

PubMed

Williams, John C

2015-01-01

The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal.

Disclosure: what works now and what can work even better.

PubMed

2004-01-01

This three-part series on disclosure of unanticipated outcomes in health care is intended to provide an overview of the current thinking about disclosure and steps the organization can take to develop an approach to disclosure that is comprehensive and supportive of the needs of patients, families and providers. What should be apparent is that disclosure is not simply a requirement--it is a philosophy and part of a comprehensive approach to patient/family communication.

The current and ideal state of anatomic pathology patient safety.

PubMed

Raab, Stephen Spencer

2014-01-01

An anatomic pathology diagnostic error may be secondary to a number of active and latent technical and/or cognitive components, which may occur anywhere along the total testing process in clinical and/or laboratory domains. For the pathologist interpretive steps of diagnosis, we examine Kahneman's framework of slow and fast thinking to explain different causes of error in precision (agreement) and in accuracy (truth). The pathologist cognitive diagnostic process involves image pattern recognition and a slow thinking error may be caused by the application of different rationally-constructed mental maps of image criteria/patterns by different pathologists. This type of error is partly related to a system failure in standardizing the application of these maps. A fast thinking error involves the flawed leap from image pattern to incorrect diagnosis. In the ideal state, anatomic pathology systems would target these cognitive error causes as well as the technical latent factors that lead to error.

[Forcing patients with bipolar disorder to make a financial contribution to secondary psychiatric care may make them forsake care completely].

PubMed

Visser, H M; Renes, J W; Koninkx, D; Kupka, R W

2013-01-01

In 2012 patients were required to make a personal financial contribution for secondary mental health care over and above their standard insurance fee. According to current guidelines, the majority of patients with bipolar disorder must be treated as outpatients at psychiatric clinics. It was to be expected that some patients would decide to discontinue their outpatient treatment on account of the newly imposed personal financial contribution. To obtain insight into the size and characteristics of the group of patients with bipolar disorder who were thinking about giving up treatment or had already decided to give it up because of the imposition of the personal financial contribution; also to find out which factors influenced patients’ decisions and to discover how patients perceived the role of the GP as the provider of subsequent psychiatric care. We conducted an exploratory study by sending a survey to all outpatients receiving treatment at three clinics specialising in the treatment of bipolar disorder. 640 patients responded to the survey (55% response); 15% of these patients were thinking about giving up treatment or had already decided to stop their treatment. They were influenced primarily by financial considerations. Two-thirds of the respondents did not consider that the GP was as a suitable alternative to outpatient care at a clinic. Even patients with moderate to serious symptoms were considering leaving secondary care. The obligatory financial contribution for secondary mental health care could have considerable consequences for a small number of patients with severe mood disorder who are currently treated as outpatients in secondary facilities. The increase in the compulsory & squo;own risk’ insurance fee as from 2013 could have similar consequences.

Patient care information systems and physicians: the transition from technology icon to health care instrument.

PubMed

Bria, W F

1993-11-01

We have discussed several important transitions now occurring in PCIS that promise to improve the utility and availability of these systems for the average physician. Charles Babbage developed the first computers as "thinking machines" so that we may extend our ability to grapple with more and more complex problems. If current trends continue, we will finally witness the evolution of patient care computing from information icons of the few to clinical instruments improving the quality of medical decision making and care for all patients.

Assessing and developing critical-thinking skills in the intensive care unit.

PubMed

Swinny, Betsy

2010-01-01

A lot of resources are spent on the development of new staff in the intensive care unit (ICU). These resources are necessary because the environment in the ICU is complex and the patients are critically ill. Nurses need an advanced knowledge base, the ability to accurately define and change priorities rapidly, good communication and teamwork skills, and the ability to work in a stressful environment in order to succeed and give their patients quality care. Critical thinking helps the nurse to navigate the complex and stressful environment of the ICU. Critical thinking includes more than just nursing knowledge. It includes the ability to think through complex, multifaceted problems to anticipate needs, recognize potential and actual complications, and to expertly communicate with the team. A nurse who is able to think critically will give better patient care. Various strategies can be used to develop critical thinking in ICU nurses. Nurse leaders are encouraged to support the development of critical-thinking skills in less experienced staff with the goal of improving the nurse's ability to work in the ICU and improving patient outcomes.

Relationship between abstract thinking and eye gaze pattern in patients with schizophrenia

PubMed Central

2014-01-01

Background Effective integration of visual information is necessary to utilize abstract thinking, but patients with schizophrenia have slow eye movement and usually explore limited visual information. This study examines the relationship between abstract thinking ability and the pattern of eye gaze in patients with schizophrenia using a novel theme identification task. Methods Twenty patients with schizophrenia and 22 healthy controls completed the theme identification task, in which subjects selected which word, out of a set of provided words, best described the theme of a picture. Eye gaze while performing the task was recorded by the eye tracker. Results Patients exhibited a significantly lower correct rate for theme identification and lesser fixation and saccade counts than controls. The correct rate was significantly correlated with the fixation count in patients, but not in controls. Conclusions Patients with schizophrenia showed impaired abstract thinking and decreased quality of gaze, which were positively associated with each other. Theme identification and eye gaze appear to be useful as tools for the objective measurement of abstract thinking in patients with schizophrenia. PMID:24739356

Critical thinking in patient centered care.

PubMed

Mitchell, Shannon H; Overman, Pamela; Forrest, Jane L

2014-06-01

Health care providers can enhance their critical thinking skills, essential to providing patient centered care, by use of motivational interviewing and evidence-based decision making techniques. The need for critical thinking skills to foster optimal patient centered care is being emphasized in educational curricula for health care professions. The theme of this paper is that evidence-based decision making (EBDM) and motivational interviewing (MI) are tools that when taught in health professions educational programs can aid in the development of critical thinking skills. This paper reviews the MI and EBDM literature for evidence regarding these patient-centered care techniques as they relate to improved oral health outcomes. Comparisons between critical thinking and EBDM skills are presented and the EBDM model and the MI technique are briefly described followed by a discussion of the research to date. The evidence suggests that EBDM and MI are valuable tools; however, further studies are needed regarding the effectiveness of EBDM and MI and the ways that health care providers can best develop critical thinking skills to facilitate improved patient care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Critical thinking dispositions and skills of senior nursing students in associate, baccalaureate, and RN-to-BSN programs.

PubMed

Shin, Kyungrim; Jung, Duk Yoo; Shin, Sujin; Kim, Myoung Soo

2006-06-01

This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program.

Assessing Students' Critical Thinking Performance: Urging for Measurements Using Multi-Response Format

ERIC Educational Resources Information Center

Ku, Kelly Y. L.

2009-01-01

The current paper discusses ambiguities in critical thinking assessment. The paper first reviews the components of critical thinking. It then discusses the features and issues of commonly used critical thinking tests and to what extend they are made compatible to the conceptualization of critical thinking. The paper argues that critical thinking…

Nurses' systems thinking competency, medical error reporting, and the occurrence of adverse events: a cross-sectional study.

PubMed

Hwang, Jee-In; Park, Hyeoun-Ae

2017-12-01

Healthcare professionals' systems thinking is emphasized for patient safety. To report nurses' systems thinking competency, and its relationship with medical error reporting and the occurrence of adverse events. A cross-sectional survey using a previously validated Systems Thinking Scale (STS), was conducted. Nurses from two teaching hospitals were invited to participate in the survey. There were 407 (60.3%) completed surveys. The mean STS score was 54.5 (SD 7.3) out of 80. Nurses with higher STS scores were more likely to report medical errors (odds ratio (OR) = 1.05; 95% confidence interval (CI) = 1.02-1.08) and were less likely to be involved in the occurrence of adverse events (OR = 0.96; 95% CI = 0.93-0.98). Nurses showed moderate systems thinking competency. Systems thinking was a significant factor associated with patient safety. Impact Statement: The findings of this study highlight the importance of enhancing nurses' systems thinking capacity to promote patient safety.

Individual Differences and Age-Related Changes in Divergent Thinking in Toddlers and Preschoolers

ERIC Educational Resources Information Center

Bijvoet-van den Berg, Simone; Hoicka, Elena

2014-01-01

Divergent thinking shows the ability to search for new ideas, which is an important factor contributing to innovation and problem solving. Current divergent thinking tests allow researchers to study children's divergent thinking from the age of 3 years on. This article presents the first measure of divergent thinking that can be used with children…

The effect of human patient simulation on critical thinking and its predictors in prelicensure nursing students.

PubMed

Shinnick, Mary Ann; Woo, Mary A

2013-09-01

Human patient simulation (HPS) is becoming a popular teaching method in nursing education globally and is believed to enhance both knowledge and critical thinking. While there is evidence that HPS improves knowledge, there is no objective nursing data to support HPS impact on critical thinking. Therefore, we studied knowledge and critical thinking before and after HPS in prelicensure nursing students and attempted to identify the predictors of higher critical thinking scores. Using a one-group, quasi-experimental, pre-test post-test design, 154 prelicensure nursing students (age 25.7± 6.7; gender=87.7% female) from 3 schools were studied at the same point in their curriculum using a high-fidelity simulation. Pre- and post-HPS assessments of knowledge, critical thinking, and self-efficacy were done as well as assessments for demographics and learning style. There was a mean improvement in knowledge scores of 6.5 points (P<0.001), showing evidence of learning. However, there was no statistically significant change in the critical thinking scores. A logistic regression with 10 covariates revealed three variables to be predictors of higher critical thinking scores: greater "age" (P=0.01), baseline "knowledge" (P=0.04) and a low self-efficacy score ("not at all confident") in "baseline self-efficacy in managing a patient's fluid levels" (P=.05). This study reveals that gains in knowledge with HPS do not equate to changes in critical thinking. It does expose the variables of older age, higher baseline knowledge and low self-efficacy in "managing a patient's fluid levels" as being predictive of higher critical thinking ability. Further study is warranted to determine the effect of repeated or sequential simulations (dosing) and timing after the HPS experience on critical thinking gains. Copyright © 2012 Elsevier Ltd. All rights reserved.

Inhaled therapies in patients with moderate COPD in clinical practice: current thinking

PubMed Central

Ariel, Amnon; Altraja, Alan; Belevskiy, Andrey; Boros, Piotr W; Danila, Edvardas; Fležar, Matjaz; Koblizek, Vladimir; Fridlender, Zvi G; Kostov, Kosta; Krams, Alvils; Milenkovic, Branislava; Somfay, Attila; Tkacova, Ruzena; Tudoric, Neven; Ulmeanu, Ruxandra; Valipour, Arschang

2018-01-01

COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations. However, current clinical practice frequently differs from published guidelines on the management of COPD. This review focuses on the current scientific evidence and expert opinion on the management of moderate COPD: the symptoms arising from moderate airflow obstruction and the burden these symptoms impose, how physical activity can improve disease outcomes, the benefits of dual bronchodilation in COPD, and the limited evidence for the benefits of inhaled corticosteroids in this disease. We emphasize the importance of maximizing bronchodilation in COPD with inhaled dual-bronchodilator treatment, enhancing patient-related outcomes, and enabling the withdrawal of inhaled corticosteroids in COPD in well-defined patient groups. PMID:29317810

Social cognition in borderline personality disorder: evidence for dichotomous thinking but no evidence for less complex attributions.

PubMed

Arntz, Arnoud; ten Haaf, José

2012-11-01

This experiment investigated social cognition in borderline personality disorder (BPD). We tested whether BPD-patients' evaluations of others were characterized by splitting, dichotomous thinking, or negativity; and whether they showed less complex understanding of others. Participants discussed a problem with three alleged mental health worker trainees, performing three interpersonal roles (rejecting, accepting and neutral). Participants evaluated trainees in a structured response format and in a semi-structured interview. BPD-patients (n = 18) were compared to Cluster-C personality disorder patients (n = 18) and nonpatients (n = 18). From visual analog scales with opposite trait descriptions (structured response format) negativity, dichotomous thinking, and splitting scores were derived. The interviews were scored by an independent rater on affect tone, differentiation, and complexity of attributions. BPD-patients showed, in all conditions, and in both response formats, more dichotomous thinking than control groups. Evidence for splitting as specific BPD-characteristic was not convincing, and more negativity in BPD was only found with the rejecting role and structured responses. The interview-based evaluations by BPD-patients could not be discriminated from nonpatients in cognitive complexity. Results indicate that dichotomous thinking, and not so much splitting, negativity, or less complexity, is central in the interpretation of others by BPD-patients. Treatment might address dichotomous thinking to reduce BPD-patients' interpersonal problems. Copyright © 2012 Elsevier Ltd. All rights reserved.

Episodic Future Thinking in Semantic Dementia: A Cognitive and fMRI Study

PubMed Central

Viard, Armelle; Piolino, Pascale; Belliard, Serge; de La Sayette, Vincent; Desgranges, Béatrice; Eustache, Francis

2014-01-01

Semantic dementia (SD) is characterized by gradual loss of semantic memory. While episodic autobiographical memory seems relatively preserved, behavioral studies suggest that episodic future thinking is impaired. We used fMRI to measure brain activity in four SD patients (JPL, EP, LL, EG) while they envisioned future events and remembered personal past events. Twelve healthy elders served as controls. Episodic quality, emotion, mental imagery and level of consciousness (via remember/know judgements) were checked at debriefing. We analyzed the future compared to the past for each patient. All patients presented lateral temporal atrophy, but varied in terms of frontal and anterior hippocampal atrophy. Patient JPL presented atrophy in bilateral superior medial frontal gyri and left anterior hippocampus and was unable to engage in episodic future thinking, despite hyperactivations in frontal and occipital regions. Patient EP presented no atrophy in the anterior hippocampus, but atrophy in bilateral superior medial frontal gyrus and had difficulties to engage in episodic future thinking. Patient LL presented atrophy in left anterior hippocampus, but hyperactivated its right counterpart for future compared to past thinking, permitting her to project efficiently in the future in an episodic way. Patient EG presented no atrophy in the superior medial frontal gyri or anterior hippocampi and was able to engage in episodic future thinking. Altogether, patients' future projections differed depending on the severity and localization of their atrophy. The functional integrity of bilateral superior medial frontal gyri and anterior hippocampus appear crucial for episodic future thinking: atrophy of both structures strongly impairs future projection, while integrity of these structures or hyperactivation of residual tissue normalizes episodic future projection. PMID:25333997

Jordanian TEFL Graduate Students' Use of Critical Thinking Skills (as Measured by the Cornell Critical Thinking Test, Level Z)

ERIC Educational Resources Information Center

Bataineh, Ruba Fahmi; Zghoul, Lamma Hmoud

2006-01-01

This study investigates the critical thinking skills of 50 students currently enrolled in the Master's TEFL Programme at Yarmouk University, Jordan. The Cornell Critical Thinking Test, Level Z is utilised to test the students' use, or lack thereof, of the critical thinking skills of deduction, semantics, credibility, induction, definition and…

Effective Instruction and Assessment Methods That Lead to Gains in Critical Thinking as Measured by the Critical Thinking Assessment Test (CAT)

ERIC Educational Resources Information Center

Leming, Katie P.

2016-01-01

Previous qualitative research on educational practices designed to improve critical thinking has relied on anecdotal or student self-reports of gains in critical thinking. Unfortunately, student self-report data have been found to be unreliable proxies for measuring critical thinking gains. Therefore, in the current interpretivist study, five…

Assessment of Higher Order Thinking Skills. Current Perspectives on Cognition, Learning and Instruction

ERIC Educational Resources Information Center

Schraw, Gregory, Ed.; Robinson, Daniel H., Ed.

2011-01-01

This volume examines the assessment of higher order thinking skills from the perspectives of applied cognitive psychology and measurement theory. The volume considers a variety of higher order thinking skills, including problem solving, critical thinking, argumentation, decision making, creativity, metacognition, and self-regulation. Fourteen…

Conceptualizing and Assessing Higher-Order Thinking in Reading

ERIC Educational Resources Information Center

Afflerbach, Peter; Cho, Byeong-Young; Kim, Jong-Yun

2015-01-01

Students engage in higher-order thinking as they read complex texts and perform complex reading-related tasks. However, the most consequential assessments, high-stakes tests, are currently limited in providing information about students' higher-order thinking. In this article, we describe higher-order thinking in relation to reading. We provide a…

Barriers to critical thinking: workflow interruptions and task switching among nurses.

PubMed

Cornell, Paul; Riordan, Monica; Townsend-Gervis, Mary; Mobley, Robin

2011-10-01

Nurses are increasingly called upon to engage in critical thinking. However, current workflow inhibits this goal with frequent task switching and unpredictable demands. To assess workflow's cognitive impact, nurses were observed at 2 hospitals with different patient loads and acuity levels. Workflow on a medical/surgical and pediatric oncology unit was observed, recording tasks, tools, collaborators, and locations. Nineteen nurses were observed for a total of 85.2 hours. Tasks were short with a mean duration of 62.4 and 81.6 seconds on the 2 units. More than 50% of the recorded tasks were less than 30 seconds in length. An analysis of task sequence revealed few patterns and little pairwise repetition. Performance on specific tasks differed between the 2 units, but the character of the workflow was highly similar. The nonrepetitive flow and high amount of switching indicate nurses experience a heavy cognitive load with little uninterrupted time. This implies that nurses rarely have the conditions necessary for critical thinking.

Can we create a valid treatment algorithm for patients with drug resistant overactive bladder (OAB) syndrome or detrusor overactivity (DO)? Results from a think tank (ICI-RS 2015).

PubMed

Apostolidis, Apostolos; Averbeck, Marcio Augusto; Sahai, Arun; Rahnama'i, Mohhamad Sajjad; Anding, Ralf; Robinson, Dudley; Gravas, Stavros; Dmochowski, Roger

2017-04-01

To review and assess the definitions of drug resistance and the evidence supporting treatment for drug resistant overactive bladder/detrusor overactivity (OAB/DO). Evidence review of the extant literature and consensus of opinion was used to derive the summary recommendations. Drug resistance or drug refractory status has been inconsistently defined and reported in current evident sources. Recent publications use some correlation of lack of efficacy and or experienced side effects to define drug resistance. Algorithms based upon these definitions largely relate to the appropriate use of neuromodulation or botulinum neurotoxin, based upon patient selection and patient choice. Current treatment pathways are hampered by inability to consistently profile patients to optimize management, particularly after failure of initial pragmatic treatment. Further research is recommended to better identify patient phenotype for purposes of directing optimized therapy for OAB/DO. Current treatment algorithms are influenced by extensive data generated from recent neuromodulation and botulinum neurotoxin trials. © 2017 Wiley Periodicals, Inc.

Getting Paid for Clinical Services.

PubMed

Martin, Caren McHenry

2018-05-01

Increasingly, pharmacists are providing advanced, patient-centered clinical services. However, pharmacists are not currently included in key sections of the Social Security Act, which determines eligibility to bill and be reimbursed by Medicare. Many state and private health plans also cite the omission from Medicare as the rationale for excluding reimbursement of pharmacists for clinical services. This has prompted forward-thinking pharmacists to seek opportunities for reimbursement in other ways, allowing them to provide value to the health care system, while carving out unique niches for pharmacists to care for patients.

The Application of Lean Thinking to the Care of Patients With Bone and Brain Metastasis With Radiation Therapy

PubMed Central

Kim, Christopher S.; Hayman, James A.; Billi, John E.; Lash, Kathy; Lawrence, Theodore S.

2007-01-01

Purpose Patients with bone and brain metastases are among the most symptomatic nonemergency patients treated by radiation oncologists. Treatment should begin as soon as possible after the request is generated. We tested the hypothesis that the operational improvement method based on lean thinking could help streamline the treatment of our patients referred for bone and brain metastases. Methods University of Michigan Health System has adopted lean thinking as a consistent approach to quality and process improvement. We applied the principles and tools of lean thinking, especially value as defined by the customer, value stream mapping processes, and one piece flow, to improve the process of delivering care to patients referred for bone or brain metastases. Results and Conclusion The initial evaluation of the process revealed that it was rather chaotic and highly variable. Implementation of the lean thinking principles permitted us to improve the process by cutting the number of individual steps to begin treatment from 27 to 16 and minimize variability by applying standardization. After an initial learning period, the percentage of new patients with brain or bone metastases receiving consultation, simulation, and treatment within the same day rose from 43% to nearly 95%. By implementing the ideas of lean thinking, we improved the delivery of clinical care for our patients with bone or brain metastases. We believe these principles can be applied to much of the care administered throughout our and other health care delivery areas. PMID:20859409

The application of lean thinking to the care of patients with bone and brain metastasis with radiation therapy.

PubMed

Kim, Christopher S; Hayman, James A; Billi, John E; Lash, Kathy; Lawrence, Theodore S

2007-07-01

Patients with bone and brain metastases are among the most symptomatic nonemergency patients treated by radiation oncologists. Treatment should begin as soon as possible after the request is generated. We tested the hypothesis that the operational improvement method based on lean thinking could help streamline the treatment of our patients referred for bone and brain metastases. University of Michigan Health System has adopted lean thinking as a consistent approach to quality and process improvement. We applied the principles and tools of lean thinking, especially value as defined by the customer, value stream mapping processes, and one piece flow, to improve the process of delivering care to patients referred for bone or brain metastases. The initial evaluation of the process revealed that it was rather chaotic and highly variable. Implementation of the lean thinking principles permitted us to improve the process by cutting the number of individual steps to begin treatment from 27 to 16 and minimize variability by applying standardization. After an initial learning period, the percentage of new patients with brain or bone metastases receiving consultation, simulation, and treatment within the same day rose from 43% to nearly 95%. By implementing the ideas of lean thinking, we improved the delivery of clinical care for our patients with bone or brain metastases. We believe these principles can be applied to much of the care administered throughout our and other health care delivery areas.

Hopelessness and future thinking in parasuicide: the role of perfectionism.

PubMed

Hunter, Elizabeth C; O'Connor, Rory C

2003-11-01

This study had three aims: (1) to independently replicate the future thinking effect, that parasuicides, when compared with controls, show a deficit in positive future thinking but no increase in negative future thinking; (2) to determine whether positive future thinking and socially prescribed perfectionism discriminate general hospital parasuicides from controls beyond measures of affect and; (3) to explore the relationship between future thinking and perfectionism. A cross-sectional design was employed. Three groups of participants took part: hospital parasuicide patients (N=22), hospital controls (N=22) and community controls (N=21). Parasuicide patients admitted, via accident and emergency, to a general hospital were matched with hospital and community controls and assessed on measures of hopelessness, depression, anxiety, perfectionism, and future thinking. There was evidence to support the future thinking effect. A discriminant function analysis revealed that social perfectionism and positive future thinking did indeed discriminate parasuicides from controls beyond the effects of hopelessness, depression, and anxiety. Exploratory relationships between perfectionism and positive future thinking were also reported. The results reinforce the importance of future thinking in parasuicide. Moreover, the role of social perfectionism in the suicidal process was elucidated and ought to be replicated within a prospective design.

The role of magical thinking in hallucinations. Comparisons of clinical and non-clinical groups.

PubMed

García-Montes, José M; Pérez-Álvarez, Marino; Odriozola-González, Paula; Vallina-Fernández, Oscar; Perona-Garcelán, Salvador

2014-11-01

Magical thinking consists of accepting the possibility that events that, according to the causal concepts of a culture, cannot have any causal relationship, but might somehow nevertheless have one. Magical thinking has been related to both obsessive-compulsive disorder and schizophrenia. The purpose of this study was to investigate the role of magical thinking in hallucinations of patients diagnosed with schizophrenia. Four groups were recruited for this purpose from a clinical population (hallucinating schizophrenic patients, patients diagnosed with psychoses who had never hallucinated, obsessive-compulsive disorder patients and a clinical control group) and a non-clinical control group, who were given the Magical Ideation Scale. The results show that magical ideation differentiates the group of schizophrenic patients with auditory hallucinations from the rest of the groups that participated in the design. Items related to "mind reading", to the presence of auditory illusions in response to sound stimuli, and to the sense of sometimes being accompanied by an evil presence are the most closely related to the presence of auditory hallucinations. Magical thinking, understood as beliefs in non-consensual modes of causation, is closely linked to auditory hallucinations in patients diagnosed with schizophrenia.

The Effects of Moderate- and High-Fidelity Patient Simulator Use on Critical Thinking in Associate Degree Nursing Students

ERIC Educational Resources Information Center

Vieck, Jana

2013-01-01

The purpose of this study was to examine the impact of moderate- and high-fidelity patient simulator use on the critical thinking skills of associate degree nursing students. This quantitative study used a quasi-experimental design and the Health Sciences Reasoning Test (HSRT) to evaluate the critical thinking skills of third semester nursing…

Relationship between Fidelity and Dose of Human Patient Simulation, Critical Thinking Skills, and Knowledge in an Associate Degree Nursing Program

ERIC Educational Resources Information Center

Beebe, Rosella I.

2012-01-01

This study examined the relationship between human patient simulation (HPS), critical thinking skills, and knowledge acquisition after HPS was integrated across the curriculum of an associate degree nursing program to determine if differences existed in critical thinking and knowledge of students based on the fidelity of HPS used and amount of…

Collaborative care: Using six thinking hats for decision making.

PubMed

Cioffi, Jane Marie

2017-12-01

To apply six thinking hats technique for decision making in collaborative care. In collaborative partnerships, effective communications need to occur in patient, family, and health care professional meetings. The effectiveness of these meetings depends on the engagement of participants and the quality of the meeting process. The use of six thinking hats technique to engage all participants in effective dialogue is proposed. Discussion paper. Electronic databases, CINAHL, Pub Med, and Science Direct, were searched for years 1990 to 2017. Using six thinking hats technique in patient family meetings nurses can guide a process of dialogue that focuses decision making to build equal care partnerships inclusive of all participants. Nurses will need to develop the skills for using six thinking hats technique and provide support to all participants during the meeting process. Collaborative decision making can be augmented by six thinking hat technique to provide patients, families, and health professionals with opportunities to make informed decisions about care that considers key issues for all involved. Nurses who are most often advocates for patients and their families are in a unique position to lead this initiative in meetings as they network with all health professionals. © 2017 John Wiley & Sons Australia, Ltd.

[How Can We Cuddle Up to Dying Patients? Attempts of Cancer Philosophy Clinic and Education].

PubMed

Yamada, Keisuke

2016-03-01

What is needed to treat problems about how can we cuddle up to dying patients is not scientific thinking but philosophical thinking. Cancer philosophy clinic is a place where both patients and medical staffs think about death and how to live until death. The author tries to manage cancer philosophy clinic with the idea of logotherapy and terminal art. The author also tries to educate medical students and other medical staffs in cancer philosophy.

Narrative thematic analysis of baccalaureate nursing students' reflections: critical thinking in the clinical education context.

PubMed

Naber, Jessica L; Hall, Joanne; Schadler, Craig Matthew

2014-09-01

This study sought to identify characteristics of clinically situated critical thinking in nursing students' reflections, originally part of a study guided by Richard Paul's model of critical thinking. Nurses are expected to apply critical thinking in all practice situations to improve health outcomes, including patient safety and satisfaction. In a previous study, Paul's model of critical thinking was used to develop questions for reflective writing assignments. Within that study, 30 nursing students completed six open-ended narratives of nurse-patient clinical encounters during an 8-week period. Improvements were seen in critical thinking scores after the intervention. This article reports the qualitative analysis of the content of six open-ended narratives. Six overarching themes were identified and combined into a tentative conceptual model. Faculty's understanding of the characteristics of critical thinking in the context of clinical education will help them to teach and evaluate students' progress and competencies for future practice.

Instructional Design Models and Teacher Thinking: Toward a New Conceptual Model for Research and Development.

ERIC Educational Resources Information Center

Moallem, Mahnaz; Earle, Rodney S.

1998-01-01

In an effort to connect current research findings on teacher thinking with components of instructional design models and principles, this article discusses a new contextual model for thinking about teaching and considers the implications of the model for instructional development of research in instructional design and teacher thinking. (Author)

Creative Thinking in Prospective Teachers: The "Status Quo" and the Impact of Contextual Factors

ERIC Educational Resources Information Center

Meintjes, Hannetjie; Grosser, Mary

2010-01-01

To create unique and appropriate learning opportunities and environments and to nurture the development of creative thinking abilities among learners are some of the demands for creative thinking currently expected of teachers globally and also in South Africa. Creative thinking in academic context assumes, among other things, the ability to…

An Analysis of Mathematics Teacher Candidates' Critical Thinking Dispositions and Their Logical Thinking Skills

ERIC Educational Resources Information Center

Incikabi, Lutfi; Tuna, Abdulkadir; Biber, Abdullah Cagri

2013-01-01

This study aimed to investigate the existence of the relationship between mathematics teacher candidates' critical thinking skills and their logical thinking dispositions in terms of the variables of grade level in college, high school type, and gender. The current study utilized relational survey model and included a total of 99 mathematics…

Evaluation and management of the elderly patient presenting with cognitive complaints.

PubMed

Hildreth, Kerry L; Church, Skotti

2015-03-01

Cognitive complaints are common in the geriatric population. Older adults should routinely be asked about any concerns about their memory or thinking, and any cognitive complaint from the patient or an informant should be evaluated rather than be attributed to aging. Several screening instruments are available to document objective impairments and guide further evaluation. Management goals for patients with cognitive impairment are focused on maintaining function and independence, providing caregiver support, and advance care planning. There are currently no treatments to effectively prevent or treat dementia. Increasing appreciation of the heterogeneity of Alzheimer disease may lead to novel treatment approaches. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing Critical Thinking Outcomes of Dental Hygiene Students Utilizing Virtual Patient Simulation: A Mixed Methods Study.

PubMed

Allaire, Joanna L

2015-09-01

Dental hygiene educators must determine which educational practices best promote critical thinking, a quality necessary to translate knowledge into sound clinical decision making. The aim of this small pilot study was to determine whether virtual patient simulation had an effect on the critical thinking of dental hygiene students. A pretest-posttest design using the Health Science Reasoning Test was used to evaluate the critical thinking skills of senior dental hygiene students at The University of Texas School of Dentistry at Houston Dental Hygiene Program before and after their experience with computer-based patient simulation cases. Additional survey questions sought to identify the students' perceptions of whether the experience had helped develop their critical thinking skills and improved their ability to provide competent patient care. A convenience sample of 31 senior dental hygiene students completed both the pretest and posttest (81.5% of total students in that class); 30 senior dental hygiene students completed the survey on perceptions of the simulation (78.9% response rate). Although the results did not show a significant increase in mean scores, the students reported feeling that the use of virtual patients was an effective teaching method to promote critical thinking, problem-solving, and confidence in the clinical realm. The results of this pilot study may have implications to support the use of virtual patient simulations in dental hygiene education. Future research could include a larger controlled study to validate findings from this study.

[Nationwide survey among institutes of microbiology in academic medicine : Is the interdisciplinary approach the right way to treat patients with urogenital infections?

PubMed

Schneidewind, L; Kranz, J; Schlager, D; Pelzer, A E

2017-06-01

Increasing antibiotic resistance is a current and severe problem in medicine, especially in urology. Multidisciplinary antibiotic stewardship programmes are an important approach to counteract increasing resistance rates. This approach includes collaboration between urologists and microbiologists. The primary endpoint was to describe the current setting of interdisciplinary work of urologists and microbiologists in university hospitals in Germany. The secondary endpoints were the identification of problems of this interdisciplinary approach in daily routine and implications for the future in patient treatment. A newly developed, 24-item questionnaire was sent to 34 German microbiology departments at medical universities between June and October 2016; the departments were contacted up to four times. Only complete questionnaires were included in our analysis. The response rate was 50.0%. In the majority of the urological cases a microbiologist was only contacted sporadically and asked for advice, but on the other hand most of the microbiologists think that this contact and discussion about the patient is reasonable and preferable. Of the respondents, 82.4% think that with a consequent interdisciplinary approach there might be lower antibiotic resistance rates in the future. One essential problem of ideal microbial diagnostics and therapeutic advice is that the microbiologist does not receive all relevant information upon request. This might be the case in up to 76.5%. Other problems are of economic nature or shortage of manpower. Interdisciplinary patient care between urologists and microbiologists is reasonable and preferable. This approach has the potential of decreasing antibiotic resistance rates in the future.

Improving self-efficacy in spinal cord injury patients through "design thinking" rehabilitation workshops.

PubMed

Wolstenholme, Daniel; Downes, Tom; Leaver, Jackie; Partridge, Rebecca; Langley, Joseph

2014-01-01

Advances in surgical and medical management have significantly reduced the length of time that patients with spinal cord injury (SCI) have to stay in hospital, but has left patients with potentially less time to psychologically adjust. Following a pilot in 2012, this project was designed to test the effect of "design thinking" workshops on the self-efficacy of people undergoing rehabilitation following spinal injuries. Design thinking is about understanding the approaches and methods that designers use and then applying these to think creatively about problems and suggest ways to solve them. In this instance, design thinking is not about designing new products (although the approaches can be used to do this) but about developing a long term creative and explorative mind-set through skills such as lateral thinking, prototyping and verbal and visual communication. The principles of "design thinking" have underpinned design education and practice for many years, it is also recognised in business and innovation for example, but a literature review indicated that there was no evidence of it being used in rehabilitation or spinal injury settings. Twenty participants took part in the study; 13 (65%) were male and the average age was 37 years (range 16 to 72). Statistically significant improvements were seen for EQ-5D score (t = -3.13, p = 0.007) and Patient Activation Measure score (t = -3.85, p = 0.001). Other outcome measures improved but not statistically. There were no statistical effects on length of stay or readmission rates, but qualitative interviews indicated improved patient experience.

Rupture or Continuity: The Arithmetico-Algebraic Thinking as an Alternative in a Modelling Process in a Paper and Pencil and Technology Environment

ERIC Educational Resources Information Center

Hitt, Fernando; Saboya, Mireille; Zavala, Carlos Cortés

2017-01-01

Part of the research community that has followed the Early Algebra paradigm is currently delimiting the differences between arithmetic thinking and algebraic thinking. This trend could prevent new research approaches to the problem of learning algebra, hiding the importance of considering an arithmetico-algebraic thinking, a new approach which…

Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems.

PubMed

Gentry, Sarah; Badrinath, Padmanabhan

2017-03-06

The demand for healthcare is rising due to aging populations, rising chronic disease prevalence, and technological innovations. There are currently more effective and cost-effective interventions available than can be afforded within limited budgets. A new way of thinking about the optimal use of resources is needed. Ensuring that available resources are used for interventions that provide outcomes that patient's most value, rather than a focus just on effectiveness and cost-effectiveness, may help to ensure that resources are used optimally. Value-based healthcare puts what patients value at the center of healthcare. It helps ensure that they receive the care that can provide them with outcomes they think are important and that limited resources are focused on high-value interventions. In order to do this, we need flexible definitions of 'health', personalized and tailored to patient values. We review the current status of value-based health care in England and identify lessons applicable to a variety of health systems. For this, we draw upon the work of the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS), Right Care Initiative, and our local experience in promoting value-based health care for specific conditions in our region. Combining the best available evidence with open and honest dialogue between patients, clinicians, and others, whilst requiring considerable time and resources are essential to building a consensus around the value that allows the best use of limited budgets. Values have been present in healthcare since its beginnings. Placing value and values at the center of healthcare could help to ensure available resources are used to provide the greatest possible benefit to patients.

Creating Science Simulations through Computational Thinking Patterns

ERIC Educational Resources Information Center

Basawapatna, Ashok Ram

2012-01-01

Computational thinking aims to outline fundamental skills from computer science that everyone should learn. As currently defined, with help from the National Science Foundation (NSF), these skills include problem formulation, logically organizing data, automating solutions through algorithmic thinking, and representing data through abstraction.…

Thinking, Creativity, and Artificial Intelligence.

ERIC Educational Resources Information Center

DeSiano, Michael; DeSiano, Salvatore

This document provides an introduction to the relationship between the current knowledge of focused and creative thinking and artificial intelligence. A model for stages of focused and creative thinking gives: problem encounter/setting, preparation, concentration/incubation, clarification/generation and evaluation/judgment. While a computer can…

Counterfactual thinking in patients with amnesia

PubMed Central

Mullally, Sinéad L; Maguire, Eleanor A

2014-01-01

We often engage in counterfactual (CF) thinking, which involves reflecting on “what might have been.” Creating alternative versions of reality seems to have parallels with recollecting the past and imagining the future in requiring the simulation of internally generated models of complex events. Given that episodic memory and imagining the future are impaired in patients with hippocampal damage and amnesia, we wondered whether successful CF thinking also depends upon the integrity of the hippocampus. Here using two nonepisodic CF thinking tasks, we found that patients with bilateral hippocampal damage and amnesia performed comparably with matched controls. They could deconstruct reality, add in and recombine elements, change relations between temporal sequences of events, enabling them to determine plausible alternatives of complex episodes. A difference between the patients and control participants was evident, however, in the patients' subtle avoidance of CF simulations that required the construction of an internal spatial representation. Overall, our findings suggest that mental simulation in the form of nonepisodic CF thinking does not seem to depend upon the hippocampus unless there is the added requirement for construction of a coherent spatial scene within which to play out scenarios. © 2014 The Authors. Hippocampus Published by Wiley Periodicals, Inc. PMID:24978690

Counterfactual thinking in patients with amnesia.

PubMed

Mullally, Sinéad L; Maguire, Eleanor A

2014-11-01

We often engage in counterfactual (CF) thinking, which involves reflecting on "what might have been." Creating alternative versions of reality seems to have parallels with recollecting the past and imagining the future in requiring the simulation of internally generated models of complex events. Given that episodic memory and imagining the future are impaired in patients with hippocampal damage and amnesia, we wondered whether successful CF thinking also depends upon the integrity of the hippocampus. Here using two nonepisodic CF thinking tasks, we found that patients with bilateral hippocampal damage and amnesia performed comparably with matched controls. They could deconstruct reality, add in and recombine elements, change relations between temporal sequences of events, enabling them to determine plausible alternatives of complex episodes. A difference between the patients and control participants was evident, however, in the patients' subtle avoidance of CF simulations that required the construction of an internal spatial representation. Overall, our findings suggest that mental simulation in the form of nonepisodic CF thinking does not seem to depend upon the hippocampus unless there is the added requirement for construction of a coherent spatial scene within which to play out scenarios. Copyright © 2014 THE AUTHORS. HIPPOCAMPUS PUBLISHED BY WILEY PERIODICALS, INC.

Metacognitions in patients with hallucinations and obsessive-compulsive disorder: the superstition factor.

PubMed

García-Montes, José M; Pérez-Alvarez, Marino; Soto Balbuena, Cristina; Perona Garcelán, Salvador; Cangas, Adolfo J

2006-08-01

On the basis of the analogy between intrusive thoughts and auditory hallucinations established by Morrison et al. [(1995). Intrusive thoughts and auditory hallucinations: a cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 265-280], the present work compares the metacognitive beliefs and processes of five groups of patients (current hallucinators, never-hallucinated people with a diagnosis of schizophrenia, recovered hallucinators, obsessive-compulsive disorder (OCD) patients, and a clinical control group) and a non-clinical group. The results show that of the five metacognitive factors considered in this study, two were found to be different in the current hallucinators group in comparison to any other group in the design. Likewise, it is found that the metacognitive beliefs of the current hallucinators coincide with those of the OCD patients in various factors, particularly that relating to superstition, and this is interpreted as lending support to the model of Morrison et al. (1995). Furthermore, the results are discussed in the light of existing research on Thought-Action Fusion, stressing the role that may be played by superstitious beliefs and magical thinking in auditory hallucinations and OCD.

Counterfactual Thinking Deficit in Huntington's Disease.

PubMed

Solca, Federica; Poletti, Barbara; Zago, Stefano; Crespi, Chiara; Sassone, Francesca; Lafronza, Annalisa; Maraschi, Anna Maria; Sassone, Jenny; Silani, Vincenzo; Ciammola, Andrea

2015-01-01

Counterfactual thinking (CFT) refers to the generation of mental simulations of alternatives to past events, actions and outcomes. CFT is a pervasive cognitive feature in every-day life and is closely related to decision-making, planning and problem-solving - all of which are cognitive processes linked to unimpaired frontal lobe functioning. Huntington's Disease (HD) is a neurodegenerative disorder characterised by motor, behavioral and cognitive dysfunctions. Because an impairment in frontal and executive functions has been described in HD, we hypothesised that HD patients may have a CFT impairment. Tests of spontaneous counterfactual thoughts and counterfactual-derived inferences were administered to 24 symptomatic HD patients and 24 age- and sex-matched healthy subjects. Our results show a significant impairment in the spontaneous generation of CFT and low performance on the Counterfactual Inference Test (CIT) in HD patients. Low performance on the spontaneous CFT test significantly correlates with impaired attention abilities, verbal fluency and frontal lobe efficiency, as measured by Trail Making Test - Part A, Phonemic Verbal Fluency Test and FAB. Spontaneous CFT and the use of this type of reasoning are impaired in HD patients. This deficit may be related to frontal lobe dysfunction, which is a hallmark of HD. Because CFT has a pervasive role in patients' daily lives regarding their planning, decision making and problem solving skills, cognitive rehabilitation may improve HD patients' ability to analyse current behaviors and future actions.

The evolution of cognitive behavior therapy for schizophrenia: current practice and recent developments.

PubMed

Tai, Sara; Turkington, Douglas

2009-09-01

Cognitive behavior therapy (CBT) evolved from behavioral theory and developed to focus more on cognitive models that incorporated reappraisal of thinking errors and schema change strategies. This article will describe the key elements of CBT for schizophrenia and the current evidence of its efficacy and effectiveness. We conclude with a description of recent concepts that extend the theoretical basis of practice and expand the range of CBT strategies for use in schizophrenia. Mindfulness, meta-cognitive approaches, compassionate mind training, and method of levels are postulated as useful adjuncts for CBT with psychotic patients.

The Evolution of Cognitive Behavior Therapy for Schizophrenia: Current Practice and Recent Developments

PubMed Central

Tai, Sara; Turkington, Douglas

2009-01-01

Cognitive behavior therapy (CBT) evolved from behavioral theory and developed to focus more on cognitive models that incorporated reappraisal of thinking errors and schema change strategies. This article will describe the key elements of CBT for schizophrenia and the current evidence of its efficacy and effectiveness. We conclude with a description of recent concepts that extend the theoretical basis of practice and expand the range of CBT strategies for use in schizophrenia. Mindfulness, meta-cognitive approaches, compassionate mind training, and method of levels are postulated as useful adjuncts for CBT with psychotic patients. PMID:19661198

Current thinking about acute compartment syndrome of the lower extremity

PubMed Central

Shadgan, Babak; Menon, Matthew; Sanders, David; Berry, Gregg; Martin, Claude; Duffy, Paul; Stephen, David; O’Brien, Peter J.

2010-01-01

Acute compartment syndrome of the lower extremity is a clinical condition that, although uncommon, is seen fairly regularly in modern orthopedic practice. The pathophysiology of the disorder has been extensively described and is well known to physicians who care for patients with musculoskeletal injuries. The diagnosis, however, is often difficult to make. In this article, we review the clinical risk factors of acute compartment syndrome of the lower extremity, identify the current concepts of diagnosis and discuss appropriate treatment plans. We also describe the Canadian medicolegal environment in regard to compartment syndrome of the lower extremity. PMID:20858378

Systems Thinking and Patient Safety

DTIC Science & Technology

2005-01-01

1 Prologue Systems Thinking and Patient Safety Paul M. Schyve Patient safety is a prominent theme in health care delivery today. This should... patient safety and a willingness to invest in patient safety research. This volume—published by the Agency for Healthcare Research and Quality (AHRQ...The recent advent of the health care field’s emphasis on patient safety came at a favorable time. One or two decades earlier, our response would have

Nurses' reported thinking during medication administration.

PubMed

Eisenhauer, Laurel A; Hurley, Ann C; Dolan, Nancy

2007-01-01

To document nurses' reported thinking processes during medication administration before and after implementation of point-of-care technology. Semistructured interviews and real-time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US. Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose-time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications. Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the "5 rights."

Phenomenological Characteristics of Future Thinking in Alzheimer's Disease.

PubMed

Moustafa, Ahmed A; El Haj, Mohamad

2018-05-11

This study investigates phenomenological reliving of future thinking in Alzheimer's disease (AD) patients and matched controls. All participants were asked to imagine in detail a future event, and afterward, were asked to rate phenomenological characteristics of their future thinking. As compared to controls, AD participants showed poor rating for reliving, travel in time, visual imagery, auditory imagery, language, and spatiotemporal specificity. However, no significant differences were observed between both groups in emotion and importance of future thinking. Results also showed lower rating for visual imagery relative to remaining phenomenological features in AD participants compared to controls; conversely, these participants showed higher ratings for emotion and importance of future thinking. AD seems to compromise some phenomenological characteristics of future thinking, especially, visual imagery; however, other phenomenological characteristics, such as emotion, seem to be relatively preserved in these populations. By highlighting the phenomenological experience of future thinking in AD, our paper opens a unique window into the conscious experience of the future in AD patients.

Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy.

PubMed

Kertz, Sarah J; Koran, Jennifer; Stevens, Kimberly T; Björgvinsson, Thröstur

2015-05-01

Repetitive negative thinking (RNT) is a common symptom across depression and anxiety disorders and preliminary evidence suggests that decreases in rumination and worry are related to improvement in depression and anxiety symptoms. However, despite its prevalence, relatively little is known about transdiagnostic RNT and its temporal associations with symptom improvement during treatment. The current study was designed to examine the influence of RNT on subsequent depression and anxiety symptoms during treatment. Participants (n = 131; 52% female; 93% White; M = 34.76 years) were patients presenting for treatment in a brief, cognitive behavior therapy based, partial hospitalization program. Participants completed multiple assessments of depression (Center for the Epidemiological Studies of Depression-10 scale), anxiety (the 7-item Generalized Anxiety Disorder Scale), and repetitive negative thinking (Perseverative Thinking Questionnaire) over the course of treatment. Results indicated statistically significant between and within person effects of RNT on depression and anxiety, even after controlling for the effect of time, previous symptom levels, referral source, and treatment length. RNT explained 22% of the unexplained variability in depression scores and 15% of the unexplained variability in anxiety scores beyond that explained by the control variables. RNT may be an important transdiagnostic treatment target for anxiety and depression. Copyright © 2015 Elsevier Ltd. All rights reserved.

A model for critical thinking measurement of dental student performance.

PubMed

Johnsen, David C; Finkelstein, Michael W; Marshall, Teresa A; Chalkley, Yvonne M

2009-02-01

The educational application of critical thinking has increased in the last twenty years with programs like problem-based learning. Performance measurement related to the dental student's capacity for critical thinking remains elusive, however. This article offers a model now in use to measure critical thinking applied to patient assessment and treatment planning across the four years of the dental school curriculum and across clinical disciplines. Two elements of the model are described: 1) a critical thinking measurement "cell," and 2) a list of minimally essential steps in critical thinking for patient assessment and treatment planning. Issues pertaining to this model are discussed: adaptations on the path from novice to expert, the role of subjective measurement, variations supportive of the model, and the correlation of individual and institutional assessment. The critical thinking measurement cell consists of interacting performance tasks and measures. The student identifies the step in the process (for example, chief complaint) with objective measurement; the student then applies the step to a patient or case with subjective measurement; the faculty member then combines the objective and subjective measurements into an evaluation on progress toward competence. The activities in the cell are then repeated until all the steps in the process have been addressed. A next task is to determine consistency across the four years and across clinical disciplines.

Enhancing Thinking through Cooperative Learning.

ERIC Educational Resources Information Center

Davidson, Neil, Ed.; Worsham, Toni, Ed.

This collection of papers provides a theoretical foundation on current practice in cooperative thinking. The papers offer many practical methods that can be applied to a full range of classroom settings. After an introduction, "HOTSICLE: Higher Order Thinking Skills in Cooperative Learning Environments" (Neil Davidson and Toni Worsham),…

Critical Thinking and the Danger of Intellectual Conformity.

ERIC Educational Resources Information Center

Walter, Kerry S.

1987-01-01

Although the goals of critical thinking are to foster critical ability and broad-mindedness, it tends to encourage absolutism, promote passivity, and breed intolerance. The current concentration on critical thinking's reductionism should be balanced with the teaching of alternative approaches to understanding knowledge and reality. (Author/LB)

Lymphoma Therapy and Adverse Events: Nursing Strategies for Thinking Critically and Acting Decisively.

PubMed

Goodrich, Amy; Wagner-Johnston, Nina; Delibovi, Dana

2017-02-01

Multiple treatment options, combined with disease heterogeneity, have created nursing challenges in the management of adverse events (AEs) during antilymphoma therapy. Testing has revealed that less than half of participating nurses correctly graded peripheral neuropathy and neutropenia related to antilymphoma regimens. This article identifies nursing challenges in the management of AEs associated with therapy for lymphomas and describes how strategies in critical thinking can help meet those challenges. A comprehensive literature search in oncology nursing, nursing education, and critical thinking was conducted; participant responses to pre- and post-tests at nursing education programs were evaluated; and a roundtable meeting of authors was convened. Oncology nurses can cultivate critical thinking skills, practice thinking critically in relation to team members and patients, leverage information from the Patient-Reported Outcomes Common Terminology Criteria for Adverse Events, and manage workflow to allow more opportunity for critical thinking.

Psychological Distress Is Associated with Greater Perceived Disability and Pain in Patients Presenting to a Shoulder Clinic.

PubMed

Menendez, Mariano E; Baker, Dustin K; Oladeji, Lasun O; Fryberger, Charles T; McGwin, Gerald; Ponce, Brent A

2015-12-16

Shoulder disorders are a common cause of disability and pain. The Shoulder Pain and Disability Index (SPADI) is a frequently employed and previously validated measure of shoulder pain and disability. Although the SPADI has high reliability and construct validity, greater differences between individual patients are often observed than would be expected on the basis of diagnosis and pathophysiology alone. This study aims to determine how psychological factors (namely depression, catastrophic thinking, and self-efficacy) affect pain and perceived disability in the shoulder. A cohort of 139 patients completed a sociodemographic survey and elements from the SPADI, Pain Self-Efficacy Questionnaire (PSEQ), Pain Catastrophizing Scale (PCS), and Patient Health Questionnaire Depression Scale (PHQ-2). Bivariate and multivariate analyses were performed to determine the association of psychosocial factors, demographic characteristics, and specific diagnosis with shoulder pain and disability. The SPADI score showed medium correlation with the PCS (r = 0.43; p < 0.001), PHQ-2 (r = 0.39; p < 0.001), and PSEQ (r = -0.45; p < 0.001). Current work status (F = 4.35; p = 0.006) and body mass index (r = 0.27; p = 0.002) were also associated with the SPADI score. In the multivariate analysis, greater catastrophic thinking (estimate, 0.003; p = 0.029), lower self-efficacy (estimate, -0.005; p = 0.001), higher body mass index (estimate, 0.006; p = 0.048), and being disabled (estimate, 0.15; p = 0.017) or retired (estimate, 0.16; p < 0.001) compared with being employed were associated with worse SPADI scores. The primary diagnosis did not have a significant relationship (p > 0.05) with the SPADI. Catastrophic thinking and decreased self-efficacy are associated with greater shoulder pain and disability. Our data support the notion that patient-to-patient variation in symptom intensity and magnitude of disability is more strongly related to psychological distress than to the specific shoulder diagnosis. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI.

PubMed

Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo; Caciagli, Patrizio; Malossini, Gianni; Nesi, Gabriella; Wagenlehner, Florian M E; Köves, Bela; Pickard, Robert; Grabe, Magnus; Bjerklund Johansen, Truls E; Bartoletti, Riccardo

2016-01-05

Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs). Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis) has been isolated.

Competency of new graduate nurses: a review of their weaknesses and strategies for success.

PubMed

Theisen, Janelle L; Sandau, Kristin E

2013-09-01

Because of the ongoing nursing shortage and the increasing acuity of patients, new graduate nurses must master both psychomotor and critical thinking skills rapidly. Inadequate orientation leads to high turnover rates for new graduates. Health care leaders must examine the competencies needed for new graduate nurses to succeed in this environment. A critical review of studies (n = 26) was conducted to identify crucial competencies that are needed for new graduate nurses to be successful. Six areas were identified in which new graduates lacked competence: communication, leadership, organization, critical thinking, specific situations, and stress management. Strategies were identified to improve the transition of new graduates. Hospitals should consider implementing nurse residency programs that include strategies for clear communication and conflict management, prioritization skills, and leadership development. Schools of nursing should add communication strategies to their current focus on critical thinking, clinical reasoning, and simulation scenarios and include situation-specific skills such as end-of-life scenarios. Further research should focus on stress management, leadership, clinical reasoning, and evaluation of measurement tools for new graduates. Copyright 2013, SLACK Incorporated.

Beyond the Lonely, Choosing Will: Professional Development in Teacher Thinking. Occasional Paper No. 131.

ERIC Educational Resources Information Center

Buchmann, Margret

This paper aims to accomplish several purposes through conceptual analysis, story telling and interpretation, excursions into philosophy, and recent studies of teachers' professional development. First, the paper identifies limitations and confusions in current conceptions of teachers' professional thinking: equating teacher thinking with planning…

Assessing Children's Multiplicative Thinking

ERIC Educational Resources Information Center

Hurst, Chris; Hurrell, Derek

2016-01-01

Multiplicative thinking is a "big idea" of mathematics that underpins much of the mathematics learned beyond the early primary school years. This paper reports on a current study that utilises an interview tool and a written quiz to gather data about children's multiplicative thinking. The development of the tools and some of the…

Program Development for Primary School Teachers' Critical Thinking

ERIC Educational Resources Information Center

Boonjeam, Waraporn; Tesaputa, Kowat; Sri-ampai, Anan

2017-01-01

The objectives of this research were: 1) to study the elements and indicators of primary school teachers' critical thinking, 2) to study current situation, desirable situation, development technique, and need for developing the primary school teachers' critical thinking, 3) to develop the program for developing the primary school teachers'…

Critical Thinking Assessment across Four Sustainability-Related Experiential Learning Settings

ERIC Educational Resources Information Center

Heinrich, William F.; Habron, Geoffrey B.; Johnson, Heather L.; Goralnik, Lissy

2015-01-01

Today's complex societal problems require both critical thinking and an engaged citizenry. Current practices in higher education, such as service learning, suggest that experiential learning can serve as a vehicle to encourage students to become engaged citizens. However, critical thinking is not necessarily a part of every experiential learning…

Rethinking Critical Thinking

ERIC Educational Resources Information Center

Downs, Christopher J.

2008-01-01

Critical thinking is of primary importance in higher education, yet the concept remains slippery and the skill elusive. The author argues that most current critical thinking textbooks are out of line with the seminal work of John Dewey. Rather than logical argument and justification, it is suggested that carefulness, open-mindedness and creativity…

Brain Stretchers, Book 3 - Advanced.

ERIC Educational Resources Information Center

Stickels, Terry H.

Current thinking suggests that solving brainteasing puzzles uses the same critical thinking skills needed to solve difficult math, science, and business problems. This book is a non-intimidating exploration of the wonderful powers of the mind with an emphasis on the joy of thinking and learning. It contains 100 puzzles, presented in order of…

Environmental Activities for Teaching Critical Thinking. [Environmental Education Information Report.

ERIC Educational Resources Information Center

Howe, Robert W.; Disinger, John F.

The ability to think critically is essential if individuals are to live, work, and function effectively in our current and changing society. The activities included in this publication were selected to identify a variety of effective strategies for teaching critical thinking skills through environmental education. Activities include library…

The Effect of Information Literacy on Teachers' Critical Thinking Disposition

ERIC Educational Resources Information Center

Saglam, Aycan Çiçek; Çankaya, Ibrahim; Üçer, Hakan; Çetin, Muhammet

2017-01-01

The concepts of information literacy and critical thinking are two important concepts of today's information and technology age closely related to each other and sometimes used interchangeably. The purpose of the current study is to explore the relationship between the secondary school teachers' critical thinking disposition and information…

Counterfactual Thinking and False Belief: The Role of Executive Function

ERIC Educational Resources Information Center

Drayton, Stefane; Turley-Ames, Kandi J.; Guajardo, Nicole R.

2011-01-01

The purpose of the current study was to examine further the relationship between counterfactual thinking and false belief (FB) as examined by Guajardo and Turley-Ames ("Cognitive Development, 19" (2004) 53-80). More specifically, the current research examined the importance of working memory and inhibitory control in understanding the relationship…

Pathways of Knowing: Integrating Citizen Science and Critical Thinking in the Adult ELL Classroom

ERIC Educational Resources Information Center

Basham, Melody

2012-01-01

This action research study examines what common perceptions and constructs currently exist in educating adult immigrants in Arizona and considers how might the integration of citizen science with the current English curriculum promote higher order thinking and educational equity in this population. A citizen science project called the Mastodon…

Milestones of critical thinking: a developmental model for medicine and nursing.

PubMed

Papp, Klara K; Huang, Grace C; Lauzon Clabo, Laurie M; Delva, Dianne; Fischer, Melissa; Konopasek, Lyuba; Schwartzstein, Richard M; Gusic, Maryellen

2014-05-01

Critical thinking is essential to a health professional's competence to assess, diagnose, and care for patients. Defined as the ability to apply higher-order cognitive skills (conceptualization, analysis, evaluation) and the disposition to be deliberate about thinking (being open-minded or intellectually honest) that lead to action that is logical and appropriate, critical thinking represents a "meta-competency" that transcends other knowledge, skills, abilities, and behaviors required in health care professions. Despite its importance, the developmental stages of critical thinking have not been delineated for nurses and physicians. As part of a task force of educators who considered different developmental stage theories, the authors have iteratively refined and proposed milestones in critical thinking. The attributes associated with unreflective, beginning, practicing, advanced, accomplished, and challenged critical thinkers are conceived as independent of an individual's level of training. Depending on circumstances and environmental factors, even the most experienced clinician may demonstrate attributes associated with a challenged thinker. The authors use the illustrative case of a patient with abdominal pain to demonstrate how critical thinking may manifest in learners at different stages of development, analyzing how the learner at each stage applies information obtained in the patient interaction to arrive at a differential diagnosis and plan for evaluation. The authors share important considerations and provide this work as a foundation for the development of effective approaches to teaching and promoting critical thinking and to establishing expectations for learners in this essential meta-competency.

Metacognitions in desire thinking: a preliminary investigation.

PubMed

Caselli, Gabriele; Spada, Marcantonio M

2010-10-01

Desire thinking is defined as a voluntary thinking process orienting to prefigure images, information and memories about positive target-related experience. Recent research has highlighted the role of desire thinking in the maintenance of addictive, eating and impulse control disorders. Currently little is known about metacognitions in desire thinking. To investigate: (1) the presence and content of desire thinking during a desire experience; (2) the presence of metacognitive beliefs in desire thinking; (3) the goal of desire thinking; (4) attentional focus during desire thinking; and (5) the impact of desire thinking on craving. Twenty-four individuals with a diagnosis of either alcohol abuse, bulimia nervosa, pathological gambling or smoking dependence were assessed using a semi-structured interview. Findings indicated that participants engaged in desire thinking and endorsed both positive and negative metacognitive beliefs about this process. The goal of desire thinking was to regulate internal states. Participants also reported that during a desire experience their attentional focus was continuously shifting between internal state and external context and that engaging in desire thinking increased craving. These findings provide preliminary evidence that metacognitions play a role in desire thinking.

Increased anal basal pressure in chronic anal fissures may be caused by overreaction of the anal-external sphincter continence reflex.

PubMed

van Meegdenburg, Maxime M; Trzpis, Monika; Heineman, Erik; Broens, Paul M A

2016-09-01

Chronic anal fissure is a painful disorder caused by linear ulcers in the distal anal mucosa. Even though it counts as one of the most common benign anorectal disorders, its precise etiology and pathophysiology remains unclear. Current thinking is that anal fissures are caused by anal trauma and pain, which leads to internal anal sphincter hypertonia. Increased anal basal pressure leads to diminished anodermal blood flow and local ischemia, which delays healing and leads to chronic anal fissure. The current treatment of choice for chronic anal fissure is either lateral internal sphincterotomy or botulinum toxin injections. In contrast to current thinking, we hypothesize that the external, rather than the internal, anal sphincter is responsible for increased anal basal pressure in patients suffering from chronic anal fissure. We think that damage to the anal mucosa leads to hypersensitivity of the contact receptors of the anal-external sphincter continence reflex, resulting in overreaction of the reflex. Overreaction causes spasm of the external anal sphincter. This in turn leads to increased anal basal pressure, diminished anodermal blood flow, and ischemia. Ischemia, finally, prevents the anal fissure from healing. Our hypothesis is supported by two findings. The first concerned a chronic anal fissure patient with increased anal basal pressure (170mmHg) who had undergone lateral sphincterotomy. Directly after the operation, while the submucosal anesthetic was still active, basal anal pressure decreased to 80mmHg. Seven hours after the operation, when the anesthetic had completely worn off, basal anal pressure increased again to 125mmHg, even though the internal anal sphincter could no longer be responsible for the increase. Second, in contrast to previous studies, recent studies demonstrated that botulinum toxin influences external anal sphincter activity and, because it is a striated muscle relaxant, it seems reasonable to presume that it affects the striated external anal sphincter, rather than the smooth internal anal sphincter. If our hypothesis is proved correct, the treatment option of lateral internal sphincterotomy should be abandoned in patients suffering from chronic anal fissures, since it fails to eliminate the cause of high anal basal pressure. Additionally, lateral internal sphincterotomy may cause damage to the anal-external sphincter continence reflex, resulting in fecal incontinence. Instead, higher doses of botulinum toxin should be administered to those patients suffering from chronic anal fissure who appeared unresponsive to lower doses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Developing critical thinking skills from clinical assignments: a pilot study on nursing students' self-reported perceptions.

PubMed

Marchigiano, Gail; Eduljee, Nina; Harvey, Kimberly

2011-01-01

Clinical assignments in nursing education provide opportunities for students to develop thinking skills vital to the effective delivery of patient care. The purpose of the present study was to examine students' perceived levels of confidence for using thinking skills when completing two types of clinical assignments. Clinical educators and managers are challenged to develop teaching and learning strategies that help students think critically and reflectively and transfer these skills into sound nursing practice. This study is based on the theoretical framework of critical thinking within the nursing process framework. Undergraduate nursing students (n=51) completed surveys indicating their confidence in using seven thinking skills for nursing care. Students indicated significantly more confidence when implementing the journal format as compared with the care plan format when analysing information, determining relevance, making connections, selecting appropriate information, applying relevant knowledge and evaluating outcomes. The findings of the present study propose a new approach for enhancing students' thinking skills. Journaling is an effective strategy for enhancing students' thinking skills. Nursing managers are in key organisational positions for supporting and promoting the use of the journal format and building supportive and collaborative learning environments for students to develop thinking skills for managing patient care. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

The Experimental Manipulation of Desire Thinking in Alcohol use Disorder.

PubMed

Caselli, Gabriele; Gemelli, Antonella; Spada, Marcantonio M

2017-03-01

Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has revealed that desire thinking may play a significant role in the escalation of craving. The goal of this study was to explore the effect of a desire thinking induction on craving in a sample of patients with alcohol use disorder. Ten patients with alcohol use disorder were exposed to a brief exposure to alcohol-related thoughts plus desire thinking induction versus brief exposure to alcohol-related thoughts plus distraction. The induction of desire thinking led to a significant increase in distress and urge to use alcohol when compared to a behavioural assessment test and a distraction task. The clinical implications for the treatment of alcohol use disorder are discussed. Copyright © 2016 John Wiley & Sons, Ltd. Psychotherapeutic strategies that target desire thinking, both at the assessment and at the intervention levels, may be relevant in the treatment of craving-related problems. Deriving and illustrating the role of desire thinking in a given episode of craving may support the development of metacognitive awareness about its functions and consequences. Copyright © 2016 John Wiley & Sons, Ltd.

The fact of ignorance: revisiting the Socratic method as a tool for teaching critical thinking.

PubMed

Oyler, Douglas R; Romanelli, Frank

2014-09-15

Critical thinking, while highly valued as an ability of health care providers, remains a skill that many educators find difficult to teach. This review provides an analysis examining why current methods of teaching critical thinking to health care students (primarily medical and pharmacy students) often fail and describes a premise and potential utility of the Socratic method as a tool to teach critical thinking in health care education.

The treatment of systemic lupus proliferative nephritis.

PubMed

Punaro, Marilynn G

2013-11-01

Lupus nephritis is one of the most common and serious complications of systemic lupus erythematosus (SLE) in childhood affecting more than 80% of patients. Treatment of this complication has undergone significant evolution in recent years. A series of randomized controlled trials has clarified the role of a variety of immunomodulating regimens including some novel biologic medications. This review touches on the major trials that have influenced practice and shaped current thinking about the treatment of proliferative lupus glomerulonephritis.

Improving deep vein thrombosis prophylaxis with mechanical modalities in surgical intensive care unit.

PubMed

Restrepo, Paula; Jameson, Deborah L; Carroll, Diane L

2015-01-01

Deep vein thrombosis remains a source of adverse outcomes in surgical patients. Deep vein thrombosis is preventable with prophylactic intervention. The success of noninvasive mechanical modalities for prophylaxis relies on compliance with correct application. The goals of this project were to create a guideline that reflected current evidence and expert thinking about mechanical modalities use, assess compliance with mechanical modalities, and develop strategies to disseminate an evidence-based guideline for deep vein thrombosis prophylaxis.

Developing the Mathematics Learning Management Model for Improving Creative Thinking in Thailand

ERIC Educational Resources Information Center

Sriwongchai, Arunee; Jantharajit, Nirat; Chookhampaeng, Sumalee

2015-01-01

The study purposes were: 1) To study current states and problems of relevant secondary students in developing mathematics learning management model for improving creative thinking, 2) To evaluate the effectiveness of model about: a) efficiency of learning process, b) comparisons of pretest and posttest on creative thinking and achievement of…

Using Computers and Original Texts to Teach Critical Reading and Thinking.

ERIC Educational Resources Information Center

Orndorff, Joseph

While ability to read and think critically is the very basis of post-secondary education, increasing numbers of college students lack these skills. A sequence of two courses in critical reading and thinking are currently offered in the Concentrated Studies program at Duquesne University in Pennsylvania. In these courses, students who are…

War, Critical Thinking, and Self-Understanding

ERIC Educational Resources Information Center

Noddings, Nel

2004-01-01

Can students learn to think critically if they are not asked to engage with critical issues? Fostering critical thinking is frequently stated as a fundamental aim of education, and yet many teachers report that they have been forbidden to discuss such critical issues as current wars, religion, and cultural differences in styles of parenting. The…

The Case against "Critical Thinking Skills": In Pursuit of a Humanizing Pedagogy

ERIC Educational Resources Information Center

Anderson, Morgan

2015-01-01

Current educational discourse is rife with the phrase "critical thinking skills." The term is wielded with such indiscretion among educators, reformers, and education policy makers that is has become commonsensical to believe that imparting critical thinking skills is an indispensable aspect of education. For example, according to the…

Toward the Thinking Curriculum: Current Cognitive Research. 1989 ASCD Yearbook.

ERIC Educational Resources Information Center

Resnick, Lauren B., Ed.; Klopfer, Leopold E., Ed.

A project of the Center for the Study of Learning at the University of Pittsburgh, this yearbook combines the two major trends/concerns impacting the future of educational development for the next decade: knowledge and thinking. The yearbook comprises the following chapters: (1) "Toward the Thinking Curriculum: An Overview" (Lauren B.…

Following Alice: Theories of Critical Thinking and Reflective Practice in Action at Postgraduate Level

ERIC Educational Resources Information Center

Swanwick, Ruth; Kitchen, Ruth; Jarvis, Joy; McCracken, Wendy; O'Neil, Rachel; Powers, Steve

2014-01-01

This paper presents a flexible framework of principles for teaching critical thinking and reflective practice skills at the postgraduate level. It reports on a collaborative project between four UK institutions providing postgraduate programmes in deaf education. Through a critical review of current theories of critical thinking and reflective…

The Effects of Computer Use on Creative Thinking among Kindergarten Children in Jordan

ERIC Educational Resources Information Center

Shawareb, Aseel

2011-01-01

The objective of the current study was to examine the effect of early computer experience, using quasi-experimental design, on creative thinking among Jordanian kindergarten children. It intended to answer two main research questions. First, does adding a computer to a kindergarten environment enhance children's creative thinking? Second, does…

Critical Thinking as Miracle Tonic: Selling Snake Oil in Education.

ERIC Educational Resources Information Center

Hyslop-Margison, Emery J.

This paper proposes that the current interest in critical thinking is based on important conceptual, epistemological, and procedural confusions. It suggests that the attempt to identify a successful critical thinking construct mirrors the search for miracle tonics often peddled by snake oil salesmen as a medicinal cure-all. It goes to suggest that…

Assessment of Unconscious Decision Aids Applied to Complex Patient-Centered Medical Decisions

PubMed Central

Manigault, Andrew Wilhelm; Whillock, Summer Rain

2015-01-01

Background To improve patient health, recent research urges for medical decision aids that are designed to enhance the effectiveness of specific medically related decisions. Many such decisions involve complex information, and decision aids that independently use deliberative (analytical and slower) or intuitive (more affective and automatic) cognitive processes for such decisions result in suboptimal decisions. Unconscious thought can arguably use both intuitive and deliberative (slow and analytic) processes, and this combination may further benefit complex patient (or practitioner) decisions as medical decision aids. Indeed, mounting research demonstrates that individuals render better decisions generally if they are distracted from thinking consciously about complex information after it is presented (but can think unconsciously), relative to thinking about that information consciously or not at all. Objective The current research tested whether the benefits of unconscious thought processes can be replicated using an Internet platform for a patient medical decision involving complex information. This research also explored the possibility that judgments reported after a period of unconscious thought are actually the result of a short period of conscious deliberation occurring during the decision report phase. Methods A total of 173 participants in a Web-based experiment received information about four medical treatments, the best (worst) associated with mostly positive (negative) side-effects/attributes and the others with equal positive-negative ratios. Next, participants were either distracted for 3 minutes (unconscious thought), instructed to think about the information for 3 minutes (conscious thought), or moved directly to the decision task (immediate decision). Finally, participants reported their choice of, and attitudes toward, the treatments while experiencing high, low, or no cognitive load, which varied their ability to think consciously while reporting judgments. Cognitive load was manipulated by having participants memorize semi-random (high), line structured (low), or no dot patterns and recall these intermittently with their decision reports. Overall then, participants were randomly assigned to the conditions of a 3 (thought condition) by 3 (cognitive-load level) between-subjects design. Results A logistic regression analysis indicated that the odds of participants choosing the best treatment were 2.25 times higher in the unconscious-thought condition compared to the immediate-decision condition (b=.81, Wald=4.32, P=.04, 95% CI 1.048-4.836), and 2.39 times greater compared to the conscious-thought condition (b=.87, Wald=4.87, P=.027, 95% CI 1.103-5.186). No difference was observed between the conscious-thought condition compared to the immediate-decision condition, and cognitive load manipulations did not affect choices or alter the above finding. Conclusions This research demonstrates a plausible benefit of unconscious thinking as a decision aid for complex medical decisions, and represents the first use of unconscious thought processes as a patient-centered medical decision aid. Further, the quality of decisions reached unconsciously does not appear to be affected by the amount of cognitive load participants experienced. PMID:25677337

Supporting Mathematical Thinking

ERIC Educational Resources Information Center

Houssart, Jenny; Roaf, Caroline; Watson, Anne

2005-01-01

This book looks at how practitioners have focused on the fully educational application of intellect to the problem of developing mathematical thinking among one's pupils. Each chapter demonstrates reflective minds at work, relying on close observation, willingness to understand the student's thinking processes and patient commitment to students…

Competence to make treatment decisions in anorexia nervosa: thinking processes and values

PubMed Central

Tan, Dr. Jacinta O. A.; Hope, Professor Tony; Stewart, Dr. Anne; Fitzpatrick, Professor Raymond

2005-01-01

This paper explores the ethical and conceptual implications of the findings from an empirical study of decision-making capacity in anorexia nervosa. In the study, ten female patients aged 13 to 21 years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semi-structured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient participants were also tested using the MacCAT-T test of competence. This is a formalised, structured interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing, and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches or current standardised tests of competence. PMID:18066393

Educational Leadership and Management: Blending Greek Philosophy, Myth and Current Thinking

ERIC Educational Resources Information Center

Pashiardis, Petros

2009-01-01

In this conceptual paper, an exploration of the leadership gap between theory and praxis, which manifests itself in three different kinds of fissure in current thinking and research in the field of educational leadership, management and administration, will be undertaken. It is argued that there is a public image/communication gap, which current…

Registered nurses' clinical reasoning in home healthcare clinical practice: A think-aloud study with protocol analysis.

PubMed

Johnsen, Hege Mari; Slettebø, Åshild; Fossum, Mariann

2016-05-01

The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. An exploratory qualitative think-aloud design with protocol analysis was used. Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. A purposeful sample of eight registered nurses with one year of experience. Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Engaging patients with digital tools: what we think we know.

PubMed

Fox, Brent I; Felkey, Bill G

2014-11-01

Patients who are engaged in their own care have better outcomes and cost the health care system less money. Creating the environment that supports patient engagement has been a recent focus across the United States, and digital tools have been suggested as an important piece of patient engagement. We discuss what we think we know about digital engagement, and present data of what is actually occurring.

New Approaches to the Diagnosis, Clinical Course, and Goals of Therapy in Multiple Sclerosis and Related Disorders.

PubMed

Krieger, Stephen C

2016-06-01

The diagnosis, categorization, and treatment of multiple sclerosis (MS) and other demyelinating diseases have shifted over the past decade, and many of the fundamental principles of MS pathogenesis and clinical course are being rewritten. Fundamental issues include selecting the right disease-modifying therapy for someone with active disease and how, or even if, patients with purely progressive MS should be treated. This article provides an overview and introduction to the current thinking in MS diagnosis and therapy with an emphasis on the data-driven and proactive approach that has come to define the current state of the art.

Health information technology: a few years of magical thinking?

PubMed

Diamond, Carol C; Shirky, Clay

2008-01-01

One of the biggest obstacles to expanding the use of information technology (IT) in health care may be the current narrow focus on how to stimulate its adoption. The challenge of thinking of IT as a tool to improve quality requires serious attention to transforming the U.S. health care system as a whole, rather than simply computerizing the current setup. Proponents of health IT must resist "magical thinking," such as the notion that technology will transform our broken system, absent integrated work on policy or incentives. The alternative route to transforming the system sets all of its sights on the destination.

When should video be added to conventional urodynamics in adults and is it justified by the evidence? ICI-RS 2014.

PubMed

Anding, Ralf; Rosier, Peter; Smith, Phillip; Gammie, Andrew; Giarenis, Ilias; Rantell, Angela; Thiruchelvam, Nikesh; Arlandis, Salvador; Cardozo, Linda

2016-02-01

To debate and evaluate the evidence base regarding the added value of video to urodynamics in adults and to define research questions. In the ICI-RS Meeting 2014 a Think Tank analyzed the current guidelines recommending video urodynamics (VUD) and performed a literature search to determine the level of evidence for the additional value of the imaging with urodynamic assessment of both neurogenic and non-neurogenic lower urinary tract dysfunction. Current guidelines do not specify the added value of imaging to urodynamics. Recommendations are based on single center series and expert opinion. Standard imaging protocols are not available and evidence regarding the balance between number and timing of pictures, patient positioning, and exposure time on the one hand and diagnosis on the other hand is lacking. On the basis of expert consensus VUD is relevant in the follow-up of patients with spinal dysraphism. Evidence for the value of VUD in non-neurogenic lower urinary tract dysfunction is sparse. There is some evidence that VUD is not necessary in uncomplicated female SUI, but expert opinion suggests it might improve the evaluation of patients with recurrent SUI. There is only low level evidence for the addition of video to urodynamics. The ICI-RS Think Tank encourages better reporting of results of imaging and systematic reporting of X-ray doses. Specific research hypotheses regarding the added value of imaging are recommended. The panel suggests the development of standards for technically optimal VUD that is practically achievable with machines that are on the market. © 2016 Wiley Periodicals, Inc.

The Fact of IgnoranceRevisiting the Socratic Method as a Tool for Teaching Critical Thinking

PubMed Central

Romanelli, Frank

2014-01-01

Critical thinking, while highly valued as an ability of health care providers, remains a skill that many educators find difficult to teach. This review provides an analysis examining why current methods of teaching critical thinking to health care students (primarily medical and pharmacy students) often fail and describes a premise and potential utility of the Socratic method as a tool to teach critical thinking in health care education. PMID:25258449

Optional thinking ability among hospital-treated deliberate self-harm patients: a 1-year follow-up study.

PubMed

McAuliffe, Carmel; Corcoran, Paul; Hickey, Portia; McLeavey, Breda C

2008-03-01

To investigate the association between optional thinking (the ability to generate alternative solutions to interpersonal problems) in deliberate self-harm (DSH) patients and repeated self-harm. A prospective study of the association between optional thinking in interpersonal problem solving and repeated DSH within 12 months. A non-consecutive sample (N=152) of DSH patients presenting to the Accident and Emergency department of an acute hospital in Cork city, Ireland, was assessed using a structured interview schedule including the Suicide Intent Scale, the Hopelessness Scale, and the Optional Thinking Test. Repetition within 1 year was established by checking Accident and Emergency records at all three city hospitals. Participants were categorized as repeaters if they engaged in at least one further hospital-treated DSH episode, or non-repeaters. Approximately two-thirds (63.1%) of the sample had engaged in at least one act of DSH prior to their index episode. During follow-up 31 individuals (20.4%) repeated. History of self-harm was significantly associated with prospective repetition when considered alongside all the other predictor variables. Among first evers, low scores on the optional thinking test were significantly associated with the increased risk of repetition within 12 months. Among those with previous DSH, there was no evidence of an association between optional thinking and repetition within 12 months. Poor optional thinking is associated with increased risk of repeated deliberate self-harm in those who present with a first self-harm episode. Interventions to improve optional thinking skills, delivered soon after a first DSH presentation, may be useful in preventing repetition.

The future of tic disorder treatment.

PubMed

Bennett, Shannon M; Keller, Alex E; Walkup, John T

2013-11-01

Competing theories on the etiology and treatment of chronic tic disorders and Tourette syndrome have long made the search for efficacious intervention more challenging for patients and families seeking to reduce functional impairment related to tic symptoms. These symptoms were historically posited to be either psychological in origin, leading to the long tradition of psychoanalytic psychotherapy for tics, or biological in nature, particularly since the advent of successful treatments using neuroleptic medications. Current thinking about the phenomenology of tic disorders comes from growing empirical evidence as well as advances in neuroscience and genetics research and reveals a biological vulnerability that is exacerbated by physiological arousal related to environmental or interpersonal stress. This manuscript summarizes the evolution of this knowledge base and describes current best-practice recommendations for patients, families, and clinicians. © 2013 New York Academy of Sciences.

Using Lean Thinking at an otorhinolaryngology outpatient clinic to improve quality of care.

PubMed

van Leijen-Zeelenberg, Janneke E; Brunings, Jan Wouter; Houkes, Inge; van Raak, Arno J A; Ruwaard, Dirk; Vrijhoef, Hubertus J M; Kremer, Bernd

2016-04-01

Although Lean Thinking has led to considerable improvement in a variety of healthcare settings, its effects on otorhinolaryngology remain underexposed. This study reports on how the implementation of Lean Thinking at an otorhinolaryngology outpatient clinic has affected patient and provider satisfaction, waste reduction, and organizational culture. Prospective before-and-after design. The 18-month prospective before-and-after design used mixed methods for data collection and analysis. A survey was conducted to measure satisfaction among patients and providers. Semistructured interviews were conducted to evaluate the effect of Lean Thinking on waste and organizational culture. During the project, 69 issues were posted on the Lean board. Improvements were made on 36 inefficiency issues, not all concerning a specific type of waste. Employees reported considerable improvement in transportation, motion, and waiting. Patient satisfaction was high both at baseline and follow-up and did not change significantly. The effects on provider satisfaction were slight; satisfaction with autonomy and participation decreased significantly, but satisfaction with communication increased significantly. The implementation of Lean Thinking at an otorhinolaryngology outpatient clinic reduced waste and increased provider satisfaction with communication. Although patient satisfaction did not change significantly, it cannot be concluded that the intervention had no effect on perceived quality of care. Other approaches to measure patients' perceptions should be considered. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

The Evolution of Deficit Thinking: Educational Thought and Practice. The Stanford Series on Education and Public Policy.

ERIC Educational Resources Information Center

Valencia, Richard R.

This book includes eight chapters that explore the history and current status of educational "deficit thinking" and its effects on educational policies and practices. Educational deficit thinking is a form of blaming the victim that views the alleged deficiencies of poor and minority group students and their families as predominantly…

Critical Thinking Skills among Elementary School Students: Comparing Identified Gifted and General Education Student Performance

ERIC Educational Resources Information Center

Kettler, Todd

2014-01-01

Education reform efforts, including the current adoption of Common Core State Standards, have increased attention to teaching critical thinking skills to all students. This study investigated the critical thinking skills of fourth-grade students from a school district in Texas, including 45 identified gifted students and 163 general education…

Using Case Studies in Business Education to Promote Networked Thinking: Findings of an Intervention Study

ERIC Educational Resources Information Center

Pilz, Matthias; Zenner, Lea

2018-01-01

Case studies are central to the way management is currently taught at universities. Among other benefits attributed to the case study method is that it promotes networked thinking by learners. Networked thinking takes account of interactions and repercussions, making it crucial to decision-making within the complex system of rules that shapes…

Stimulating Creativity: Modulation of Convergent and Divergent Thinking by Transcranial Direct Current Stimulation (tDCS)

ERIC Educational Resources Information Center

Zmigrod, Sharon; Colzato, Lorenza S.; Hommel, Bernhard

2015-01-01

Creativity has been conceptualized as involving 2 distinct components; divergent thinking, the search for multiple solutions to a single problem, and convergent thinking, the quest for a single solution either through an analytical process or the experience of insight. Studies have demonstrated that these abilities can be improved by cognitive…

About the Reflective Thought Also Known as the Critical Thinking

ERIC Educational Resources Information Center

León, Federico R.

2014-01-01

This article deals with the concept of reflective thought or critical thinking from its initial formulation as an intellectual attitude to its current articulation as a third level of cognitive processing. Issues dealt with include critical thinking as a goal, as a cognitive process, as a part of dual cognitive processes, as a measurable…

Making the Familiar Strange: Thinking Visually in a Study Abroad Course in Professional Communication

ERIC Educational Resources Information Center

Andrews, Deborah C.

2016-01-01

Business and professional communicators increasingly rely on visual thinking and design strategies to create effective messages. The workplace need for such thinking, however, is not readily accommodated in current pedagogy. A long-running study abroad short course for American students taught in London provides a model for meeting this need.…

Current knowledge related to intelligence and thinking with implications for the development and use of case studies.

PubMed

Lunney, Margaret

2008-01-01

This paper reviews current knowledge regarding intelligence and thinking, and relates this knowledge to learning to diagnose human responses and to select health outcomes and nursing interventions. Knowledge from relevant literature sources was summarized. The provision of high-quality nursing care requires use of critical thinking with three elements of nursing care: nursing diagnosis, health outcomes, and nursing interventions. Metacognition (thinking about thinking) should be used with knowledge of the subject matter and repeated practice in using the knowledge. Because there are limited clinical opportunities to practice using metacognition and knowledge of these nursing care elements, case studies can be used to foster nurses' expertise. Simulations of clinical cases are needed that illustrate application of the nursing knowledge represented in NANDA International, Nursing Outcomes Classification, and Nursing Interventions Classification. The International Journal of Nursing Terminologies and Classifications will promote the dispersion of case studies as a means of facilitating the implementation and use of nursing languages and classifications.

Thinking about thinking: implications for patient safety.

PubMed

Montgomery, Kathryn

2009-01-01

Clinical medicine, a learned, rational, science-using practice, is labelled a science even though physicians have the good sense not to practise it that way. Rather than thinking like scientists - or how we think scientists think - physicians are engaged in analogical, interpretive reasoning that resembles Aristotle's phronesis, or practical reasoning, more closely than episteme, or scientific reasoning. In medicine, phronesis is clinical judgment; and while it depends on both a fund of information and extensive experience, somehow it is not quite teachable. This practical, clinical rationality relies on case narrative for teaching and learning about illness and disease, for recording and communicating about patient care and, inevitably, for thinking about and remembering the details, as well as the overarching rules of practice. At the same time, "anecdotal" remains the most pejorative word in medicine, and the tension between the justifiable caution this disdain expresses and the pervasive narrative structure of medical knowledge is characteristic of clinical knowing generally: a tug-of-war between apparent irreconcilables that can be settled only by an appeal to the circumstances of the clinical situation. Practical rationality in the clinical encounter is characterized by a productive circulation between the particular details of the patient's presentation and general information about disease stored as a taxonomy of cases. Evidence-based medicine can improve this negotiation between general knowledge and the patient's particulars, but it cannot replace it. In a scientific era, clinical judgment remains the quintessential intellectual strength of the clinician. Why, then, do we not teach the epistemology of medicine? Understanding the mis-description of physicians' thinking - and the accompanying claim that medicine is, in itself, a science - could mitigate the misplaced perfectionism that makes mistakes in medicine personal and unthinkable.

[Career planning for explanation of clinical test results and program of inspections: developing medical technologists for team medical care].

PubMed

Uchida, Misuko

2013-04-01

Current medical care is subdivided according to medical advances, and sophistication and new techniques are necessary. In this setting, doctors and nurses have been explaining to and consulting patients about their medical examinations; however, in recent years, medical technologists have performed these duties at the start of the team's medical care. Therefore, we think it is possible for patients to receive clear and convincing explanations. Most patients cannot understand their examination data, which are written using numbers and charts, etc. Recently, the Nagano Medical Technologist Society has been developing technologists who could explain examination results to patients. This development training included hospitality and communication. The certificate of completion will be issued in March when the program starts.

[Investigation into the formation of proportions of "realistic thinking vs magical thinking" in paranoid schizophrenia].

PubMed

Jarosz, M; Pankiewicz, Z; Buczek, I; Poprawska, I; Rojek, J; Zaborowski, A

1993-01-01

Both magical thinking among healthy persons and magical and symbolic thinking in schizophrenia were discussed. The investigation covered 100 paranoid schizophrenics. They also underwent an examination in connection with the formation of the remaining 3 proportions. Both "realistic thinking and magical thinking" scales were used. An ability to think realistically was preserved, to a varying degree, in all patients, with 50% of those examined having shown an explicit or very explicit ability to follow realistic thinking. The above findings deviate from a simplified cognitive model within the discussed range. It was further confirmed that realistic thinking may coexist with magical thinking, and, in some cases, it concerns the same events. That type of disorders of the content of thinking are referred to as magical-realistic interpenetration. The results, and particularly high coefficient of negative correlation within the scales of the examined proportions, confirm the correctness of the assumption that the investigated modes of thinking form an antithetic bipolarity of proportions, aggregating antithetic values, therefore being also complementary.

A critical thinking disposition scale for nurses: short form.

PubMed

Hwang, Shiow-Y; Yen, Miaofen; Lee, Bih-O; Huang, Mei-C; Tseng, Hung-F

2010-11-01

The aim of this study was to test the Chinese version of the Critical Thinking Disposition Inventory (CTDI-CV) among nurses in Taiwan. Critical thinking is the use of purposeful self-regulatory judgments to identify patient's problems and provide patient care. Critical thinking influences nurses' decision making. To date, no inventory to understand nurse's critical thinking disposition has been developed. This was a survey design with a stratified random sampling to test the reliability and validity of the CTDI-CV. The participants comprised 864 registered nurses who were chosen by stratified random sampling from seven hospitals in Taiwan. Data were collected through self-administered structured questionnaires. A new scale, short form (SF) CTDI-CV, contains 18 items with three subscales: 'systematic analysis', 'thinking within the box' and 'thinking out of the box', was generated from the analysis with 44% explained variance. Cronbach's alpha coefficients and intra-class correlation coefficients for overall and subscale were above 0.8. Goodness-of-fit test for the final model of SF-CTDI-CV revealed an acceptable result in the overall fit (χ(2)/df = 4.04, p < 0.05, GFI = 0.93, AGFI = 0.91, SRMR = 0.076, RMSEA = 0.059). On the basis of these results, the SF-CTDI-CV is a reliable instrument for assessing critical thinking disposition for nurses. A short and valid critical thinking instrument for nurses will facilitate critical thinking research in the clinical practice arena. When designing continuing education activities, clinical educators will be able to efficiently and effectively evaluate the quality of critical thinking among practicing nurses. © 2010 Blackwell Publishing Ltd.

Evidence and its uses in health care and research: the role of critical thinking.

PubMed

Jenicek, Milos; Croskerry, Pat; Hitchcock, David L

2011-01-01

Obtaining and critically appraising evidence is clearly not enough to make better decisions in clinical care. The evidence should be linked to the clinician's expertise, the patient's individual circumstances (including values and preferences), and clinical context and settings. We propose critical thinking and decision-making as the tools for making that link. Critical thinking is also called for in medical research and medical writing, especially where pre-canned methodologies are not enough. It is also involved in our exchanges of ideas at floor rounds, grand rounds and case discussions; our communications with patients and lay stakeholders in health care; and our writing of research papers, grant applications and grant reviews. Critical thinking is a learned process which benefits from teaching and guided practice like any discipline in health sciences. Training in critical thinking should be a part or a pre-requisite of the medical curriculum.

Critical thinking as an educational outcome: an evaluation of current tools of measurement.

PubMed

Adams, M H; Whitlow, J F; Stover, L M; Johnson, K W

1996-01-01

Critical thinking, an outcome criterion of the National League for Nursing and the Council of Baccalaureate and Higher Degree Programs, is an abstract skill difficult to measure. The authors provide a comprehensive review of four instruments designed to measure critical thinking and summarize research in which the tools were used. Analysis of this information will empower nursing faculty members to select a critical-thinking instrument that is individualized to the needs of their respective nursing programs.

Empowering Critical Thinking Skills with Computerized Patient Simulators

ERIC Educational Resources Information Center

Farrar, Francisca Cisneros; Suggs, Leslie

2010-01-01

Students struggle with the mastery of critical thinking skills which are essential to their academic success. University faculty are challenged to create teaching strategies to help students build critical thinking skills. Nursing faculty at Austin Peay State University in Clarksville, Tennessee looked to research and technology for ways to…

Could simulated emergency procedures practised in a static environment improve the clinical performance of a Critical Care Air Support Team (CCAST)? A literature review.

PubMed

Lamb, Di

2007-02-01

The Royal Air Force Critical Care Air Support Teams (CCASTs) have a philosophy to undertake transfers of critically ill patients from anywhere in the world back to a UK medical facility in a stable or improved clinical condition. The training they receive is primarily taught by traditional didactic methods, with no standardisation of education between teams that are expected to deliver care to the same standard. Notwithstanding there being no current compromise to patient care during air transfer, it was important to consider the benefits of an alternative experiential teaching modality. Experiential learning utilised in the static environment could potentially improve the current CCAST training curriculum and, therefore, improve clinical performance during air transfer. In the absence of primary research evidence investigating beneficial teaching modalities for medical flight crews, a review of recent literature was undertaken to observe any potential relevance to the aeromedical specialty. This critical review examined recent quantitative research on various modalities of experiential learning and their influence on the critical thinking, higher cognitive and psychomotor skill acquisition by healthcare professionals in a static hospital environment. The main databases were interrogated using the following inclusion criteria: patient simulation, clinical competence, aeromedical, education, computer simulation, critical thinking and problem-based learning. The number of articles obtained was 13; these were coded on methodological strength to reduce the potential for inclusion bias. Nine studies were finally selected for review. Many small studies have been undertaken, primarily observing benefits of experiential learning to medical students and doctors. No studies show conclusively that simulated learning improves patient outcome, but the body of evidence suggests human patient simulators to be advantageous over other modalities because of their realistic recreation of critical events. They have proven to be at least as effective as traditional teaching by didactic methods. For CCASTs to have a standardised training curriculum, they should undertake real-time missions in a flight simulator, supported by a human patient simulator programmed to respond to the physiological changes associated with altitude. Real scenarios could then be practised, on demand, in a safe environment as an augmentation to the current training programme. Consequently, those acquired skills could then be carried out with improved proficiency during real missions with a concomitant potential for improvement in the standard of patient care.

Future-directed thinking in first-episode psychosis.

PubMed

Goodby, Emmeline; MacLeod, Andrew K

2016-06-01

This study employed the Future Thinking Task (MacLeod et al., 2005, Br. J. Clin. Psychol., 44, 495) to investigate whether future-directed thinking in first-episode psychosis is significantly different from that of matched controls, and to identify its correlates in this patient group. Cross-sectional, mixed-model, case-control design. Participants were 30 patients with first-episode psychosis and 27 matched controls. The Future Thinking Task was used to assess future-directed thinking in both groups. Anxiety and depression were also measured as well as self-report measures of hopelessness, suicide ideation and a measure of negative symptoms. Individuals with psychosis were impaired in future-directed thinking in both positive and negative domains, particularly with respect to the coming year. Increased self-reported hopelessness was associated with reduced positive future thinking and increased negative future thinking. Increased positive future thinking was also associated with reduced severity of negative symptoms, whilst negative future thinking was associated with suicide ideation. Individuals with first-episode psychosis show a reduction in positive future thinking in line with that seen in other clinical groups, but this is accompanied by an unexpected reduction in negative future thinking. The findings suggest a general disengagement with the future in this group that may affect recovery and functioning. Individuals with first-episode psychosis may benefit from interventions to help them engage with their future, in particular in the mid-range, up to 1 year. The Future Thinking Task may be a helpful addition to the assessment of suicide risk in those with first-episode psychosis. Decreased positive future thinking was associated with increased severity of negative symptoms, indicating a potential new treatment angle for this resistant aspect of psychosis. The cross-sectional design of this study does not allow for conclusions about the causal relationship between psychosis and future-directed thinking. This study investigated future-directed thinking in individuals with a range of psychotic illnesses employing a trans-diagnostic approach; therefore, conclusions cannot be drawn about the nature of future-directed thinking in individual psychotic disorders. © 2015 The British Psychological Society.

How shrinks think: decision making in psychiatry.

PubMed

Bhugra, Dinesh; Malliaris, Yanni; Gupta, Susham

2010-10-01

Psychiatrists use biopsychosocial models in identifying aetiological factors in assessing their patients and similar approaches in planning management. Models in decision making will be influenced by previous experience, training, age and gender, among other factors. Critical thinking and evidence base are both important components in the process of reaching clinical decisions. Expected outcome of treatment may be another factor. The way we think influences our decision making, clinical or otherwise. With patients expecting and taking larger roles in their own management, there needs to be a shift towards patient-centred care in decision making. Further exploration in how clinical decisions are made by psychiatrists is necessary. An understanding of the manner in which therapeutic alliances are formed between the clinician and the patient is necessary to understand decision making.

The Effectiveness of the Master Thinker Program in Developing Critical Thinking Skills of 11th Grade Students in Bahrain

ERIC Educational Resources Information Center

Alnabhan, Mousa; Alhamdan, Najat; Darwish, Ahmed

2014-01-01

The current study aimed at investigating the effect of the Master Thinker program on developing critical thinking skills of 11th grade students in Bahrain. Specifically, this research attempts to examine the hypothesis: Teaching the Master Thinker program will be significantly effective in developing critical thinking and its skills (inference,…

Exploring Saudi Pre-Service Teachers' Knowledge of Critical Thinking Skills and Their Teaching Perceptions

ERIC Educational Resources Information Center

Gashan, Amani K.

2015-01-01

The current study aimed to investigate Saudi pre-service teachers' knowledge about the general concepts of critical thinking, as well as its skills. In addition, the study explored their perceptions about critical thinking and its teaching in classrooms with an aim to develop learning and teaching process. The study was conducted with twenty-nine…

The Practice and Challenges of Implementing Critical Thinking Skills in Omani Post-Basic EFL Classrooms

ERIC Educational Resources Information Center

Al-Kindi, Naeema Saleh; AL-Mekhlafi, Abdo Mohammed

2017-01-01

The purpose of the current study is to investigate post-basic English teachers' practice of critical thinking skills and the challenges they face while teaching skills in EFL classrooms. Three research questions were investigated to achieve this purpose: 1--To what extent do EFL teachers use classroom behaviors that nurture critical thinking at…

Sabbatical Leave Report: Suggested Guidelines for Selecting or Creating Programs To Enhance Thinking and Reasoning Skills.

ERIC Educational Resources Information Center

Kemler, William

When designing a program to improve the critical thinking skills of students, it is important to identify the specific learning outcomes for which to strive. In addition, the instructor must determine why students are not currently exhibiting the kind of critical thinking skills desired in order to develop the appropriate techniques and methods to…

Critical thinking and accuracy of nurses' diagnoses.

PubMed

Lunney, Margaret

2003-01-01

Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.

The bench is closer to the bedside than we think: Uncovering the ethical ties between preclinical researchers in translational neuroscience and patients in clinical trials.

PubMed

Yarborough, Mark; Bredenoord, Annelien; D'Abramo, Flavio; Joyce, Nanette C; Kimmelman, Jonathan; Ogbogu, Ubaka; Sena, Emily; Strech, Daniel; Dirnagl, Ulrich

2018-06-01

Millions of people worldwide currently suffer from serious neurological diseases and injuries for which there are few, and often no, effective treatments. The paucity of effective interventions is, no doubt, due in large part to the complexity of the disorders, as well as our currently limited understanding of their pathophysiology. The bleak picture for patients, however, is also attributable to avoidable impediments stemming from quality concerns in preclinical research that often escape detection by research regulation efforts. In our essay, we connect the dots between these concerns about the quality of preclinical research and their potential ethical impact on the patients who volunteer for early trials of interventions informed by it. We do so in hopes that a greater appreciation among preclinical researchers of these serious ethical consequences can lead to a greater commitment within the research community to adopt widely available tools and measures that can help to improve the quality of research.

Promotion of Critical Thinking in Clinical Nursing Post Conferences: A Peer Interactive Approach

ERIC Educational Resources Information Center

Stevens, Joanne

2009-01-01

Several workshops presented at the 2005 Lilly Conference on College Teaching in Oxford, Ohio, provided the inspiration for redesigning the clinical post conference for a foundational nursing course. Given the complexity and acuity of patient conditions today, fostering critical thinking in student nurses is central to quality patient care. The…

Critical Thinking Skill Acquisition in Accelerated LVN to RN Nursing Programs: An Evaluative Case Study

ERIC Educational Resources Information Center

Hutchison, Billy Eugene

2013-01-01

Accelerated transitional nursing programs (ATNPs) designed specifically for licensed vocational nurses (LVNs) to transition to become registered nurses (RNs) are graduating novice nurses who need critical thinking skills to solve patient problems. The health care industry and patient outcomes depend on graduate nurses to be proficient with quality…

A design thinking framework for healthcare management and innovation.

PubMed

Roberts, Jess P; Fisher, Thomas R; Trowbridge, Matthew J; Bent, Christine

2016-03-01

The business community has learned the value of design thinking as a way to innovate in addressing people's needs--and health systems could benefit enormously from doing the same. This paper lays out how design thinking applies to healthcare challenges and how systems might utilize this proven and accessible problem-solving process. We show how design thinking can foster new approaches to complex and persistent healthcare problems through human-centered research, collective and diverse teamwork and rapid prototyping. We introduce the core elements of design thinking for a healthcare audience and show how it can supplement current healthcare management, innovation and practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Flexibility decline contributes to similarity of past and future thinking in Alzheimer's disease.

PubMed

El Haj, Mohamad; Antoine, Pascal; Kapogiannis, Dimitrios

2015-11-01

A striking similarity has been suggested between past and future thinking in Alzheimer's Disease (AD), a similarity attributable to abnormalities in common modular cognitive functions and neuroanatomical substrates. This study extends this literature by identifying specific executive function deficits underlying past and future thinking in AD. Twenty-four participants with a clinical diagnosis of probable (mild) AD and 26 older controls generated past and future events and underwent tests of binding and the executive functions of flexibility, inhibition, and updating. AD patients showed similar autobiographical performances in past and future event generation, and so did control participants. In each group, the similarity of past and future thinking was predicted by flexibility. Furthermore, AD patients with low flexibility showed higher similarity of past and future thinking than those with high flexibility. These findings are interpreted in terms of involvement of the hippocampus and frontal lobes in future thinking. Deficits in these brain regions in AD are likely to compromise the ability to recombine episodic information into novel and flexible configurations as scenarios for the future. © 2015 Wiley Periodicals, Inc.

Flexibility Decline Contributes to Similarity of Past and Future Thinking in Alzheimer’s Disease

PubMed Central

El Haj, Mohamad; Antoine, Pascal; Kapogiannis, Dimitrios

2017-01-01

A striking similarity has been suggested between past and future thinking in Alzheimer’s Disease (AD), a similarity attributable to abnormalities in common modular cognitive functions and neuroanatomical substrates. This study extends this literature by identifying specific executive function deficits underlying past and future thinking in AD. Twenty-four participants with a clinical diagnosis of probable (mild) AD and 26 older controls generated past and future events and underwent tests of binding and the executive functions of flexibility, inhibition, and updating. AD patients showed similar autobiographical performances in past and future event generation, and so did control participants. In each group, the similarity of past and future thinking was predicted by flexibility. Furthermore, AD patients with low flexibility showed higher similarity of past and future thinking than those with high flexibility. These findings are interpreted in terms of involvement of the hippocampus and frontal lobes in future thinking. Deficits in these brain regions in AD are likely to compromise the ability to recombine episodic information into novel and flexible configurations as scenarios for the future. PMID:25850800

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2018-03-01

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.

Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS)

PubMed Central

Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

2016-01-01

Objectives To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Design Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. Setting North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Participants Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. Interventions NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Main outcome measures Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. Results NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014–7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. Conclusions NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a structured framework to evaluate and redesign the service with the aim to improve effectiveness and efficiency. PMID:27566629

Revisiting the Relationship between Individual Differences in Analytic Thinking and Religious Belief: Evidence That Measurement Order Moderates Their Inverse Correlation.

PubMed

Finley, Anna J; Tang, David; Schmeichel, Brandon J

2015-01-01

Prior research has found that persons who favor more analytic modes of thought are less religious. We propose that individual differences in analytic thought are associated with reduced religious beliefs particularly when analytic thought is measured (hence, primed) first. The current study provides a direct replication of prior evidence that individual differences in analytic thinking are negatively related to religious beliefs when analytic thought is measured before religious beliefs. When religious belief is measured before analytic thinking, however, the negative relationship is reduced to non-significance, suggesting that the link between analytic thought and religious belief is more tenuous than previously reported. The current study suggests that whereas inducing analytic processing may reduce religious belief, more analytic thinkers are not necessarily less religious. The potential for measurement order to inflate the inverse correlation between analytic thinking and religious beliefs deserves additional consideration.

Revisiting the Relationship between Individual Differences in Analytic Thinking and Religious Belief: Evidence That Measurement Order Moderates Their Inverse Correlation

PubMed Central

Finley, Anna J.; Tang, David; Schmeichel, Brandon J.

2015-01-01

Prior research has found that persons who favor more analytic modes of thought are less religious. We propose that individual differences in analytic thought are associated with reduced religious beliefs particularly when analytic thought is measured (hence, primed) first. The current study provides a direct replication of prior evidence that individual differences in analytic thinking are negatively related to religious beliefs when analytic thought is measured before religious beliefs. When religious belief is measured before analytic thinking, however, the negative relationship is reduced to non-significance, suggesting that the link between analytic thought and religious belief is more tenuous than previously reported. The current study suggests that whereas inducing analytic processing may reduce religious belief, more analytic thinkers are not necessarily less religious. The potential for measurement order to inflate the inverse correlation between analytic thinking and religious beliefs deserves additional consideration. PMID:26402334

Urine trouble: should we think differently about UTI?

PubMed

Price, Travis K; Hilt, Evann E; Dune, Tanaka J; Mueller, Elizabeth R; Wolfe, Alan J; Brubaker, Linda

2018-02-01

Urinary tract infection (UTI) is clinically important, given that it is one of the most common bacterial infections in adult women. However, the current understanding of UTI remains based on a now disproven concept that the urinary bladder is sterile. Thus, current standards for UTI diagnosis have significant limitations that may reduce the opportunity to improve patient care. Using data from our work and numerous other peer-reviewed studies, we identified four major limitations to the contemporary UTI description: the language of UTI, UTI diagnostic testing, the Escherichia coli-centric view of UTI, and the colony-forming units (CFU) threshold-based diagnosis. Contemporary methods and technology, combined with continued rigorous clinical research can be used to correct these limitations.

Enhancing critical thinking with case studies and nursing process.

PubMed

Neill, K M; Lachat, M F; Taylor-Panek, S

1997-01-01

Challenged to enhance critical thinking concepts in a sophomore nursing process course, faculty expanded the lecture format to include group explorations of patient case studies. The group format facilitated a higher level of analysis of patient cases and more sophisticated applications of nursing process. This teaching strategy was a positive learning experience for students and faculty.

Critical Thinking Skills of Nursing Students in Lecture-Based Teaching and Case-Based Learning

ERIC Educational Resources Information Center

Kaddoura, Mahmoud A.

2011-01-01

In today's technologically advanced healthcare world, nursing students should be active learners and think critically to provide safe patient care. A strategy that promotes students' active learning is case-based learning (CBL). The purpose of this study was to examine critical thinking (CT) abilities of nursing students from two different…

Relationships between Concept Mapping and Critical Thinking Skills of Vocational Nursing Students

ERIC Educational Resources Information Center

Carson-Davis, Shirley

2012-01-01

The task of developing vocational nursing students' critical thinking abilities is one of the greatest challenges facing nurse educators today. Licensed vocational nurses (LVNs) must be trained to think critically in order to provide safe patient care. Due to the expanded role and functions in the LVN's scope of practice, LVNs are making more…

Considering the role of semantic memory in episodic future thinking: evidence from semantic dementia.

PubMed

Irish, Muireann; Addis, Donna Rose; Hodges, John R; Piguet, Olivier

2012-07-01

Semantic dementia is a progressive neurodegenerative condition characterized by the profound and amodal loss of semantic memory in the context of relatively preserved episodic memory. In contrast, patients with Alzheimer's disease typically display impairments in episodic memory, but with semantic deficits of a much lesser magnitude than in semantic dementia. Our understanding of episodic memory retrieval in these cohorts has greatly increased over the last decade, however, we know relatively little regarding the ability of these patients to imagine and describe possible future events, and whether episodic future thinking is mediated by divergent neural substrates contingent on dementia subtype. Here, we explored episodic future thinking in patients with semantic dementia (n=11) and Alzheimer's disease (n=11), in comparison with healthy control participants (n=10). Participants completed a battery of tests designed to probe episodic and semantic thinking across past and future conditions, as well as standardized tests of episodic and semantic memory. Further, all participants underwent magnetic resonance imaging. Despite their relatively intact episodic retrieval for recent past events, the semantic dementia cohort showed significant impairments for episodic future thinking. In contrast, the group with Alzheimer's disease showed parallel deficits across past and future episodic conditions. Voxel-based morphometry analyses confirmed that atrophy in the left inferior temporal gyrus and bilateral temporal poles, regions strongly implicated in semantic memory, correlated significantly with deficits in episodic future thinking in semantic dementia. Conversely, episodic future thinking performance in Alzheimer's disease correlated with atrophy in regions associated with episodic memory, namely the posterior cingulate, parahippocampal gyrus and frontal pole. These distinct neuroanatomical substrates contingent on dementia group were further qualified by correlational analyses that confirmed the relation between semantic memory deficits and episodic future thinking in semantic dementia, in contrast with the role of episodic memory deficits and episodic future thinking in Alzheimer's disease. Our findings demonstrate that semantic knowledge is critical for the construction of novel future events, providing the necessary scaffolding into which episodic details can be integrated. Further research is necessary to elucidate the precise contribution of semantic memory to future thinking, and to explore how deficits in self-projection manifest on behavioural and social levels in different dementia subtypes.

Analysis of critical thinking ability in direct current electrical problems solving

NASA Astrophysics Data System (ADS)

Hartono; Sunarno, Widha; Sarwanto; Arya Nugraha, Dewanta

2017-11-01

This study concern on analyzing the ability of students in critical thinking skills on the subject matter of direct current electricity. Samples were taken using purposive random sampling consisted of 32 students of grade XI, Multimedia 1, SMK Negeri 3 Surakarta in academic year 2016/2017. This study used descriptive quantitative method. The data were collected using tests and interviews regarding the subject matter of direct current electricity. Based on the results, students are getting some difficulties in solving problem in indicator 4. The average of students’ correct answer is 62.8%.

Resuscitation decisions in the elderly: a discussion of current thinking.

PubMed

Bruce-Jones, P N

1996-10-01

Decisions about cardiopulmonary resuscitation may be based on medical prognosis, quality of life and patients' choices. Low survival rates indicate its overuse. Although the concept of medical futility has limitations, several strong predictors of non-survival have been identified and prognostic indices developed. Early results indicate that consideration of resuscitation in the elderly should be very selective, and support "opt-in" policies. In this minority of patients, quality of life is the principal issue. This is subjective and best assessed by the individual in question. Patients' attitudes cannot be predicted reliably and surrogate decision-making is inadequate. Lay knowledge is poor. However, patients can use prognostic information to make rational choices. The majority welcome discussion of resuscitation and prefer this to be initiated by their doctors; many wish to decide for themselves. There is little evidence that this causes distress. The views of such patients, if competent, should be sought actively.

Managing Multiplicity: Conceptualizing Physician Cognition in Multipatient Environments.

PubMed

Chan, Teresa M; Mercuri, Mathew; Van Dewark, Kenneth; Sherbino, Jonathan; Schwartz, Alan; Norman, Geoff; Lineberry, Matthew

2018-05-01

Emergency physicians (EPs) regularly manage multiple patients simultaneously, often making time-sensitive decisions around priorities for multiple patients. Few studies have explored physician cognition in multipatient scenarios. The authors sought to develop a conceptual framework to describe how EPs think in busy, multipatient environments. From July 2014 to May 2015, a qualitative study was conducted at McMaster University, using a think-aloud protocol to examine how 10 attending EPs and 10 junior residents made decisions in multipatient environments. Participants engaged in the think-aloud exercise for five different simulated multipatient scenarios. Transcripts from recorded interviews were analyzed inductively, with an iterative process involving two independent coders, and compared between attendings and residents. The attending EPs and junior residents used similar processes to prioritize patients in these multipatient scenarios. The think-aloud processes demonstrated a similar process used by almost all participants. The cognitive task of patient prioritization consisted of three components: a brief overview of the entire cohort of patients to determine a general strategy; an individual chart review, whereby the participant created a functional patient story from information available in a file (i.e., vitals, brief clinical history); and creation of a relative priority list. Compared with residents, the attendings were better able to construct deeper and more complex patient stories. The authors propose a conceptual framework for how EPs prioritize care for multiple patients in complex environments. This study may be useful to teachers who train physicians to function more efficiently in busy clinical environments.

Reflections on Measuring Thinking, while Listening to Mozart's "Jupiter" Symphony.

ERIC Educational Resources Information Center

Wasserman, Selma

1989-01-01

Reflects on educators' current preoccupation with assessment of higher order thinking skills. Easy-to-mark, forced-choice, pencil-and-paper tests with single numerical scores may trivialize the wonderful complexity of human capabilities. Includes 17 references. (MLH)

Critical thinking in health professions education: summary and consensus statements of the Millennium Conference 2011.

PubMed

Huang, Grace C; Newman, Lori R; Schwartzstein, Richard M

2014-01-01

Critical thinking is central to the function of health care professionals. However, this topic is not explicitly taught or assessed within current programs, yet the need is greater than ever, in an era of information explosion, spiraling health care costs, and increased understanding about metacognition. To address the importance of teaching critical thinking in health professions education, the Shapiro Institute for Education and Research and the Josiah Macy Jr. Foundation jointly sponsored the Millennium Conference 2011 on Critical Thinking. Teams of physician and nurse educators were selected through an application process. Attendees proposed strategies for integrating principles of critical thinking more explicitly into health professions curricula. Working in interprofessional, multi-institutional groups, participants tackled questions about teaching, assessment, and faculty development. Deliberations were summarized into consensus statements. Educational leaders participated in a structured dialogue about the enhancement of critical thinking in health professions education and recommend strategies to teach critical thinking.

Exploring parenting as a predictor of criminogenic thinking in college students.

PubMed

Gonzalez, Rose; Mandracchia, Jon T; Nicholson, Bonnie; Dahlen, Eric

2014-09-01

Crime-promoting cognitions and attitudes, globally labeled as criminogenic thinking, are shown to perpetuate maladaptive and antisocial behavior in criminals and nonoffenders. In the nonoffender population, these thinking patterns may not lead to illegal behavior, but can result in irresponsible or maladaptive behavioral consequences. Theories suggest that early childhood parent-child interactions may be partly responsible for the development of criminogenic thinking. While the relationship between parenting and antisocial behavior is well documented, the connection between parenting and the development of criminogenic thinking styles has not yet been explored. The current study examined the nature of the relationship between exposure to parenting behaviors and subsequent criminogenic thoughts in a nonoffender, college population. The sample included 119 undergraduates. Results indicate that parenting may affect general criminogenic thinking as well as specific types of criminogenic thinking styles. Relevance and importance of the findings with regard to clinical work and parenting are also discussed. © The Author(s) 2013.

Integrating Systems Thinking Into Nursing Education.

PubMed

Phillips, Janet M; Stalter, Ann M

2016-09-01

A critical need exists for nursing leadership in current complex health care settings. Systems thinking can be incorporated into nursing education at all levels by using evidence-based principles in education. Teaching tips are provided using a systems awareness model to guide nurse educators in the assessment and integration of systems thinking and engaging learners in interprofessional education and practice. J Contin Educ Nurs. 2016;47(9):395-397. Copyright 2016, SLACK Incorporated.

A descriptive inquiry of the definitions of critical thinking and enhancers and barriers reported by nurses working in long-term care facilities.

PubMed

Raterink, Ginger

2008-09-01

Critical thinking has been an outcome of nursing education since the 1980s. There remains a lack of agreement on definitions, methods of teaching, and methods of evaluation among practicing nurses. This study asked practicing nurses to define critical thinking. It also asked nurses to describe what work-related factors enhanced or posed barriers to the use of critical thinking in practice. Elements of the definitions presented were found to be consistent with current nursing definitions of critical thinking. Enhancers and barriers overlapped and were found to be consistent among the nurses at all facilities studied, with implications for continuing education and staff development.

Profile of Students’ Critical Thinking Skill Measured by Science Virtual Test on Living Things and Environmental Sustainability Theme

NASA Astrophysics Data System (ADS)

Maulida, N. I.; Firman, H.; Rusyati, L.

2017-02-01

The aims of this study are: (1) to investigate the level of students’ critical thinking skill on living things and environmental sustainability theme for each Inch’ critical thinking elements and overall, (2) to investigate the level of students’ critical thinking skill on living things characteristic, biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics. The research was conducted due to the important of critical thinking measurement to get the current skill description as the basic consideration for further critical thinking skill improvement in lower secondary science. The research method used was descriptive. 331 seventh grade students taken from five lower secondary schools in Cirebon were tested to get the critical thinking skill data by using Science Virtual Test as the instrument. Generally, the mean scores on eight Inch’ critical thinking elements and overall score from descriptive statistic reveals a moderate attainments level. Students’ critical thinking skill on biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics are in moderate level. While students’ critical thinking skill on living things characteristic is identified as high level. Students’ experience in thinking critically during science learning process and the characteristic of the topic are emerged as the reason behind the students’ critical thinking skill level on certain science topic.

Teaching for Thinking.

ERIC Educational Resources Information Center

Keefe, James W., Ed.; Walberg, Herbert J., Ed.

This volume represents a variety of current efforts to incorporate thought-provoking methods into teaching. There are three sections. "Curriculum Developments" defines key curricular terms and offers a framework and general examples of teaching tactics. In this section, Barbara Presseisen distinguishes thinking from other cognitive…

Poor creativity in frontotemporal dementia: a window into the neural bases of the creative mind.

PubMed

de Souza, Leonardo Cruz; Volle, Emmanuelle; Bertoux, Maxime; Czernecki, Virginie; Funkiewiez, Aurélie; Allali, Gilles; Leroy, Baptiste; Sarazin, Marie; Habert, Marie-Odile; Dubois, Bruno; Kas, Aurélie; Levy, Richard

2010-11-01

The prefrontal cortex (PFC) supports functions critical for creative thinking. Damage to the PFC is expected to impair creativity. Yet, previous works suggested the emergence of artistic talent in patients with frontotemporal lobar degeneration (FTLD), which was interpreted as increased creativity. We designed a study in patients with frontal variant (fv) of FTLD in order to verify whether: (1) creativity is impaired after frontal degeneration, (2) poor creativity is associated with frontal dysfunctions, and (3) poor creativity is related to hypoperfusion in specific PFC regions. Three groups of subjects were enrolled in the study: fvFTLD patients (n=17), non-demented Parkinson's disease (PD) patients (n=12) and healthy controls (n=17). Participants performed a standardized test of creativity, the Torrance Test of Creative Thinking (TTCT) and tests assessing frontal functions. Brain perfusion was correlated to fvFTLD patients' performance in the TTCT. Patients with fvFTLD were strongly impaired in all dimensions of the TTCT, compared to PD patients and controls. Disinhibited and perseverative responses were observed only in fvFTLD patients, leading to "pseudo-creative" responses. Poor creativity was positively correlated with several frontal tests. Poor creativity was also correlated with prefrontal hypoperfusion, particularly in the frontal pole. Poor creativity is associated with fvFTLD. The results also suggest that the integrity of the PFC (in particular frontopolar) is strongly associated with creative thinking. The emergence of artistic talent in patients with fvFTLD is explained by the release of involuntary behaviors, rather than by the development of creative thinking. Copyright © 2010 Elsevier Ltd. All rights reserved.

Providing health care to human beings trapped in the poverty culture.

PubMed

Benson, D S

2000-01-01

The culture of poverty impacts everything patients in this socioeconomic group think and do. If what poor patients say does not sit well with the way we think, that doesn't mean they are wrong. Physicians have to adjust their mental model and think in different cultural terms. The author recently completed his thirtieth year of a career dedicated to providing health care to people living in poverty. He shares seven concepts important in building a mental model that will enable physicians to successfully provide health care to this patient population: (1) Poverty is the number one health problem; (2) we see same diseases as everyone else; (3) patients are trapped in the poverty culture; (4) patients' behavior is often manipulative; (5) compliance is a unique challenge; (6) patients have limited resources; and (7) the ultimate contributors to poverty are unwanted adolescent pregnancy and substance abuse. These concepts can help physicians to be more effective in providing health care to patients living in poverty. They can help them understand what is happening, so that their experience might be fulfilling rather than demoralizing.

Enabling social listening for cardiac safety monitoring: Proceedings from a drug information association-cardiac safety research consortium cosponsored think tank.

PubMed

Seifert, Harry A; Malik, Raleigh E; Bhattacharya, Mondira; Campbell, Kevin R; Okun, Sally; Pierce, Carrie; Terkowitz, Jeffrey; Turner, J Rick; Krucoff, Mitchell W; Powell, Gregory E

2017-12-01

This white paper provides a summary of the presentations and discussions from a think tank on "Enabling Social Listening for Cardiac Safety Monitoring" trials that was cosponsored by the Drug Information Association and the Cardiac Safety Research Consortium, and held at the White Oak headquarters of the US Food and Drug Administration on June 3, 2016. The meeting's goals were to explore current methods of collecting and evaluating social listening data and to consider their applicability to cardiac safety surveillance. Social listening is defined as the act of monitoring public postings on the Internet. It has several theoretical advantages for drug and device safety. First, these include the ability to detect adverse events that are "missed" by traditional sources and the ability to detect adverse events sooner than would be allowed by traditional sources, both by affording near-real-time access to data from culturally and geographically diverse sources. Social listening can also potentially introduce a novel patient voice into the conversation about drug safety, which could uniquely augment understanding of real-world medication use obtained from more traditional methodologies. Finally, it can allow for access to information about drug misuse and diversion. To date, the latter 2 of these have been realized. Although regulators from the Food and Drug Administration and the United Kingdom's Medicines and Healthcare Products Regulatory Agency participated in the think tank along with representatives from industry, academia, and patient groups, this article should not be construed to constitute regulatory guidance. Copyright © 2017 Elsevier Inc. All rights reserved.

Environmental factors associated with asthma.

PubMed Central

Walker, Bailus; Stokes, Lynette D.; Warren, Rueben

2003-01-01

Asthma, a disease of attacks and remission, continues to account for substantial morbidity and direct economic costs. Numerous studies--epidemiologic, toxicologic and clinical--present evidence for a broad spectrum of environmental risk factors associated with asthma. This review summarizes current thinking on a subset of these factors. Knowledge of potential environmental determinants of asthma is important to both the patient and healthcare professional in the application of multiple modalities of medical and environmental intervention for management of the development, and exacerbation of this chronic inflammatory disorder of the airways. PMID:12760611

Critical thinking of nurse managers related to staff RNs' perceptions of the practice environment.

PubMed

Zori, Susan; Nosek, Laura J; Musil, Carol M

2010-09-01

BACKGROUND INFORMATION AND SIGNIFICANCE: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Significant (p < .001) differences were found between specific nurse managers' CCTDI scores for open-mindedness, analyticity, and critical thinking confidence, and significant differences (p < .01) were found for systematicity when compared with their respective staff RNs' mean subscale and overall PES scores. Results of the study support the positive relationship between strength in critical thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care.

Modelling difficulties in abstract thinking in psychosis: the importance of socio-developmental background.

PubMed

Berg, A O; Melle, I; Zuber, V; Simonsen, C; Nerhus, M; Ueland, T; Andreassen, O A; Sundet, K; Vaskinn, A

2017-01-01

Abstract thinking is important in modern understanding of neurocognitive abilities, and a symptom of thought disorder in psychosis. In patients with psychosis, we assessed if socio-developmental background influences abstract thinking, and the association with executive functioning and clinical psychosis symptoms. Participants (n = 174) had a diagnosis of psychotic or bipolar disorder, were 17-65 years, intelligence quotient (IQ) > 70, fluent in a Scandinavian language, and their full primary education in Norway. Immigrants (N = 58) were matched (1:2) with participants without a history of migration (N = 116). All participants completed a neurocognitive and clinical assessment. Socio-developmental background was operationalised as human developmental index (HDI) of country of birth, at year of birth. Structural equation modelling was used to assess the model with best fit. The model with best fit, χ 2  = 96.591, df = 33, p < .001, confirmed a significant indirect effect of HDI scores on abstract thinking through executive functioning, but not through clinical psychosis symptoms. This study found that socio-developmental background influences abstract thinking in psychosis by indirect effect through executive functioning. We should take into account socio-developmental background in the interpretation of neurocognitive performance in patients with psychosis, and prioritise cognitive remediation in treatment of immigrant patients.

Think of HIT.

PubMed

Warkentin, Theodore E

2006-01-01

Heparin-induced thrombocytopenia, or HIT, can present in many ways, ranging from common-isolated thrombocytopenia, venous thromboembolism, acute limb ischemia-to less common but specific presentations-necrotizing skin lesions at heparin injection sites, post-bolus acute systemic reactions, and adrenal hemorrhagic necrosis (secondary to adrenal vein thrombosis). Many patients with HIT have mild or moderate thrombocytopenia: the median platelet count nadir is 60 x 10(9)/L, and ranges from 15 to 150 x 10(9)/L in 90% of patients, most of whom evince a 50% or greater fall in the platelet count. HIT that begins after stopping heparin ("delayed-onset HIT") is increasingly recognized. Factors influencing risk of HIT include type of heparin (unfractionated heparin > low-molecular-weight heparin), type of patient (surgical > medical), and gender (female > male). Since timely diagnosis and treatment of HIT may reduce the risk of adverse outcomes, this review focuses on those clinical circumstances that should prompt the clinician to "think of HIT." Coumarin anticoagulants such as warfarin are ineffective in acute HIT and can even be deleterious by predisposing to micro-thrombosis via protein C depletion (venous limb gangrene and skin necrosis syndromes). Thus, it is important to avoid or postpone coumarin while managing HIT hypercoagulability, focusing on agents that inhibit thrombin directly (lepirudin, argatroban) or that inhibit its generation (danaparoid, fondaparinux). Post-marketing experience suggests that standard dosing of lepirudin is too high; current recommendations are to avoid the initial lepirudin bolus and to begin with lower infusion rates, even in patients without overt renal dysfunction.

Counterfactual Thinking Deficit in Huntington’s Disease

PubMed Central

Solca, Federica; Poletti, Barbara; Zago, Stefano; Crespi, Chiara; Sassone, Francesca; Lafronza, Annalisa; Maraschi, Anna Maria; Sassone, Jenny; Silani, Vincenzo; Ciammola, Andrea

2015-01-01

Background and Objective Counterfactual thinking (CFT) refers to the generation of mental simulations of alternatives to past events, actions and outcomes. CFT is a pervasive cognitive feature in every-day life and is closely related to decision-making, planning and problem-solving – all of which are cognitive processes linked to unimpaired frontal lobe functioning. Huntington’s Disease (HD) is a neurodegenerative disorder characterised by motor, behavioral and cognitive dysfunctions. Because an impairment in frontal and executive functions has been described in HD, we hypothesised that HD patients may have a CFT impairment. Methods Tests of spontaneous counterfactual thoughts and counterfactual-derived inferences were administered to 24 symptomatic HD patients and 24 age- and sex-matched healthy subjects. Results Our results show a significant impairment in the spontaneous generation of CFT and low performance on the Counterfactual Inference Test (CIT) in HD patients. Low performance on the spontaneous CFT test significantly correlates with impaired attention abilities, verbal fluency and frontal lobe efficiency, as measured by Trail Making Test – Part A, Phonemic Verbal Fluency Test and FAB. Conclusions Spontaneous CFT and the use of this type of reasoning are impaired in HD patients. This deficit may be related to frontal lobe dysfunction, which is a hallmark of HD. Because CFT has a pervasive role in patients’ daily lives regarding their planning, decision making and problem solving skills, cognitive rehabilitation may improve HD patients’ ability to analyse current behaviors and future actions. PMID:26070155

Using Learning Trajectories to Enhance Formative Assessment

ERIC Educational Resources Information Center

Ebby, Caroline B.; Petit, Marjorie

2017-01-01

A learning trajectory describes the progression of student thinking and strategies over time in terms of sophistication of both conceptual understanding and procedural fluency. Currently, learning trajectories exist in the research literature for many mathematical domains, including counting, addition and subtraction, multiplicative thinking,…

Thinking in nursing education. Part II. A teacher's experience.

PubMed

Ironside, P M

1999-01-01

Across academia, educators are investigating teaching strategies that facilitate students' abilities to think critically. Because may these strategies require low teacher-student ratios or sustained involvement over time, efforts to implement them are often constrained by diminishing resources for education, faculty reductions, and increasing number of part-time teachers and students. In nursing, the challenges of teaching and learning critical thinking are compounded by the demands of providing care to patients with increasingly acute and complex problems in a wide variety of settings. To meet these challenges, nurse teachers have commonly used a variety of strategies to teach critical thinking (1). For instance, they often provide students with case studies or simulated clinical situations in classroom and laboratory settings (2). At other times, students are taught a process of critical thinking and given structured clinical assignments, such as care plans or care maps, where they apply this process in anticipating the care a particular patient will require. Accompanying students onto clinical units, teachers typically evaluate critical thinking ability by reviewing a student's preparation prior to the experience and discussing it with the student during the course of the experience. The rationales students provide for particular nursing interventions are taken as evidence of their critical thinking ability. While this approach is commonly thought to be effective, the evolving health care system has placed increased emphasis on community nursing (3,4), where it is often difficult to prespecify learning experiences or to anticipate patient care needs. In addition, teachers are often not able to accompany each student to the clinical site. Thus, the traditional strategies for teaching and learning critical thinking common to hospital-based clinical courses are being challenged, transformed, and extended (5). Part II of this article describes findings that suggest how many teachers and students are challenging the conventional approaches to schooling and creating pedagogies that are more responsive to the contemporary context of health care.

Fundamentals and clinical perspective of urethral sphincter instability as a contributing factor in patients with lower urinary tract dysfunction--ICI-RS 2014.

PubMed

Kirschner-Hermanns, Ruth; Anding, Ralf; Rosier, Peter; Birder, Lori; Andersson, Karl Erik; Djurhuus, Jens Christian

2016-02-01

Urethral pathophysiology is often neglected in discussions of bladder dysfunction. It has been debated whether "urethral sphincter instability," referred to based on observed "urethral pressure variations," is an important aspect of overactive bladder syndrome (OAB). The purpose of this report is to summarize current urethral pathophysiology evidence and outline directions for future research based on a literature review and discussions during the ICI-RS meeting in Bristol in 2014. Urethral pathophysiology with a focus on urethral pressure variation (UPV) was presented and discussed in a multidisciplinary think tank session at the ICI_R meeting in Bristol 2014. This think tank session was based on collaboration between physicians and basic science researchers. Experimental animal studies or studies performed in clinical series (predominantly symptomatic women) provided insights into UPV, but the findings were inconsistent and incomplete. However, UPV is certainly associated with lower urinary tract symptoms (likely OAB), and thus, future research on this topic is relevant. Future research based on adequately defined clinical (and urodynamic) parameters with precisely defined patient groups might shed better light on the cause of OAB symptoms. Further fundamental investigation of urethral epithelial-neural interactions via the release of mediators should enhance our knowledge and improve the management of patients with OAB. © 2016 The Authors. Neurourology and Urodynamics published by Wiley Periodicals, Inc.

Effectiveness of teaching strategies to improve critical thinking in nurses in clinical practice: a systematic review protocol.

PubMed

da Costa Carbogim, Fábio; de Oliveira, Larissa Bertacchini; de Campos, Guilherme Gushiken; de Araújo Nunes, Esther Alves; Alves, Katiusse Rezende; de Araújo Püschel, Vilanice Alves

2017-06-01

The aim of this review is to identify and synthesize the best available evidence on the effectiveness of teaching strategies aimed at improving critical thinking (CT) in registered nurses who provide direct patient care. Specifically, the research question is: What are the best teaching strategies to improve CT skills in registered nurses who provide direct patient care?

Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS).

PubMed

Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

2016-08-26

To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014-7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a structured framework to evaluate and redesign the service with the aim to improve effectiveness and efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Implementation and evaluation of critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses.

PubMed

Simpson, Elaine; Courtney, Mary

2008-12-01

The purpose of this study was to develop, implement and evaluate critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses. Critical thinking strategies such as questioning, debate, role play and small group activity were developed and used in a professional development programme, which was trialled on a sample of Middle Eastern nurses (n = 20), to promote critical thinking skills, encourage problem solving, development of clinical judgment making and care prioritization in order to improve patient care and outcomes. Classroom learning was transformed from memorization to interaction and active participation. The intervention programme was successful in developing critical thinking skills in both the nurse educators and student nurses in this programme. This programme successfully integrated critical thinking strategies into a Middle Eastern nursing curriculum. Recommendations are as follows: (1) utilize evidence-based practice and stem questions to encourage the formulation of critical thinking questions; (2) support the needs of nurse educators for them to effectively implement teaching strategies to foster critical thinking skills; and (3) adopt creative approaches to (i) transform students into interactive participants and (ii) open students' minds and stimulate higher-level thinking and problem-solving abilities.

Visual-spatial thinking: An aspect of science overlooked by educators

NASA Astrophysics Data System (ADS)

Mathewson, James H.

1999-01-01

Thinking with images plays a central role in scientific creativity and communication but is neglected in science classrooms. This article reviews the fundamental role of imagery in science and technology and our current knowledge of visual-spatial cognition. A novel analogic and thematic organization of images and visualization within science and technology is proposed that can help in the generation and evaluation of classroom activities and materials, and serve as a focus for professional development programs in visual-spatial thinking for science teachers. Visual-spatial thinking includes vision - using the eyes to identify, locate, and think about objects and ourselves in the world, and imagery - the formation, inspection, transformation, and maintenance of images in the mind's eye in the absence of a visual stimulus. A spatial image preserves relationships among a complex set of ideas as a single chunk in working memory, increasing the amount of information that can be maintained in consciousness at a given moment. Vision and imagery are fundamental cognitive processes using specialized pathways in the brain and rely on our memory of prior experience. Visual-spatial thinking develops from birth, together with language and other specialized abilities, through interactions between inherited capabilities and experience. Scientific creativity can be considered as an amalgam of three closely allied mental formats: images; metaphors; and unifying ideas (themes). Combinations of images, analogies, and themes pervade science in the form of master images and visualization techniques. A critique of current practice in education contrasts the subservient role of visual-spatial learning with the dominance of the alphanumeric encoding skills in classroom and textbooks. The lack of coherence in curriculum, pedagogy, and learning theory requires reform that addresses thinking skills, including imagery. Successful integration of information, skills and attitudes into cohesive mental schemata employed by self-aware human beings is a basic goal of education. The current attempt to impose integration using themes is criticized on the grounds that the required underpinning in cognitive skills and content knowledge by teachers and students may be absent. Teaching strategies that employ visual-spatial thinking are reviewed. Master images are recommended as a novel point of departure for a systematic development of programs on visual-spatial thinking in research, teacher education, curriculum, and classroom practice.

Cultural Myopia: A Challenge to Spanish Education.

ERIC Educational Resources Information Center

Cowan, Bryan J.; Perez-Dominguez, Servando

1996-01-01

Considers current thinking about intercultural attitudes in Spain to demonstrate reasons why the Spanish approach to interculturalism, particularly in schools, has not been at the forefront of societal, governmental, or educational thinking. Discusses the dangers of ignoring immigrants' needs and abilities within the community and the…

Contrast media controversies in 2015: imaging patients with renal impairment or risk of contrast reaction.

PubMed

Davenport, Matthew S; Cohan, Richard H; Ellis, James H

2015-06-01

The incidence and significance of complications related to intravascular contrast material administration have become increasingly controversial. This review will highlight current thinking regarding the imaging of patients with renal impairment and those at risk for an allergiclike contrast reaction. The risk of contrast-induced acute kidney injury remains uncertain for patients with an estimated glomerular filtration rate (GFR) less than 45 mL/min/1.73 m(2), but if there is a risk, it is greatest in those with estimated GFR less than 30 mL/min/1.73 m(2). In this population, low-risk gadolinium-based contrast agents appear to have a large safety margin. Corticosteroid prophylaxis remains the standard of care in the United States for patients identified to be at high risk of a contrast reaction, but it has an incomplete mitigating effect on contrast reaction rates and the number needed to treat is large.

Factors of complicated grief pre-death in caregivers of cancer patients

PubMed Central

Tomarken, Alexis; Holland, Jimmie; Schachter, Sherry; Vanderwerker, Lauren; Zuckerman, Enid; Nelson, Christian; Coups, Elliot; Ramirez, Paul Michael; Prigerson, Holly

2008-01-01

Purpose Over the past decade, Prigerson and her colleagues have shown that symptoms of ‘complicated grief’—intense yearning, difficulty accepting the death, excessive bitterness, numbness, emptiness, and feeling uneasy moving on and that the future is bleak—are distinct from depression and anxiety and are independently associated with substantial morbidity. Little is known about complicated grief experienced by family caregivers prior to the death. This study sought to examine differences in caregiver age groups and potential risk factors for complicated grief pre-death. Method Two hundred and forty eight caregivers from multiple sites nationwide (20–86 years of age) identified themselves as primary caregivers to a terminally ill cancer patient. Each caregiver was interviewed using the following measures: the Pre-Death Inventory of Complicated Grief-Caregiver Version; the Brief Interpersonal Support Evaluation List; the Structured Clinical Interview for the DSM-IV Axis I; the Life Orientation Test-Revised; the SEPRATE Measure of Stressful Life Events; the Covinsky Family Impact Survey; and mental health access questions. Results The study found that those under 60 years old had higher levels of complicated grief pre-death than caregivers 60 and older (t(246) = 2.30, p<0.05). Significant correlations were also found between levels of complicated grief pre-loss and the following psychosocial factors: perceived social support (r = −0.415, p<0.001); history of depression (r = −0.169, p<0.05); current depression (r = −0.158, p<0.05); current annual income (Spearman rho = −0.210, p<0.01); annual income at time of patient's diagnosis (Spearman rho = −0.155, p = 0.05); pessimistic thinking (r = 0.320; p<0.001); and number of moderate to severe stressful life events (Spearman rho = 0.218, p = 0.001). In a multi-variate analysis (R2 = 0.368), pessimistic thinking (Beta = 0.208, p<0.05) and severity of stressful life events (Beta = 0.222, p<0.05) remained as important factors to developing complicated grief pre-death. Conclusions These results suggest that mental health professionals who work with caregivers should pay particular attention to pessimistic thinking and stressful life events, beyond the stress of the loved one's illness, that caretakers experience. Additionally, although not reaching significance, mental health professionals should also consider younger caregivers at greater risk for complicated grief pre-loss. PMID:17443644

Regulatory perspectives on acceptability testing of dosage forms in children.

PubMed

Kozarewicz, Piotr

2014-08-05

Current knowledge about the age-appropriateness of different dosage forms is still fragmented or limited. Applicants are asked to demonstrate that the target age group(s) can manage the dosage form or propose an alternative strategy. However, questions remain about how far the applicant must go and what percentage of patients must find the strategy 'acceptable'. The aim of this overview is to provide an update on current thinking and understanding of the problem, and discuss issues relating to the acceptability testing. This overview should be considered as means to start a wider discussion which hopefully will result in a harmonised, globally acceptable approach for confirmation of the acceptability in the future. Copyright © 2014 Elsevier B.V. All rights reserved.

Extravasation management of nonchemotherapeutic medications.

PubMed

Martin, Sarah M

2013-01-01

Many who think of vesicants think of chemotherapy and oncology patients. But not all vesicants are chemotherapy medications. This article reviews the factors that increase the risk of extravasation, the nonchemotherapeutic medications associated with extravasation injuries, and the recommended treatments.

The dangers of euthanasia and dementia: how Kantian thinking might be used to support non-voluntary euthanasia in cases of extreme dementia.

PubMed

Sharp, Robert

2012-06-01

Some writers have argued that a Kantian approach to ethics can be used to justify suicide in cases of extreme dementia, where a patient lacks the rationality required of Kantian moral agents. I worry that this line of thinking may lead to the more extreme claim that euthanasia is a proper Kantian response to severe dementia (and similar afflictions). Such morally treacherous thinking seems to be directly implied by the arguments that lead Dennis Cooley and similar writers to claim that Kant might support suicide. If rationality is the only factor in valuing a human life, then the loss of that rationality (however such loss might be defined) would allow us to use essentially utilitarian thinking in order to support non-voluntary euthanasia, since the patients themselves would no longer be moral agents that demand respect. © 2012 Blackwell Publishing Ltd.

How mental health nurses improve their critical thinking through problem-based learning.

PubMed

Hung, Tsui-Mei; Tang, Lee-Chun; Ko, Chen-Ju

2015-01-01

Critical thinking has been regarded as one of the most important elements for nurses to improve quality of patient care. The aim of this study was to use problem-based learning (PBL) as a method in a continuing education program to evaluate nurses' critical thinking skills. A quasiexperimental study design was carried out. The "Critical Thinking Disposition Inventory" in Chinese was used for data collection. The results indicated significant improvement after PBL continuous education, notably in the dimensions of systematic analysis and curiosity. Content analysis extracted four themes: (a) changes in linear thinking required, (b) logical and systematic thinking required performance improved, (3) integration of prior knowledge and clinical application, and (4) brainstorming learning strategy. The study supports PBL as a continuing education strategy for mental health nurses, and that systematic analysis and curiosity effectively facilitate the development of critical thinking.

Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners.

PubMed

Leemrijse, C J; de Bakker, D H; Ooms, L; Veenhof, C

2015-08-06

General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners perceptions and current practices regarding referral of patients to local exercise facilities. Furthermore, collaboration with exercise providers in the community was investigated, and motivators and barriers for referral. A written questionnaire sent to a representative random sample of 800 Dutch general practitioners. Descriptive statistics and Chi(2) tests were used. All responding general practitioners (340) recommend their patients to take more exercise when necessary and 87 % say to refer patients sometimes. Limited motivation of the patient (44 %) and reduced health status (34 %) are the most mentioned barriers for advising patients to increase physical activity. When referred, most patients are send to a physical therapist (69 %) but also local exercise facilities were mentioned (54 %). The most important barrier for referring patients to local exercise activities are patients limited financial possibilities (46 %). Restricted knowledge of local exercise- or sport facilities was an additional barrier (19 %). There is little structural collaboration between general practitioners and exercise providers, but when collaboration exists general practitioners refer more often. Positive experiences of patients (67 %), affordable offers (59 %) and information of local exercise facilities (46 %) are seen as important promoting factors for referral. Although 32 % of the general practitioners think that good collaboration would be stimulating, regular meetings with sports and exercise providers were considered the least important for increasing referral (3 %). Dutch physicians have a positive attitude towards stimulating physical activity but referral to local exercise facilities is low. Referral is partly hindered by restricted knowledge of local exercise facilities. Although general practitioners think that collaboration is important for physical activity promotion, it should not cost them much extra time. A coordinator with knowledge of the local situation can facilitate contacts between GP practices and sports providers.

Postdecisional counterfactual thinking by actors and readers.

PubMed

Girotto, Vittorio; Ferrante, Donatella; Pighin, Stefania; Gonzalez, Michel

2007-06-01

How do individuals think counterfactually about the outcomes of their decisions? Most previous studies have investigated how readers think about fictional stories, rather than how actors think about events they have actually experienced. We assumed that differences in individuals' roles (actor vs. reader) can make different information available, which in turn can affect counterfactual thinking. Hence, we predicted an effect of role on postdecisional counterfactual thinking. Reporting the results of eight studies, we show that readers undo the negative outcome of a story by undoing the protagonist's choice to tackle a given problem, rather than the protagonist's unsuccessful attempt to solve it. But actors who make the same choice and experience the same negative outcome as the protagonist undo this outcome by altering features of the problem. We also show that this effect does not depend on motivational factors. These results contradict current accounts of counterfactual thinking and demonstrate the necessity of investigating the counterfactual thoughts of individuals in varied roles.

The efficacy of botulinum toxin A and sacral neuromodulation in the management of interstitial cystitis (IC)/bladder pain syndrome (BPS), what do we know? ICI-RS 2017 think thank, Bristol.

PubMed

Rahnama'i, Mohammad S; Marcelissen, Tom; Apostolidis, Apostolos; Veit-Rubin, Nikolaus; Schurch, Brigitte; Cardozo, Linda; Dmochowski, Roger

2018-01-24

This manuscript aims to address the evidence availale in the literature on the efficacy of Botulinum Toxin A (BoNT-A) and sacral neuromodulation (SNM) in patients suffering from Interstitial Cystitis (IC)/BPS and propose further research to identify mechanisms of action and establish the clinical efficacy of either therapy. At the International Consultation on Incontinence-Research Society (ICI-RS) in 2017, a panel of Functional Urologists and Urogynaecologists participated in a Think Tank (TT) discussing the management of IC/BPS by BoNT-A and SNM, using available data from both PubMed and Medicine literature searches. The role of BoNT-A and SNM in the treatment of IC/BPS are discussed and mechanisms of actions are proposed. Despite the available randomized trial data on the effect of intravesical BoNT-A treatment on symptoms of IC/BPS, a consistent conclusion of a positive effect cannot be drawn at the moment, as the published studies are small and heterogeneous in design. There is substantive evidence for the positive effects of SNM on symptoms of IC/BPS patients however, during patient selection, it is important to distinguish the degree and the location of pain in order to tailor the best therapy to the right patients. Both intravesical BoNT-A treatment and SNM have been shown to have positive effects in patients with IC/BPS. However, firm conclusions cannot yet be drawn. Patient-reported outcomes and quality of life should be assessed in addition to urinary and pain symptoms. Since current treatments mainly focus on symptomatic relief, future research should also focus on clarifying the pathogenic mechanisms involved in IC/BPS. © 2018 Wiley Periodicals, Inc.

Proceedings from Duke resistant hypertension think tank.

PubMed

Vemulapalli, Sreekanth; Ard, Jamy; Bakris, George L; Bhatt, Deepak L; Brown, Alan S; Cushman, William C; Ferdinand, Keith C; Flack, John M; Fleg, Jerome L; Katzen, Barry T; Kostis, John B; Oparil, Suzanne; Patel, Chet B; Pepine, Carl J; Piña, Ileana L; Rocha-Singh, Krishna J; Townsend, Raymond R; Peterson, Eric D; Califf, Robert M; Patel, Manesh R

2014-06-01

To identify patients at increased risk for cardiovascular outcomes, apparent treatment resistant hypertension (aTRH) is defined as having a blood pressure (BP) above goal despite the use of ≥3 antihypertensive therapies of different classes at maximally tolerated doses, ideally including a diuretic. In light of growing scientific interest in the treatment of this group, a multistakeholder think tank was convened to discuss the current state of knowledge, improve the care of these patients, and identify appropriate study populations for future observational and randomized trials in the field. Although recent epidemiologic studies in selected populations estimate that the prevalence of aTRH is 10% to 15% of hypertensive patients, further large-scale observational studies will be needed to better elucidate risk factors. To spur the development of therapies for aTRH, the development of an "aTRH" label for pharmacologic and device therapies with a developmental pathway including treatment added to the use of existing therapies is favored. Although demonstration of adequate BP lowering should be sufficient to gain Food and Drug Administration approval for therapies targeting aTRH, assessment of improvement in quality of life and cardiovascular outcomes is also desirable and considered in Centers for Medicare and Medicaid Services coverage decisions. Device trials under the aTRH label will need uniform and consistent processes for defining appropriate patient populations as well as postapproval registries assessing both long-term safety and duration of responses. Finally, patients with aTRH are likely to benefit from evaluation by a hypertension team to assure proper patient identification, diagnostic work-up, and therapeutic management before consideration of advanced or novel therapies to lower BP. Copyright © 2014 Mosby, Inc. All rights reserved.

Critical thinking in nurse managers.

PubMed

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

Enhancing the Empathic Connection: Using Action Methods to Understand Conflicts in End-of-Life Care

PubMed Central

Tanzi, Silvia; Biasco, Guido; Baile, Walter F.

2014-01-01

Empathy is a core feature of patient-centered care. It enables practitioners to better understand the patient and family concerns that are key to patient and family satisfaction, prevention of anxiety and depression, and provider empowerment. Current methods of teaching communication skills do not specifically focus on enhancing the ability to “stand in the patient's shoes” as a way of connecting with the patient and/or family experience and understanding feelings that may be a source of conflict with providers. In this paper, we present a model for deepening empathic understanding based upon action methods (role-reversal and doubling) derived from psychodrama and sociodrama. We describe these techniques and illustrate how they can be used to identify hidden emotions and attitudes and reveal that which the patient and family member may be thinking or feeling but be afraid to say. Finally, we present data showing that these methods were valuable to participants in enhancing their professional experience and skills. PMID:28725796

Enhancing the Empathic Connection: Using Action Methods to Understand Conflicts in End-of-Life Care.

PubMed

Tanzi, Silvia; Biasco, Guido; Baile, Walter F

2014-05-01

Empathy is a core feature of patient-centered care. It enables practitioners to better understand the patient and family concerns that are key to patient and family satisfaction, prevention of anxiety and depression, and provider empowerment. Current methods of teaching communication skills do not specifically focus on enhancing the ability to "stand in the patient's shoes" as a way of connecting with the patient and/or family experience and understanding feelings that may be a source of conflict with providers. In this paper, we present a model for deepening empathic understanding based upon action methods (role-reversal and doubling) derived from psychodrama and sociodrama. We describe these techniques and illustrate how they can be used to identify hidden emotions and attitudes and reveal that which the patient and family member may be thinking or feeling but be afraid to say. Finally, we present data showing that these methods were valuable to participants in enhancing their professional experience and skills.

Nurse educators' perceptions of critical thinking in developing countries: Ghana as a case study.

PubMed

Boso, Christian Makafui; Gross, Janet J

2015-01-01

The ability to critically evaluate information for the purpose of rendering health care is a prerequisite for modern nurses in a complex and ever-changing health care environment. The nurse educators' perceptions influence the utilization of critical thinking strategies in the classroom. The purpose of this study was to assess nursing faculty's perceptions of critical thinking. Using a questionnaire 106 nurse educators from two types of nursing educational program self-reported their perceptions. Data were collected from November 2013 to March 2014. Results were presented using frequencies, percentages, and t-test. The findings revealed that majority (95.3%) of nurse educators could not provide definitions that captured both affective and cognitive aspects of critical thinking. However, the majority of nurse educators had positive perceptions of critical thinking. Nurse educators in universities had more positive perceptions of critical thinking than those in the nurses' training colleges (P=0.007). The results suggested that the current nursing programs are not preparing nurses with the necessary critical thinking skills for the complex health care environment. Professional development programs in critical thinking should be instituted for nurse educators to assist them in developing appropriate teaching strategies to foster students' acquisition of critical thinking skills.

Vitalistic thinking in adults.

PubMed

Wilson, Stuart

2013-11-01

Vitalistic thinking has traditionally been associated with reasoning about biological phenomena. The current research aimed to investigate a broader range of vitalistic thinking than previously studied. Esoteric notions of 'energy' are frequently used by individuals when making causal attributions for strange occurrences, and previous literature has linked such thinking with paranormal, magical, and superstitious beliefs. Two experiments are described that aim to investigate whether adults are vitalistic when asked to make causal judgments, and whether this can be predicted by thinking styles and prior paranormal belief. Experiment 1 asked participants to rate three causal options (one of which was vitalistic) for six vignettes. Scores on one dimension of paranormal belief (New Age Philosophy) and analytical thinking significantly predicted vitalism, but scores on intuitive thinking and Traditional Paranormal Beliefs did not. Experiment 2 extended the findings by asking participants to generate their own causal responses. Again, paranormal belief was found to be the best predictor of vitalism, but this time Traditional Paranormal Beliefs were associated with vitalistic responses whilst both intuitive and analytical thinking were unable to significantly predict classification. Results challenge previous findings, suggesting that vitalistic thinking may operate differently when applied to everyday causal reasoning. © 2012 The British Psychological Society.

Learning to Improve: Using Writing to Increase Critical Thinking Performance in General Education Biology

PubMed Central

Kurtz, Martha J.

2007-01-01

Increasingly, national stakeholders express concern that U.S. college graduates cannot adequately solve problems and think critically. As a set of cognitive abilities, critical thinking skills provide students with tangible academic, personal, and professional benefits that may ultimately address these concerns. As an instructional method, writing has long been perceived as a way to improve critical thinking. In the current study, the researchers compared critical thinking performance of students who experienced a laboratory writing treatment with those who experienced traditional quiz-based laboratory in a general education biology course. The effects of writing were determined within the context of multiple covariables. Results indicated that the writing group significantly improved critical thinking skills whereas the nonwriting group did not. Specifically, analysis and inference skills increased significantly in the writing group but not the nonwriting group. Writing students also showed greater gains in evaluation skills; however, these were not significant. In addition to writing, prior critical thinking skill and instructor significantly affected critical thinking performance, whereas other covariables such as gender, ethnicity, and age were not significant. With improved critical thinking skill, general education biology students will be better prepared to solve problems as engaged and productive citizens. PMID:17548876

Teaching and evaluating critical thinking in respiratory care.

PubMed

Mishoe, Shelley C; Hernlen, Kitty

2005-09-01

The capacity to perform critical thinking in respiratory care may be enhanced through awareness and education to improve skills, abilities, and opportunities. The essential skills for critical thinking in respiratory care include prioritizing, anticipating, troubleshooting, communicating, negotiating, decision making, and reflecting. In addition to these skills, critical thinkers exhibit certain characteristics such as critical evaluation, judgment,insight, motivation, and lifelong learning. The teaching of critical thinking may be accomplished though problem-based learning using an evidenced-based approach to solve clinical problems similar to those encountered in professional practice. Other traditional strategies such as discussion, debate, case study, and case presentations can be used. Web-based curriculum and technologic advances have created opportunities such as bulletin boards, real-time chats, and interactive media tools that can incorporate critical thinking. Many concerns and controversies surround the assessment of critical thinking, and individuals who administer critical thinking tests must be aware of the strengths and limitations of these assessment tools, as well as their relevance to the workplace. The foundational works reported in this article summarize the current status of assessment of critical thinking and can stimulate further investigation and application of the skills, characteristics, educational strategies, and measurement of critical thinking in respiratory care.

Navy-NGO Coordination for Health-Related HCA Missions: A Suggested Planning Framework

DTIC Science & Technology

2008-11-01

however, on how to work with NCOs in the HCA setting. As a result, there is currendy no systematic frame - work for military-NGO coordination. The...agencies and NGOs, make up a tertiary audience. The issues are framed in a way that reflects the Navy’s current views and thinking, but NGO perspectives...it is written mainly from a Navy-centric perspective. The framing of the issues, in particular, reflects the Navy’s current views and thinking. NGO

Usability testing of Avoiding Diabetes Thru Action Plan Targeting (ADAPT) decision support for integrating care-based counseling of pre-diabetes in an electronic health record

PubMed Central

Chrimes, Dillon; Kushniruk, Andre; Kitos, Nicole R.

2014-01-01

Purpose Usability testing can be used to evaluate human computer interaction (HCI) and communication in shared decision making (SDM) for patient-provider behavioral change and behavioral contracting. Traditional evaluations of usability using scripted or mock patient scenarios with think-aloud protocol analysis provide a to identify HCI issues. In this paper we describe the application of these methods in the evaluation of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) tool, and test the usability of the tool to support the ADAPT framework for integrated care counseling of pre-diabetes. The think-aloud protocol analysis typically does not provide an assessment of how patient-provider interactions are effected in “live” clinical workflow or whether a tool is successful. Therefore, “Near-live” clinical simulations involving applied simulation methods were used to compliment the think-aloud results. This complementary usability technique was used to test the end-user HCI and tool performance by more closely mimicking the clinical workflow and capturing interaction sequences along with assessing the functionality of computer module prototypes on clinician workflow. We expected this method to further complement and provide different usability findings as compared to think-aloud analysis. Together, this mixed method evaluation provided comprehensive and realistic feedback for iterative refinement of the ADAPT system prior to implementation. Methods The study employed two phases of testing of a new interactive ADAPT tool that embedded an evidence-based shared goal setting component into primary care workflow for dealing with pre-diabetes counseling within a commercial physician office electronic health record (EHR). Phase I applied usability testing that involved “think-aloud” protocol analysis of 8 primary care providers interacting with several scripted clinical scenarios. Phase II used “near-live” clinical simulations of 5 providers interacting with standardized trained patient actors enacting the clinical scenario of counseling for pre-diabetes, each of whom had a pedometer that recorded the number of steps taken over a week. In both phases, all sessions were audio-taped and motion screen-capture software was activated for onscreen recordings. Transcripts were coded using iterative qualitative content analysis methods. Results In Phase I, the impact of the components and layout of ADAPT on user’s Navigation, Understandability, and Workflow were associated with the largest volume of negative comments (i.e. approximately 80% of end-user commentary), while Usability and Content of ADAPT were representative of more positive than negative user commentary. The heuristic category of Usability had a positive-to-negative comment ratio of 2.1, reflecting positive perception of the usability of the tool, its functionality, and overall co-productive utilization of ADAPT. However, there were mixed perceptions about content (i.e., how the information was displayed, organized and described in the tool). In Phase II, the duration of patient encounters was approximately 10 minutes with all of the Patient Instructions (prescriptions) and behavioral contracting being activated at the end of each visit. Upon activation, providers accepted the pathway prescribed by the tool 100% of the time and completed all the fields in the tool in the simulation cases. Only 14% of encounter time was spent using the functionality of the ADAPT tool in terms of keystrokes and entering relevant data. The rest of the time was spent on communication and dialogue to populate the patient instructions. In all cases, the interaction sequence of reviewing and discussing exercise and diet of the patient was linked to the functionality of the ADAPT tool in terms of monitoring, response-efficacy, self-efficacy, and negotiation in the patient-provider dialogue. There was a change from one-way dialogue to two-way dialogue and negotiation that ended in a behavioral contract. This change demonstrated the tool’s sequence, which supported recording current exercise and diet followed by a diet and exercise goal setting procedure to reduce the risk of diabetes onset. Conclusions This study demonstrated that “think-aloud” protocol analysis with “near-live” clinical simulations provided a successful usability evaluation of a new primary care pre-diabetes shared goal setting tool. Each phase of the study provided complementary observations on problems with the new onscreen tool and was used to show the influence of the ADAPT framework on the usability, workflow integration, and communication between the patient and provider. The think-aloud tests with the provider showed the tool can be used according to the ADAPT framework (exercise-to-diet behavior change and tool utilization), while the clinical simulations revealed the ADAPT framework to realistically support patient-provider communication to obtain behavioral change contract. SDM interactions and mechanisms affecting protocol-based care can be more completely captured by combining “near-live” clinical simulations with traditional “think-aloud analysis” which augments clinician utilization. More analysis is required to verify if the rich communication actions found in Phase II compliment clinical workflows. PMID:24981988

Usability testing of Avoiding Diabetes Thru Action Plan Targeting (ADAPT) decision support for integrating care-based counseling of pre-diabetes in an electronic health record.

PubMed

Chrimes, Dillon; Kitos, Nicole R; Kushniruk, Andre; Mann, Devin M

2014-09-01

Usability testing can be used to evaluate human-computer interaction (HCI) and communication in shared decision making (SDM) for patient-provider behavioral change and behavioral contracting. Traditional evaluations of usability using scripted or mock patient scenarios with think-aloud protocol analysis provide a way to identify HCI issues. In this paper we describe the application of these methods in the evaluation of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) tool, and test the usability of the tool to support the ADAPT framework for integrated care counseling of pre-diabetes. The think-aloud protocol analysis typically does not provide an assessment of how patient-provider interactions are effected in "live" clinical workflow or whether a tool is successful. Therefore, "Near-live" clinical simulations involving applied simulation methods were used to compliment the think-aloud results. This complementary usability technique was used to test the end-user HCI and tool performance by more closely mimicking the clinical workflow and capturing interaction sequences along with assessing the functionality of computer module prototypes on clinician workflow. We expected this method to further complement and provide different usability findings as compared to think-aloud analysis. Together, this mixed method evaluation provided comprehensive and realistic feedback for iterative refinement of the ADAPT system prior to implementation. The study employed two phases of testing of a new interactive ADAPT tool that embedded an evidence-based shared goal setting component into primary care workflow for dealing with pre-diabetes counseling within a commercial physician office electronic health record (EHR). Phase I applied usability testing that involved "think-aloud" protocol analysis of eight primary care providers interacting with several scripted clinical scenarios. Phase II used "near-live" clinical simulations of five providers interacting with standardized trained patient actors enacting the clinical scenario of counseling for pre-diabetes, each of whom had a pedometer that recorded the number of steps taken over a week. In both phases, all sessions were audio-taped and motion screen-capture software was activated for onscreen recordings. Transcripts were coded using iterative qualitative content analysis methods. In Phase I, the impact of the components and layout of ADAPT on user's Navigation, Understandability, and Workflow were associated with the largest volume of negative comments (i.e. approximately 80% of end-user commentary), while Usability and Content of ADAPT were representative of more positive than negative user commentary. The heuristic category of Usability had a positive-to-negative comment ratio of 2.1, reflecting positive perception of the usability of the tool, its functionality, and overall co-productive utilization of ADAPT. However, there were mixed perceptions about content (i.e., how the information was displayed, organized and described in the tool). In Phase II, the duration of patient encounters was approximately 10 min with all of the Patient Instructions (prescriptions) and behavioral contracting being activated at the end of each visit. Upon activation, providers accepted the pathway prescribed by the tool 100% of the time and completed all the fields in the tool in the simulation cases. Only 14% of encounter time was spent using the functionality of the ADAPT tool in terms of keystrokes and entering relevant data. The rest of the time was spent on communication and dialog to populate the patient instructions. In all cases, the interaction sequence of reviewing and discussing exercise and diet of the patient was linked to the functionality of the ADAPT tool in terms of monitoring, response-efficacy, self-efficacy, and negotiation in the patient-provider dialog. There was a change from one-way dialog to two-way dialog and negotiation that ended in a behavioral contract. This change demonstrated the tool's sequence, which supported recording current exercise and diet followed by a diet and exercise goal setting procedure to reduce the risk of diabetes onset. This study demonstrated that "think-aloud" protocol analysis with "near-live" clinical simulations provided a successful usability evaluation of a new primary care pre-diabetes shared goal setting tool. Each phase of the study provided complementary observations on problems with the new onscreen tool and was used to show the influence of the ADAPT framework on the usability, workflow integration, and communication between the patient and provider. The think-aloud tests with the provider showed the tool can be used according to the ADAPT framework (exercise-to-diet behavior change and tool utilization), while the clinical simulations revealed the ADAPT framework to realistically support patient-provider communication to obtain behavioral change contract. SDM interactions and mechanisms affecting protocol-based care can be more completely captured by combining "near-live" clinical simulations with traditional "think-aloud analysis" which augments clinician utilization. More analysis is required to verify if the rich communication actions found in Phase II compliment clinical workflows. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Critical thinking dispositions of nursing students in Asian and non-Asian countries: a literature review.

PubMed

Salsali, Mahvash; Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad

2013-09-26

Critical thinking disposition represents an inclination of a person to use possessed skills in relation to critical thinking. The trend of critical thinking has been described as inner motivation to solve problems and make decisions by thinking. In nursing as a practical profession, the concept of critical thinking dispositions is important component in helping to manage complex health situations and to deal with patient issues effectively. Willingness to think critically is a prerequisite for safe and subtly performance. The results of studies show critical thinking dispositions of nursing students in Asian countries are different from non-Asian countries. Aim of this literature review was to compare critical thinking dispositions of nursing students in Asian and non-Asian countries. Literature review was done in English and Persian databases. The results showed of the 795 articles published in English and Persian language that studied critical thinking, 73 ones studied critical thinking skills and dispositions in nursing education, and relationship between teaching methods and critical thinking skills and dispositions in nursing education of different countries. Fifteen of seventy three articles assessed critical thinking dispositions in nursing students. Limited studies showed that the Asian nursing students had mostly undermining score of the critical thinking dispositions, while non-Asian countries tend to positive scores. The reasons for these differences could be due to issues such as environmental, educational methods and cultural differences. However, future studies should measure critical thinking disposition by discipline-based tools.

Critical Thinking Dispositions of Nursing Students in Asian and Non-Asian Countries: A Literature Review

PubMed Central

Salsali, Mahvash; Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad

2013-01-01

Critical thinking disposition represents an inclination of a person to use possessed skills in relation to critical thinking. The trend of critical thinking has been described as inner motivation to solve problems and make decisions by thinking. In nursing as a practical profession, the concept of critical thinking dispositions is important component in helping to manage complex health situations and to deal with patient issues effectively. Willingness to think critically is a prerequisite for safe and subtly performance. The results of studies show critical thinking dispositions of nursing students in Asian countries are different from non-Asian countries. Aim of this literature review was to compare critical thinking dispositions of nursing students in Asian and non-Asian countries. Literature review was done in English and Persian databases. The results showed of the 795 articles published in English and Persian language that studied critical thinking, 73 ones studied critical thinking skills and dispositions in nursing education, and relationship between teaching methods and critical thinking skills and dispositions in nursing education of different countries. Fifteen of seventy three articles assessed critical thinking dispositions in nursing students. Limited studies showed that the Asian nursing students had mostly undermining score of the critical thinking dispositions, while non-Asian countries tend to positive scores. The reasons for these differences could be due to issues such as environmental, educational methods and cultural differences. However, future studies should measure critical thinking disposition by discipline-based tools. PMID:24171885

The effects of using a human patient simulator compared to a CD-ROM in teaching critical thinking and performance.

PubMed

Johnson, Don; Johnson, Sabine

2014-01-01

Military healthcare personnel, including nurse anesthetists, must have the knowledge and skills to care for the extensive, severe injuries incurred on the battlefield. No studies have compared the 2 teaching strategies of using the human patient simulator (HPS) and a CD-ROM in caring for combat injuries relative to critical thinking and performance using nurse anesthesia participants. A prospective, pretest-posttest experimental, mixed design (within and between) was used to determine if there were statistically significant differences in HPS and CD-ROM educational strategies relative to caring for patients who have trauma. Two instruments were used: critical thinking, which consisted of multiple-choice questions; and a combat performance instrument that measured ability to care for patients. A repeated analysis of variance and a least significant difference post-hoc test were used to analyze the data. The HPS group performed better than the CD-ROM and control groups relative to performance (P=.000) but not on critical thinking (P=.239). There was no difference between the CD-ROM and control group (P=.171) on the combat performance instrument. In this study, the HPS method of instruction was a more effective method of teaching than the CD-ROM approach.

The phenomenology of deep brain stimulation-induced changes in OCD: an enactive affordance-based model

PubMed Central

de Haan, Sanneke; Rietveld, Erik; Stokhof, Martin; Denys, Damiaan

2013-01-01

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10% of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). DBS involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioral measures of the severity of the symptoms. In this article we aim to capture the changes in the patients' phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients' experience of the world. We propose to specify the patients' world in terms of a field of affordances, with the three dimensions of broadness of scope (“width” of the field), temporal horizon (“depth”), and relevance of the perceived affordances (“height”). The second aspect is the person-side of the interaction, that is, the patients' self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take toward the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment. PMID:24133438

Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017.

PubMed

MacMahon, Heber; Naidich, David P; Goo, Jin Mo; Lee, Kyung Soo; Leung, Ann N C; Mayo, John R; Mehta, Atul C; Ohno, Yoshiharu; Powell, Charles A; Prokop, Mathias; Rubin, Geoffrey D; Schaefer-Prokop, Cornelia M; Travis, William D; Van Schil, Paul E; Bankier, Alexander A

2017-07-01

The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on March 13, 2017.

An integrated review of the correlation between critical thinking ability and clinical decision-making in nursing.

PubMed

Lee, Daphne Sk; Abdullah, Khatijah Lim; Subramanian, Pathmawathi; Bachmann, Robert Thomas; Ong, Swee Leong

2017-12-01

To explore whether there is a correlation between critical thinking ability and clinical decision-making among nurses. Critical thinking is currently considered as an essential component of nurses' professional judgement and clinical decision-making. If confirmed, nursing curricula may be revised emphasising on critical thinking with the expectation to improve clinical decision-making and thus better health care. Integrated literature review. The integrative review was carried out after a comprehensive literature search using electronic databases Ovid, EBESCO MEDLINE, EBESCO CINAHL, PROQuest and Internet search engine Google Scholar. Two hundred and 22 articles from January 1980 to end of 2015 were retrieved. All studies evaluating the relationship between critical thinking and clinical decision-making, published in English language with nurses or nursing students as the study population, were included. No qualitative studies were found investigating the relationship between critical thinking and clinical decision-making, while 10 quantitative studies met the inclusion criteria and were further evaluated using the Quality Assessment and Validity Tool. As a result, one study was excluded due to a low-quality score, with the remaining nine accepted for this review. Four of nine studies established a positive relationship between critical thinking and clinical decision-making. Another five studies did not demonstrate a significant correlation. The lack of refinement in studies' design and instrumentation were arguably the main reasons for the inconsistent results. Research studies yielded contradictory results as regard to the relationship between critical thinking and clinical decision-making; therefore, the evidence is not convincing. Future quantitative studies should have representative sample size, use critical thinking measurement tools related to the healthcare sector and evaluate the predisposition of test takers towards their willingness and ability to think. There is also a need for qualitative studies to provide a fresh approach in exploring the relationship between these variables uncovering currently unknown contributing factors. This review confirmed that evidence to support the existence of relationships between critical thinking and clinical decision-making is still unsubstantiated. Therefore, it serves as a call for nurse leaders and nursing academics to produce quality studies in order to firmly support or reject the hypothesis that there is a statistically significant correlation between critical thinking and clinical decision-making. © 2017 John Wiley & Sons Ltd.

A critical evaluation of the validity of episodic future thinking: A clinical neuropsychology perspective.

PubMed

Ward, Amanda M

2016-11-01

Episodic future thinking is defined as the ability to mentally simulate a future event. Although episodic future thinking has been studied extensively in neuroscience, this construct has not been explored in depth from the perspective of clinical neuropsychology. The aim of this critical narrative review is to assess the validity and clinical implications of episodic future thinking. A systematic review of episodic future thinking literature was conducted. PubMed and PsycInfo were searched through July 2015 for review and empirical articles with the following search terms: "episodic future thinking," "future mental simulation," "imagining the future," "imagining new experiences," "future mental time travel," "future autobiographical experience," and "prospection." The review discusses evidence that episodic future thinking is important for adaptive functioning, which has implications for neurological populations. To determine the validity of episodic future thinking, the construct is evaluated with respect to related constructs, such as imagination, episodic memory, autobiographical memory, prospective memory, narrative construction, and working memory. Although it has been minimally investigated, there is evidence of convergent and discriminant validity for episodic future thinking. Research has not addressed the incremental validity of episodic future thinking. Practical considerations of episodic future thinking tasks and related constructs in a clinical neuropsychological setting are considered. The utility of episodic future thinking is currently unknown due to the lack of research investigating the validity of episodic future thinking. Future work is discussed, which could determine whether episodic future thinking is an important missing piece in standard clinical neuropsychological assessment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Identifying Personal Goals of Patients With Long Term Condition: A Service Design Thinking Approach.

PubMed

Lee, Eunji; Gammon, Deede

2017-01-01

Care for patients with long term conditions is often characterized as fragmented and ineffective, and fails to engage the resources of patients and their families in the care process. Information and communication technology can potentially help bridge the gap between patients' lives and resources and services provided by professionals. However, there is little attention on how to identify and incorporate the patients' individual needs, values, preferences and care goals into the digitally driven care settings. We conducted a case study with healthcare professionals and patients participated applying a service design thinking approach. The participants could elaborate some personal goals of patients with long term condition which can potentially be incorporated in digitally driven care plans using examples from their own experiences.

Thinking Broadly: Financing Strategies for Comprehensive Child and Family Initiatives.

ERIC Educational Resources Information Center

Hayes, Cheryl D.

In the current tight fiscal environment, it is critical for state and community leaders to think broadly and systematically about how to finance important education, family, and child services, and community development initiatives. This guide presents a conceptual framework for financing child and family services and community building and…

Simulated and Virtual Science Laboratory Experiments: Improving Critical Thinking and Higher-Order Learning Skills

ERIC Educational Resources Information Center

Simon, Nicole A.

2013-01-01

Virtual laboratory experiments using interactive computer simulations are not being employed as viable alternatives to laboratory science curriculum at extensive enough rates within higher education. Rote traditional lab experiments are currently the norm and are not addressing inquiry, Critical Thinking, and cognition throughout the laboratory…

Understanding Our American Economy.

ERIC Educational Resources Information Center

Nelson, Glen T.; Nelson, Ray D.

This handbook of economics reviews current economic activities in the United States, encouraging thinking and further study for the reader, rather than providing answers. The book provides a basic framework of knowledge in economics for a better informed citizenry to think clearly and objectively about economic issues in an attempt to combat…

A Hopeful Pedagogy to Critical Thinking

ERIC Educational Resources Information Center

Nicholas, Mark C.; Raider-Roth, Miriam

2016-01-01

Elements of what we are calling a "hopeful pedagogy" emerged when faculty reflected on the question--Do you think your current approach to develop CT in students is successful? Faculty across disciplines and institutions used the word "hope" to characterize the outcome of their efforts. While attempting to disentangle the…

The Faculty Perspective on Holistic and Systems Thinking in American and Australian Mechanical Engineering Programmes

ERIC Educational Resources Information Center

Kellam, N. N.; Maher, M. A.; Peters, W. H.

2008-01-01

This research effort examined current mechanical engineering educational programmes in America and Australia to determine the degree of holistic, systems thinking of each programme. Faculty from ten American universities and ten Australian universities participated in online surveys and interviews. Resulting data analysis and interpretation…

Influences of Teleological and Lamarckian Thinking on Student Understanding of Natural Selection

ERIC Educational Resources Information Center

Stover, Shawn K.; Mabry, Michelle L.

2007-01-01

Previous research has demonstrated creationist, Lamarckian, and teleological reasoning in high school and college students. These lines of thinking conflict with the Darwinian notion of natural selection, which serves as the primary catalyst for biological evolution. The current study assessed evolutionary conceptions in non-science majors,…

Thinking like an Ecologist

ERIC Educational Resources Information Center

Carlson, Jenn

2008-01-01

This article presents a lesson in which students examine current field research on global change. In particular, students investigate the effect of carbon dioxide and tropospheric ozone on ecosystems by applying their knowledge of scientific inquiry and photosynthesis. The goal of the activity is for students to think like ecologists and draw…

Who Are Our Heroes? A Critical-Thinking, Consciousness-Raising Lesson.

ERIC Educational Resources Information Center

Reissman, Rose

1994-01-01

When teachers discuss different types of heroes in the classroom, they allow their students to meet powerful new role models. The article discusses how teachers can get students thinking about what makes a hero and in the process, teach them about historical figures, social issues, and current events. (SM)

Career Development: Theory and Practice.

ERIC Educational Resources Information Center

Montross, David H., Ed.; Shinkman, Christopher J., Ed.

This book explores the latest developments in the theory and practice of career development, as seen by 21 professionals in the field. The study is organized in four parts that cover the following areas: the latest thinking about career theory; the career stages of exploration, establishment, maintenance, and decline; current thinking about the…

Elementary Mathematics Teachers' Perceptions and Lived Experiences on Mathematical Communication

ERIC Educational Resources Information Center

Kaya, Defne; Aydin, Hasan

2016-01-01

Mathematical thinking skills and meaningful mathematical understanding are among the goals of current mathematics education. There is a wide consensus among scholars about the purpose of developing mathematical understanding and higher order thinking skills in students. However, how to develop those skills in classroom settings is an area that…

SPELT (Strategies Program for Effective Learning/Thinking): A Description and Analysis of Instructional Procedures.

ERIC Educational Resources Information Center

Peat, D.; And Others

1989-01-01

Describes an instructional model, Strategies Program for Effective Learning/Thinking (SPELT), that was developed to translate cognitive psychological theory and research into a practical instructional program. The extent to which SPELT conforms to current instructional design principles is examined, and macro versus micro instructional sequencing…

Thinking with Theory in an Era of Trump

ERIC Educational Resources Information Center

Strom, Kathryn J.; Martin, Adrian D.

2017-01-01

This introduction to this special issue on "Thinking with Theory in Teacher Education" dedicates considerable space to broadly discussing the current U.S. political context to emphasize why, at this precise moment in history, educators, teacher educators, and educational researchers are in dire need of different ways to understand the…

Social Studies Teacher Candidates' Views on Historical Thinking Skills

ERIC Educational Resources Information Center

Ozmen, Cengiz

2015-01-01

Current study aimed to present Social Studies teacher candidates' views on historical thinking skills. Study was conducted using qualitative design and working group was composed of a total of 121 teacher candidates (62 females and 59 males) attending Social Studies Teaching Department of Karadeniz Technical University and Adiyaman University…

A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law.

PubMed

O'Brien, J W; Natarajan, M; Shaikh, I

2017-06-01

The UK Supreme Court recently ruled that when consenting patients for treatments or procedures, clinicians must also discuss any associated material risks. We surveyed medical staff at a large UK teaching hospital in order to ascertain knowledge of consent law and current understanding of this change. Email survey sent to medical staff in all specialities at Norfolk and Norwich University Hospital in February 2016. 245 responses (141 Consultants and 104 junior doctors, response rate 32%). 82% consent patients for procedures at least monthly and 23% daily. 31% were not familiar with the concept of material risk. 35% were familiar with the recent change in consent law, 41% were not. 18% were "very uncertain" and 64% "a little uncertain" that their consenting process meets current legal requirements. >92% think that landmark cases and changes in law should be discussed through professional bodies and circulated better locally. The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

The effect of positive thinking training on the level of spiritual well-being among the patients with coronary artery diseases referred to Imam Reza specialty and subspecialty clinic in Shiraz, Iran: A randomized controlled clinical trial.

PubMed

Ghodsbin, Fariba; Safaei, Marzieh; Jahanbin, Iran; Ostovan, Mohammad Ali; Keshvarzi, Sareh

2015-11-01

Positive thinking which is derived from an optimistic view toward the universe and plays an important role in the incidence of better and a more targeted behavior among human beings. It can improve spiritual health in the individuals through increased communication with God and thanksgiving and accelerate the healing process. Accordingly, we aimed to evaluate the effect of positive thinking on the level of spiritual health in the patients with coronary artery disease (CAD) referred to Imam Reza specialty and subspecialty clinic in Shiraz, Iran. In this study randomized controlled clinical trial, we enrolled 90 patients with confirmed CAD referred to Imam Reza clinic, Shiraz, during April to July 2013. A blocking randomization method was used to randomize the final 90 participants into intervention (n = 45) and control groups (n = 45). After obtaining written informed consent, the participants were asked to complete two questionnaires. Data were collected using Ellison and Paloutzian's spiritual well-being scale (SWBS) and a demographic questionnaire. The patients in the intervention group participated in 7 training sessions on positive thinking in which several topics were discussed. The SWBS questionnaire was completed two more times by the participants; once immediately after, and once 1 month after the intervention. 16 patients were excluded from the study due to different reasons, and finally the analysis was performed on 74 patients. The mean ± standard deviation (SD) of spiritual well-being (SWB) increased from 88.71 ± 12.5 to 96.63 ± 12.58 in the intervention group; while, it decreased from 93.19 ± 17.55 to 94.45 ± 16.01 in the control group in the interval of before and 1 month after the intervention. We observed a statistically significant difference between the two groups regarding both variables of time and group (P < 0.001). SWB is an important factor which should be considered in the treatment process, and nurses could maintain and improve such dimension of health in the patients through their intervention including drawing the patients' attention to optimism and positive thinking.

Effects of a case-based interactive e-learning course on knowledge and attitudes about patient safety: a quasi-experimental study with third-year medical students.

PubMed

Gaupp, Rainer; Körner, Mirjam; Fabry, Götz

2016-07-11

Patient safety (PS) is influenced by a set of factors on various levels of the healthcare system. Therefore, a systems-level approach and systems thinking is required to understand and improve PS. The use of e-learning may help to develop a systems thinking approach in medical students, as case studies featuring audiovisual media can be used to visualize systemic relationships in organizations. The goal of this quasi-experimental study was to determine if an e-learning can be utilized to improve systems thinking, knowledge, and attitudes towards PS. A quasi-experimental, longitudinal within- subjects design was employed. Participants were 321 third-year medical students who received online surveys before and after they participated in an e-learning course on PS. Primary outcome measures where levels of systems thinking and attitudes towards PS. Secondary outcome measures were the improvement of PS specific knowledge through the e-learning course. Levels of systems thinking showed significant improvement (58.72 vs. 61.27; p < .001) after the e-learning. Student's attitudes towards patient safety improved in several dimensions: After the course, students rated the influence of fatigue on safety higher (6.23 vs. 6.42, p < .01), considered patient empowerment more important (5.16 vs. 5.93, p < .001) and realized more often that human error is inevitable (5.75 vs. 5.97, p < .05). Knowledge on PS improved from 36.27 % correct answers before to 76.45 % after the e-learning (p < .001). Our results suggest that e-learning can be used to teach PS. Attitudes towards PS improved on several dimensions. Furthermore, we were able to demonstrate that a specifically designed e-learning program can foster the development of conceptual frameworks such as systems thinking, which facilitates the understanding of complex socio-technical systems within healthcare organisations.

Existential concerns about death: a qualitative study of dying patients in a Danish hospice.

PubMed

Moestrup, Lene; Hansen, Helle Ploug

2015-06-01

Research suggests that addressing dying patients' existential concerns can improve their quality of life. We aimed to illuminate dying patients' existential concerns about the impending death through a descriptive analysis of semistructured interviews with 17 patients in Danish hospices. The main findings demonstrated how the patients faced the imminent death without being anxious of death but sorrowful about leaving life. Some patients expressed that they avoided thinking about death. They wished to focus on positive aspects in their daily life. We argue that the patients' existential concerns could not be fully captured by Yalom's existential psychology or by Kübler-Ross's theory about death stages. Patients' complex concerns could be more fully explained taking an outset in Heidegger's phenomenological thinking. © The Author(s) 2014.

A Randomized Controlled Trial to Decrease Suicidal Thinking in a Military Emergency Department

DTIC Science & Technology

2016-12-01

informed consent, participants would receive 0.2mg/kg ketamine or placebo. Their suicidal thinking, depression , and other symptoms would be monitored...as treatment for the depression underlying suicidal thinking typically takes weeks to months to be effective. In the meantime, the only option may...Determine whether a single sub-anesthetic rapid IV bolus dose of ketamine administered to acutely depressed patients with or without suicidality has a

Prevalence of Criminal Thinking among State Prison Inmates with Serious Mental Illness

PubMed Central

Fisher, William H.; Duan, Naihua; Mandracchia, Jon T.; Murray, Danielle

2010-01-01

To examine the prevalence of criminal thinking in mentally disordered offenders, incarcerated male (n = 265) and female (n = 149) offenders completed measures of psychiatric functioning and criminal thinking. Results indicated 92% of the participants were diagnosed with a serious mental illness, and mentally disordered offenders produced criminal thinking scores on the Psychological Inventory of Criminal Thinking Styles (PICTS) and Criminal Sentiments Scale-Modified (CSS-M) similar to that of non-mentally ill offenders. Collectively, results indicated the clinical presentation of mentally disordered offenders is similar to that of psychiatric patients and criminals. Implications are discussed with specific focus on the need for mental health professionals to treat co-occurring issues of mental illness and criminality in correctional mental health treatment programs. PMID:19551496

Counterfactual thinking in Tourette's syndrome: a study using three measures.

PubMed

Zago, Stefano; Delli Ponti, Adriana; Mastroianni, Silvia; Solca, Federica; Tomasini, Emanuele; Poletti, Barbara; Inglese, Silvia; Sartori, Giuseppe; Porta, Mauro

2014-01-01

Pathophysiological evidence suggests an involvement of frontostriatal circuits in Tourette syndrome (TS) and cognitive abnormalities have been detected in tasks sensitive to cognitive deficits associated with prefrontal damage (verbal fluency, planning, attention shifting, working memory, cognitive flexibility, and social reasoning). A disorder in counterfactual thinking (CFT), a behavioural executive process linked to the prefrontal cortex functioning, has not been investigated in TS. CFT refers to the generation of a mental simulation of alternatives to past factual events, actions, and outcomes. It is a pervasive cognitive feature in everyday life and it is closely related to decision-making, planning, problem-solving, and experience-driven learning-cognitive processes that involve wide neuronal networks in which prefrontal lobes play a fundamental role. Clinical observations in patients with focal prefrontal lobe damage or with neurological and psychiatric diseases related to frontal lobe dysfunction (e.g., Parkinson's disease, Huntington's disease, and schizophrenia) show counterfactual thinking impairments. In this work, we evaluate the performance of CFT in a group of patients with Tourette's syndrome compared with a group of healthy participants. Overall results showed no statistical differences in counterfactual thinking between TS patients and controls in the three counterfactual measures proposed. The possible explanations of this unexpected result are discussed below.

Patient-centered care: the key to cultural competence.

PubMed

Epner, D E; Baile, W F

2012-04-01

Much of the early literature on 'cultural competence' focuses on the 'categorical' or 'multicultural' approach, in which providers learn relevant attitudes, values, beliefs, and behaviors of certain cultural groups. In essence, this involves learning key 'dos and don'ts' for each group. Literature and educational materials of this kind focus on broad ethnic, racial, religious, or national groups, such as 'African American', 'Hispanic', or 'Asian'. The problem with this categorical or 'list of traits' approach to clinical cultural competence is that culture is multidimensional and dynamic. Culture comprises multiple variables, affecting all aspects of experience. Cultural processes frequently differ within the same ethnic or social group because of differences in age cohort, gender, political association, class, religion, ethnicity, and even personality. Culture is therefore a very elusive and nebulous concept, like art. The multicultural approach to cultural competence results in stereotypical thinking rather than clinical competence. A newer, cross cultural approach to culturally competent clinical practice focuses on foundational communication skills, awareness of cross-cutting cultural and social issues, and health beliefs that are present in all cultures. We can think of these as universal human beliefs, needs, and traits. This patient centered approach relies on identifying and negotiating different styles of communication, decision-making preferences, roles of family, sexual and gender issues, and issues of mistrust, prejudice, and racism, among other factors. In the current paper, we describe 'cultural' challenges that arise in the care of four patients from disparate cultures, each of whom has advanced colon cancer that is no longer responding to chemotherapy. We then illustrate how to apply principles of patient centered care to these challenges.

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2016-01-07

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Systems thinking and incivility in nursing practice: An integrative review.

PubMed

Phillips, Janet M; Stalter, Ann M; Winegardner, Sherri; Wiggs, Carol; Jauch, Amy

2018-01-23

There is a critical need for nurses and interprofessional healthcare providers to implement systems thinking (ST) across international borders, addressing incivility and its perilous effects on patient quality and safety. An estimated one million patients die in hospitals worldwide due to avoidable patient-related errors. Establishing safe and civil workplaces using ST is paramount to promoting clear, level-headed thinking from which patient-centered nursing actions can impact health systems. The purpose of the paper is to answer the research question, What ST evidence fosters the effect of workplace civility in practice settings? Whittemore and Knafl's integrative review method guided this study. The quality of articles was determined using Chu et al.'s Mixed Methods Assessment Tool. Thirty-eight studies were reviewed. Themes emerged describing antecedents and consequences of incivility as embedded within complex systems, suggesting improvements for civility and systems/ST in nursing practice. This integrative review provides information about worldwide incivility in nursing practice from a systems perspective. Several models are offered as a means of promoting civility in nursing practice to improve patient quality and safety. Further study is needed regarding incivility and resultant effects on patient quality and safety. © 2018 Wiley Periodicals, Inc.

Students' Perceptions of Teaching Methods That Bridge Theory to Practice in Dental Hygiene Education.

PubMed

Wilkinson, Denise M; Smallidge, Dianne; Boyd, Linda D; Giblin, Lori

2015-10-01

Health care education requires students to connect classroom learning with patient care. The purpose of this study was to explore dental hygiene students' perceptions of teaching tools, activities and teaching methods useful in closing the gap between theory and practice as students transition from classroom learning into the clinical phase of their training. This was an exploratory qualitative study design examining retrospective data from journal postings of a convenience sample of dental hygiene students (n=85). Open-ended questions related to patient care were given to junior and senior students to respond in a reflective journaling activity. A systematic approach was used to establish themes. Junior students predicted hands-on experiences (51%), critical thinking exercises (42%) and visual aids (27%) would be the most supportive in helping them connect theory to practice. Senior students identified critical thinking exercises (44%) and visual aids (44%) as the most beneficial in connecting classroom learning to patient care. Seniors also identified barriers preventing them from connecting theory to patient care. Barriers most often cited were not being able to see firsthand what is in the text (56%) and being unsure that what was seen during clinical practice was the same as what was taught (28%). Students recognized the benefits of critical thinking and problem solving skills after having experienced patient care and were most concerned with performance abilities prior to patient care experiences. This information will be useful in developing curricula to enhance critical thinking and problem solving skills. Copyright © 2015 The American Dental Hygienists’ Association.

Tracking reflective practice-based learning by medical students during an ambulatory clerkship.

PubMed

Thomas, Patricia A; Goldberg, Harry

2007-11-01

To explore the use of web and palm digital assistant (PDA)-based patient logs to facilitate reflective learning in an ambulatory medicine clerkship. Thematic analysis of convenience sample of three successive rotations of medical students' patient log entries. Johns Hopkins University School of Medicine. MS3 and MS4 students rotating through a required block ambulatory medicine clerkship. Students are required to enter patient encounters into a web-based log system during the clerkship. Patient-linked entries included an open text field entitled, "Learning Need." Students were encouraged to use this field to enter goals for future study or teaching points related to the encounter. The logs of 59 students were examined. These students entered 3,051 patient encounters, and 51 students entered 1,347 learning need entries (44.1% of encounters). The use of the "Learning Need" field was not correlated with MS year, gender or end-of-clerkship knowledge test performance. There were strong correlations between the use of diagnostic thinking comments and observations of therapeutic relationships (Pearson's r=.42, p<0.001), and between diagnostic thinking and primary interpretation skills (Pearson's r=.60, p<0.001), but not between diagnostic thinking and factual knowledge (Pearson's r =.10, p=.46). We found that when clerkship students were cued to reflect on each patient encounter with the electronic log system, student entries grouped into categories that suggested different levels of reflective thinking. Future efforts should explore the use of such entries to encourage and track habits of reflective practice in the clinical curriculum.

[Business organization theory: its potential use in the organization of the operating room].

PubMed

Bartz, H-J

2005-07-01

The paradigm of patient care in the German health system is changing. The introduction of German Diagnosis Related Groups (G-DRGs), a diagnosis-related coding system, has made process-oriented thinking increasingly important. The treatment process is viewed and managed as a whole from the admission to the discharge of the patient. The interfaces of departments and sectors are diminished. A main objective of these measures is to render patient care more cost efficient. Within the hospital, the operating room (OR) is the most expensive factor accounting for 25 - 50 % of the costs of a surgical patient and is also a bottleneck in the surgical patient care. Therefore, controlling of the perioperative treatment process is getting more and more important. Here, the business organisation theory can be a very useful tool. Especially the concepts of process organisation and process management can be applied to hospitals. Process-oriented thinking uncovers and solves typical organisational problems. Competences, responsibilities and tasks are reorganised by process orientation and the enterprise is gradually transformed to a process-oriented system. Process management includes objective-oriented controlling of the value chain of an enterprise with regard to quality, time, costs and customer satisfaction. The quality of the process is continuously improved using process-management techniques. The main advantage of process management is consistent customer orientation. Customer orientation means to be aware of the customer's needs at any time during the daily routine. The performance is therefore always directed towards current market requirements. This paper presents the basics of business organisation theory and to point out its potential use in the organisation of the OR.

Thinking in clinical nursing practice: a study of critical care nurses' thinking applying the think-aloud, protocol analysis method.

PubMed

Han, Kyung-Ja; Kim, Hesook Suzie; Kim, Mae-Ja; Hong, Kyung-Ja; Park, Sungae; Yun, Soon-Nyoung; Song, Misoon; Jung, Yoenyi; Kim, Haewon; Kim, Dong-Oak Debbie; Choi, Heejung; Kim, Kyungae

2007-06-01

The purpose of the paper is to discover the patterns and processes of decision-making in clinical nursing practice. A set of think-aloud data from five critical care nurses during 40 to 50 minutes of caregiving in intensive care units were obtained and analyzed by applying the procedures recommended by Ericsson and Simon for protocol analysis. Four thinking processes before acting were identified to constitute various sorts of thoughts in which the nurses were engaged during patient care: reviewing, validation, consideration, rationalization, and action. In addition, three patterns of sequential streaming of thinking (short, intermediate, long) were identified to reveal various ways the nurses dealt with clinical situations involving nursing tasks and responsibilities. This study specifies the initial categories of thoughts for each of the processes and various patterns with which these processes are sequentially combined, providing insights into the ways nurses think about problems and address their concerns. The findings suggest that the thinking in clinical practice involves more than focused decision-making and reasoning, and needs to be examined from a broader perspective.

Nurse educators’ perceptions of critical thinking in developing countries: Ghana as a case study

PubMed Central

Boso, Christian Makafui; Gross, Janet J

2015-01-01

The ability to critically evaluate information for the purpose of rendering health care is a prerequisite for modern nurses in a complex and ever-changing health care environment. The nurse educators’ perceptions influence the utilization of critical thinking strategies in the classroom. The purpose of this study was to assess nursing faculty’s perceptions of critical thinking. Using a questionnaire 106 nurse educators from two types of nursing educational program self-reported their perceptions. Data were collected from November 2013 to March 2014. Results were presented using frequencies, percentages, and t-test. The findings revealed that majority (95.3%) of nurse educators could not provide definitions that captured both affective and cognitive aspects of critical thinking. However, the majority of nurse educators had positive perceptions of critical thinking. Nurse educators in universities had more positive perceptions of critical thinking than those in the nurses’ training colleges (P=0.007). The results suggested that the current nursing programs are not preparing nurses with the necessary critical thinking skills for the complex health care environment. Professional development programs in critical thinking should be instituted for nurse educators to assist them in developing appropriate teaching strategies to foster students’ acquisition of critical thinking skills. PMID:26379453

Defining Computational Thinking for Mathematics and Science Classrooms

NASA Astrophysics Data System (ADS)

Weintrop, David; Beheshti, Elham; Horn, Michael; Orton, Kai; Jona, Kemi; Trouille, Laura; Wilensky, Uri

2016-02-01

Science and mathematics are becoming computational endeavors. This fact is reflected in the recently released Next Generation Science Standards and the decision to include "computational thinking" as a core scientific practice. With this addition, and the increased presence of computation in mathematics and scientific contexts, a new urgency has come to the challenge of defining computational thinking and providing a theoretical grounding for what form it should take in school science and mathematics classrooms. This paper presents a response to this challenge by proposing a definition of computational thinking for mathematics and science in the form of a taxonomy consisting of four main categories: data practices, modeling and simulation practices, computational problem solving practices, and systems thinking practices. In formulating this taxonomy, we draw on the existing computational thinking literature, interviews with mathematicians and scientists, and exemplary computational thinking instructional materials. This work was undertaken as part of a larger effort to infuse computational thinking into high school science and mathematics curricular materials. In this paper, we argue for the approach of embedding computational thinking in mathematics and science contexts, present the taxonomy, and discuss how we envision the taxonomy being used to bring current educational efforts in line with the increasingly computational nature of modern science and mathematics.

The Relationship between Critical Thinking and EFL Learners' Speaking Ability

ERIC Educational Resources Information Center

Ramezani, Raana; Larsari, Ebrahim Ezzati; Kiasi, Mohammad Aghajanzadeh

2016-01-01

The current study sought to investigate the relationship between critical thinking and speaking ability among EFL students at Payame Noor University (PNU) of Rasht. This research concerned determining the fact that whether language students who are as critical thinker, perform better in their speaking ability or not. In order to answer the…

Thinking Beyond Numbers: Learning Numeracy for the Future Workplace. Support Document

ERIC Educational Resources Information Center

Marr, Beth; Hagston, Jan

2007-01-01

The use, learning and transfer of workplace numeracy skills, as well as current understandings of the term numeracy, are examined in this study. It also highlights the importance of numeracy as an essential workplace skill. "Thinking Beyond Numbers: Learning Numeracy for the Future Workplace" challenges the training system and training…

Nice Thinking! an Educational Intervention That Teaches Children to Think Gratefully

ERIC Educational Resources Information Center

Froh, Jeffrey J.; Bono, Giacomo; Fan, Jinyan; Emmons, Robert A.; Henderson, Katherine; Harris, Cheray; Leggio, Heather; Wood, Alex M.

2014-01-01

Gratitude is essential to social life and well-being. Although research with youth populations has gained momentum recently, only two gratitude interventions have been conducted in youth, targeting mostly adolescents. In the current research, we tested a new intervention for promoting gratitude among the youngest children targeted to date.…

Setting the Mood for Critical Thinking in the Classroom

ERIC Educational Resources Information Center

Lewine, Rich; Sommers, Alison; Waford, Rachel; Robertson, Catherine

2015-01-01

Most current efforts to enhance critical thinking focus on skills practice and training. The empirical research from the fields of cognition and affect sciences suggest that positive mood, even when transiently induced, can have beneficial effects on cognitive flexibility and problem solving. We undertook this study to test this hypothesis in a…

An Evaluation of Critical Thinking Competencies in Business Settings

ERIC Educational Resources Information Center

Dwyer, Christopher P.; Boswell, Amy; Elliott, Mark A.

2015-01-01

Although critical thinking (CT) skills are usually considered as domain general (Gabbenesch, 2006; Halpern, 2003), CT ability may benefit from expertise knowledge and skill. The current study examined both general CT ability and CT ability related to business scenarios for individuals (a) expert in business, (b) novice in business, and (c) with no…

Improving the Past and the Future: A Temporal Asymmetry in Hypothetical Thinking

ERIC Educational Resources Information Center

Ferrante, Donatella; Girotto, Vittorio; Straga, Marta; Walsh, Clare

2013-01-01

Current views of hypothetical thinking implicitly assume that the content of imaginary thoughts about the past and future should be the same. Two experiments show that, given the same experienced facts of reality, future imagination may differ from past reconstruction. When participants failed a task, their counterfactual thoughts focused on…

The Relationships between Critical Thinking Skills and Learning Styles of Gifted Students

ERIC Educational Resources Information Center

Dilekli, Yalçin

2017-01-01

The current study investigates the relationship between critical thinking skills and learning styles of mentally gifted students. The participants were 225 gifted students in Turkey attending Science and Art Centres which are after-school activity centers for mentally gifted students. Participants were 9-15 years old and were attending secondary…

The Impact of a Capstone Farm Management Course on Critical Thinking Abilities

ERIC Educational Resources Information Center

Perry, Dustin K.; Paulsen, Thomas H.; Retallick, Michael S.

2015-01-01

Current research demonstrates a need to explore the effects of specific course designs or directed activities on higher education students' critical thinking abilities. Specifically, such research on the effect of an experiential learning-based capstone course is limited. All students (N = 54) enrolled in a capstone farm management course…

The Need to Introduce System Thinking in Teaching Climate Change

ERIC Educational Resources Information Center

Roychoudhury, Anita; Shepardson, Daniel P.; Hirsch, Andrew; Niyogi, Devdutta; Mehta, Jignesh; Top, Sara

2017-01-01

Research related to teaching climate change, system thinking, current reform in science education, and the research on reform-oriented assessment indicate that we need to explore student understanding in greater detail instead of only testing for an incremental gain in disciplinary knowledge. Using open-ended items we assessed details in student…

Navigating Dilemmas in Transforming Assessment Practices: Experiences of Mathematics Teachers in Ontario, Canada

ERIC Educational Resources Information Center

Suurtamm, Christine; Koch, Martha J.

2014-01-01

Current thinking encourages teachers to incorporate a range of assessment practices that are responsive to student thinking and promote student learning. At the same time, teachers are situated in a landscape of accountability, where they are often seen as technicians who implement prescribed curriculum, policies, and procedures with success…

Education in the New Millennium: The Case for Design-Based Learning

ERIC Educational Resources Information Center

Lee, Hyun-Kyung; Breitenberg, Mark

2010-01-01

This article focuses on current examples of project or design-based learning at the secondary school level in the context of the increasing importance of creativity and innovative thinking in the twenty-first century. The authors argue that students today learn more effectively in pedagogical practices that emphasise holistic thinking, active…

Toward a Pedagogy of Border Thinking: Building on Latin@ Students' Subaltern Knowledge

ERIC Educational Resources Information Center

Cervantes-Soon, Claudia G.; Carrillo, Juan F.

2016-01-01

Based on Walter Mignolo's (2000) notion of border thinking, that is, the subaltern knowledge generated from the exterior borders of the modern/colonial world system, this article extends current conceptual frameworks for the implementation of a decolonizing border pedagogy with Latin@ students in secondary schools. In particular, Cervantes-Soon…

Assessing Aspects of Creativity in Deaf and Hearing High School Students

ERIC Educational Resources Information Center

Stanzione, Christopher M.; Perez, Susan M.; Lederberg, Amy R.

2013-01-01

To address the paucity of current research on the development of creativity in deaf students, and to extend existing research to adolescents, the present study investigated divergent thinking, a method of assessing creativity, in both deaf and hearing adolescents. We assessed divergent thinking in two domains, figural and verbal, while also…

Professional Development on a Shoestring

ERIC Educational Resources Information Center

Young, Terrence E., Jr.; Harvey, Carl A., II

2010-01-01

Summer is nearly here, and school librarians will have a little more time to catch up with the current thinking in the world of school libraries. There are many options--both traditional and nontraditional--for learning about some of the latest thinking in the profession. In this article, the authors have chosen several available formats and…

Decoding the Disciplines: An Approach to Scientific Thinking

ERIC Educational Resources Information Center

Pinnow, Eleni

2016-01-01

The Decoding the Disciplines methodology aims to teach students to think like experts in discipline-specific tasks. The central aspect of the methodology is to identify a bottleneck in the course content: a particular topic that a substantial number of students struggle to master. The current study compared the efficacy of standard lecture and…

[Lean thinking and brain-dead patient assistance in the organ donation process].

PubMed

Pestana, Aline Lima; dos Santos, José Luís Guedes; Erdmann, Rolf Hermann; da Silva, Elza Lima; Erdmann, Alacoque Lorenzini

2013-02-01

Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

Good Thinking or Gut Feeling? Cognitive Reflection and Intuition in Traders, Bankers and Financial Non-Experts

PubMed Central

Thoma, Volker; White, Elliott; Panigrahi, Asha; Strowger, Vanessa; Anderson, Irina

2015-01-01

The current study investigated differences in decision-making style and risk-taking between financial traders, non-trading bank employees, and people not working in finance. Traders scored significantly higher than participants in the other two groups on the cognitive reflection test (CRT) which measures the tendency to inhibit automatic but frequently false responses in reasoning tasks. Scores for traders compared to people outside the banking sector were also higher on a self-rated scale for reflective thinking in decision-making, but there were no differences in self-rated intuitive thinking between groups. Financial risk-taking correlated with cognitive reflection scores and was significantly lower in the non-expert group compared to the other groups working in financial services. Traders in the current study showed no elevated preference to use ‘intuition’ in their decision-making compared to other groups. Overall, these results indicate that compared to non-expert participants financial traders have a higher self-rated tendency for reflective thinking and a greater propensity to inhibit the use of mental shortcuts (heuristics) in decision-making. PMID:25875674

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

PubMed Central

Deeb, Wissam; Giordano, James J.; Rossi, Peter J.; Mogilner, Alon Y.; Gunduz, Aysegul; Judy, Jack W.; Klassen, Bryan T.; Butson, Christopher R.; Van Horne, Craig; Deny, Damiaan; Dougherty, Darin D.; Rowell, David; Gerhardt, Greg A.; Smith, Gwenn S.; Ponce, Francisco A.; Walker, Harrison C.; Bronte-Stewart, Helen M.; Mayberg, Helen S.; Chizeck, Howard J.; Langevin, Jean-Philippe; Volkmann, Jens; Ostrem, Jill L.; Shute, Jonathan B.; Jimenez-Shahed, Joohi; Foote, Kelly D.; Wagle Shukla, Aparna; Rossi, Marvin A.; Oh, Michael; Pourfar, Michael; Rosenberg, Paul B.; Silburn, Peter A.; de Hemptine, Coralie; Starr, Philip A.; Denison, Timothy; Akbar, Umer; Grill, Warren M.; Okun, Michael S.

2016-01-01

This paper provides an overview of current progress in the technological advances and the use of deep brain stimulation (DBS) to treat neurological and neuropsychiatric disorders, as presented by participants of the Fourth Annual DBS Think Tank, which was convened in March 2016 in conjunction with the Center for Movement Disorders and Neurorestoration at the University of Florida, Gainesveille FL, USA. The Think Tank discussions first focused on policy and advocacy in DBS research and clinical practice, formation of registries, and issues involving the use of DBS in the treatment of Tourette Syndrome. Next, advances in the use of neuroimaging and electrochemical markers to enhance DBS specificity were addressed. Updates on ongoing use and developments of DBS for the treatment of Parkinson's disease, essential tremor, Alzheimer's disease, depression, post-traumatic stress disorder, obesity, addiction were presented, and progress toward innovation(s) in closed-loop applications were discussed. Each section of these proceedings provides updates and highlights of new information as presented at this year's international Think Tank, with a view toward current and near future advancement of the field. PMID:27920671

LEAN thinking in Finnish healthcare.

PubMed

Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

2016-01-01

Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

Framework See-Think as a Tool for Crowdsourcing Support - Case Study on Crisis Management

NASA Astrophysics Data System (ADS)

Netek, R.; Panek, J.

2016-06-01

See-Think-Do is a framework originally used as an approach focused on a service and product marketing on the Internet. Customers can be classified into three groups according to their involvement from potential users to real customers. The article presents an idea of public involvement in community mapping in three levels: "See"—almost any user; "Think"—potential contributors; and "Do"—interested users. The case study implements the See-Think-Do framework as an awareness-based approach used for The Crisis Map of the Czech Republic. It is an Ushahidi-based crowdsourcing platform for sharing spatial and multimedia information during crisis situations, e.g. disaster floods in 2013. While the current crisis projects use public mapping just at the onset of the disaster, according to See-Think-Do any user can be considered as a potential contributor even during the dormant period. The focus is put on the "See" and "Think" groups of contributors, which are currently ignored. The objective of this paper is to summarize approaches (social networks, mass-media, emailing, gamification, …) and tools (GIT/GIS, ICT, multimedia) for increasing the awareness about the project within the resting phase. That recruits a higher number of both active and passive users during the disaster. It allows the training in ICT, cartographical, spatial and GIS skills in a non-stressful way and the targeting on specific operators. Volunteers from the "Think" group may be used for data processing or rectification, GIS professionals from the "Do" group for data verification. The results refer that contributors with already established skills and required literacy (interface, data uploading) provide data faster and more accurate, the usability of the project increases based on users' comments.

Proverb familiarity and the mental status examination.

PubMed

Haynes, R M; Resnick, P J; Dougherty, K C; Althof, S E

1993-01-01

Asking patients to interpret proverbs is a traditional method of assessing abstract thinking ability. Familiarity with a proverb increases the likelihood of interpreting it correctly. Differences in proverb familiarity among patients could lead clinicians to incorrectly conclude that a patient is thinking concretely, and thus to underestimate the patient's cognitive ability. Clinicians should be aware of this possibility when assessing patients from different racial and gender groups. The authors surveyed 229 Afro-American and 104 Caucasian high school students to determine their familiarity with 25 proverbs. Thirty-seven clinicians were also asked to rate their patients' familiarity with the same proverbs. The authors found no differences in proverb familiarity between the black and white students or the male and female students. Clinicians' beliefs about proverb familiarity in their patients were found to be inaccurate.

Historical thinking in clinical medicine: lessons from R.G. Collingwood's philosophy of history.

PubMed

Chin-Yee, Benjamin H; Upshur, Ross E G

2015-06-01

The aim of this article is to create a space for historical thinking in medical practice. To this end, we draw on the ideas of R.G. Collingwood (1889-1943), the renowned British philosopher of history, and explore the implications of his philosophy for clinical medicine. We show how Collingwood's philosophy provides a compelling argument for the re-centring of medical practice around the patient history as a means of restoring to the clinical encounter the human meaning that is too often lost in modern medicine. Furthermore, we examine how Collingwood's historical thinking offers a patient-centred epistemology and a more pluralistic concept of evidence that includes the qualitative, narrative evidence necessary for human understanding. We suggest that clinical medicine can benefit from Collingwood's historical thinking, and, more generally, illustrates how a philosophy of medicine that draws on diverse sources from the humanities offers a richer, more empathetic clinical practice. © 2015 John Wiley & Sons, Ltd.

Critical thinking in nursing: Scoping review of the literature.

PubMed

Zuriguel Pérez, Esperanza; Lluch Canut, Maria Teresa; Falcó Pegueroles, Anna; Puig Llobet, Montserrat; Moreno Arroyo, Carmen; Roldán Merino, Juan

2015-12-01

This article seeks to analyse the current state of scientific knowledge concerning critical thinking in nursing. The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January 1999 to June 2013 were identified, of which 90 met the inclusion criteria. The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest in the study of both its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals. Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting, independent of conceptual models, with a variety of instruments used for its measurement. We recommend (i) the investigation of critical thinking among working professionals, (ii) the designing of evaluative instruments linked to conceptual models and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care. © 2014 Wiley Publishing Asia Pty Ltd.

Think tank (2) Its development and the current situation of the key organizations in Japan

NASA Astrophysics Data System (ADS)

Obara, Michio

There were some think tank businesses in Japan before the war. South Manchuria Railway Company established its Research Department for the purpose of getting power to control Manchuria as a colony, and got the good results. Think tank business was flourishing three times after the war. This business attracts much attention when the social and economic paradigm is going to change. Among the key large-scale think tanks in Japan, Nomura Research Institute, Ltd. (NRI) was the first to enhance the system functions by the merger, and posted think tank function up in the SI business. Mitsubishi Research Institute, Inc. (MRI) intends to be an orthodox think tank, and established an advanced research institute and the laboratory for R&D. Daiwa Institute of Research, Ltd. (DIR) focuses on economic forecast by using system. Fuji Research Institute. Corp. (FUJI RIC) focuses on survey and policy proposing in macro-economics, and analyzing technology. The Japan Research Institute, Ltd. (JRI) focuses on regional development, and R&D in advanced technology.

The fate of the dream in contemporary psychoanalysis.

PubMed

Loden, Susan

2003-01-01

Freud's metapsychology of dream formation has implicitly been discarded, as indicated in a brief review of trends in psychoanalytic thinking about dreams, with a focus on the relationship of the dream process to ego capacities. The current bias toward exclusive emphasis on the exploration of the analytic relationship and the transference has evolved at the expense of classical, in-depth dream interpretation, and, by extension, at the expense of strengthening the patient's capacity for self-inquiry. This trend is shown to be especially evident in the treatment of borderline patients, who today are believed by many analysts to misuse the dream in the analytic situation. An extended clinical example of a borderline patient with whom an unmodified Freudian associative technique of dream interpretation is used with good outcome illustrates the author's contrary conviction. In clinical practice, we should neglect neither the uniqueness of the dream as a central intrapsychic event nor the Freudian art of total dream analysis.

Development and Evaluation of a Systems Thinking Education Strategy for Baccalaureate Nursing Curriculum: A Pilot Study.

PubMed

Fura, Louise A; Wisser, Kathleen Z

Nurse educators are charged to develop and evaluate curricula on systems thinking to prepare future nurses to provide safe nursing care. The goal of this pilot study was to design and evaluate a four-hour educational strategy that prepares future professional nurses to use systems thinking approaches in the delivery of safe patient care. This study exposed prelicensure baccalaureate nursing students to systems thinking principles, which included didactic and experiential activities. A descriptive design was used to determine the effect of an on-campus educational strategy. A paired samples t-test revealed statistical significance from pretest to posttest.

Evolutionary Science as a Method to Facilitate Higher Level Thinking and Reasoning in Medical Training.

PubMed

Graves, Joseph L; Reiber, Chris; Thanukos, Anna; Hurtado, Magdalena; Wolpaw, Terry

2016-10-15

Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula. To illuminate how evolution may be helpful in these areas, examples in which the insights of evolutionary science are already improving medical treatment and ways in which evolutionary reasoning can be practiced in the context of medicine are provided. In order to facilitate the learning of evolutionary principles, concepts derived from evolutionary science that medical students and professionals should understand are outlined. These concepts are designed to be authoritative and at the same time easily accessible for anyone with the general biological knowledge of a first-year medical student. Thus we conclude that medical practice informed by evolutionary principles will be more effective and lead to better patient outcomes.Furthermore, it is argued that evolutionary medicine complements general medical training because it provides an additional means by which medical students can practice the critical thinking skills that will be important in their future practice. We argue that core concepts from evolutionary science have the potential to improve critical thinking and facilitate more effective learning in medical training. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

Current Challenges for Healthcare Services and the Opportunities Created by the Marketing Abilities

PubMed Central

Purcărea, T; Purcărea, LV; Raţiu, M

2008-01-01

Life is changing dramatically, market position as part of life is becoming more and more important, and marketing, considered a key cultural architect of nowadays that involves voluntary relation exchanges between the communicating partners, is placing the patient in the center of most adequate action towards the medical future which represents his life quality. We think that the moment has come to resort to marketing as a new method to identify innovation opportunities in healthcare services' delivery, considering that the high quality of healthcare services, answering to demands of healthcare systems' consumers, represents a well recognized priority for the European citizens. Consequently, the model of ‘healthcare business’ has to rely on the value for patient by creating competition concerning the results at medical condition level. PMID:20108474

Seniors, risk and rehabilitation: broadening our thinking.

PubMed

Egan, Mary Y; Laliberte Rudman, Debbie; Ceci, Christine; Kessler, Dorothy; McGrath, Colleen; Gardner, Paula; King, Judy; Lanoix, Monique; Malhotra, Ravi

2017-06-01

Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant conceptualizations. Invitees reflected on conceptualizations of risk in stroke rehabilitation and low vision rehabilitation, identified and explored positive and negative implications and generated alternative perspectives to support rehabilitation approaches related to living a good life. Current risk conceptualizations help focus rehabilitation teamwork and make this work publically recognizable and valued. However, they also lead to practice that is depersonalized, decontextualized and restrictive. Further research and practice development initiatives should include the voices of clinicians and seniors to more adequately support meaningfully living, and foster safe spaces for seniors and clinicians to speak candidly, comprehensively and respectfully about risk. To ensure that seniors' rehabilitation targets a satisfying life as defined by seniors, increased focus on the environment and more explicit examination of how cost containment concerns are driving services is also necessary. This work reinforced current concerns about conceptualizations of risk in seniors' rehabilitation and generated ways forward that re-focus rehabilitation more on promoting a satisfying life. Implications for rehabilitation In seniors' rehabilitation, considerations of risk focus on physical injury, functional dependence and cost containment. Focus on provider-defined risk of physical injury limits examination of patient goals and patients' histories of judging and dealing with risk. Focus on functional dependence and cost containment may lead to practice that is depersonalized and decontextualized. Abandonment of ableist and ageist thinking and an explicit focus on person-centered definitions of risk and a satisfying life are recommended.

A New Parallel Corpus Approach to Japanese Learners' English, Using Their Corrected Essays

ERIC Educational Resources Information Center

Miki, Nozomi

2010-01-01

This research introduces unique parallel corpora to uncover linguistic behaviors in L2 argumentative writing in the exact correspondence to their appropriate forms provided by English native speakers (NSs). The current paper targets at the mysterious behavior of I think in argumentative prose. I think is regarded as arguably problematic and…

Mastering Leadership Concepts through Utilizing Critical Thinking Strategies within Educational Administration Courses at Kuwait University

ERIC Educational Resources Information Center

Alqahtani, Abdulmuhsen Ayedh; Al-Enezi, Mutlaq M.

2012-01-01

The current study aims at exploring the students' perceptions of mastering leadership concepts and critical thinking strategies implemented by faculty members in the college of education at Kuwait University, and the impact of the later on former. The data was collected using a questionnaire on a sample consisting of 411 students representing…

Re-Thinking School-University Collaboration: Agenda for the 21st Century

ERIC Educational Resources Information Center

Wasonga, C. O.; Rari, B. O.; Wanzare, Z. O.

2011-01-01

Collaboration is a hard and challenging endeavor. It takes all the key players to make it happen. This paper discusses our current thinking about school-university collaboration. In it, we define what collaboration involves in the context of universities and schools. Next, we discuss what we believe are the essential benefits of effective…

How Scientists Use Critical-Thinking Skills: Isolating Both Total RNA and Protein Using the Same Small Organ

ERIC Educational Resources Information Center

Porta, Angela R.; Dhawan, Puneet

2006-01-01

Undergraduate biology programs are currently undergoing reform to involve students in biomedical research. Engaging students in more active, hands-on experiments allows students to discover scientific principles for themselves, and to develop techniques of critical thinking and problem solving. This models the world of real scientific research,…

SPEAKING, WRITING, AND LISTENING IN THE ST. PAUL ELEMENTARY SCHOOLS.

ERIC Educational Resources Information Center

AMBROSE, HELEN; AND OTHERS

DESIGNED AS A RESOURCE FOR ELEMENTARY SCHOOL TEACHERS TO USE IN HELPING CHILDREN THINK CLEARLY AND COMMUNICATE EFFECTIVELY, THE ST. PAUL CURRICULUM GUIDE IS DIVIDED INTO THREE SECTIONS--SPEAKING, LISTENING, AND WRITING. AN OVERVIEW OF EACH SECTION DESCRIBES CURRENT THINKING IN THE FIELD AND GENERAL SKILLS WHICH NEED TO BE ACQUIRED BY STUDENTS.…

Dual-Process Theories of Reasoning: Contemporary Issues and Developmental Applications

ERIC Educational Resources Information Center

Evans, Jonathan St. B. T.

2011-01-01

In this paper, I discuss the current state of theorising about dual processes in adult performance on reasoning and decision making tasks, in which Type 1 intuitive processing is distinguished from Type 2 reflective thinking. I show that there are many types of theory some of which distinguish modes rather than types of thinking and that…

Keeping It Current: Using Technology to Teach about Social Issues

ERIC Educational Resources Information Center

Sardone, Nancy B.; Devlin-Scherer, Roberta

2010-01-01

In thinking about teaching nonfiction, the authors acknowledge that many contemporary and important nonfiction texts that students should be encouraged to read take up social issues that are not easy to talk about or even to think about. They discovered that combining well-chosen nonfiction on social issues with specialized digital games and other…

Thinking and Caring about Indigenous Peoples' Human Rights: Swedish Students Writing History beyond Scholarly Debate

ERIC Educational Resources Information Center

Nygren, Thomas

2016-01-01

According to national and international guidelines, schools should promote historical thinking and foster moral values. Scholars have debated, but not analysed in depth in practice, whether history education can and should hold a normative dimension. This study analyses current human rights education in two Swedish senior high school groups, in…

Effectiveness of Critical Thinking Instruction in Higher Education: A Systematic Review of Intervention Studies

ERIC Educational Resources Information Center

Tiruneh, Dawit T.; Verburgh, An; Elen, Jan

2014-01-01

Promoting students' critical thinking (CT) has been an essential goal of higher education. However, despite the various attempts to make CT a primary focus of higher education, there is little agreement regarding the conditions under which instruction could result in greater CT outcomes. In this review, we systematically examined current empirical…

Development of System Thinking Skills in the Context of Earth System Education

ERIC Educational Resources Information Center

Assaraf, Orit Ben-Zvi; Orion, Nir

2005-01-01

The current study deals with the development of system thinking skills at the junior high school level. The sample population included about 50 eighth-grade students from two different classes of an urban Israeli junior high school who studied an earth systems-based curriculum that focused on the hydro cycle. The study addressed the following…

Ideology, "Truth" and Spin: Dialectic Relations between the Neoliberal Think-Tank Movement and Academia in Australia

ERIC Educational Resources Information Center

Thompson, Lester; Wadley, David

2017-01-01

The context of contemporary universities restrains their ability to drive public policy. Yet, currently, they confront the relative success of a global network of neoliberal institutes, referred to as think-tanks, promoting freedoms derived from particular ideologies. Neoliberal reasoning has so moulded classical ideas of individual freedom into a…

To Think without Thinking: The Implications of Combinatory Play and the Creative Process for Neuroaesthetics

ERIC Educational Resources Information Center

Stevens, Victoria

2014-01-01

The author considers combinatory play as an intersection between creativity, play, and neuroaesthetics. She discusses combinatory play as vital to the creative process in art and science, particularly with regard to the incubation of new ideas. She reviews findings from current neurobiological research and outlines the way that the brain activates…

The Role of CLEAR Thinking in Learning Science from Multiple-Document Inquiry Tasks

ERIC Educational Resources Information Center

Griffin, Thomas D.; Wiley, Jennifer; Britt, M. Anne; Salas, Carlos R.

2012-01-01

The main goal for the current study was to investigate whether individual differences in domain-general thinking dispositions might affect learning from multiple-document inquiry tasks in science. Middle school students were given a set of documents and were tasked with understanding how and why recent patterns in global temperature might be…

Peering around the Corner: Futures Thinking for Academic Librarians

ERIC Educational Resources Information Center

Hinchliffe, Lisa Janicke; Malenfant, Kara

2010-01-01

The Association of College and Research Libraries (ACRL) has a long history of data collection, environmental scanning, and trends analysis. Its most recent work, "Futures Thinking for Academic Librarians," uses a 15-year horizon to look beyond the worries of the current economic cycle and the short-term future in order to anticipate the changing…

Thinking about Digestive System in Early Childhood: A Comparative Study about Biological Knowledge

ERIC Educational Resources Information Center

AHI, Berat

2017-01-01

The current study aims to explore how children explain the concepts of biology and how biological knowledge develops across ages by focusing on the structure and functions of the digestive system. The study was conducted with 60 children. The data were collected through the interviews conducted within a think-aloud protocol. The interview data…

Reading Essentials: The Specifics You Need To Teach Reading Well.

ERIC Educational Resources Information Center

Routman, Regie

Currently, there is much controversy and confusion over "best practice" issues in teaching reading. This book, written by a "lifelong teacher/learner," is based on the premise that good teaching does not have to mean lots of hours spent planning but instead requires lots of thinking--thinking about what matters to children, what children need to…

Scripting to Enhance University Students' Critical Thinking in Flipped Learning: Implications of the Delayed Effect on Science Reading Literacy

ERIC Educational Resources Information Center

Lee, Yuan-Hsuan

2018-01-01

Premised on Web 2.0 technology, the current study investigated the effect of facilitating critical thinking using the Collaborative Questioning, Reading, Answering, and Checking (C-QRAC) collaboration script on university students' science reading literacy in flipped learning conditions. Participants were 85 Taiwanese university students recruited…

Developing Thinking Skills within the Context of the Existing Secondary Curriculum: The Case of Economics.

ERIC Educational Resources Information Center

Morris, Paul

Topics and issues which are central features of current secondary school economics curricula can be used to develop two aspects of students' thinking skills: (1) the development of problem-solving skills, and (2) the recognition of logical fallacies. The efficacy of economics instruction as a vehicle for developing student problem-solving skills…

Systems and complexity thinking in general practice: part 1 - clinical application.

PubMed

Sturmberg, Joachim P

2007-03-01

Many problems encountered in general practice cannot be sufficiently explained within the Newtonian reductionist paradigm. Systems and complexity thinking - already widely adopted in most nonmedical disciplines - describes and explores the contextual nature of questions posed in medicine, and in general practice in particular. This article briefly describes the framework underpinning systems and complexity sciences. A case study illustrates how systems and complexity thinking can help to better understand the contextual nature of patient presentations, and how different approaches will lead to different outcomes.

Depressive states amplify both upward and downward counterfactual thinking.

PubMed

Feng, Xue; Gu, Ruolei; Liang, Fucheng; Broster, Lucas S; Liu, Yunzhe; Zhang, Dandan; Luo, Yue-jia

2015-08-01

Depression has been linked to counterfactual thinking in many behavioral studies, but the direction of this effect remains disputed. In the current study, the relationship between depression and counterfactual thinking was examined using the event-related potential (ERP) technique. In a binary choice gambling task, outcome feedback of the chosen option and that of the alternative option were both provided, so as to elicit the process of counterfactual comparison. By investigating ERP signals in response to outcome presentation, we discovered that when the fictive outcome was better or worse than the factual outcome, the amplitude of the P3 component was positively correlated with individual levels of depression, but not levels of anxiety. These results indicate that depression strengthens both upward counterfactual thinking and downward counterfactual thinking. The implication of this finding to clinical research is discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

The importance of thinking styles in predicting binge eating.

PubMed

Nikčević, A V; Marino, C; Caselli, G; Spada, M M

2017-08-01

Impulsivity, Body Mass Index, negative emotions and irrational food beliefs are often reported as predictors of binge eating. In the current study we explored the role played by two thinking styles, namely food thought suppression and desire thinking, in predicting binge eating among young adults controlling for established predictors of this condition. A total of 338 university students (268 females) participated in this study by completing a battery of questionnaires measuring the study variables. Path analysis revealed that impulsivity was not associated with binge eating, that Body Mass Index and negative emotions predicted binge eating, and that irrational food beliefs only influenced binge eating via food thought suppression and desire thinking. In conclusion, thinking styles appear an important predictor of binge eating and they should be taken into consideration when developing clinical interventions for binge eating. Copyright © 2017 Elsevier Ltd. All rights reserved.

Critical thinking competence and disposition of clinical nurses in a medical center.

PubMed

Feng, Rung-Chuang; Chen, Mei-Jung; Chen, Mei-Chuan; Pai, Yu-Chu

2010-06-01

Critical thinking is essential in nursing practice. Promoting critical thinking competence in clinical nurses is an important way to improve problem solving and decision-making competence to further improve the quality of patient care. However, using an adequate tool to test nurses' critical thinking competence and disposition may provide the reference criteria for clinical nurse characterization, training planning, and resource allocation for human resource management. The purpose of this study was to measure the critical thinking competence and critical thinking disposition of clinical nurses as well as to explore the related factors of critical thinking competence. Clinical nurses from four different clinical ladders selected from one medical center were stratified randomly. All qualified subjects who submitted valid questionnaires were included in the study. A Taiwan version of the modified Watson-Glaser Critical Thinking Appraisal and Critical Thinking Disposition Inventory was developed to measure the critical thinking competence and critical thinking disposition of clinical nurses. Validity was evaluated using the professional content test (content validity index = .93). Reliability was assessed with a Cronbach's alpha coefficient of .85. Data were analyzed using the SPSS for Windows (Version 12.0; SPSS Inc., Chicago, IL). Results showed that competence of interpretation was the highest critical thinking competence factor. Inference was the lowest, and reflective thinking as a critical thinking disposition was more positive. In addition, age, years of nursing experience, and experiences in other hospitals significantly influenced critical thinking competence (p < .05). Factors of age, years of experience, and nurses clinical ladder were shown to affect critical thinking disposition scores. Clinical ladder N4 nurses had the highest scores in both competence and disposition. A significant relationship was found between critical thinking competence and disposition scores, with 29.3% of the variance in critical thinking competence potentially explained by total years of nurse hospital experience. Clinical ladder and age were predictive factors for critical thinking disposition. Commonality was 27.9%. Nursing experience and clinical ladders positively affect critical thinking competence and disposition. Issues of critical thinking competence increasingly need to be measured. Therefore, appropriate tools for nursing professions should be further developed and explored for specific areas of practice.

The Meaning of Visual Thinking Strategies for Nursing Students

ERIC Educational Resources Information Center

Moorman, Margaret M.

2013-01-01

Nurse educators are called upon to provide creative, innovative experiences for students in order to prepare nurses to work in complex healthcare settings. As part of this preparation, teaching observational and communication skills is critical for nurses and can directly affect patient outcomes. Visual thinking strategies (VTS) are a teaching…

Reliability, validity and factorial structure of the Arabic version of the international suicide prevention trial (InterSePT) scale for suicidal thinking in schizophrenia patients in Doha, Qatar.

PubMed

Hammoudeh, Samer; Ghuloum, Suhaila; Mahfoud, Ziyad; Opler, Mark; Khan, Anzalee; Yehya, Arij; Abdulhakam, Abdulmoneim; Al-Mujalli, Azza; Hani, Yahya; Elsherbiny, Reem; Al-Amin, Hassen

2016-12-07

Patients with schizophrenia are known to have higher rates of mortality and morbidity when compared to the general population. Suicidality is a major contributor to increased mortality. The International Suicide Prevention Trial (InterSePT) Scale for Suicidal Thinking (ISST) is a validated tool to assess current suicidal ideation in patients with schizophrenia. The aims of the study were to culturally adapt the Arabic translation of ISST and to examine the psychometric characteristics of the Arabic version of the ISST among patients with schizophrenia in Qatar. ISST was translated and adapted into formal Arabic using the back translation method. Patients diagnosed with schizophrenia were randomly recruited from the department of Psychiatry, Rumailah Hospital, Doha, Qatar. Healthy controls were randomly recruited from two primary health care centers in Doha, Qatar. The Arabic version of Module B for suicidality in Mini International Neuropsychiatric Interview was used as the gold standard to which the Arabic ISST was compared. The study sample (n = 199) was composed of 100 patients diagnosed with schizophrenia (age 35.30 ± 10.04 years; M/F is 2/1) and 99 controls (age 33.98 ± 8.33 years; M/F is 2/3). The mean score on the ISST was 3.03 ± 4.75 vs. 0.47 ± 1.44 for the schizophrenia and control groups, respectively. Inter-rater reliability coefficient was 0.95, p > 0.001. The overall Cronbach's alpha was 0.92. Principal Component Analysis produced 3 factors explaining a total of 73.8% of variance. This is the first study in the Arab countries to validate the Arabic version of the ISST. The psychometric properties indicate that the Arabic ISST is a valid tool to assess the severity of suicidal ideation in Arabic patients with schizophrenia.

Dorsomedial prefontal cortex supports spontaneous thinking per se.

PubMed

Raij, T T; Riekki, T J J

2017-06-01

Spontaneous thinking, an action to produce, consider, integrate, and reason through mental representations, is central to our daily experience and has been suggested to serve crucial adaptive purposes. Such thinking occurs among other experiences during mind wandering that is associated with activation of the default mode network among other brain circuitries. Whether and how such brain activation is linked to the experience of spontaneous thinking per se remains poorly known. We studied 51 healthy subjects using a comprehensive experience-sampling paradigm during 3T functional magnetic resonance imaging. In comparison with fixation, the experiences of spontaneous thinking and spontaneous perception were related to activation of wide-spread brain circuitries, including the cortical midline structures, the anterior cingulate cortex and the visual cortex. In direct comparison of the spontaneous thinking versus spontaneous perception, activation was observed in the anterior dorsomedial prefrontal cortex. Modality congruence of spontaneous-experience-related brain activation was suggested by several findings, including association of the lingual gyrus with visual in comparison with non-verbal-non-visual thinking. In the context of current literature, these findings suggest that the cortical midline structures are involved in the integrative core substrate of spontaneous thinking that is coupled with other brain systems depending on the characteristics of thinking. Furthermore, involvement of the anterior dorsomedial prefrontal cortex suggests the control of high-order abstract functions to characterize spontaneous thinking per se. Hum Brain Mapp 38:3277-3288, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Patient perspective workshop: moving towards OMERACT guidelines for choosing or developing instruments to measure patient-reported outcomes.

PubMed

Kirwan, John R; Fries, James F; Hewlett, Sarah E; Osborne, Richard H; Newman, Stanton; Ciciriello, Sabina; van de Laar, Mart A; Dures, Emma; Minnock, Patricia; Heiberg, Turid; Sanderson, Tessa C; Flurey, Caroline A; Leong, Amy L; Montie, Pamela; Richards, Pam

2011-08-01

The workshop Choosing or Developing Instruments held at the Outcome Measures in Rheumatology (OMERACT) 10 meeting was designed to help participants think about the underlying methods of instrument development. Conference pre-reading material and 3 brief introductory presentations elaborated the issues, and participants broke into discussion groups before reconvening to share insights, engage in a more general discussion of the issues, and vote on recommendations. Tradeoffs between using current imperfect measures and the long and complex process of developing new instruments were considered, together with the need for rigor in patient-reported outcome (PRO) instrument development. The main considerations for PRO instrument development were listed and a research agenda for action produced. As part of the agenda for action, it is recommended that researchers and patient partners work together to tackle these issues, and that OMERACT bring forward proposals for acceptable instrument development protocols that would meet an enhanced "Truth" statement in the OMERACT Filter.

Direct-to-consumer communication on prescription only medicines via the internet in the Netherlands, a pilot study. Opinion of the pharmaceutical industry, patient associations and support groups.

PubMed

Fabius, A Mariette; Cheung, Ka-Chun; Rijcken, Cristianne J F; Vinkers, Christiaan H; Talsma, Herre

2004-06-01

Investigation of the current application of direct-to-consumer (DTC) communication on prescription only medicines via the Intemet in the Netherlands. Questionnaires were sent by e-mail to 43 Dutch innovative pharmaceutical industries and 130 Patient Association and Support Groups (PASGs). In this pilot study, the response of the pharmaceutical industry was rather low but the impression is that they were willing to invest in DTC communication. The majority of the websites of PASGs did not link to websites of pharmaceutical companies. The PASGs had no opinion whether patients can make a good distinction between DTC advertising and information on websites of the pharmaceutical industry nor about the quality. PASGs did not think unambiguously about the impact on the patient-doctor relationship. The impact of DTC communication on prescription only medicines via the internet is not yet clear in the Netherlands.

Transcutaneous vagus nerve stimulation (tVNS) enhances divergent thinking.

PubMed

Colzato, Lorenza S; Ritter, Simone M; Steenbergen, Laura

2018-03-01

Creativity is one of the most important cognitive skills in our complex and fast-changing world. Previous correlative evidence showed that gamma-aminobutyric acid (GABA) is involved in divergent but not convergent thinking. In the current study, a placebo/sham-controlled, randomized between-group design was used to test a causal relation between vagus nerve and creativity. We employed transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique to stimulate afferent fibers of the vagus nerve and speculated to increase GABA levels, in 80 healthy young volunteers. Creative performance was assessed in terms of divergent thinking (Alternate Uses Task) and convergent thinking tasks (Remote Associates Test, Creative Problem Solving Task, Idea Selection Task). Results demonstrate active tVNS, compared to sham stimulation, enhanced divergent thinking. Bayesian analysis reported the data to be inconclusive regarding a possible effect of tVNS on convergent thinking. Therefore, our findings corroborate the idea that the vagus nerve is causally involved in creative performance. Even thought we did not directly measure GABA levels, our results suggest that GABA (likely to be increased in active tVNS condition) supports the ability to select among competing options in high selection demand (divergent thinking) but not in low selection demand (convergent thinking). Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Medial Temporal Lobes are Critical for Reward-Based Decision Making under Conditions that Promote Episodic Future Thinking

PubMed Central

Palombo, Daniela J.; Keane, Margaret M.; Verfaellie, Mieke

2014-01-01

In the present study, we investigated the effect of medial temporal lobe (MTL) damage on human decision making in the context of reward-based intertemporal choice. During intertemporal choice, humans typically devalue (or discount) a future reward to account for its delayed arrival (e.g., preferring $30 now over $42 in 2 months), but this effect is attenuated when participants engage in episodic future thinking, i.e., project themselves into the future to imagine a specific event. We hypothesized that this attenuation would be selectively impaired in amnesic patients, who have deficits in episodic future thinking. Replicating previous work, in a standard intertemporal choice task, amnesic patients showed temporal discounting indices similar to healthy controls. Consistent with our hypothesis, while healthy controls demonstrated attenuated temporal discounting in a condition that required participants first to engage in episodic future thinking (e.g., to imagine spending $42 at a theatre in 2 months), amnesic patients failed to demonstrate this effect. Moreover, as expected, amnesic patients’ narratives were less episodically rich than those of controls. These findings extend the range of tasks that are shown to be MTL dependent to include not only memory-based decision-making tasks but also future-oriented ones. PMID:25284804

Establishing consciousness in non-communicative patients: a modern-day version of the Turing test.

PubMed

Stins, John F

2009-03-01

In a recent study of a patient in a persistent vegetative state, [Owen, A. M., Coleman, M. R., Boly, M., Davis, M. H., Laureys, S., & Pickard, J. D. (2006). Detecting awareness in the vegetative state. Science, 313, 1402] claimed that they had demonstrated the presence of consciousness in this patient. This bold conclusion was based on the isomorphy between brain activity in this patient and a set of conscious control subjects, obtained in various imagery tasks. However, establishing consciousness in unresponsive patients is fraught with methodological and conceptual difficulties. The aim of this paper is to demonstrate that the current debate surrounding consciousness in VS patients has parallels in the artificial intelligence (AI) debate as to whether machines can think. Basically, (Owen et al., 2006) used a method analogous to the Turing test to reveal the presence of consciousness, whereas their adversaries adopted a line of reasoning akin to Searle's Chinese room argument. Highlighting the correspondence between these two debates can help to clarify the issues surrounding consciousness in non-communicative agents.

A Concept Analysis of Systems Thinking.

PubMed

Stalter, Ann M; Phillips, Janet M; Ruggiero, Jeanne S; Scardaville, Debra L; Merriam, Deborah; Dolansky, Mary A; Goldschmidt, Karen A; Wiggs, Carol M; Winegardner, Sherri

2017-10-01

This concept analysis, written by the National Quality and Safety Education for Nurses (QSEN) RN-BSN Task Force, defines systems thinking in relation to healthcare delivery. A review of the literature was conducted using five databases with the keywords "systems thinking" as well as "nursing education," "nursing curriculum," "online," "capstone," "practicum," "RN-BSN/RN to BSN," "healthcare organizations," "hospitals," and "clinical agencies." Only articles that focused on systems thinking in health care were used. The authors identified defining attributes, antecedents, consequences, and empirical referents of systems thinking. Systems thinking was defined as a process applied to individuals, teams, and organizations to impact cause and effect where solutions to complex problems are accomplished through collaborative effort according to personal ability with respect to improving components and the greater whole. Four primary attributes characterized systems thinking: dynamic system, holistic perspective, pattern identification, and transformation. Using the platform provided in this concept analysis, interprofessional practice has the ability to embrace planned efforts to improve critically needed quality and safety initiatives across patients' lifespans and all healthcare settings. © 2016 Wiley Periodicals, Inc.

Critical thinking, delegation, and missed care in nursing practice.

PubMed

Bittner, Nancy Phoenix; Gravlin, Gayle

2009-03-01

The aim of this study was to understand how nurses use critical thinking to delegate nursing care. Nurses must synthesize large amounts of information and think through complex and often emergent clinical situations when making critical decisions about patient care, including delegation. A qualitative, descriptive study was used in this article. Before delegating, nurses reported considering patient condition, competency, experience, and workload of unlicensed assistive personnel (UAP). Nurses expected UAP to report significant findings and have higher level knowledge, including assessment and prioritizing skills. Successful delegation was dependent on the relationship between the RN and the UAP, communication, system support, and nursing leadership. Nurses reported frequent instances of missed or omitted routine care. Findings from this project provide insight into factors that influence delegation effectiveness. These can guide CNOs and frontline nurse leaders to focus on implementing strategies to mitigate the consequence of missed care. Ineffective delegation of basic nursing care can result in poor patient outcomes, potentially impacting quality measures, satisfaction, and reimbursement for the institution.

Enhancing nursing informatics competencies and critical thinking skills using wireless clinical simulation laboratories.

PubMed

Cholewka, Patricia A; Mohr, Bernard

2009-01-01

Nursing students at New York City College of Technology are assigned client care experiences that focus on common alterations in health status. However, due to the unpredictability of client census within any healthcare facility, it is not possible for all students to have the same opportunity to care for clients with specific medical conditions. But with the use of patient simulators in a dedicated Clinical Simulation Laboratory setting, students can be universally, consistently, and repeatedly exposed to programmed scenarios that connect theory with the clinical environment. Outcomes from using patient simulators include improved nursing knowledge base, enhanced critical thinking, reflective learning, and increased understanding of information technology for using a Personal Digital Assistant and documenting care by means of an electronic Patient Record System. An innovative nursing education model using a wireless, inter-connective data network was developed by this college in response to the need for increasing nursing informatics competencies and critical thinking skills by students in preparation for client care.

Think tank (1) - Its definition and the overseas situation

NASA Astrophysics Data System (ADS)

Obara, Michio

The definition as organization is that 1) the think tank should be policy oriented and propose the current issues, 2) it should be interdisciplinary and future oriented, and 3) it should be independent without any outside interference upon it. It is divided into three types in terms of business activity; 1) policy proposing, 2) R&D undertaking and 3) business consulting think tanks. Historically the U.S. has been leading the world because the first think tank was born in this country, and three types of think tanks have brought out the mature business undertakings there. Most of the countries other than the U.S. has held policy proposing type think tanks. The notable think tanks are Brookings Research Institute, Rand Research Institute, Battelle Memorial Institute, Arthur D. Little Co. Ltd. SRI International in the U.S.A., IFO Economic Research Institute, German Economic Research Institute in Germany, France International Relations Research Institute in France, Royal International Relations Research institute, International Strategic Matters Research Institute in the U.K., and Korean Development Research Institute, Korean industrial Research Institute in Korea. All of these have been active in the areas of politics, economics, industry and technology.

Does substance misuse moderate the relationship between criminal thinking and recidivism?

PubMed Central

Caudy, Michael S.; Folk, Johanna B.; Stuewig, Jeffrey B.; Wooditch, Alese; Martinez, Andres; Maass, Stephanie; Tangney, June P.; Taxman, Faye S.

2014-01-01

Purpose Some differential intervention frameworks contend that substance use is less robustly related to recidivism outcomes than other criminogenic needs such as criminal thinking. The current study tested the hypothesis that substance use disorder severity moderates the relationship between criminal thinking and recidivism. Methods The study utilized two independent criminal justice samples. Study 1 included 226 drug-involved probationers. Study 2 included 337 jail inmates with varying levels of substance use disorder severity. Logistic regression was employed to test the main and interactive effects of criminal thinking and substance use on multiple dichotomous indicators of recidivism. Results Bivariate analyses revealed a significant correlation between criminal thinking and recidivism in the jail sample (r = .18, p < .05) but no significant relationship in the probation sample. Logistic regressions revealed that SUD symptoms moderated the relationship between criminal thinking and recidivism in the jail-based sample (B = −.58, p < .05). A significant moderation effect was not observed in the probation sample. Conclusions Study findings indicate that substance use disorder symptoms moderate the strength of the association between criminal thinking and recidivism. These findings demonstrate the need for further research into the interaction between various dynamic risk factors. PMID:25598559

The parallel impact of episodic memory and episodic future thinking on food intake.

PubMed

Vartanian, Lenny R; Chen, William H; Reily, Natalie M; Castel, Alan D

2016-06-01

This research examined the effects of both episodic memory and episodic future thinking (EFT) on snack food intake. In Study 1, female participants (n = 158) were asked to recall their lunch from earlier in the day, to think about the dinner they planned to have later in the day, or to think about a non-food activity before taking part in a cookie taste test. Participants who recalled their lunch or who thought about their dinner ate less than did participants who thought about non-food activities. These effects were not explained by group differences in the hedonic value of the food. Study 2 examined whether the suppression effect observed in Study 1 was driven by a general health consciousness. Female participants (n = 74) were asked to think about their past or future exercise (or a non-exercise activity), but thinking about exercise had no impact on participants' cookie consumption. Overall, both thinking about past food intake and imagining future food intake had the same suppression effect on participants' current food intake, but further research is needed to determine the underlying mechanism. Copyright © 2016 Elsevier Ltd. All rights reserved.

M-OSCE as a method to measure dental hygiene students' critical thinking: a pilot study.

PubMed

McComas, Martha J; Wright, Rebecca A; Mann, Nancy K; Cooper, Mary D; Jacks, Mary E

2013-04-01

Educators in all academic disciplines have been encouraged to utilize assessment strategies to evaluate students' critical thinking. The purpose of this study was to assess the viability of the modified objective structured clinical examination (m-OSCE) to evaluate critical thinking in dental hygiene education. This evaluation utilized a convenience sample of senior dental hygiene students. Students participated in the m-OSCE in which portions of a patient case were revealed at four stations. The exam consisted of multiple-choice questions intended to measure students' ability to utilize critical thinking skills. Additionally, there was one fill-in-the-blank question and a treatment plan that was completed at the fifth station. The results of this study revealed that the m-OSCE did not reliably measure dental hygiene students' critical thinking. Statistical analysis found no satisfactory reliability within the multiple-choice questions and moderately reliable results within the treatment planning portion of the examination. In addition, the item analysis found gaps in students' abilities to transfer clinical evidence/data to basic biomedical knowledge as demonstrated through the multiple-choice questioning results. This outcome warrants further investigation of the utility of the m-OSCE, with a focus on modifications to the evaluation questions, grading rubric, and patient case.

Predictors of response to pain management treatment. The role of family environment and changes in cognitive processes.

PubMed

Tota-Faucette, M E; Gil, K M; Williams, D A; Keefe, F J; Goli, V

1993-06-01

The purpose of the present study was to examine factors that influence individual differences in treatment response after multidisciplinary pain management. Pre-post assessment design. 119 chronic pain inpatients. Outcome measures included pain report from the McGill Pain Questionnaire, emotional distress from the Symptom Checklist-90 Revised, and activity discomfort from the Activity Discomfort Scale. Process measures included the Family Environment Scale, the Coping Strategies Questionnaire, and the Inventory of Negative Thoughts in Response to Pain. Results indicated that pretreatment family environment, cognitive coping strategies, and negative thinking accounted for small yet significant proportions of the variance in outcome. The proportion of variance accounted for by the changes in cognitive coping and negative thinking was somewhat higher. An increase in pain control and rational thinking was related to decreases in depression and anxiety, pain report, and activity discomfort. Decreases in negative social cognitions were related to decreased depression at posttreatment. Changes in coping strategies and negative thinking may be important mechanisms related to improvement, or lack of improvement, in a range of outcome measures. Patients from families who are controlling and disorganized, and patients high on negative thinking at pretreatment may represent high-risk groups in need of further individually tailored interventions.

Catastrophic Thinking Is Associated With Finger Stiffness After Distal Radius Fracture Surgery.

PubMed

Teunis, Teun; Bot, Arjan G J; Thornton, Emily R; Ring, David

2015-10-01

To identify demographic, injury-related, or psychologic factors associated with finger stiffness at suture removal and 6 weeks after distal radius fracture surgery. We hypothesize that there are no factors associated with distance to palmar crease at suture removal. Prospective cohort study. Level I Academic Urban Trauma Center. One hundred sixteen adult patients underwent open reduction and internal fixation of their distal radius fractures; 96 of whom were also available 6 weeks after surgery. None. At suture removal, we recorded patients' demographics, AO fracture type, carpal tunnel release at the time of surgery, pain catastrophizing scale, Whiteley Index, Patient Health Questionnaire-9, and disabilities of the arm, shoulder, and hand questionnaire, 11-point ordinal measure of pain intensity, distance to palmar crease, and active flexion of the thumb through the small finger. At 6 weeks after surgery, we measured motion, disabilities of the arm, shoulder, and hand, and pain intensity. Prereduction and postsurgery radiographic fracture characteristics were assessed. Female sex, being married, specific surgeons, carpal tunnel release, AO type C fractures, and greater catastrophic thinking were associated with increased distance to palmar crease at suture removal. At 6 weeks, greater catastrophic thinking was the only factor associated with increased distance to palmar crease. Catastrophic thinking was a consistent and major determinant of finger stiffness at suture removal and 6 weeks after injury. Future research should assess if treatments that ameliorate catastrophic thinking can facilitate recovery of finger motion after operative treatment of a distal radius fracture. Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

The Relationship between Critical Thinking Disposition and Locus of Control in Pre-Service Teachers

ERIC Educational Resources Information Center

Oguz, Aytunga; Sariçam, Hakan

2016-01-01

The aim of the current research study was to examine the link between critical thinking dispositions and locus of control in pre-service teachers. The participants of this study were selected via easily accessible sampling technique. The participants consist of 347 pre-service teachers (203 female, 144 male) in Kütahya, Turkey. The Rotter…

Investigating the Relationship between Critical Thinking Skills and the Quality of Iranian Intermediate TEFL Students' Writing

ERIC Educational Resources Information Center

Nikou, Farahnaz Rimani; Bonyadi, Alireza; Amirikar, Negin

2015-01-01

The current study intended to find out the relationship between critical thinking skills and the quality of Iranian TEFL (Teaching English as a Foreign Language) students' writing. One-hundred forty students who were homogeneous in their language proficiency were selected non-randomly. The researcher asked students to take part in a proficiency…

Assessing Critical Thinking in Higher Education: Current State and Directions for Next-Generation Assessment. Research Report. ETS RR-14-10

ERIC Educational Resources Information Center

Liu, Ou Lydia; Frankel, Lois; Roohr, Katrina Crotts

2014-01-01

Critical thinking is one of the most important skills deemed necessary for college graduates to become effective contributors in the global workforce. The first part of this article provides a comprehensive review of its definitions by major frameworks in higher education and the workforce, existing assessments and their psychometric qualities,…

On Embodiment, Artifacts, and Signs: A Semiotic-Cultural Perspective on Mathematical Thinking

ERIC Educational Resources Information Center

Radford, Luis; Bardini, Caroline; Sabena, Cristina; Diallo, Pounthioun; Simbagoye, Athanase

2005-01-01

The cognitive significance of the body has become one of the major topics in current psychology. However, it is our contention that claims about the embodied nature of thinking must come to terms with the problem of the relationship between the body as a locus for the constitution of students' subjective mathematical meanings and the historical…

Effect of Robotics on Elementary Preservice Teachers' Self-Efficacy, Science Learning, and Computational Thinking

ERIC Educational Resources Information Center

Jaipal-Jamani, Kamini; Angeli, Charoula

2017-01-01

The current impetus for increasing STEM in K-12 education calls for an examination of how preservice teachers are being prepared to teach STEM. This paper reports on a study that examined elementary preservice teachers' (n = 21) self-efficacy, understanding of science concepts, and computational thinking as they engaged with robotics in a science…

No-boundary thinking in bioinformatics research

PubMed Central

2013-01-01

Currently there are definitions from many agencies and research societies defining “bioinformatics” as deriving knowledge from computational analysis of large volumes of biological and biomedical data. Should this be the bioinformatics research focus? We will discuss this issue in this review article. We would like to promote the idea of supporting human-infrastructure (HI) with no-boundary thinking (NT) in bioinformatics (HINT). PMID:24192339

National Strategies for Educational Leaders to Implement Postmodern Thinking in Public Education in the United States of America

ERIC Educational Resources Information Center

Johnson, Clarence

2006-01-01

Our world today is full of challenges and opportunities. Religion is at the center of attention by the world audience. Civilization will survive if, and only if, educational leaders implement postmodern thinking in public education. Postmodernism was originally a critique of modernism. My views support postmodernism as a current state of mind…

Can Boards of Directors Think Strategically? Some Issues in Developing Direction-Givers' Thinking to a Mega Level

ERIC Educational Resources Information Center

Garratt, Bob

2005-01-01

The author argues that current corporate government legislation and practice is weighted too much in the direction of "board compliance." It is, therefore, in danger of reducing the risks taken by boards of directors. In the long term this could slow significantly the growth of capitalism. He proposes a rebalancing of the fundamental board…

The case for systems thinking about climate change and mental health

NASA Astrophysics Data System (ADS)

Berry, Helen L.; Waite, Thomas D.; Dear, Keith B. G.; Capon, Anthony G.; Murray, Virginia

2018-04-01

It is increasingly necessary to quantify the impacts of climate change on populations, and to quantify the effectiveness of mitigation and adaptation strategies. Despite growing interest in the health effects of climate change, the relationship between mental health and climate change has received little attention in research or policy. Here, we outline current thinking about climate change and mental health, and discuss crucial limitations in modern epidemiology for examining this issue. A systems approach, complemented by a new style of research thinking and leadership, can help align the needs of this emerging field with existing and research policy agendas.

An illustration of whole systems thinking.

PubMed

Kalim, Kanwal; Carson, Ewart; Cramp, Derek

2006-08-01

The complexity of policy-making in the NHS is such that systemic, holistic thinking is needed if the current government's plans are to be realized. This paper describes systems thinking and illustrates its value in understanding the complexity of the diabetes National Service Framework (NSF); its role in identifying problems and barriers previously not predicted; and in reaching conclusions as to how it should be implemented. The approach adopted makes use of soft systems methodology (SSM) devised by Peter Checkland. This analysis reveals issues relating to human communication, information provision and resource allocation needing to be addressed. From this, desirable and feasible changes are explored as means of achieving a more effective NSF, examining possible changes from technical, organizational, economic and cultural perspectives. As well as testing current health policies and plans, SSM can be used to test the feasibility of new health policies. This is achieved by providing a greater understanding and appreciation of what is happening in the real world and how people work. Soft systems thinking is the best approach, given the complexity of health care. It is a flexible, cost-effective solution, which should be a prerequisite before any new health policy is launched.

Hippocampal amnesia disrupts creative thinking.

PubMed

Duff, Melissa C; Kurczek, Jake; Rubin, Rachael; Cohen, Neal J; Tranel, Daniel

2013-12-01

Creativity requires the rapid combination and recombination of existing mental representations to create novel ideas and ways of thinking. The hippocampal system, through its interaction with neocortical storage sites, provides a relational database necessary for the creation, updating, maintenance, and juxtaposition of mental representations used in service of declarative memory. Given this functionality, we hypothesized that hippocampus would play a critical role in creative thinking. We examined creative thinking, as measured by verbal and figural forms of the torrance tests of creative thinking (TTCT), in a group of participants with hippocampal damage and severe declarative memory impairment as well as in a group of demographically matched healthy comparison participants. The patients with bilateral hippocampal damage performed significantly worse than comparison participants on both the verbal and figural portions of the TTCT. These findings suggest that hippocampus plays a role critical in creative thinking, adding to a growing body of work pointing to the diverse ways the hallmark processing features of hippocampus serve a variety of behaviors that require flexible cognition. Copyright © 2013 Wiley Periodicals, Inc.

Genetic Advances in Autism: Heterogeneity and Convergence on Shared Pathways

PubMed Central

Bill, Brent R.; Geschwind, Daniel H.

2009-01-01

The autism spectrum disorders (ASD) are a heterogeneous set of developmental disorders characterized at their core by deficits in social interaction and communication. Current psychiatric nosology groups this broad set of disorders with strong genetic liability and multiple etiologies into the same diagnostic category. This heterogeneity has challenged genetic analyses. But shared patient resources, genomic technologies, more refined phenotypes, and novel computational approaches have begun to yield dividends in defining the genetic mechanisms at work. Over the last five years, a large number of autism susceptibility loci have emerged, redefining our notion of autism’s etiologies, and reframing how we think about ASD. PMID:19477629

How do clinicians and suicide attempters understand suicide attempt impulsivity? A qualitative study.

PubMed

Rimkeviciene, Jurgita; O'Gorman, John; De Leo, Diego

2016-01-01

Inconsistencies in the definition of impulsive suicide attempts hamper research integration. To expand the currently limited data on how this construct is used in clinical practice, researchers interviewed eight suicide attempters to create timelines of their suicide process, then had seven experienced clinicians review these timelines. Thematic analysis of the patient and clinician data revealed three themes: "thinking out," build-up, and unclear intentionality. The results imply that assessing build-up of agitation and exhaustion symptoms can contribute to understanding acuteness of suicide risk. In addition, uncertainty about one's intentions during the attempt should not be equated to low intent to die.

Continuous subcutaneous infusion in palliative care: a review of current practice.

PubMed

Thomas, Tabitha; Barclay, Stephen

2015-02-01

Syringe drivers are widely used in palliative care, and this article reviews the challenges and outstanding questions associated with their use. Misperceptions among the lay public and some health professionals can be addressed by sensitive communication with patients and families and clear thinking in clinical teams concerning the drugs and doses used, particularly in non-malignant disease. Good levels of knowledge concerning syringe driver use has been found among GPs and community nurses, although this is not the case in some nursing home teams. The advantages of newer devices, safety and efficacy of drug combinations, selection of diluent, and management of site reactions are discussed.

Should informed consent be based on rational beliefs?

PubMed Central

Savulescu, J; Momeyer, R W

1997-01-01

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences. PMID:9358347

Should informed consent be based on rational beliefs?

PubMed

Savulescu, J; Momeyer, R W

1997-10-01

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences.

Using standardized patients versus video cases for representing clinical problems in problem-based learning.

PubMed

Yoon, Bo Young; Choi, Ikseon; Choi, Seokjin; Kim, Tae-Hee; Roh, Hyerin; Rhee, Byoung Doo; Lee, Jong-Tae

2016-06-01

The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

A Wittgenstein Approach to the Learning of OO-modeling

NASA Astrophysics Data System (ADS)

Holmboe, Christian

2004-12-01

The paper uses Ludwig Wittgenstein's theories about the relationship between thought, language, and objects of the world to explore the assumption that OO-thinking resembles natural thinking. The paper imports from research in linguistic philosophy to computer science education research. I show how UML class diagrams (i.e., an artificial context-free language) correspond to the logically perfect languages described in Tractatus Logico-Philosophicus. In Philosophical Investigations Wittgenstein disputes his previous theories by showing that natural languages are not constructed by rules of mathematical logic, but are language games where the meaning of a word is constructed through its use in social contexts. Contradicting the claim that OO-thinking is easy to learn because of its similarity to natural thinking, I claim that OO-thinking is difficult to learn because of its differences from natural thinking. The nature of these differences is not currently well known or appreciated. I suggest how explicit attention to the nature and implications of different language games may improve the teaching and learning of OO-modeling as well as programming.

The Rorschach Perceptual-Thinking Index (PTI): An Examination of Reliability, Validity, and Diagnostic Efficiency

ERIC Educational Resources Information Center

Hilsenroth, Mark J.; Eudell-Simmons, Erin M.; DeFife, Jared A.; Charnas, Jocelyn W.

2007-01-01

This study investigates the reliability, validity, and diagnostic efficiency of the Rorschach Perceptual-Thinking Index (PTI) in relation to the accurate identification of psychotic disorder (PTD) patients. The PTI is a revision of the Rorschach Schizophrenia Index (SCZI), designed to achieve several criteria, including an increase in the…

Promoting Critical Thinking among Dental Hygiene Students: Strategies for Educators

ERIC Educational Resources Information Center

Jordan D'Ambrisi, Kathleen M.

2011-01-01

Dental hygiene education has evolved over the years from dental hygiene professions who provide patient education on oral health care to assuming the responsibility for the assimilation of knowledge that requires judgment, decision making and critical thinking skills. Given that the dental hygiene professions has moved toward evidence-based,…

Scientific Skills as Core Competences in Medical Education: What Do Medical Students Think?

ERIC Educational Resources Information Center

Ribeiro, Laura; Severo, Milton; Pereira, Margarida; Ferreira, Maria Amélia

2015-01-01

Background: Scientific excellence is one of the most fundamental underpinnings of medical education and its relevance is unquestionable. To be involved in research activities enhances students' critical thinking and problem-solving capacities, which are mandatory competences for new achievements in patient care and consequently to the improvement…

A systematic review comparing open-book and closed-book examinations: Evaluating effects on development of critical thinking skills.

PubMed

Johanns, Beth; Dinkens, Amber; Moore, Jill

2017-11-01

The advantages of using traditional closed-book examinations are closely compared to the advantages of using open-book examinations for the development of critical thinking skills in nursing students. The use of critical thinking skills is vital among nurses to assess patient needs and modify standard approaches to individualize care for better patient outcomes. The following areas are compared and contrasted for both closed-book and open-book examinations: examination preparation, rote memorization versus active learning, intellectual engagement, simulation of working environment, higher order thinking skills, anxiety reduction and student satisfaction. During investigation of closed-book examinations and open-book examinations, the use of collaborative testing was unveiled. Collaborative testing combines areas from both closed-book and open-book examinations. Based on the systematic review of literature, the recommendation is to use a mixed method of examination types throughout the course of the nursing program. Each type of examination helps develop different skill sets in the nursing student. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using systems thinking in patient safety: a case study on medicines management.

PubMed

Brimble, Mandy; Jones, Aled

2017-06-29

Systems thinking is used as a way of understanding behaviours and actions in complex healthcare organisations. An important premise of the concept is that every action in a system causes a reaction elsewhere in that system. These reactions can lead to unintended consequences, sometimes long after the original action, and so are not always attributed to them. This article applies systems thinking to a medicines management case study, to highlight how quality-improvement practitioners can use the approach to underpin planning and implementation of patient-safety initiatives. The case study is specific to transcribing in children's hospices, but the strategies can be applied to other areas. The article explains that, while root cause analysis tools are useful for identifying the cause of, and possible solutions to, problems, they need to be considered carefully in terms of unintended consequences, and how the system into which the solution is implemented can be affected by the change. Analysis of problems using a systems-thinking approach can help practitioners to develop robust and well informed business cases to present to decision makers.

Pitfalls of Counterfactual Thinking in Medical Practice: Preventing Errors by Using More Functional Reference Points

PubMed Central

Petrocelli, John V.

2013-01-01

Background Counterfactual thinking involves mentally simulating alternatives to reality. The current article reviews literature pertaining to the relevance counterfactual thinking has for the quality of medical decision making. Although earlier counterfactual thought research concluded that counterfactuals have important benefits for the individual, there are reasons to believe that counterfactual thinking is also associated with dysfunctional consequences. Of particular focus is whether or not medical experience, and its influence on counterfactual thinking, actually informs or improves medical practice. It is hypothesized that relatively more probable decision alternatives, followed by undesirable outcomes and counterfactual thought responses, can be abandoned for relatively less probable decision alternatives. Design and Methods Building on earlier research demonstrating that counterfactual thinking can impede memory and learning in a decision paradigm with undergraduate students, the current study examines the extent to which earlier findings can be generalized to practicing physicians (N=10). Participants were asked to complete 60 trials of a computerized Monty Hall Problem simulation. Learning by experience was operationalized as the frequency of switch-decisions. Results Although some learning was evidenced by a general increase in switch-decision frequency across block trials, the extent of learning demonstrated was not ideal, nor practical. Conclusions A simple, multiple-trial, decision paradigm demonstrated that doctors fail to learn basic decision-outcome associations through experience. An agenda for future research, which tests the functionality of reference points (other than counterfactual alternatives) for the purposes of medical decision making, is proposed. Significance for public health The quality of healthcare depends heavily on the judgments and decisions made by doctors and other medical professionals. Findings from this research indicate that doctors fail to learn basic decision-outcome associations through experience, as evidenced by the sample’s tendency to select the optimal decision strategy in only 50% of 60 trials (each of which was followed by veridical feedback). These findings suggest that professional experience is unlikely to enhance the quality of medical decision making. Thus, this research has implications for understanding how doctors’ reactions to medical outcomes shape their judgments and affect the degree to which their future treatment intentions are consistent with clinical practice guidelines. The current research is integrated with earlier research on counter-factual thinking, which appears to be a primary element inhibiting the learning of decision-outcome associations. An agenda for future research is proposed. PMID:25170495

[Barriers to ART initiation in HIV infected subjects and with treatment indication in Spain. Why don't they start their treatment? Bridgap Study].

PubMed

Viciana-Fernández, Pompeyo; Falcó, Vicenç; Castaño, Manuel; de los Santos-Gil, Ignacio; Olalla-Sierra, Julián; Hernando, Asunción; Deig, Elisabet; Clotet, Bonaventura; Knobel, Hernando; Podzamczer, Daniel; Pedrol, Pere Domingo

2015-01-01

In Spain, HIV treatment guidelines are well known and generally followed. However, in some patients there are no plans to initiate ART despite having treatment indications. The current barriers to ART initiation are presented. A cross-sectional survey including every HIV infected patient in care in 19 hospitals across Spain in 2012, with ≥1 indication to start ART according to 2011 national treatment guidelines, who had not been scheduled for ART initiation. Reasons for deferring treatment were categorized as follows (non-exclusive categories): a) The physician thinks the indication is not absolute and prefers to defer it; b) The patient does not want to start it; c) The physician thinks ART must be started, but there is some limitation to starting it, and d) The patient has undetectable viral load in absence of ART. A total of 256 patients, out of 784 originally planned, were included. The large majority (84%) were male, median age 39 years, 57% MSM, 24% heterosexuals, and 16% IDUs. Median time since HIV diagnosis was 3 years, median CD4 count, 501 cells/mm3, median viral load 4.4 log copies/ml. Main ART indications were: CD4 count <500 cells/mm(3), 48%; having an uninfected sexual partner, 28%, and hepatitis C coinfection, 23%. Barriers due to, the physician, 55%; the patient, 28%; other limitations, 23%; and undetectable viral load, 6%. The majority of subjects with ART indication were on it. The most frequent barriers among those who did not receive it were physician-related, suggesting that the relevance of the conditions that indicate ART may need reinforcing. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Better management of multimorbidity: a critical look at the 'Ariadne principles'.

PubMed

Bower, Peter

2014-12-08

Primary care clinicians and researchers are growing increasingly aware of the prevalence of multimorbidity among long-term conditions, and the impact on patient experience, health, and utilisation of care. The correspondence paper by Muth et al. entitled 'The Ariadne principles: how to handle multimorbidity in primary care consultations' outlines new thinking on a better way to manage the challenges of decision-making in multimorbidity. The paper highlights the importance of shared treatment goals as a fundamental basis for more effective management. Although a welcome contribution to the literature, the principles raise a number of challenges: the complexities of achieving effective patient-centred assessment and goal-setting; how best to encourage implementation of new practices; and the current state of the evidence around multimorbidity and its management.Please see related article: http://www.biomedcentral.com/1741-7015/12/223.

Patient safety in phlebology: The ACP Phlebology Safety Checklist.

PubMed

Collares, Felipe Birchal; Sonde, Mehru; Harper, Kenneth; Armitage, Michael; Neuhardt, Diana L; Fronek, Helane S

2018-05-01

Objectives To assess the current use of safety checklists among the American College of Phlebology (ACP) members and their interest in implementing a checklist supported by the ACP on their clinical practices; and to develop a phlebology safety checklist. Method Online surveys were sent to ACP members, and a phlebology safety checklist was developed by a multispecialty team through the ACP Leadership Academy. Results Forty-seven percent of respondents are using a safety checklist in their practices; 23% think that a phlebology safety checklist would interfere or disrupt workflow; 79% answered that a phlebology safety checklist could improve procedure outcomes or prevent complications; and 85% would be interested in implementing a phlebology safety checklist approved by the ACP. Conclusion A phlebology safety checklist was developed with the intent to increase awareness on patient safety and improve outcome in phlebology practice.

The Use of Visual Thinking Strategies and Art to Help Nurses Find Their Voices.

PubMed

Moorman, Margaret

2017-08-01

Health care is increasingly complex, as nurses navigate working in teams and conveying critical information to others. Clear communication and accuracy are critical for nurses because they communicate to patients and other members of the health care team. Art, and more specifically, Visual Thinking Strategies (VTS), are ways for nurses to practice communication and clear articulation of ideas. VTS also allows nurses to explore finding their voices and working with others to provide safe and effective communication among the team, including patients and their families.

Practical ethical theory for nurses responding to complexity in care.

PubMed

Fairchild, Roseanne Moody

2010-05-01

In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.

[Current treatment situation and progress on bone defect of collapsed tibial plateau fractures].

PubMed

Luo, Chang-qi; Fang, Yue; Tu, Chong-qi; Yang, Tian-fu

2016-02-01

Characteristics of collapsed tibial plateau fracture determines that the joint surface must remain anatomical reduction,line of force in tibial must exist and internal fixation must be strong. However, while renewing articular surface smoothness, surgeons have a lot of problems in dealing with bone defect under the joint surface. Current materials used for bone defect treatment include three categories: autologous bone, allograft bone and bone substitutes. Some scholars think that autologous bone grafts have a number of drawbacks, such as increasing trauma, prolonged operation time, the limited source, bone area bleeding,continuous pain, local infection and anesthesia,but most scholars believe that the autologous cancellous bone graft is still the golden standard. Allograft bone has the ability of bone conduction, but the existence of immune responses, the possibility of a virus infection, and the limited source of the allograft cannot meet the clinical demands. Likewise, bone substitutes have the problem that osteogenesis does not match with degradation in rates. Clinical doctors can meet the demand of the patient's bone graft according to patient's own situation and economic conditions.

Do future thoughts reflect personal goals? Current concerns and mental time travel into the past and future.

PubMed

Cole, Scott N; Berntsen, Dorthe

2016-01-01

Our overriding hypothesis was that future thinking would be linked with goals to a greater extent than memories; conceptualizing goals as current concerns (i.e., uncompleted personal goals). We also hypothesized that current-concern-related events would differ from non-current-concern-related events on a set of phenomenological characteristics. We report novel data from a study examining involuntary and voluntary mental time travel using an adapted laboratory paradigm. Specifically, after autobiographical memories or future thoughts were elicited (between participants) in an involuntary and voluntary retrieval mode (within participants), participants self-generated five current concerns and decided whether each event was relevant or not to their current concerns. Consistent with our hypothesis, compared with memories, a larger percentage of involuntary and voluntary future thoughts reflected current concerns. Furthermore, events related to current concerns differed from non-concern-related events on a range of cognitive, representational, and affective phenomenological measures. These effects were consistent across temporal direction. In general, our results agree with the proposition that involuntary and voluntary future thinking is important for goal-directed cognition and behaviour.

Turning Towards or Turning Away: A Comparison of Mindfulness Meditation and Guided Imagery Relaxation in Patients with Acute Depression.

PubMed

Costa, Ana; Barnhofer, Thorsten

2016-07-01

Disengaging from maladaptive thinking is an important imperative in the treatment of depression. Mindfulness training is aimed at helping patients acquire relevant skills for this purpose. It remains unclear, however, whether this practice is helpful when patients are acutely depressed. In order to investigate effects of mindfulness on symptoms and self-regulatory capacities in this group, the current study compared a brief training in mindfulness (n = 19) to guided imagery relaxation (n = 18). Participants were introduced to the respective techniques in a single session, and practised daily over one week. Self-reported severity of symptoms, difficulties in emotion-regulation, attentional control, the ability to decentre, and mindfulness were assessed pre and postintervention, and at a one-week follow-up. Symptoms of depression significantly decreased and self-regulatory functioning significantly increased in both groups, with changes being maintained during follow-up. When controlling for change in depressive symptoms, results showed significantly higher improvements in emotion regulation at follow-up in the mindfulness group. The ability to decentre predicted changes in symptoms from pre to postintervention, while mindfulness skills predicted changes in symptoms during the maintenance phase. The findings suggest that both practices can help to instigate reductions in symptoms and enhance self-regulatory functioning in depression. However, in order to improve emotion regulation above levels explained by reductions in symptoms more intentional mental training seems necessary. Furthermore, while the ability to disengage from negative patterns of thinking seems crucial for initial reduction of symptoms, maintenance of gains might require broader skills in mindfulness.

Counterfactual Reasoning in Non-psychotic First-Degree Relatives of People with Schizophrenia

PubMed Central

Albacete, Auria; Contreras, Fernando; Bosque, Clara; Gilabert, Ester; Albiach, Ángela; Menchón, José M.; Crespo-Facorro, Benedicto; Ayesa-Arriola, Rosa

2016-01-01

Counterfactual thinking (CFT) is a type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Previous research has found this cognitive feature to be disrupted in schizophrenia (Hooker et al., 2000; Contreras et al., 2016). At the same time, the study of cognitive deficits in unaffected relatives of people with schizophrenia has significantly increased, supporting its potential endophenotypic role in this disorder. Using an exploratory approach, the current study examined CFT for the first time in a sample of non-psychotic first-degree relatives of schizophrenia patients (N = 43), in comparison with schizophrenia patients (N = 54) and healthy controls (N = 44). A series of tests that assessed the “causal order effect” in CFT and the ability to generate counterfactual thoughts and counterfactually derive inferences using the Counterfactual Inference Test was completed. Associations with variables of basic and social cognition, levels of schizotypy and psychotic-like experiences in addition to clinical and socio-demographic characteristics were also explored. Findings showed that first-degree relatives generated a lower number of counterfactual thoughts than controls, and were more adept at counterfactually deriving inferences, specifically in the scenarios related to regret and to judgments of avoidance in an unusual situation. No other significant results were found. These preliminary findings suggest that non-psychotic first-degree relatives of schizophrenia patients show a subtle disruption of global counterfactual thinking compared with what is normally expected in the general population. Due to the potential impact of such deficits, new treatments targeting CFT improvement might be considered in future management strategies. PMID:27242583

Counterfactual Reasoning in Non-psychotic First-Degree Relatives of People with Schizophrenia.

PubMed

Albacete, Auria; Contreras, Fernando; Bosque, Clara; Gilabert, Ester; Albiach, Ángela; Menchón, José M; Crespo-Facorro, Benedicto; Ayesa-Arriola, Rosa

2016-01-01

Counterfactual thinking (CFT) is a type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Previous research has found this cognitive feature to be disrupted in schizophrenia (Hooker et al., 2000; Contreras et al., 2016). At the same time, the study of cognitive deficits in unaffected relatives of people with schizophrenia has significantly increased, supporting its potential endophenotypic role in this disorder. Using an exploratory approach, the current study examined CFT for the first time in a sample of non-psychotic first-degree relatives of schizophrenia patients (N = 43), in comparison with schizophrenia patients (N = 54) and healthy controls (N = 44). A series of tests that assessed the "causal order effect" in CFT and the ability to generate counterfactual thoughts and counterfactually derive inferences using the Counterfactual Inference Test was completed. Associations with variables of basic and social cognition, levels of schizotypy and psychotic-like experiences in addition to clinical and socio-demographic characteristics were also explored. Findings showed that first-degree relatives generated a lower number of counterfactual thoughts than controls, and were more adept at counterfactually deriving inferences, specifically in the scenarios related to regret and to judgments of avoidance in an unusual situation. No other significant results were found. These preliminary findings suggest that non-psychotic first-degree relatives of schizophrenia patients show a subtle disruption of global counterfactual thinking compared with what is normally expected in the general population. Due to the potential impact of such deficits, new treatments targeting CFT improvement might be considered in future management strategies.

Argumentation: A Methodology to Facilitate Critical Thinking.

PubMed

Makhene, Agnes

2017-06-20

Caring is a difficult nursing activity that involves a complex nature of a human being in need of complex decision-making and problem solving through the critical thinking process. It is mandatory that critical thinking is facilitated in general and in nursing education particularly in order to render care in diverse multicultural patient care settings. This paper aims to describe how argumentation can be used to facilitate critical thinking in learners. A qualitative, exploratory and descriptive design that is contextual was used. Purposive sampling method was used to draw a sample and Miles and Huberman methodology of qualitative analysis was used to analyse data. Lincoln and Guba's strategies were employed to ensure trustworthiness, while Dhai and McQuoid-Mason's principles of ethical consideration were used. Following data analysis the findings were integrated within literature which culminated into the formulation of guidelines that can be followed when using argumentation as a methodology to facilitate critical thinking.

[Critical thinking skills in the nursing diagnosis process].

PubMed

Bittencourt, Greicy Kelly Gouveia Dias; Crossetti, Maria da Graça Oliveira

2013-04-01

The aim of this study was to identify the critical thinking skills utilized in the nursing diagnosis process. This was an exploratory descriptive study conducted with seven nursing students on the application of a clinical case to identify critical thinking skills, as well as their justifications in the nursing diagnosis process. Content analysis was performed to evaluate descriptive data. Six participants reported that analysis, scientific and technical knowledge and logical reasoning skills are important in identifying priority nursing diagnoses; clinical experience was cited by five participants, knowledge about the patient and application of standards were mentioned by three participants; Furthermore, discernment and contextual perspective were skills noted by two participants. Based on these results, the use of critical thinking skills related to the steps of the nursing diagnosis process was observed. Therefore, that the application of this process may constitute a strategy that enables the development of critical thinking skills.

Lean thinking across a hospital: redesigning care at the Flinders Medical Centre.

PubMed

Ben-Tovim, David I; Bassham, Jane E; Bolch, Denise; Martin, Margaret A; Dougherty, Melissa; Szwarcbord, Michael

2007-02-01

Lean thinking is a method for organising complex production processes so as to encourage flow and reduce waste. While the principles of lean thinking were developed in the manufacturing sector, there is increasing interest in its application in health care. This case history documents the introduction and development of Redesigning Care, a lean thinking-based program to redesign care processes across a teaching general hospital. Redesigning Care has produced substantial benefits over the first two-and-a-half years of its implementation, making care both safer and more accessible. Redesigning Care has not been aimed at changing the specifics of clinical practice. Rather, it has been concerned with improving the flow of patients through clinical and other systems. Concepts that emerged in the manufacturing sector have been readily translatable into health care. Lean thinking may play an important role in the reform of health care in Australia and elsewhere.

Evidence and its uses in health care and research: The role of critical thinking

PubMed Central

Jenicek, Milos; Croskerry, Pat; Hitchcock, David L.

2011-01-01

Summary Obtaining and critically appraising evidence is clearly not enough to make better decisions in clinical care. The evidence should be linked to the clinician’s expertise, the patient’s individual circumstances (including values and preferences), and clinical context and settings. We propose critical thinking and decision-making as the tools for making that link. Critical thinking is also called for in medical research and medical writing, especially where pre-canned methodologies are not enough. It is also involved in our exchanges of ideas at floor rounds, grand rounds and case discussions; our communications with patients and lay stakeholders in health care; and our writing of research papers, grant applications and grant reviews. Critical thinking is a learned process which benefits from teaching and guided practice like any discipline in health sciences. Training in critical thinking should be a part or a pre-requisite of the medical curriculum. PMID:21169920

Abstract and concrete repetitive thinking modes in alcohol-dependence.

PubMed

Grynberg, Delphine; de Timary, Philippe; Philippot, Pierre; D'Hondt, Fabien; Briane, Yasmine; Devynck, Faustine; Douilliez, Céline; Billieux, Joël; Heeren, Alexandre; Maurage, Pierre

2016-01-01

Emotional and interpersonal deficits play a crucial role in alcohol-related disorders as they predict alcohol consumption and relapse. Recent models of emotion regulation in psychopathology postulate that these deficits are centrally related to increased abstract/analytic repetitive thinking, combined with reduced concrete/experiential repetitive thinking. As this assumption has not been tested in addictions, this study aimed at investigating repetitive thinking modes in a large sample of alcohol-dependent individuals. One hundred recently detoxified alcohol-dependent individuals (29 females; mean age = 49.51-years-old) recruited during the 3rd week of their treatment in a detoxification center were compared to 100 healthy controls (29 females; mean age = 48.51-years-old) recruited in the experimenters' social network, matched at the group level for age, gender, and educational level. All participants completed the Mini Cambridge Exeter Repetitive Thought Scale measuring abstract/analytic and concrete/experiential repetitive thinking modes as well as complementary psychopathological measures (Beck Depression Inventory and State/Trait Anxiety Inventory). Alcohol-dependent individuals have similar levels of concrete repetitive thinking as controls but report significantly higher levels of abstract repetitive thinking (p < 0.001; d = 1.28). This effect remains significant after controlling for depression and anxiety. Relative to healthy controls, alcohol-dependent patients report more frequent use of abstract/analytic repetitive thinking, with preserved concrete/experiential thinking. Despite the cross-sectional nature of the study, the frequent use of abstract repetitive thinking thus appears to constitute a main feature of alcohol-dependence.

Creativity: Creativity in Complex Military Systems

DTIC Science & Technology

2017-05-25

generation later in the problem-solving process. The design process is an alternative problem-solving framework individuals or groups use to orient...no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control ...the potential of their formations. 15. SUBJECT TERMS Creativity, Divergent Thinking, Design , Systems Thinking, Operational Art 16. SECURITY

Predictors of Improvement in Critical Thinking Skills among Nursing Students in an Online Graduate Nursing Research Course

ERIC Educational Resources Information Center

Riccio, Patricia A.

2015-01-01

The purpose of this pilot study was to examine predictors of improvement in critical thinking skills among online graduate nursing students in a graduate nursing research course. Thirty-five students who had taken an online Nursing research course within the prior 12 months and who were currently enrolled in the online graduate Nursing program at…

An Evaluation of Argument Mapping as a Method of Enhancing Critical Thinking Performance in E-Learning Environments

ERIC Educational Resources Information Center

Dwyer, Christopher P.; Hogan, Michael J.; Stewart, Ian

2012-01-01

The current research examined the effects of a critical thinking (CT) e-learning course taught through argument mapping (AM) on measures of CT ability. Seventy-four undergraduate psychology students were allocated to either an AM-infused CT e-learning course or a no instruction control group and were tested both before and after an 8-week…

"The Good, the Bad and the Ugly": A Model for Reflective Teaching Practices in Coaching Pedagogy

ERIC Educational Resources Information Center

Gordon, Evelyn J.

2017-01-01

Coaching should go beyond drills and preparing for the big game. One question many coaches have asked themselves is, "How do I get better?" One way to ensure that future coaches (current students) in sport coaching education are thinking of ways to improve for the future is to teach them to think about the past. This is where reflection…

Scrambling the Nest Egg: How Well Do Teachers Understand Their Pensions, and What Do They Think about Alternative Pension Structures?

ERIC Educational Resources Information Center

DeArmond, Michael; Goldhaber, Dan

2010-01-01

In this article we focus on two questions: How well do teachers understand their current pension plans, and what do they think about alternative plan structures? The data come from administrative records and a 2006 survey of teachers in Washington State. The results suggest that Washington's teachers are fairly knowledgeable about their pensions,…

Everything You Need To Know To Understand the Current Controversies You Learned from Psychological Research: A Comment on the Rind and Lilienfeld Controversies.

ERIC Educational Resources Information Center

Sternberg, Robert J.

2002-01-01

Discusses applications of theories and research in psychology to understand controversies generated by two recent articles, explaining the need to distinguish between rational and intuitive thinking, recognize the power of context, think reflectively, and realize the costs of defying the crowd, and noting steps one can take to be wiser and more…

The Lived Experiences of Leading Edge Certified Elementary School Teachers Who Use Instructional Technology to Foster Critical Thinking, Collaboration, Creativity, and Communication in Their Classrooms: A Phenomenological Study

ERIC Educational Resources Information Center

Ruddell, Natalie

2017-01-01

Purpose: The purpose of this phenomenological study was to describe the perceptions of current and former Leading Edge Certified (LEC) elementary school teachers regarding instructional technology practices that facilitate students' development of critical thinking, collaboration, communication, and creativity (4Cs) in one-to-one computer…

Scrambling the Nest Egg: How Well Do Teachers Understand Their Pensions, and What Do They Think about Alternative Pension Structures? Working Paper 51

ERIC Educational Resources Information Center

DeArmond, Michael; Goldhaber, Dan

2010-01-01

This paper addresses two questions: How well do teachers understand their current pension plans? And, what do they think about alternative plan structures? The data come from administrative records and a 2006 survey of teachers in Washington State. The results suggest Washington's teachers are fairly knowledgeable about their pensions, though new…

A Comparison of Mother-Tongue Curricula of Successful Countries in PISA and Turkey by Higher-Order Thinking Processes

ERIC Educational Resources Information Center

Cer, Erkan

2018-01-01

Purpose: The purpose of the current study is to reveal general qualities of the objectives in the mother-tongue curricula of Hong Kong and Shanghai-China, South Korea, Singapore, and Turkey in terms of higher-order thinking processes specified by PISA tests. Research Methods: In this study, the researcher used a qualitative research design.…

[Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

PubMed

Müller-Staub, Maria; Stuker-Studer, Ursula

2006-10-01

Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

Critical thinking: Reported enhancers and barriers by nurses in long-term care: implications for staff development.

PubMed

Raterink, Ginger

2011-01-01

Nursing acknowledges critical thinking as an important guide to clinical decision making. Agreement on how to define, teach, and evaluate this skill is lacking. The purpose of this study was to evaluate critical thinking in practice using a survey that asked nurses to evaluate work-related factors that enhance or pose barriers to the use of critical thinking in practice. Results indicated that enhancers and barriers to practice included teamwork, staffing patterns, and staff and administrator support. A relationship with patients was the most satisfying factor, whereas paperwork was the least. Staff development educators must consider the work environment aspects that affect performance and create the life long learning needed for increased competency in practice.

Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters.

PubMed

O'Connor, Rory C; Smyth, Roger; Williams, J Mark G

2015-02-01

Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking-suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression-as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking-suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

When Slights Beget Slights: Attachment Anxiety, Subjective Time, and Intrusion of the Relational Past in the Present.

PubMed

Cortes, Kassandra; Wilson, Anne E

2016-12-01

Every close relationship has a history, but how people manage their relational past varies and can have important implications in the present. The current research investigated the role of subjective representation of time: How feeling subjectively close (vs. distant) to a past relational transgression (vs. kind act) predicted "kitchen thinking"-the tendency to bring to mind relational past memories in new, unrelated contexts. We explored the role of attachment anxiety as a predictor of subjective time perception and kitchen thinking. We found support for our hypothesis that when negative memories felt subjectively closer relative to positive memories, people were more likely to kitchen think (Studies 1-3). Kitchen thinking, in turn, predicted negative relationship outcomes (Study 4). Furthermore, people high (vs. low) in attachment anxiety were less likely to perceive the timing of their relational memories adaptively, accounting for more kitchen thinking and in turn, maladaptive relational outcomes. © 2016 by the Society for Personality and Social Psychology, Inc.

Prospective thinking and decision making in primary school age children.

PubMed

Lombardi, Elisabetta; Di Dio, Cinzia; Castelli, Ilaria; Massaro, Davide; Marchetti, Antonella

2017-06-01

In this study, we seek to widen our understanding of the developmental processes underlying bargaining behaviour in children addressing the concept of prospective thinking. We argue that the emergence of the capacity to think prospectively about future outcomes or behaviours in response to current actions is a required precedent to strategic decision making. To test this idea, we compared 6, 8 and 10 years old children's performance on three tasks: the ultimatum game assessing fairness/inequality aversion, the marshmallow task, an intertemporal choice task evaluating the ability to delay gratification, and the dictator game assessing altruism. The children's socio-demographic and cognitive variables were also evaluated. We hypothesized that development of strategic thinking in the ultimatum game is related to an increased ability to delay gratification - given that both tasks require looking at prospective benefits - and, crucially, not to altruism, which benefits from immediate selfless reward. Our results confirmed our hypothesis suggesting that increased strategic planning with age would also stem from the development of competencies like prospective thinking.

The essence of student visual-spatial literacy and higher order thinking skills in undergraduate biology.

PubMed

Milner-Bolotin, Marina; Nashon, Samson Madera

2012-02-01

Science, engineering and mathematics-related disciplines have relied heavily on a researcher's ability to visualize phenomena under study and being able to link and superimpose various abstract and concrete representations including visual, spatial, and temporal. The spatial representations are especially important in all branches of biology (in developmental biology time becomes an important dimension), where 3D and often 4D representations are crucial for understanding the phenomena. By the time biology students get to undergraduate education, they are supposed to have acquired visual-spatial thinking skills, yet it has been documented that very few undergraduates and a small percentage of graduate students have had a chance to develop these skills to a sufficient degree. The current paper discusses the literature that highlights the essence of visual-spatial thinking and the development of visual-spatial literacy, considers the application of the visual-spatial thinking to biology education, and proposes how modern technology can help to promote visual-spatial literacy and higher order thinking among undergraduate students of biology.

Self-perception of women after mastectomy as an ego defence mechanism. Comparison with a group of healthy women.

PubMed

Mącik, Dorota; Ziółkowska, Patrycja; Kowalska, Monika

2012-01-01

Analysis of changes in self-perception in post-mastectomy patients and its comparison with self-perception of healthy women. The subjects of this study were 50 women. The main group was post-mastectomy patients involved in the meetings of the Amazons Club (25 women). The reference group consisted of 25 healthy women. The method used in the study was the ACL (Adjective Check List) test, identifying 37 dimensions of self-image. Oncological patients completed a test twice (for current and pre-cancer self-image), and healthy women once - for current self. Both groups were selected similarly in respect of education level for the purpose of ensuring a similar level of insight. Retrospective self-image and the current one in the Amazon women group were highly convergent. Existing differences include a reduced need for achievement and dominance, and a lower level of self-confidence. However, the comparison of current self-images in both groups showed a large discrepancy of the results. The Amazon women assess themselves in a much more negative way. Also, their self-image is self-contradictory in certain characteristics. Mastectomy is a difficult experience requiring one to re-adapt and to accept oneself thereafter. The way of thinking about oneself is a defence mechanism helping to cope. The work with patients programmes must, therefore, focus on identifying their emotions and thoughts, especially on those they do not want to accept because of the perceived pressure from the environment to effectively and quickly deal with this difficult situation. The increasing acceptance of personal limitations may help the affected women to adjust psychologically faster and easier.

The Practices of Critical Thinking Component and Its Impact in Malaysian Nurses Health Education

ERIC Educational Resources Information Center

Abdullah, Abdul Ghani Kanesan; Alzaidiyeen, Naser Jamil; Yee, Ng Mooi

2010-01-01

The purpose of this research is to study the impact of the critical thinking component in the health education curriculum of nurses for patients with different health needs. Data for this research was gathered from mixed approaches, quantitative and qualitative approaches. For the quantitative approach 84 student nurses were selected randomly to…

The ideal moisturizer: a survey of parental expectations and practice in childhood-onset eczema.

PubMed

Hon, Kam-Lun Ellis; Wang, Shuxin Susan; Pong, Nga Hin; Leung, Ting Fan

2013-02-01

We evaluated the moisturizing and bathing practices and preferences of patients with childhood-onset eczema. The attitudes and practice of patients with eczema managed at a pediatric dermatology clinic were evaluated, using children with non-eczematous skin diseases as controls. Disease severity of eczema in the preceding 12 months was evaluated by the Nottingham Eczema Severity Score (NESS). Skin hydration (SH) and transepidermal water loss (TEWL) were assessed. Majority of patients took shower instead of bath and spent 12-13 min in shower. Most eczema patients applied emollients after shower/bath. Air-conditioning use was frequent, and patients with eczema maintained a lower ambient temperature than non-eczema patients (p = 0.001). Most eczema patients reported regular emollient usage (1.8 times/day for mild vs 2.8 times/day for moderate-to-severe eczema, p = 0.001), and acceptability of the current product was good to fair. Parents reported that the current emollients were most often recommended by doctors. Majority of parents/patients with mild eczema thought an ideal emollient needs only to be used twice a day whereas moderate-to-severe patients preferred more frequent usage (p = 0.001), and most of them preferred a non-fragrant, non-herbal white cream. Agreements concerning ideal emollient usage were only "moderate-to-fair" (kappa values <0.61), implying what parents/patients practiced was not the same as what they preferred. This study helps better understand the emolliation practices and preferences of eczema patients. Doctors remain the most important source of recommendation. Majority think an ideal moisturizer is a non-fragrant, non-herbal, white or transparent cream which needs only to be used two to three times per day. Compliance may be enhanced if the recommended moisturizer conforms to the parents/patients preference.

The effect of role assignment in high fidelity patient simulation on nursing students: An experimental research study.

PubMed

Weiler, Dustin T; Gibson, Andrea L; Saleem, Jason J

2018-04-01

Previous studies have evaluated the effectiveness of high fidelity patient simulators (HFPS) on nursing training; however, a gap exists on the effects of role assignment on critical thinking, self-efficacy, and situation awareness skills in team-based simulation scenarios. This study aims to determine if role assignment and the involvement level related to the roles yields significant effects and differences in critical thinking, situation awareness and self-efficacy scores in team-based high-fidelity simulation scenarios. A single factorial design with five levels and random assignment was utilized. A public university-sponsored simulation center in the United States of America. A convenience sample of 69 junior-level baccalaureate nursing students was recruited for participation. Participants were randomly assigned one of five possible roles and completed pre-simulation critical thinking and self-efficacy assessments prior to the simulation beginning. Playing within their assigned roles, participants experienced post-partum hemorrhaging scenario using an HFPS. After completing the simulation, participants completed a situation awareness assessment and a post-simulation critical thinking and self-efficacy assessment. Role assignment was found to have a statistically significant effect on critical thinking skills and a statistically significant difference in various areas of self-efficacy was also noted. However, no statistical significance in situation awareness abilities was found. Results support the notion that certain roles required the participant to be more involved with the simulation scenario, which may have yielded higher critical thinking and self-efficacy scores than roles that required a lesser level of involvement. Copyright © 2018 Elsevier Ltd. All rights reserved.

Critical Thinking Theory to Practice: Using the Expert's Thought Process as Guide for Learning and Assessment.

PubMed

Marshall, Teresa A; Marchini, Leonardo; Cowen, Howard; Hartshorn, Jennifer E; Holloway, Julie A; Straub-Morarend, Cheryl L; Gratton, David; Solow, Catherine M; Colangelo, Nicholas; Johnsen, David C

2017-08-01

Critical thinking skills are essential for the successful dentist, yet few explicit skillsets in critical thinking have been developed and published in peer-reviewed literature. The aims of this article are to 1) offer an assessable critical thinking teaching model with the expert's thought process as the outcome, learning guide, and assessment instrument and 2) offer three critical thinking skillsets following this model: for geriatric risk assessment, technology decision making, and situation analysis/reflections. For the objective component, the student demonstrates delivery of each step in the thought process. For the subjective component, the student is judged to have grasped the principles as applied to the patient or case. This article describes the framework and the results of pilot tests in which students in one year at this school used the model in the three areas, earning scores of 90% or above on the assessments. The model was thus judged to be successful for students to demonstrate critical thinking skillsets in the course settings. Students consistently delivered each step of the thought process and were nearly as consistent in grasping the principles behind each step. As more critical thinking skillsets are implemented, a reinforcing network develops.

Attentional Bias Modification for Social Anxiety Disorder: What do Patients Think and Why does it Matter?

PubMed

Kuckertz, Jennie M; Schofield, Casey A; Clerkin, Elise M; Primack, Jennifer; Boettcher, Hannah; Weisberg, Risa B; Amir, Nader; Beard, Courtney

2018-05-06

In the past decade, a great deal of research has examined the efficacy and mechanisms of attentional bias modification (ABM), a computerized cognitive training intervention for anxiety and other disorders. However, little research has examined how anxious patients perceive ABM, and it is unclear to what extent perceptions of ABM influence outcome. To examine patient perceptions of ABM across two studies, using a mixed methods approach. In the first study, participants completed a traditional ABM program and received a hand-out with minimal information about the purpose of the task. In the second study, participants completed an adaptive ABM program and were provided with more extensive rationale and instructions for changing attentional biases. A number of themes emerged from qualitative data related to perceived symptom changes and mechanisms of action, acceptability, early perceptions of the program, barriers/facilitators to engagement, and responses to adaptive features. Moreover, quantitative data suggested that patients' perceptions of the program predicted symptom reduction as well as change in attentional bias. Our quantitative data suggest that it may be possible to quickly and inexpensively identify some patients who may benefit from current ABM programs, although our qualitative data suggest that ABM needs major modifications before it will be an acceptable and credible treatment more broadly. Although the current study was limited by sample size and design features of the parent trials from which these data originated, our findings may be useful for guiding hypotheses in future studies examining patient perceptions towards ABM.

A review of post-modern management techniques as currently applied to Turkish forestry.

PubMed

Dölarslan, Emre Sahin

2009-01-01

This paper reviews the effects of six post-modern management concepts as applied to Turkish forestry. Up to now, Turkish forestry has been constrained, both in terms of its operations and internal organization, by a highly bureaucratic system. The application of new thinking in forestry management, however, has recently resulted in new organizational and production concepts that promise to address problems specific to this Turkish industry and bring about positive changes. This paper will elucidate these specific issues and demonstrate how post-modern management thinking is influencing the administration and operational capacity of Turkish forestry within its current structure.

Parental mediation of media messages does matter: more interaction about objectionable content is associated with emerging adults' sexual attitudes and behaviors.

PubMed

Radanielina-Hita, Marie Louise

2015-01-01

An online survey of undergraduates explored the effects of recalled parent-child interaction regarding media on their critical thinking skills, beliefs about alcohol and sex, and current reports of attitudes and risky sexual behaviors. Students from a northwestern university completed the questionnaire three times during the fall of 2011. Effective parental mediation was found to be a protective factor against the negative effects of objectionable content on sexual attitudes and behaviors through its effect on critical thinking toward media content and expectancies. Participants whose parents critiqued media portrayals reported a higher level of critical thinking. More critical orientation toward media decreased the effects of objectionable content on expectancies and sexual behaviors. On the other hand, participants whose parents endorsed media portrayals reported lower levels of critical thinking. Developing critical thinking toward media is an effective approach to helping young people make good decisions about their health. Although viewers' understanding of media content may be biased by the emotional aspect of decision making, critical thinking was shown to decrease the appeal of mediated messages on behaviors. Parents play an important role in developing children's critical thinking skills, and those who mediate their children's media use can establish behaviors that will prove beneficial to their children later in life.

Effectiveness of a self-administered intervention for criminal thinking: Taking a Chance on Change.

PubMed

Folk, Johanna B; Disabato, David J; Daylor, Jordan M; Tangney, June P; Barboza, Sharen; Wilson, John S; Bonieskie, Lynda; Holwager, James

2016-08-01

The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[The application of creative thinking teaching in nursing education].

PubMed

Ku, Ya-Lie; Chang, Ching-Feng; Kuo, Chien-Lin; Sheu, Sheila

2010-04-01

Nursing education is increasingly expected to cultivate nursing student creative abilities in line with general Ministry of Education promotion of greater creativity within education and the greater leeway for creativity won domestically for nurses by professional nursing organizations. Creative thinking has been named by education experts in the United States as the third most important goal of nursing education. However, nursing students in Taiwan have been shown to test lower in terms of creativity than students enrolled in business management. Leaders in nursing education should consider methods by which to improve the creative thinking capabilities of nursing students. Articles in the literature indicate that courses in creative studies are concentrated in the field of education, with few designed specifically for nursing. The teaching of constructing creative thinking is particularly weak in the nursing field. The purpose of this article was to review literature on education and nursing in order to explore current definitions, teaching strategies, and evaluation approaches related to creativity, and to develop a foundation for teaching creativity in nursing. The authors hope that an appropriate creative thinking course for nursing students may be constructed by referencing guidance provided in this in order to further cultivate creative thinking abilities in nursing students that will facilitate their application of creative thinking in their future clinical practicum.

Effectiveness of a self-administered intervention for criminal thinking: Taking a chance on change

PubMed Central

Folk, Johanna B.; Disabato, David J.; Daylor, Jordan M.; Tangney, June P.; Barboza, Sharen; Wilson, John S.; Bonieskie, Lynda; Holwager, James

2016-01-01

The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. PMID:27243111

[Cognitive disorders in patients with chronic mercury intoxication].

PubMed

Katamanova, E V; Shevchenko, O I; Lakhman, O L; Denisova, I A

2014-01-01

To assess severity of cognitive disorders in chronic mercury intoxication, the authors performed claster and discrimination analysis of neuropsychologic and neurophysiologic research data from workers exposed to mercury during long length of service, from patients with early and marked stages of chronic mercurial intoxication. Cognitive disorders in chronic mercurial intoxication have three severity degrees, in the light degree disorders patients demonstrate lower amplitude of cognitive evoked potentials, poor long-term memory and associative thinking. Moderate cognitive disorders are characterized by decreased visual, long-term memory, concentration of attention, poor optic and spatial gnosis. Marked cognitive disorders with chronic mercurial intoxication present with more decreased long-term, short-term, picturesque memory, poor intellect, optic and spatial gnosis and associative thinking.

Educational interventions to advance children's scientific thinking.

PubMed

Klahr, David; Zimmerman, Corinne; Jirout, Jamie

2011-08-19

The goal of science education interventions is to nurture, enrich, and sustain children's natural and spontaneous interest in scientific knowledge and procedures. We present taxonomy for classifying different types of research on scientific thinking from the perspective of cognitive development and associated attempts to teach science. We summarize the literature on the early--unschooled--development of scientific thinking, and then focus on recent research on how best to teach science to children from preschool to middle school. We summarize some of the current disagreements in the field of science education and offer some suggestions on ways to continue to advance the science of science instruction.

Improving the past and the future: a temporal asymmetry in hypothetical thinking.

PubMed

Ferrante, Donatella; Girotto, Vittorio; Stragà, Marta; Walsh, Clare

2013-02-01

Current views of hypothetical thinking implicitly assume that the content of imaginary thoughts about the past and future should be the same. Two experiments show that, given the same experienced facts of reality, future imagination may differ from past reconstruction. When participants failed a task, their counterfactual thoughts focused on uncontrollable features of their attempt (e.g., "Things would have been better if the allocated time were longer/if I had better logic skills"). But their prefactual thoughts focused on controllable features of their ensuing endeavor (e.g., "Things will be better next time if I concentrate more/if I use another strategy"). This finding suggests that compared with prefactual thinking, counterfactual thinking may be less subject to reality checks and less likely to serve preparatory goals. 2013 APA, all rights reserved

[Family characteristics, organic risk factors, psychopathological picture and premorbid adjustment of hospitalized adolescent patients].

PubMed

Małkiewicz-Borkowska, M; Namysłowska, I; Siewierska, A; Puzyńska, E; Sredniawa, H; Zechowski, C; Iwanek, A; Ruszkowska, E

1996-01-01

The relation of some family characteristics such as cohesion and adaptability with organic risk factors, developmental psychopathology, clinical picture and premorbid adjustment was assessed in the group of 100 hospitalized adolescent patients and families. We found correlation between: some of organic risk factors (pathology of neonatal period, pathology of early childhood), some of indicators of developmental psychopathology (eating disorders, conduct disorders), some of clinical signs (mannerism, grandiosity, hostility, suspciousness, disturbances of content of thinking), premorbid adjustment, and variables related to families, described before. We think that biological variables characterizing child (pathology of neonatal period, pathology of early childhood) have an influence on some family characteristics as independent variable. General system theory and circular thinking support these conclusions. In order to verify them, it is necessary to undertake further investigations, based on other methodology, using this results as preliminary findings.

Self-reported exposure to tobacco warning labels among U.S. middle and high school students.

PubMed

Johnson, Sarah E; Wu, Charles C; Coleman, Blair N; Choiniere, Conrad J

2014-08-01

Warning labels on tobacco products are a means to communicate information about the negative health effects of tobacco use to current and potential users. Most tobacco use begins in early adolescence, making it particularly important to understand the degree to which warning labels reach adolescents. To examine the extent to which youth report (1) seeing the current warnings on cigarettes and smokeless tobacco (SLT) products in the U.S. and (2) that seeing warnings makes them think about the health risks associated with tobacco use. Exposure to warning labels on cigarettes and SLT, as well as the degree to which adolescents report thinking about health risks in response to warnings, was examined among U.S. middle and high school students using data from the 2012 National Youth Tobacco Survey (NYTS) and analyzed in 2013. Current data suggest that less than half of adolescents who saw a cigarette pack (46.9%) or SLT product (40.3%) reported seeing the warning label "most of the time" or "always." Among adolescents who reported seeing a warning, less than one third reported that cigarette (30.4%) or SLT (25.2%) warning labels made them think about health risks "a lot." These rates were even lower among current tobacco users (<14%). Current warning labels for cigarettes and SLT could be improved by implementing warnings that incorporate features that make them salient and more likely to evoke thoughts about health risks. Published by Elsevier Inc.

Preschool Children's Conceptions about the Electric Current and the Functioning of Electric Appliances.

ERIC Educational Resources Information Center

Solomonidou, Christina; Kakana, Domna-Mika

2000-01-01

Examined 5- and 6-year-olds' ideas about the functioning of common electrical appliances and properties of electric current. Found that children represented current in a static way, thinking it was included in the appliance, and confounded electric current and water flow, believing external electricity was different from internal. They were…

Using standardized patients versus video cases for representing clinical problems in problem-based learning

PubMed Central

2016-01-01

Purpose: The quality of problem representation is critical for developing students’ problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students’ experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. Methods: A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. Results: The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. Conclusion: SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum. PMID:26923094

Impact of a concept map teaching approach on nursing students' critical thinking skills.

PubMed

Kaddoura, Mahmoud; Van-Dyke, Olga; Yang, Qing

2016-09-01

Nurses confront complex problems and decisions that require critical thinking in order to identify patient needs and implement best practices. An active strategy for teaching students the skills to think critically is the concept map. This study explores the development of critical thinking among nursing students in a required pathophysiology and pharmacology course during the first year of a Bachelor of Science in Nursing in response to concept mapping as an interventional strategy, using the Health Education Systems, Incorporated critical thinking test. A two-group experimental study with a pretest and posttest design was used. Participants were randomly divided into a control group (n = 42) taught by traditional didactic lecturing alone, and an intervention group (n = 41), taught by traditional didactic lecturing with concept mapping. Students in the concept mapping group performed much better on the Health Education Systems, Incorporated than students in the control group. It is recommended that deans, program directors, and nursing faculties evaluate their curricula to integrate concept map teaching strategies in courses in order to develop critical thinking abilities in their students. © 2016 John Wiley & Sons Australia, Ltd.

Preceptor questioning and student critical thinking.

PubMed

Myrick, Florence; Yonge, Olive

2002-01-01

Questioning is fundamental to student learning. Not only does it enable students to elevate their level of thinking, but in the process it also affords them the opportunity to deal with their world intelligently. The practice setting is an environment rich in opportunity for enabling critical thinking through the use of questioning. In the preceptorship experience, preceptors are in a prime position to use questioning behaviors that can challenge the way preceptees think, encourage them to justify or clarify their assertions, promote the generation of original ideas, explanations, or solutions to patient problems, provide mental and emotional tools to help resolve dilemmas, promote discussion, and evaluate learning. This article discusses the importance of preceptor questioning for the development and promotion of student critical thinking. Contextually, the authors draw on the findings of a recent study in which preceptor questioning of the knowledge base, decision making, and actions of the preceptee were found to directly bring about or trigger their critical thinking. This article allows for some further reflection on that process and its contribution to the enhancement of the preceptorship experience. Copyright 2002, Elsevier Science (USA). All rights reserved.

Development of a Culture Specific Critical Thinking Ability Test and Using It as a Supportive Diagnostic Test for Giftedness

ERIC Educational Resources Information Center

Köksal, Mustafa Serdar

2016-01-01

The purposes of this study were to develop a culture specific critical thinking ability test for 6, 7, and 8. grade students in Turkey and to use it as an assessment instrument for giftedness. For these purposes, item pool involving 22 items was formed by writing items focusing on the current and common events presented in (Turkish) media from…

The Level of High-Order Thinking and Its Relation to Quality of Life among Students at Ajloun University College

ERIC Educational Resources Information Center

Al Rabadi, Wail Minwer; Salem, Rifqa Khleif

2018-01-01

The study was designed to identify the effect of high-order thinking on the quality of life among Ajloun University students. The study used the associative method. The randomly selected sample consisted of 147 students from Ajloun University College. The study used two tools: The two measures were applied to the sample of the current study after…

Judging Retirement Reform Using the Strategic Thinking Framework

DTIC Science & Technology

2012-03-22

separation and that it would be both, “ex ante and ex post incentive-compatible.”23 Several fundamentals of the current MRS, such as retaining a...critically about whether modern conditions lead to the same conclusion of requiring a defined benefit MRS. For example, critical thinking can test ...budget. Many believe this proposal meets the test of acceptability and should be considered for further discussion and analysis. . To support their

Does One Stand to Gain by Combining Art with Philosophy? A Study of Fourth-Year College (13/14 Years of Age) Philosophical Writings Produced within the "Precphi/Philosophemes" Corpus

ERIC Educational Resources Information Center

Maire, Hélène; Auriac-Slusarczyk, Emmanuèle; Slusarsczyk, Bernard; Daniel, Marie-France; Thebault, Cathy

2018-01-01

Creative thinking is sometimes neglected by schools. Introducing philosophy in schools represents a commitment to balancing the development of logical and creative thinking, currently exercised only orally. In the present study, the focus is on writing. Firstly, the value of authentic pupil writings is underscored. The pupils and students studied…

Evaluating the Effects of Lesson Study as a Way to Help Student Teachers Learn How to Use Student Thinking when Planning and Revising Mathematics Lesson Plans

ERIC Educational Resources Information Center

Sisofo, Eric Joseph

2010-01-01

The use of student thinking in teaching has been linked to improved instruction and learning. It is reasonable to assume that the University of Delaware's undergraduate program might be interested in figuring out ways to develop this skill in its mathematics specialist pre-service teachers. Currently, the student teaching experience at the…

Enrich the Physics Curriculum Scheduled for Students of Intermediate School E-Learning and Its Effectiveness in Scientific Thinking and Their Attitude towards the Development of Physics

ERIC Educational Resources Information Center

Hameed, Saddam Mohammed; Mohammed, Essam Mahmoud

2016-01-01

The current research aims know the effectiveness of enriching the physics curriculum for students in middle school electronic learning in the development of their thinking and scientific their direction towards physics, sample formed from second grade students in Sinae intermediate school 64 students (32) student as experimental group & (32)…

Enhancing Identity Development at Senior Service Colleges

DTIC Science & Technology

2016-12-01

also act as a “ think factory” for commanders and civilian leaders at the strategic level worldwide and routinely engage in discourse and debate...current and past senior leaders, helping them bet - ter appreciate the decisions and activities those lead- ers undertook so as to ease their own...to instill “requisite values, strategic, and critical thinking skills to keep pace with the [changing] strategic environment.”78 Six DLAs were

Thinking styles and doctors' knowledge and behaviours relating to acute coronary syndromes guidelines

PubMed Central

Sladek, Ruth M; Bond, Malcolm J; Huynh, Luan T; Chew, Derek PB; Phillips, Paddy A

2008-01-01

Background How humans think and make decisions is important in understanding behaviour. Hence an understanding of cognitive processes among physicians may inform our understanding of behaviour in relation to evidence implementation strategies. A personality theory, Cognitive-Experiential Self Theory (CEST) proposes a relationship between different ways of thinking and behaviour, and articulates pathways for behaviour change. However prior to the empirical testing of interventions based on CEST, it is first necessary to demonstrate its suitability among a sample of healthcare workers. Objectives To investigate the relationship between thinking styles and the knowledge and clinical practices of doctors directly involved in the management of acute coronary syndromes. Methods Self-reported doctors' thinking styles (N = 74) were correlated with results from a survey investigating knowledge, attitudes, and clinical practice, and evaluated against recently published acute coronary syndrome clinical guidelines. Results Guideline-discordant practice was associated with an experiential style of thinking. Conversely, guideline-concordant practice was associated with a higher preference for a rational style of reasoning. Conclusion Findings support that while guidelines might be necessary to communicate evidence, other strategies may be necessary to target discordant behaviours. Further research designed to examine the relationships found in the current study is required. PMID:18439250

The Influence of Client Risks and Treatment Engagement on Recidivism

PubMed Central

YANG, YANG; KNIGHT, KEVIN; JOE, GEORGE W.; ROWAN-SZAL, GRACE A.; LEHMAN, WAYNE E. K.; FLYNN, PATRICK M.

2018-01-01

The current study modeled 12 month post-release re-arrest (recidivism) in terms of pretreatment risk factors (i.e., criminal history, criminal thinking,) and during-treatment engagement in a sample of 653 subjects admitted to four prison-based substance treatment programs. Structural Equation Modeling was used to test during-treatment engagement as a mediator variable in explaining the relationship between the pretreatment risk factors and recidivism. Results indicated that (1) a long history of criminal conduct correlated with criminal thinking, which in turn had a significantly negative relationship with engagement in treatment; (2) the level of criminal involvement had a significant relationship with re-arrest, whereas the level of criminal thinking did not influence being re-arrested directly; (3) the relationship between criminal history and re-arrest was partially mediated by criminal thinking and treatment engagement, whereas the relationship between criminal thinking and re-arrest was fully mediated by treatment engagement. The findings suggest that it is important to design interventions targeting criminal thinking and monitor treatment engagement as an indicator of treatment performance. Clinical implications also include the importance of facilitating treatment engagement and the utility of conducting prognostic assessment to inform treatment. PMID:29353986

Interventions Used by Nurse Preceptors to Develop Critical Thinking of New Graduate Nurses: A Systematic Review.

PubMed

Schuelke, Sue; Barnason, Susan

Healthcare complexity and patient acuity necessitate competent nurses with critical thinking abilities. However, these skill sets are less developed among newly hired graduate nurses. The overall purpose of this systematic review was to examine interventions/strategies implemented by preceptors in healthcare organizations to promote critical thinking of new graduate nurses. A systematic search of the literature resulted in 602 citations, with nine studies meeting the inclusion criteria. Educational interventions were varied and will be described in this article. Preceptor education was a key component in the studies reviewed.

Identifying critical thinking indicators and critical thinker attributes in nursing practice.

PubMed

Chao, Shu-Yuan; Liu, Hsing-Yuan; Wu, Ming-Chang; Clark, Mary Jo; Tan, Jung-Ying

2013-09-01

Critical thinking is an essential skill in the nursing process. Although several studies have evaluated the critical thinking skills of nurses, there is limited information related to the indicators of critical thinking or evaluation of critical thinking in the context of the nursing process. This study investigated the potential indicators of critical thinking and the attributes of critical thinkers in clinical nursing practice. Knowledge of these indicators can aid the development of tools to assess nursing students' critical thinking skills. The study was conducted between September 2009 and August 2010. In phase 1, a literature review and four focus groups were conducted to identify the indicators of critical thinking in the context of nursing and the attributes of critical thinkers. In phase 2, 30 nursing professionals participated in a modified Delphi research survey to establish consensus and the appropriateness of each indicator and attribute identified in phase 1. We identified 37 indicators of critical thinking and 10 attributes of critical thinkers. The indicators were categorized into five subscales within the context of the nursing process toreflect nursing clinical practice: assessment, 16 indicators of ability to apply professional knowledge and skills to analyze and interpret patient problems; diagnosis, five indicators of ability to propose preliminary suppositions; planning, five indicators of ability to develop problem-solving strategies; implementation, five indicators of ability to implement planning; and evaluation, six indicators of ability to self-assess and reflect. The study operationalized critical thinking into a practical indicator suitable for nursing contexts in which critical thinking is required for clinical problem solving. Identified indicators and attributes can assist clinical instructors to evaluate student critical thought skills and development-related teaching strategies.

Obsessionality & compulsivity: a phenomenology of obsessive-compulsive disorder.

PubMed

Denys, Damiaan

2011-02-01

Progress in psychiatry depends on accurate definitions of disorders. As long as there are no known biologic markers available that are highly specific for a particular psychiatric disorder, clinical practice as well as scientific research is forced to appeal to clinical symptoms. Currently, the nosology of obsessive-compulsive disorder is being reconsidered in view of the publication of DSM-V. Since our diagnostic entities are often simplifications of the complicated clinical profile of patients, definitions of psychiatric disorders are imprecise and always indeterminate. This urges researchers and clinicians to constantly think and rethink well-established definitions that in psychiatry are at risk of being fossilised. In this paper, we offer an alternative view to the current definition of obsessive-compulsive disorder from a phenomenological perspective. TRANSLATION: This article is translated from Dutch, originally published in [Handbook Obsessive-compulsive disorders, Damiaan Denys, Femke de Geus (Eds.), (2007). De Tijdstroom uitgeverij BV, Utrecht. ISBN13: 9789058980878.].

Outside-the-(Cavity-prep)-Box Thinking

PubMed Central

Thompson, V.P.; Watson, T.F.; Marshall, G.W.; Blackman, B.R.K.; Stansbury, J.W.; Schadler, L.S.; Pearson, R.A.; Libanori, R.

2013-01-01

Direct placement restorative materials must interface with tooth structures that are often compromised by caries or trauma. The material must seal the interface while providing sufficient strength and wear resistance to assure function of the tooth for, ideally, the lifetime of the patient. Needed are direct restorative materials that are less technique-sensitive than current resin-based composite systems while having improved properties. The ideal material could be successfully used in areas of the world with limited infrastructure. Advances in our understanding of the interface between the restoration adhesive system and the stages of carious dentin can be used to promote remineralization. Application of fracture mechanics to adhesion at the tooth-restoration interface can provide insights for improvement. Research in polymer systems suggests alternatives to current composite resin matrix systems to overcome technique sensitivity, while advances in nano- and mesoparticle reinforcement and alignment in composite systems can increase material strength, toughness, and wear resistance, foreshadowing dental application. PMID:24129814

Development of drugs for celiac disease: review of endpoints for Phase 2 and 3 trials

PubMed Central

Gottlieb, Klaus; Dawson, Jill; Hussain, Fez; Murray, Joseph A.

2015-01-01

Celiac disease is a lifelong disorder for which there is currently only one known, effective treatment: a gluten-free diet. New treatment approaches have recently emerged; several drugs are in Phase 2 trials and results appear promising; however, discussion around regulatory endpoints is in its infancy. We will briefly discuss the drugs that are under development and then shift our attention to potential trial endpoints, such as patient-reported outcomes, histology, serology, gene expression analysis and other tests. We will outline the differing requirements for proof-of-concept Phase 2 trials and Phase 3 registration trials, with a particular emphasis on current thinking in regulatory agencies. We conclude our paper with recommendations and a glossary of regulatory terms, to enable readers who are less familiar with regulatory language to take maximum advantage of this review. PMID:25725041

Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture

PubMed Central

Johnson, Eric J.; Hassin, Ran; Baker, Tom; Bajger, Allison T.; Treuer, Galen

2013-01-01

Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a “smart” default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

Mobile three-dimensional visualisation technologies for clinician-led fall prevention assessments.

PubMed

Hamm, Julian; Money, Arthur G; Atwal, Anita; Ghinea, Gheorghita

2017-08-01

The assistive equipment provision process is routinely carried out with patients to mitigate fall risk factors via the fitment of assistive equipment within the home. However, currently, over 50% of assistive equipment is abandoned by the patients due to poor fit between the patient and the assistive equipment. This paper explores clinician perceptions of an early stage three-dimensional measurement aid prototype, which provides enhanced assistive equipment provision process guidance to clinicians. Ten occupational therapists trialled the three-dimensional measurement aid prototype application; think-aloud and semi-structured interview data was collected. Usability was measured with the System Usability Scale. Participants scored three-dimensional measurement aid prototype as 'excellent' and agreed strongly with items relating to the usability and learnability of the application. The qualitative analysis identified opportunities for improving existing practice, including, improved interpretation/recording measurements; enhanced collaborative practice within the assistive equipment provision process. Future research is needed to determine the clinical utility of this application compared with two-dimensional counterpart paper-based guidance leaflets.

Systems Thinking and Systems-Based Practice Across the Health Professions: An Inquiry Into Definitions, Teaching Practices, and Assessment.

PubMed

Plack, Margaret M; Goldman, Ellen F; Scott, Andrea R; Pintz, Christine; Herrmann, Debra; Kline, Kathleen; Thompson, Tracey; Brundage, Shelley B

2018-01-01

Phenomenon: Systems thinking is the cornerstone of systems-based practice (SBP) and a core competency in medicine and health sciences. Literature regarding how to teach or apply systems thinking in practice is limited. This study aimed to understand how educators in medicine, physical therapy, physician assistant, nursing, and speech-language pathology education programs teach and assess systems thinking and SBP. Twenty-six educators from seven different degree programs across the five professions were interviewed and program descriptions and relevant course syllabi were reviewed. Qualitative analysis was iterative and incorporated inductive and deductive methods as well as a constant comparison of units of data to identify patterns and themes. Six themes were identified: 1) participants described systems thinking as ranging across four major levels of healthcare (i.e., patient, care team, organization, and external environment); 2) participants associated systems thinking with a wide range of activities across the curriculum including quality improvement, Inter-professional education (IPE), error mitigation, and advocacy; 3) the need for healthcare professionals to understand systems thinking was primarily externally driven; 4) participants perceived that learning systems thinking occurred mainly informally and experientially rather than through formal didactic instruction; 5) participants characterized systems thinking content as interspersed across the curriculum and described a variety of strategies for teaching and assessing it; 6) participants indicated a structured framework and inter-professional approach may enhance teaching and assessment of systems thinking. Insights: Systems thinking means different things to different health professionals. Teaching and assessing systems thinking across the health professions will require further training and practice. Tools, techniques, taxonomies and expertise outside of healthcare may be used to enhance the teaching, assessment, and application of systems thinking and SBP to clinical practice; however, these would need to be adapted and refined for use in healthcare.

Is adolescence a critical period for learning formal thinking skills? A case study investigating the development of formal thinking skills in a short-term inquiry-based intervention program

NASA Astrophysics Data System (ADS)

Towne, Forrest S.

Current domestic and international comparative studies of student achievement in science are demonstrating that the U.S. needs to improve science education if it wants to remain competitive in the global economy. One of the causes of the poor performance of U.S. science education is the lack of students who have developed the formal thinking skills that are necessary to obtain scientific literacy. Previous studies have demonstrated that formal thinking skills can be taught to adolescents, however only 25% of incoming college freshman have these necessary skills. There is some evidence that adolescence (girls aged 11-13, boys aged 12-14) is a critical period where students must learn formal thinking skills, similar to the critical period that exists for young children learning languages. It is not known whether it is more difficult for students to learn formal thinking skills either prior to or following adolescence. The purpose of this quantitative case study is to determine whether adolescence is a critical period for students to learn formal thinking skills. The study also investigates whether a formal thinking skills focused program can improve students' intelligence. In this study 32 students who had not developed any formal thinking skills, ranging in age from 10-16, underwent an intensive four-week, inquiry-based, formal thinking skill intervention program that focused on two formal thinking skills: (1) the ability to control and exclude variables; and (2) the ability to manipulate ratios and proportionalities. The students undergoing the training were matched with control students by age, gender, formal thinking skill ability, and intelligence. The control group attended their traditional science course during the intervention periods. The results of the study showed that the intervention program was successful in developing students' formal thinking skills. The pre-adolescents (males, age 10-11, females, age 10) were unable to learn formal thinking skills. The data indicated that there is not a significant difference between adolescents and post-adolescents (up to 16-years-old) ability to learn formal thinking skills. Both groups (adolescent and post-adolescent) showed improvement in their formal thinking skill ability after the intervention. The intervention also demonstrated evidence of improving students' intelligence scores.

Development of Geostatistical Models to Estimate CO2 Storage Resource in Sedimentary Geologic Formations

NASA Astrophysics Data System (ADS)

Popova, Olga H.

Dental hygiene students must embody effective critical thinking skills in order to provide evidence-based comprehensive patient care. The problem addressed in this study it was not known if and to what extent concept mapping and reflective journaling activities embedded in a curriculum over a 4-week period, impacted the critical thinking skills of 22 first and second-year dental hygiene students attending a community college in the Midwest. The overarching research questions were: what is the effect of concept mapping, and what is the effect of reflective journaling on the level of critical thinking skills of first and second year dental hygiene students? This quantitative study employed a quasi-experimental, pretest-posttest design. Analysis of Covariance (ANCOVA) assessed students' mean scores of critical thinking on the California Critical Thinking Skills Test (CCTST) pretest and posttest for the concept mapping and reflective journaling treatment groups. The results of the study found an increase in CCTST posttest scores with the use of both concept mapping and reflective journaling. However, the increase in scores was not found to be statistically significant. Hence, this study identified concept mapping using Ausubel's assimilation theory and reflective journaling incorporating Johns's revision of Carper's patterns of knowing as potential instructional strategies and theoretical models to enhance undergraduate students' critical thinking skills. More research is required in this area to draw further conclusions. Keywords: Critical thinking, critical thinking development, critical thinking skills, instructional strategies, concept mapping, reflective journaling, dental hygiene, college students.

The Criterion and Discriminant Validity of the Referential Thinking (REF) Scale

ERIC Educational Resources Information Center

Startup, Mike; Sakrouge, Rebecca; Mason, Oliver J.

2010-01-01

The Referential Thinking (REF) scale was designed to be a comprehensive self-report measure of both simple and guilty ideas of reference in the general population. One aim of the present study was to test the proposed interpretations of REF scores by comparing REF scores with ratings of delusions among psychotic patients. A 2nd aim was to test…

Collaborative testing: assessing teamwork and critical thinking behaviors in baccalaureate nursing students.

PubMed

Wiggs, Carol M

2011-04-01

The purpose of this study was to foster teamwork and critical thinking behaviors in baccalaureate nursing students using a collaborative testing environment. Collaborative testing affords the nurse educator a unique opportunity to actively influence the development of critical thinking skills directly influencing the nursing student's ability to solve complex patient problems. Using a quasi-experimental approach exam scores from students in prior semesters were compared to students in several semesters using collaborative testing in one undergraduate course taught by the same faculty. In the experimental group collaborative testing was used in the two unit examinations, while the final examination remained individual. For collaborative testing the students were grouped by random assignment. They were not allowed the use of notes, textbooks, or other resource materials. Any student who wished to work alone was allowed do so and any student coming late (within 15 min of examination beginning) was required to work alone. Each student submitted individual examination answer forms, and groups were not required to reach consensus. Collaborative testing is one means to foster critical thinking by allowing students to solve complex patient problems within an examination environment. This better prepares them for national certification exams. Copyright © 2010 Elsevier Ltd. All rights reserved.

Creative thinking in schizophrenia: the role of executive dysfunction and symptom severity.

PubMed

Abraham, Anna; Windmann, Sabine; McKenna, Peter; Güntürkün, Onur

2007-05-01

This study examines the notion of enhanced creative thinking in schizophrenia and determines the mediating role of executive dysfunction and symptom severity in this relationship. Patients with chronic schizophrenia (n=28) were assessed on varied facets of creative cognition and standard tests of executive control relative to matched healthy control participants (n=18). Multivariate analyses revealed poorer performance by the patient group across almost all creative and executive function measures, except in the ability to be unconstrained by the influence of restrictive examples. Symptom-based contrasts using partial correlations revealed that differences were most extensive in the presence of thought disorder. Using hierarchical regression analyses, performance on the executive function tasks was found to play a mediatory role on specific aspects of creative cognition. Results are at odds with the popular notion of enhanced creative thinking in schizophrenia, but elucidate complex interactions between executive control and certain facets of creative thinking. In particular, performance of the schizophrenia group on measures that tap creativity elements of fluency and relevance were either partially or fully mediated by their performance on the executive control tasks, but this was not true of measures of originality.

Informing Patients About Placebo Effects: Using Evidence, Theory, and Qualitative Methods to Develop a New Website.

PubMed

Greville-Harris, Maddy; Bostock, Jennifer; Din, Amy; Graham, Cynthia A; Lewith, George; Liossi, Christina; O'Riordan, Tim; White, Peter; Yardley, Lucy; Bishop, Felicity L

2016-06-10

According to established ethical principles and guidelines, patients in clinical trials should be fully informed about the interventions they might receive. However, information about placebo-controlled clinical trials typically focuses on the new intervention being tested and provides limited and at times misleading information about placebos. We aimed to create an informative, scientifically accurate, and engaging website that could be used to improve understanding of placebo effects among patients who might be considering taking part in a placebo-controlled clinical trial. Our approach drew on evidence-, theory-, and person-based intervention development. We used existing evidence and theory about placebo effects to develop content that was scientifically accurate. We used existing evidence and theory of health behavior to ensure our content would be communicated persuasively, to an audience who might currently be ignorant or misinformed about placebo effects. A qualitative 'think aloud' study was conducted in which 10 participants viewed prototypes of the website and spoke their thoughts out loud in the presence of a researcher. The website provides information about 10 key topics and uses text, evidence summaries, quizzes, audio clips of patients' stories, and a short film to convey key messages. Comments from participants in the think aloud study highlighted occasional misunderstandings and off-putting/confusing features. These were addressed by modifying elements of content, style, and navigation to improve participants' experiences of using the website. We have developed an evidence-based website that incorporates theory-based techniques to inform members of the public about placebos and placebo effects. Qualitative research ensured our website was engaging and convincing for our target audience who might not perceive a need to learn about placebo effects. Before using the website in clinical trials, it is necessary to test its effects on key outcomes including patients' knowledge and capacity for making informed choices about placebos.

Caring for patients of diverse religious traditions: Catholicism.

PubMed

Narayan, Mary Curry

2006-03-01

Your patient is a Catholic, and you are not. How can you be sensitive to the patient's spiritual needs? How do Catholics think about health and illness? What kind of spiritual resources do they draw upon when facing a health crisis?

From systems biology to systems biomedicine.

PubMed

Antony, Paul M A; Balling, Rudi; Vlassis, Nikos

2012-08-01

Systems Biology is about combining theory, technology, and targeted experiments in a way that drives not only data accumulation but knowledge as well. The challenge in Systems Biomedicine is to furthermore translate mechanistic insights in biological systems to clinical application, with the central aim of improving patients' quality of life. The challenge is to find theoretically well-chosen models for the contextually correct and intelligible representation of multi-scale biological systems. In this review, we discuss the current state of Systems Biology, highlight the emergence of Systems Biomedicine, and highlight some of the topics and views that we think are important for the efficient application of Systems Theory in Biomedicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

Six-part series on the state of the RN workforce in the United States.

PubMed

Buerhaus, Peter I

2005-01-01

This series on the state of the nursing workforce focuses on describing the results of the national surveys of RNs. The series begins with an analysis of RNs' perceptions of the current nursing shortage and whether they perceive the shortage has gotten better or worse over the past few years. Future topics will include RNs' perceptions of being a nurse and how they perceive certain aspects of their jobs; RNs' awareness of the J&J Campaign and whether they think it has been effective; RNs' perceptions of the impact of the shortage on the quality of patient care in hospitals; and various issues related to the age and diversity of the nursing profession.

Endoscopic colloid cyst excision: surgical techniques and nuances.

PubMed

Azab, Waleed Abdelfattah; Najibullah, Mustafa; Yosef, Waleed

2017-06-01

Endoscopic excision of colloid cysts is currently well established as a minimally invasive and highly effective technique that is associated with less morbidity in comparison to microsurgical resection. Operative charts and videos of patients undergoing endoscopic colloid cyst excision were retrieved from the senior author's database of endoscopic procedures and reviewed. This revealed nine trans-foraminal and three trans-septal procedures. Description of the surgical techniques was then formulated. Variation of the technique is based on the specific patho-anatomical features of the colloid cyst being resected. For the trans-foraminal approach, we think that the rotational technique is associated with a more complete removal of the cyst wall and consequently lower recurrence rate.

The divided self: near death experiences of resuscitated patients--a review of literature.

PubMed

Cant, Robyn; Cooper, Simon; Chung, Catherine; O'Connor, Margaret

2012-04-01

This paper explores the prevalence of 'near death experience' phenomena associated with a resuscitation event and examines the current state of evidence for causation. Patients' reports of unusual recollections associated with a period of unconsciousness (perceived as approaching death) have fascinated individuals and the medical fraternity. Near death experiences (NDE) are reported in 4-9% of general community members and up to 23% of critical illness patients, although they can occur in healthy individuals who may think they are in peril. One explanation is that paranormal visions that include seeing bright lights, a tunnel and having feelings of peace may be a stage of enlightenment as death approaches. More objective explanations point to neuro-chemical changes in a stressed or dying brain as explanation for nearly all the elements of near death experience. However if this is so, NDE should occur in all patients who are critically ill and near death. In general, patients report positive psychological outcomes after a near death experience. Nurses can support patients during a time of crisis by assisting them and their families to comprehend the experiential event using effective communication and listening skill. Copyright © 2011 Elsevier Ltd. All rights reserved.

Positive imagery cognitive bias modification (CBM) and internet-based cognitive behavioural therapy (iCBT) versus control CBM and iCBT for depression: study protocol for a parallel-group randomised controlled trial.

PubMed

Williams, Alishia D; Blackwell, Simon E; Holmes, Emily A; Andrews, Gavin

2013-10-29

The current randomised controlled trial will evaluate the efficacy of an internet-delivered positive imagery cognitive bias modification (CBM) intervention for depression when compared with an active control condition and help establish the additive benefit of positive imagery CBM when delivered in combination with internet cognitive behavioural therapy for depression. Patients meeting diagnostic criteria for a current major depressive episode will be recruited through the research arm of a not-for-profit clinical and research unit in Australia. The minimum sample size for each group (α set at 0.05, power at 0.80) was identified as 29, but at least 10% more will be recruited to hedge against expected attrition. We will measure the impact of CBM on primary measures of depressive symptoms (Beck Depression Inventory-second edition (BDI-II), Patient Health Questionnaire (PHQ9)) and interpretive bias (ambiguous scenarios test-depression), and on a secondary measure of psychological distress (Kessler-10 (K10)) following the 1-week CBM intervention. Secondary outcome measures of psychological distress (K10), as well as disability (WHO disability assessment schedule-II), repetitive negative thinking (repetitive thinking questionnaire), and anxiety (state trait anxiety inventory-trait version) will be evaluated following completion of the 11-week combined intervention, in addition to the BDI-II and PHQ9. Intent-to-treat marginal and mixed effect models using restricted maximum likelihood estimation will be used to evaluate the primary hypotheses. Clinically significant change will be defined as high-end state functioning (a BDI-II score <14) combined with a total score reduction greater than the reliable change index score. Maintenance of gains will be assessed at 3-month follow-up. The current trial protocol has been approved by the Human Research Ethics Committee of St Vincent's Hospital and the University of New South Wales, Sydney. Australian New Zealand Clinical Trials Registry: ACTRN12613000139774 and Clinicaltrials.gov: NCT01787513. This trial protocol is written in compliance with the Standard Protocol Items: recommendations for Interventional Trials (SPIRIT) guidelines.

Consumer beware: a systematic assessment of potential bias in the lay electronic media to examine the portrayal of "PARP" inhibitors for cancer treatment.

PubMed

Coleman, Shawnta; Peethambaram, Prema P; Jatoi, Aminah

2011-09-01

This study examined how the lay electronic media covers poly-ADP-ribose polymerase, or "PARP," inhibitors, a class of cancer agents currently under clinical investigation. Of 771 internet links, 51 targeted the lay public. Independent review by two investigators yielded the following categorizations: 36 (71%) were "overly positive", 15 (29%) "neutral", and none "overly negative". "Overly positive" articles used: (l) overstated benefit, (2) included quotations from enthusiastic scientists, and (3) discussed single or small patient subsets. They used such phrases as "the holy grail of cancer research", "the most exciting development in cancer research in a decade or more…. it could save thousands of lives", and "we were surprised and delighted…. it's the kind of thing you don't really think will happen". Healthcare providers should be aware of the foregoing when discussing PARP inhibitors-and perhaps other novel therapies-with cancer patients.

Molecular mechanisms that underpin EML4-ALK driven cancers and their response to targeted drugs.

PubMed

Bayliss, Richard; Choi, Jene; Fennell, Dean A; Fry, Andrew M; Richards, Mark W

2016-03-01

A fusion between the EML4 (echinoderm microtubule-associated protein-like) and ALK (anaplastic lymphoma kinase) genes was identified in non-small cell lung cancer (NSCLC) in 2007 and there has been rapid progress in applying this knowledge to the benefit of patients. However, we have a poor understanding of EML4 and ALK biology and there are many challenges to devising the optimal strategy for treating EML4-ALK NSCLC patients. In this review, we describe the biology of EML4 and ALK, explain the main features of EML4-ALK fusion proteins and outline the therapies that target EML4-ALK. In particular, we highlight the recent advances in our understanding of the structures of EML proteins, describe the molecular mechanisms of resistance to ALK inhibitors and assess current thinking about combinations of ALK drugs with inhibitors that target other kinases or Hsp90.

Embracing uncertainty, managing complexity: applying complexity thinking principles to transformation efforts in healthcare systems.

PubMed

Khan, Sobia; Vandermorris, Ashley; Shepherd, John; Begun, James W; Lanham, Holly Jordan; Uhl-Bien, Mary; Berta, Whitney

2018-03-21

Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here. We synthesized topics from this series into a set of six insights on how complexity thinking fosters a deeper understanding of accepted ideas in healthcare, applications of CAS to actors within the system, and paradoxes in applications of complexity thinking that may require further debate: 1) a complexity lens helps us better understand the nebulous term "context"; 2) concepts of CAS may be applied differently when actors are cognizant of the system in which they operate; 3) actor responses to uncertainty within a CAS is a mechanism for emergent and intentional adaptation; 4) acknowledging complexity supports patient-centred intersectional approaches to patient care; 5) complexity perspectives can support ways that leaders manage change (and transformation) in healthcare; and 6) complexity demands different ways of implementing ideas and assessing the system. To enhance our exploration of key insights, we augmented the knowledge gleaned from the series with key articles on complexity in the literature. Ultimately, complexity thinking acknowledges the "messiness" that we seek to control in healthcare and encourages us to embrace it. This means seeing challenges as opportunities for adaptation, stimulating innovative solutions to ensure positive adaptation, leveraging the social system to enable ideas to emerge and spread across the system, and even more important, acknowledging that these adaptive actions are part of system behaviour just as much as periods of stability are. By embracing uncertainty and adapting innovatively, complexity thinking enables system actors to engage meaningfully and comfortably in healthcare system transformation.

Overgeneral past and future thinking in dysphoria: the role of emotional cues and cueing methodology.

PubMed

Anderson, Rachel J; Boland, Jennifer; Garner, Sarah R

2016-01-01

Overgeneral memory, where individuals exhibit difficulties in retrieving specific episodes from autobiographical memory, has been consistently linked with emotional disorders. However, the majority of this literature has relied upon a single methodology, in which participants respond to emotional cue words with explicit instructions to retrieve/simulate specific events. Through the use of sentence completion tasks the current studies explored whether overgenerality represents a habitual pattern of thinking that extends to how individuals naturally consider their personal past and future life story. In both studies, when compared with controls, dysphoric individuals evidenced overgeneral thinking style with respect to their personal past. However, overgeneral future thinking was only evident when the sentence stems included emotional words. These findings highlight the importance of investigating the overgenerality phenomenon using a variety of cueing techniques and results are discussed with reference to the previous literature exploring overgenerality and cognitive models of depression.

Non-invasive electric current stimulation for restoration of vision after unilateral occipital stroke.

PubMed

Gall, Carolin; Silvennoinen, Katri; Granata, Giuseppe; de Rossi, Francesca; Vecchio, Fabrizio; Brösel, Doreen; Bola, Michał; Sailer, Michael; Waleszczyk, Wioletta J; Rossini, Paolo M; Tatlisumak, Turgut; Sabel, Bernhard A

2015-07-01

Occipital stroke often leads to visual field loss, for which no effective treatment exists. Little is known about the potential of non-invasive electric current stimulation to ameliorate visual functions in patients suffering from unilateral occipital stroke. One reason is the traditional thinking that visual field loss after brain lesions is permanent. Since evidence is available documenting vision restoration by means of vision training or non-invasive electric current stimulation future studies should also consider investigating recovery processes after visual cortical strokes. Here, protocols of repetitive transorbital alternating current stimulation (rtACS) and transcranial direct current stimulation (tDCS) are presented and the European consortium for restoration of vision (REVIS) is introduced. Within the consortium different stimulation approaches will be applied to patients with unilateral occipital strokes resulting in homonymous hemianopic visual field defects. The aim of the study is to evaluate effects of current stimulation of the brain on vision parameters, vision-related quality of life, and physiological parameters that allow concluding about the mechanisms of vision restoration. These include EEG-spectra and coherence measures, and visual evoked potentials. The design of stimulation protocols involves an appropriate sham-stimulation condition and sufficient follow-up periods to test whether the effects are stable. This is the first application of non-invasive current stimulation for vision rehabilitation in stroke-related visual field deficits. Positive results of the trials could have far-reaching implications for clinical practice. The ability of non-invasive electrical current brain stimulation to modulate the activity of neuronal networks may have implications for stroke rehabilitation also in the visual domain. Copyright © 2015 Elsevier Inc. All rights reserved.

Critical thinking, nurse education and universities: some thoughts on current issues and implications for nursing practice.

PubMed

Morrall, Peter; Goodman, Benny

2013-09-01

When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities. Copyright © 2012 Elsevier Ltd. All rights reserved.

Masculinity and suicidal thinking.

PubMed

Pirkis, Jane; Spittal, Matthew J; Keogh, Louise; Mousaferiadis, Tass; Currier, Dianne

2017-03-01

Males feature prominently in suicide statistics, but relatively little work has been done to date to explore whether endorsement of dominant masculinity norms heightens the risk of or is protective against suicidal thinking. This paper aimed to further knowledge in this area. We used baseline data from 13,884 men (aged 18-55) in the Australian Longitudinal Study on Male Health (Ten to Men) cohort. These men filled in self-complete questionnaires in 2013/14 which covered a range of topics, including conformity to dominant masculinity norms and suicidal thinking. We conducted logistic regression analyses to estimate the strength of association between these two variables. After controlling for other key predictors of suicidal thinking, one characteristic of dominant masculinity-self-reliance-stood out as a risk factor for suicidal thinking (AOR 1.34; 95% CI 1.26-1.43). It suggests that one particular element of dominant masculinity-being self-reliant-may place men at increased risk of suicidal thinking. This finding resonates with current theories of how suicidal thinking develops and leads to action. It also has implications for the full gamut of suicide prevention approaches that target males in clinical settings and in the general population, and for our broader society. Further work is needed, however, to confirm the direction of the relationship between self-reliance and suicidality, and to unpack the means through which self-reliance may exert an influence.

Explorations in Cooperative Systems: Thinking Collectively to Learn, Learning Individually to Think

DTIC Science & Technology

1989-12-01

indicates that the CL research lacks sufficient experimental controls, as well as, fails to use current theories associated with cognitiv-e approaches...comparing/contrasting some of the differences between CL and GPS. Finally, examples of successful CL are given to show the transition from theory to...Schmuck, 1985). For example, Stodolsky (1984) differentiates peer-work groups from teacher- led groups. She suggests that there are five types of

Histological, molecular and functional subtypes of breast cancers

PubMed Central

Malhotra, Gautam K; Zhao, Xiangshan; Band, Hamid

2010-01-01

Increased understanding of the molecular heterogeneity that is intrinsic to the various subtypes of breast cancer will likely shape the future of breast cancer diagnosis, prognosis and treatment. Advances in the field over the last several decades have been remarkable and have clearly translated into better patient care as evidenced by the earlier detection, better prognosis and new targeted therapies. There have been two recent advances in the breast cancer research field that have lead to paradigm shifts: first, the identification of intrinsic breast tumor subtypes, which has changed the way we think about breast cancer and second, the recent characterization of cancer stem cells (CSCs), which are suspected to be responsible for tumor initiation, recurrence and resistance to therapy. These findings have opened new exciting avenues to think about breast cancer therapeutic strategies. While these advances constitute major paradigm shifts within the research realm, the clinical arena has yet to adopt and apply our understanding of the molecular basis of the disease to early diagnosis, prognosis and therapy of breast cancers. Here, we will review the current clinical approach to classification of breast cancers, newer molecular-based classification schemes and potential future of biomarkers representing a functional classification of breast cancer. PMID:21057215

Hypercognitive seizures - Proposal of a new term for the phenomenon forced thinking in epilepsy.

PubMed

Stephani, C; Koubeissi, M

2017-08-01

Here we propose the term hypercognitive seizures as a descriptor for seizures that manifest as a transient mental experience of intrusive thoughts or words that do not consist mainly of reminiscence. Currently, the term forced thinking is used to describe this uncommon seizure semiology, which has also been elicited by electrical brain stimulation. The available literature on forced thinking shows discordant interpretations of its meaning, justifying the suggestion of a new descriptor. In this paper, we would like to suggest and explain the term hypercognitive seizure and argue that this type of seizure lateralizes to the dominant hemisphere. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessing aspects of creativity in deaf and hearing high school students.

PubMed

Stanzione, Christopher M; Perez, Susan M; Lederberg, Amy R

2013-04-01

To address the paucity of current research on the development of creativity in deaf students, and to extend existing research to adolescents, the present study investigated divergent thinking, a method of assessing creativity, in both deaf and hearing adolescents. We assessed divergent thinking in two domains, figural and verbal, while also adjusting the instructional method in written format, sign language, or spoken English. Deaf students' performance was equal to, or more creative than, hearing students on the figural assessment of divergent thinking, but less creative on the verbal assessment. Additional studies should be conducted to determine whether this was an anomalous finding or one that might contribute to hypotheses yielding effective interventions.

A preliminary study on the integral relationship between critical thinking and mathematical thinking among practicing civil engineers

NASA Astrophysics Data System (ADS)

Osman, Sharifah; Mohammad, Shahrin; Abu, Mohd Salleh

2015-05-01

Mathematics and engineering are inexorably and significantly linked and essentially required in analyzing and accessing thought to make good judgment when dealing in complex and varied engineering problems. A study in the current engineering education curriculum to explore how the critical thinking and mathematical thinking relates to one another, is therefore timely crucial. Unfortunately, there is not much information available explicating about the link. This paper aims to report findings of a critical review as well as to provide brief description of an on-going research aimed to investigate the dispositions of critical thinking and the relationship and integration between critical thinking and mathematical thinking during the execution of civil engineering tasks. The first part of the paper reports an in-depth review on these matters based on rather limited resources. The review showed a considerable form of congruency between these two perspectives of thinking, with some prevalent trends of engineering workplace tasks, problems and challenges. The second part describes an on-going research to be conducted by the researcher to investigate rigorously the relationship and integration between these two types of thinking within the perspective of civil engineering tasks. A reasonably close non-participant observations and semi-structured interviews will be executed for the pilot and main stages of the study. The data will be analyzed using constant comparative analysis in which the grounded theory methodology will be adopted. The findings will serve as a useful grounding for constructing a substantive theory revealing the integral relationship between critical thinking and mathematical thinking in the real civil engineering practice context. The substantive theory, from an angle of view, is expected to contribute some additional useful information to the engineering program outcomes and engineering education instructions, aligns with the expectations of engineering program outcomes set by the Engineering Accreditation Council.

Assessing and Improving Student Understanding of Tree-Thinking

NASA Astrophysics Data System (ADS)

Kummer, Tyler A.

Evolution is the unifying theory of biology. The importance of understanding evolution by those who study the origins, diversification and diversity life cannot be overstated. Because of its importance, in addition to a scientific study of evolution, many researchers have spent time studying the acceptance and the teaching of evolution. Phylogenetic Systematics is the field of study developed to understand the evolutionary history of organisms, traits, and genes. Tree-thinking is the term by which we identify concepts related to the evolutionary history of organisms. It is vital that those who undertake a study of biology be able to understand and interpret what information these phylogenies are meant to convey. In this project, we evaluated the current impact a traditional study of biology has on the misconceptions students hold by assessing tree-thinking in freshman biology students to those nearing the end of their studies. We found that the impact of studying biology was varied with some misconceptions changing significantly while others persisted. Despite the importance of tree-thinking no appropriately developed concept inventory exists to measure student understanding of these important concepts. We developed a concept inventory capable of filling this important need and provide evidence to support its use among undergraduate students. Finally, we developed and modified activities as well as courses based on best practices to improve teaching and learning of tree-thinking and organismal diversity. We accomplished this by focusing on two key questions. First, how do we best introduce students to tree-thinking and second does tree-thinking as a course theme enhance student understanding of not only tree-thinking but also organismal diversity. We found important evidence suggesting that introducing students to tree-thinking via building evolutionary trees was less successful than introducing the concept via tree interpretation and may have in fact introduced or strengthened a misconception. We also found evidence that infusing tree-thinking into an organismal diversity course not only enhances student understanding of tree-thinking but also helps them better learn organismal diversity.

Sudden Arrhythmia Death Syndromes (SADS) Foundation

MedlinePlus

... research crucial for health of patients and the economy 7/18/2017 More funding for heart disease research crucial for health of patients and the economy Quick-thinking coaches use app to help save ...

A psychometric evaluation of the Rorschach comprehensive system's perceptual thinking index.

PubMed

Dao, Tam K; Prevatt, Frances

2006-04-01

In this study, we investigated evidence for reliability and validity of the Perceptual Thinking Index (PTI; Exner, 2000a, 2000b) among an adult inpatient population. We conducted reliability and validity analyses on 107 patients who met the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; American Psychiatric Association, 2000) criteria for a schizophrenia-spectrum disorder (SSD) or mood disorder with no psychotic features (MD). Results provided support for interrater reliability as well as internal consistency of the PTI. Furthermore, the PTI was an effective index in differentiating SSD patients from patients diagnosed with an MD. Finally, the PTI demonstrated adequate diagnostic statistics that can be useful in the classification of patients diagnosed with SSD and MD. We discuss methodological issues, implications for assessment practice, and directions for future research.

[Cancer Survivorship: the patient and medical care staff - how will society deal with cancer ?].

PubMed

Honda, Mayumi

2011-07-01

Instead of being preoccupied with treatment effectiveness, rates of survival, and asking how much longer will I live?, let us think in terms of how will I live my life the way I want to live it? In recent years, a new way of thinking called Cancer Survivorship has emerged in the United States, and has been drawing attention in Japan. Cancer Survivorship is a concept developed by a cancer patient support group in the United States in 1986, focusing on the experience of living with, through, and beyond cancer. Opposing society's narrow view of cancer patients as victims handed out a death sentence, Cancer Survivorship focuses on living life to the fullest from the time of cancer diagnosis until the moment of death,and works as a movement appealing to society to allow cancer survivors the right to live as they wish. This way of thinking has spread globally, and in Italy, a movement aimed at protecting cancer survivors' freedom to do paid work has unfolded. Even in Japan, with an increase in the number of cancer patients and an improved five-year survival rate, patient support groups have been emerging with the Cancer Survivorship mentality. However, Japanese society still has not given the movement sufficient recognition, and the question now is if cancer patients, even those in the terminal stage, can seize their lives and be someone who lives in the present.

US neurologists: attitudes on rationing.

PubMed

Holloway, R G; Ringel, S P; Bernat, J L; Keran, C M; Lawyer, B L

2000-11-28

To assess neurologists' attitudes on rationing health care and to determine whether neurologists would set healthcare priorities in ways that are consistent with cost-effectiveness research. Cost-effectiveness research can suggest ways to maximize health benefits within fixed budgets but is currently being underused in resource allocation decisions. The authors surveyed a random sample of neurologists practicing in the United States (response rate, 44.4%) with three hypothetical scenarios. Two scenarios were designed to address general attitudes on allocating finite resources with emphasis on formulary decisions for costly drugs. The third scenario was designed to assess whether neurologists would optimize the allocation of a fixed budget as recommended by cost-effectiveness analysis. Three-quarters of respondents thought that neurologists make daily decisions that effectively ration healthcare resources, and 60% felt a professional responsibility to consider the financial impact of individualized treatment decisions on other patients. Only 25% of respondents thought that there should be no restrictions placed on any of the five newer antiepileptic agents. In a 1995 survey, 75% of similarly sampled neurologists agreed that no restrictions should be placed on the availability of FDA-approved medications. Nearly half (46%) of respondents favored a less effective test and would be willing to let patients die to ensure the offering of a more equitable alternative. Most neurologists recognize the need to ration health care, and although they think cost-effectiveness research is one method to achieve efficient distribution of resources, many think that considerable attention should also be given to equity.

Relationship-centered health care as a Lean intervention.

PubMed

Dunsford, Jennifer; Reimer, Laura E

2017-12-01

Continuous improvement efforts, recognized in much literature as Lean management techniques have been used in efforts to improve efficiency in democratic health care contexts for some time to varying degrees of success. The complexity of the health care system is magnified by the sheer number of processes and sub processes required to deliver value within a bureaucratic environment, while maintaining some level of compassionate and personalized care. There is inherent tension between what is required to be efficient and what is required to be caring and this conflict presses against Lean practice at the level of delivery.Administration and care intersect at the point of the patient's experience. In order to achieve the dual goals of improved value and lower costs, the application of Lean thinking for meaningful health care reform must acknowledge the fundamental dichotomy between the impersonal tasks required to provide health services, and human interactions. Meaningful health care reform requires an acknowledgement of this distinction, currently not recognized in literature. While administrative process improvements are necessary, they are insufficient to achieve a sustainable and caring health care system. Lean thinking must be applied differently for administrative processes and patient care encounters, because these are fundamentally different processes. In this way, Lean principles will effectively contribute to sustainable health system improvements. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Clinical reasoning in undergraduate nursing education: a scoping review].

PubMed

Menezes, Sáskia Sampaio Cipriano de; Corrêa, Consuelo Garcia; Silva, Rita de Cássia Gengo E; Cruz, Diná de Almeida Monteiro Lopes da

2015-12-01

This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

An item response theory analysis of the Psychological Inventory of Criminal Thinking Styles: comparing male and female probationers and prisoners.

PubMed

Walters, Glenn D

2014-09-01

An item response theory (IRT) analysis of the Psychological Inventory of Criminal Thinking Styles (PICTS) was performed on 26,831 (19,067 male and 7,764 female) federal probationers and compared with results obtained on 3,266 (3,039 male and 227 female) prisoners from previous research. Despite the fact male and female federal probationers scored significantly lower on the PICTS thinking style scales than male and female prisoners, discrimination and location parameter estimates for the individual PICTS items were comparable across sex and setting. Consistent with the results of a previous IRT analysis conducted on the PICTS, the current results did not support sentimentality as a component of general criminal thinking. Findings from this study indicate that the discriminative power of the individual PICTS items is relatively stable across sex (male, female) and correctional setting (probation, prison) and that the PICTS may be measuring the same criminal thinking construct in male and female probationers and prisoners. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A systematic review on critical thinking in medical education.

PubMed

Chan, Zenobia C Y

2016-04-18

Critical thinking is the ability to raise discriminating questions in an attempt to search for better ideas, a deeper understanding and better solutions relating to a given issue. This systematic review provides a summary of efforts that have been made to enhance and assess critical thinking in medical education. Nine databases [Ovid MEDLINE(R), AMED, Academic Search Premier, ERIC, CINAHL, Web of Science, JSTOR, SCOPUS and PsycINFO] were searched to identify journal articles published from the start of each database to October 2012. A total of 41 articles published from 1981 to 2012 were categorised into two main themes: (i) evaluation of current education on critical thinking and (ii) development of new strategies about critical thinking. Under each theme, the teaching strategies, assessment tools, uses of multimedia and stakeholders were analysed. While a majority of studies developed teaching strategies and multimedia tools, a further examination of their quality and variety could yield some insights. The articles on assessment placed a greater focus on learning outcomes than on learning processes. It is expected that more research will be conducted on teacher development and students' voices.

Intrapersonal Positive Future Thinking Predicts Repeat Suicide Attempts in Hospital-Treated Suicide Attempters

PubMed Central

2014-01-01

Objective: Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking–suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. Method: A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression—as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Discussion: Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking–suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. PMID:25181026

A Survey to Determine Decision-Making Styles of Working Paramedics and Student Paramedics.

PubMed

Jensen, J L; Bienkowski, A; Travers, A H; Calder, L A; Walker, M; Tavares, W; Croskerry, P

2016-05-01

Two major processes underlie human decision-making: experiential (intuitive) and rational (conscious) thinking. The predominant thinking process used by working paramedics and student paramedics to make clinical decisions is unknown. A survey was administered to ground ambulance paramedics and to primary care paramedic students. The survey included demographic questions and the Rational Experiential Inventory-40, a validated psychometric tool involving 40 questions. Twenty questions evaluated each thinking style: 10 assessed preference and 10 assessed ability to use that style. Responses were provided on a five-point Likert scale, with higher scores indicating higher affinity for the style in question. Analysis included both descriptive statistics and t tests to evaluate differences in thinking style. The response rate was 88.4% (1172/1326). Paramedics (n=904) had a median age of 36 years (IQR 29-42) and most were male (69.5%) and primary or advanced care paramedics (PCP=55.5%; ACP=32.5%). Paramedic students (n=268) had a median age of 23 years (IQR 21-26), most were male (63.1%) and had completed high school (31.7%) or an undergraduate degree (25.4%) prior to paramedic training. Both groups scored their ability to use and favourability toward rational thinking significantly higher than experiential thinking. The mean score for rational thinking was 3.86/5 among paramedics and 3.97/5 among paramedic students (p<0.001). The mean score for experiential thinking was 3.41/5 among paramedics and 3.35/5 among paramedic students (p=0.06). Working paramedics and student paramedics prefer and perceive that they have the ability to use rational over experiential thinking. This information adds to our current knowledge on paramedic decision-making and is potentially important for developing continuing education and clinical support tools.

Enhanced creative thinking under dopaminergic therapy in Parkinson disease.

PubMed

Faust-Socher, Achinoam; Kenett, Yoed N; Cohen, Oren S; Hassin-Baer, Sharon; Inzelberg, Rivka

2014-06-01

Creative thinking requires a combination of originality, flexibility, and usefulness. Several reports described enhanced artistic creativity in Parkinson disease (PD) patients treated with dopaminergic agents. We aimed to examine PD patients' ability to perform creativity tasks compared to healthy controls and to verify whether creativity is related to an impulse control disorder (ICD) as a complication of dopaminergic therapy. Right-handed PD patients treated with dopamine agonists and/or levodopa, and age- and education- matched neurologically healthy controls were assessed using the Montreal Cognitive Assessment, semantic verbal fluency, Beck Depression Inventory, and Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease Rating Scale (QUIP-RS). Creativity assessment included Comprehension of Novel Metaphors (CNM), Remote Association Test, and Tel Aviv Creativity Test (TACT). Groups were compared using analyses of variance, t tests, and correlation analyses. Twenty-seven PD patients (age, mean ± standard deviation = 62 ± 7 years; education = 16 ± 3 years; disease duration = 5.8 ± 3.9 years) and 27 controls (age = 59 ± 9 years; education 17 ± 3 years) participated. PD patients performed significantly better than controls in divergent thinking tasks; specifically, the TACT-Visual for both fluency (33.48 ± 11.83 vs 25.59 ± 10.27, p = 0.034) and quality (15.78 ± 7.6 vs 11.19 ± 6.22, p = 0.025). Comprehension of Novel Metaphors was better in PD patients vs controls (0.71 ± 0.23 vs 0.55 ± 0.29, p = 0.04). QUIP-RS scores did not correlate with creativity measures. PD patients treated with dopaminergic drugs demonstrated enhanced verbal and visual creativity as compared to neurologically healthy controls. This feature was unrelated to ICD. Dopaminergic agents might act through the reduction of latent inhibition, resulting in widening of the associative network and enriched divergent thinking. © 2014 American Neurological Association.

Reflective thinking and medical students: some thoughtful distillations regarding John Dewey and Hannah Arendt.

PubMed

Papadimos, Thomas J

2009-04-16

Reflective thought (critical thinking) is essential to the medical student who hopes to become an effective physician. John Dewey, one of America's foremost educators in the early twentieth century, revolutionized critical thinking and its role in education. In the mid twentieth century Hannah Arendt provided profound insights into the problem of diminishing human agency and political freedom. Taken together, Dewey's insight regarding reflective thought, and Arendt's view of action, speech, and power in the public realm, provide mentors and teachers of medical students guidance in the training of thought and the need for its effective projection at the patient's bedside and in the community.

When families cannot "let go": ethical decision-making at the bedside.

PubMed

Thomas, J E; Latimer, E J

1989-09-01

Shared decision-making at the bedside is now a regular feature of medical practice. When disagreements arise between a patient and family members caregivers sometimes find themselves caught in a complex tangle of human relationships that strains monochrome ethical thinking. The patient's expressed wishes are often compromised for the sake of the family's needs. Conversely, a unilateral appeal for patient autonomy may prove insensitive to the hurt and the needs of the family. We describe a relatively unsuccessful attempt by a patient's caregivers to buy time to maximize the interests of the patient and her family and discuss the way in which the family dynamics militated against the rather obvious solution of promoting the patient's right to refuse treatment. The purpose of this article is not to evoke sympathy for health care professionals in dealing with such conflicts but rather to heighten awareness of the issues at stake and to stimulate thinking about ways and means to bring about a more favourable outcome than the one described here.

Ethnopsychiatry fosters creativity and the adoption of critical and reflexive thinking in higher education students: insights from a qualitative analysis of a preliminary pilot experience at the Faculty of Medicine and Surgery, University of Genoa, Italy

PubMed Central

Siri, Anna; Del Puente, Giovanni; Martini, Mariano; Bragazzi, Nicola Luigi

2017-01-01

Creativity is an ability that plays a major role in the modern economy and society. It should represent an important component of the medical syllabus. However, it is often overlooked by the formal courses at universities. The current study aimed at evaluating whether the interactive educational models, recently adopted by the Faculty of Medicine and Surgery, at the University of Genoa, Italy, would favor the adoption of critical thinking, attitudes to changes, cultural diversity acceptance, and the adoption of relational soft skills versus traditional and frontal didactic teaching. Thirty students, who attended the last year of health care professional course at the Faculty of Medicine, volunteered to take part in the study and were randomly allocated to two groups: one group receiving an innovative, interactive excellence course and the other group receiving a more traditional approach. Ethnopsychiatry was chosen as the topic since it was hypothesized that it would have contributed to generation of a new approach toward diseases and patients. The first group of students, exposed to interactive lectures with the aim of promoting the adoption of critical thinking, were more satisfied than the second group. Participants who were involved in an active manner and had to work in small groups, actively finding their own solutions to solve the problems, perceived the utilized teaching method and experience more stimulating, involving, and effective. Implications for education policy makers are also envisaged. PMID:28496378

Ethnopsychiatry fosters creativity and the adoption of critical and reflexive thinking in higher education students: insights from a qualitative analysis of a preliminary pilot experience at the Faculty of Medicine and Surgery, University of Genoa, Italy.

PubMed

Siri, Anna; Del Puente, Giovanni; Martini, Mariano; Bragazzi, Nicola Luigi

2017-01-01

Creativity is an ability that plays a major role in the modern economy and society. It should represent an important component of the medical syllabus. However, it is often overlooked by the formal courses at universities. The current study aimed at evaluating whether the interactive educational models, recently adopted by the Faculty of Medicine and Surgery, at the University of Genoa, Italy, would favor the adoption of critical thinking, attitudes to changes, cultural diversity acceptance, and the adoption of relational soft skills versus traditional and frontal didactic teaching. Thirty students, who attended the last year of health care professional course at the Faculty of Medicine, volunteered to take part in the study and were randomly allocated to two groups: one group receiving an innovative, interactive excellence course and the other group receiving a more traditional approach. Ethnopsychiatry was chosen as the topic since it was hypothesized that it would have contributed to generation of a new approach toward diseases and patients. The first group of students, exposed to interactive lectures with the aim of promoting the adoption of critical thinking, were more satisfied than the second group. Participants who were involved in an active manner and had to work in small groups, actively finding their own solutions to solve the problems, perceived the utilized teaching method and experience more stimulating, involving, and effective. Implications for education policy makers are also envisaged.

Patients' Future Expectations for Diabetes and Hypertension Treatments: "Through the Diet… I Think This is Going to Go Away."

PubMed

Fairchild, Paige C; Nathan, Aviva G; Quinn, Michael; Huang, Elbert S; Laiteerapong, Neda

2017-01-01

Diabetes and hypertension are chronic conditions for which over 90 % of patients require medication regimens that must be intensified over time. However, delays in intensification are common, and may be partially due to unrealistic patient expectations. To explore whether patient expectations regarding their diabetes and hypertension are congruent with the natural history of these conditions. Qualitative analysis of semi-structured interviews. Sixty adults from an urban academic primary care clinic taking oral medications for both diabetes (duration <10 years) and hypertension (any duration) MAIN MEASURES: (1) Expectations for their a) current diabetes and hypertension medications, b) need for additional medications, c) likelihood of cure (not requiring medications); (2) preferences for receiving information on expected duration of treatments KEY RESULTS: The average patient age was 60 years, and 65 % were women. Nearly half (48 %) of participants expected to discontinue current diabetes medications in 6 years or less, whereas only one-fifth (22 %) expected to take medications for life. For blood pressure medications, one-third (37 %) expected to stop medicines in 6 years or less, and one-third expected to take medicines for life. The vast majority did not expect that they would need additional medications in the future (oral diabetes medications: 85 %; insulin: 87 %; hypertension medications: 93 %). A majority expected that their diabetes (65 %) and hypertension (58 %) would be cured. Most participants believed that intensifying lifestyle changes would allow them to discontinue medications, avoid additional medications, or cure their diabetes and hypertension. Nearly all participants (97 %) wanted to hear information on the expected duration of their diabetes and hypertension treatments from their healthcare provider. Providers should educate patients on the natural history of diabetes and hypertension in order to manage patient expectations for current and future medications. Future research should assess whether education can increase the adoption of and adherence to medications, without diminishing enthusiasm for lifestyle changes.

EEG source imaging during two Qigong meditations.

PubMed

Faber, Pascal L; Lehmann, Dietrich; Tei, Shisei; Tsujiuchi, Takuya; Kumano, Hiroaki; Pascual-Marqui, Roberto D; Kochi, Kieko

2012-08-01

Experienced Qigong meditators who regularly perform the exercises "Thinking of Nothing" and "Qigong" were studied with multichannel EEG source imaging during their meditations. The intracerebral localization of brain electric activity during the two meditation conditions was compared using sLORETA functional EEG tomography. Differences between conditions were assessed using t statistics (corrected for multiple testing) on the normalized and log-transformed current density values of the sLORETA images. In the EEG alpha-2 frequency, 125 voxels differed significantly; all were more active during "Qigong" than "Thinking of Nothing," forming a single cluster in parietal Brodmann areas 5, 7, 31, and 40, all in the right hemisphere. In the EEG beta-1 frequency, 37 voxels differed significantly; all were more active during "Thinking of Nothing" than "Qigong," forming a single cluster in prefrontal Brodmann areas 6, 8, and 9, all in the left hemisphere. Compared to combined initial-final no-task resting, "Qigong" showed activation in posterior areas whereas "Thinking of Nothing" showed activation in anterior areas. The stronger activity of posterior (right) parietal areas during "Qigong" and anterior (left) prefrontal areas during "Thinking of Nothing" may reflect a predominance of self-reference, attention and input-centered processing in the "Qigong" meditation, and of control-centered processing in the "Thinking of Nothing" meditation.

Problematic internet pornography use: The role of craving, desire thinking, and metacognition.

PubMed

Allen, Andrew; Kannis-Dymand, Lee; Katsikitis, Mary

2017-07-01

Defined as sexually explicit material that elicits erotic thoughts, feelings, and behaviours, internet pornography is a prevalent form of media that may facilitate problematic use and craving for engagement. Research suggests that superordinate cognitions and information processing, such as desire thinking and metacognition, are central to the activation and escalation of craving in addictive behaviours. The current study aimed to contribute to the literature by testing the proposed metacognitive model of desire thinking and craving in a sample of problematic pornography users, while revising the model by incorporating negative affect. From a theoretical perspective, environmental cues trigger positive metacognitions about desire thinking that directly influence desire thinking, resulting in the escalation of craving, negative metacognitions, and negative affect. Participants were recruited via an online survey and screened for problematic internet pornography use. Path analyses were used to investigate relationships among the aforementioned constructs in a final sample of 191 participants. Consistent with previous research, results of this study validated the existence of metacognitive processes in the activation of desire thinking and escalation of craving, while indicating that desire thinking has the potential to influence negative affect. Additionally, results supported the role of significant indirect relationships between constructs within the revised model of metacognition, desire thinking, and psychopathology. Collectively, the findings demonstrate the clinical value of a metacognitive conceptualisation of problematic pornography use. Exploring the metacognitive mechanisms that underpin problematic internet pornography use may give rise to the development of new treatment and relapse prevention strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effectiveness of problem-based learning on development of nursing students' critical thinking: a systematic review and meta-analysis.

PubMed

Kong, Ling-Na; Qin, Bo; Zhou, Ying-qing; Mou, Shao-yu; Gao, Hui-Ming

2014-03-01

The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I(2) statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13-0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I(2)=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Modeling and Simulation in the Army Intermediate Level Education Critical Thinking Curriculum

DTIC Science & Technology

2015-06-12

of the subjective nature of critical thinking. Because Ms. Fischers experiment compares a CT2 control group against a group that was representative...to serve peacekeeping roles, for example, in which their job is to control conflict among two or more opposing and hostile groups within a foreign...subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT

Is Adolescence a Critical Period for Learning Formal Thinking Skills? A Case Study Investigating the Development of Formal Thinking Skills in a Short-Term Inquiry-Based Intervention Program

ERIC Educational Resources Information Center

Towne, Forrest S.

2009-01-01

Current domestic and international comparative studies of student achievement in science are demonstrating that the U.S. needs to improve science education if it wants to remain competitive in the global economy. One of the causes of the poor performance of U.S. science education is the lack of students who have developed the formal thinking…

Alzheimer disease: diagnosis, costs, and dimensions of treatment.

PubMed

DeKosky, S T; Orgogozo, J M

2001-08-01

Alzheimer disease (AD) is the most frequent cause of dementia in developed Western countries. Over time, affected patients invariably develop cognitive and functional decline, and most develop early or later behavioral disturbances. Declining cognitive and functional abilities contribute to loss of independent living and feelings of denial, confusion, fear and guilt until, finally, the patient loses most abilities to think, move, speak, or perceive. As patients' dependency on assistance increases, the level of caregiver strain rises. The caregiver may develop feelings of anger, grief, loneliness and resentment, and the health and well-being of most caregivers are often affected. Approximately 3-4 million people currently have AD in the USA, at an annual cost of up to US$100 billion, and the disease is expected to reach epidemic proportions by 2020. To achieve a clinically relevant, long-term outcome, pharmacotherapy must have sustained favorable effects on cognitive, functional and behavioral symptoms of AD. Slowing the development of these features of the disease will mean a long-term improvement in quality of life for patients and caregivers. Postponing the emergence of behavioral symptoms would bring about direct beneficial effects on patients with AD and their families, help delay long-term care placement and lower costs.

An Update on Triptorelin: Current Thinking on Androgen Deprivation Therapy for Prostate Cancer.

PubMed

Merseburger, Axel S; Hupe, Marie C

2016-07-01

Androgen deprivation therapy (ADT) is the mainstay palliative treatment for men with locally advanced and metastatic prostate cancer, and aims to reduce testosterone to levels obtained by surgical castration. Use of gonadotropin-releasing hormone (GnRH) agonists predominates among the ADT options. The GnRH agonist, triptorelin is a first-line hormonal therapy that has demonstrated efficacy and safety in clinical trials of patients with locally advanced non-metastatic or metastatic disease. Sustained-release 1-, 3- and 6-month formulations of triptorelin, administered intramuscularly or subcutaneously, have been developed to provide improved flexibility and convenience for the patient. Head-to-head studies of GnRH agonists are lacking in the field of prostate cancer. Despite the inevitable progression to castration-resistant prostate cancer (CRPC) in most patients receiving ADT, monitoring of testosterone levels needs to improve in routine practice and physicians should not overlook the benefits of continued ADT in their patients when introducing one of the various new treatment options for CRPC. For improved survival outcomes, there remains a need to tailor ADT treatment regimens, novel hormonal agents and chemotherapy according to the individual patient with advanced prostate cancer.

Factors Influencing Cancer Patients' Choice of End-of-Life Care Place.

PubMed

Natsume, Maika; Watanabe, Kiyotaka; Matsumoto, Satoko; Naruge, Daisuke; Hayashi, Kazuhiko; Furuse, Junji; Kawamura, Masafumi; Jinno, Hiromitsu; Sano, Keiji; Fukushima, Ryoji; Osawa, Gakuji; Aruga, Etsuko; Hashiguchi, Yojiro; Tanaka, Atsushi; Takikawa, Hajime; Seki, Nobuhiko

2018-06-01

It is important for cancer patients to receive end-of-life care at the desired place. To identify issues in selection of place for end-of-life care of cancer patients to realize their optimal survivorship. Between September 2015 and January 2016, a questionnaire consisting of 33 items, including end-of-life care place preferences, was administered to cancer patients who attended three university hospitals in Japan. A total of 971 questionnaires were collected (response rate, 88.4%). Fifty-eight percent of patients preferred to stay at home to receive end-of-life care. In contrast, more than 80% of patients did not know the details of healthcare services. The factors significantly associated with patients' choice for place of end-of-life care at home were "male gender" (odds ratio [OR] = 1.43, p = 0.030), "living in a one-person household" (OR = 0.21, p < 0.001), "feeling close to friends" (OR = 0.94, p = 0.049), "thinking that the family is burdened" (OR = 0.55, p < 0.001), "thinking that pain is controllable at home" (OR = 1.39, p < 0.001), and "thinking that society should establish a system of home palliative care" (OR = 1.93, p < 0.001). This study identified six factors influencing the selection of a place for end-of-life care. Most patients have a desire for a social system that allows end-of-life care at home where they can live with their family, but have anxiety about treatment to deal with symptom change, with concern about burden on their family. These issues should be addressed in the future.

Seeing wholes: The concept of systems thinking and its implementation in school leadership

NASA Astrophysics Data System (ADS)

Shaked, Haim; Schechter, Chen

2013-12-01

Systems thinking (ST) is an approach advocating thinking about any given issue as a whole, emphasising the interrelationships between its components rather than the components themselves. This article aims to link ST and school leadership, claiming that ST may enable school principals to develop highly performing schools that can cope successfully with current challenges, which are more complex than ever before in today's era of accountability and high expectations. The article presents the concept of ST - its definition, components, history and applications. Thereafter, its connection to education and its contribution to school management are described. The article concludes by discussing practical processes including screening for ST-skilled principal candidates and developing ST skills among prospective and currently performing school principals, pinpointing three opportunities for skills acquisition: during preparatory programmes; during their first years on the job, supported by veteran school principals as mentors; and throughout their entire career. Such opportunities may not only provide school principals with ST skills but also improve their functioning throughout the aforementioned stages of professional development.

Anemia and iron deficiency in gastrointestinal and liver conditions

PubMed Central

Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

2016-01-01

Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice. PMID:27672287

Anemia and iron deficiency in gastrointestinal and liver conditions.

PubMed

Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

2016-09-21

Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice.

Nonliteral language in Alzheimer dementia: a review.

PubMed

Rapp, Alexander M; Wild, Barbara

2011-03-01

The use of nonliteral language in clinical assessment, especially testing the patients' ability to interpret proverbs, has a long tradition in psychiatry. However, its diagnostic sensitivity and specificity in dementias is not yet clear. The aim of this review article is to examine the current evidence on nonliteral/figurative language (proverb, metaphor, metonymy, idiom, irony, sarcasm) comprehension in Alzheimer's disease and related disorders. A comprehensive literature search identified 25 studies (16 proverb, 3 metaphor, 0 metonymy, 5 idiom, 3 sarcasm) on nonliteral language comprehension in dementia. Studies predominantly indicate a deficit. Most studies investigated Alzheimer's dementia. Applied correctly, nonliteral language is a worthwhile diagnostic tool to evaluate language and abstract thinking in dementias. During assessment, familiarity testing (e.g., by asking "are you familiar with the proverb XY") is obligatory. Still, future research is needed in several areas: evidence on decline of nonliteral language over the course of the illness is limited. So far, almost no studies delineated proverb comprehension in high risk populations such as patients with mild cognitive impairment. Currently, there is a lack of studies addressing performance in direct comparison to relevant differential diagnosis like older-age depression, delirium, brain lesion, or other psychiatric conditions.

Pain Coping Strategies in Osteoarthritis Patients.

ERIC Educational Resources Information Center

Keefe, Francis J.; And Others

1987-01-01

Investigated the relation of pain coping strategies to pain, health status, and psychological distress in a group of osteoarthritis patients with chronic pain. Patients completed various questionnaires. Medical status variables were also used. The Pain Control and Rational Thinking factor derived from the Coping Strategies Questionnaire proved to…

Developing professional attributes in critical care nurses using Team-Based Learning.

PubMed

Currey, Judy; Eustace, Paula; Oldland, Elizabeth; Glanville, David; Story, Ian

2015-05-01

Australian nurses prepare for specialty practice by undertaking postgraduate theoretical and clinical education in partnership models between universities and hospitals. In our global healthcare system, nurses require advanced critical thinking and strong communication skills to provide safe, high quality patient care. Yet, few education programs focus on developing these skills. Team-Based Learning (TBL) is a specific educational strategy that encourages and rewards students to think critically and solve clinical problems individually and in teams. The aim of this study was to investigate critical care nursing students' perceptions and experiences of TBL after it was introduced into the second half of their postgraduate specialty course. Following Ethics Committee approval, thirty-two students were invited to participate in an extended response questionnaire on their perceptions of TBL as part of a larger study. Data were analyzed thematically. Postgraduate students perceived their professional growth was accelerated due to the skills and knowledge acquired through TBL. Four themes underpinned the development and accelerated acquisition of specialty nurse attributes due to TBL: Engagement, Learning Effectiveness, Critical Thinking, and Motivation to Participate. Team-Based Learning offered deep and satisfying learning experiences for students. The early acquisition of advanced critical thinking, teamwork and communication skills, and specialty practice knowledge empowered nurses to provide safe patient care with confidence. Copyright © 2015 Elsevier Ltd. All rights reserved.

Asian Americans and Diabetes

MedlinePlus

... care and nutrition therapy that acknowledges differences. Patient perspectives on diabetes care Cheung says that many Asian American patients think treating diabetes means following a specific regimen for a period of time to cure the disease. They believe that certain ...

The right to information for the terminally ill patient.

PubMed Central

Osuna, E; Pérez-Cárceles, M D; Esteban, M A; Luna, A

1998-01-01

OBJECTIVES: To analyse the attitudes of medical personnel towards terminally ill patients and their right to be fully informed. DESIGN: Self-administered questionnaire composed of 56 closed questions. SETTING: Three general hospitals and eleven health centres in Granada (Spain). The sample comprised 168 doctors and 207 nurses. RESULTS: A high percentage of medical personnel (24.1%) do not think that informing the terminally ill would help them face their illness with greater serenity. Eighty-four per cent think the patient's own home is the best place to die: 8.9% of the subjects questioned state that the would not like to be informed of an incurable illness. CONCLUSION: In our opinion any information given should depend on the patient's personality, the stage of the illness and family circumstances. Our study confirms that a hospital is not the ideal environment for attending to the needs of the terminally ill and their families. PMID:9602997

[Using complementary therapy with a hemodialysis patient with colon cancer and a sense of hopelessness].

PubMed

Yeh, Shih-Chun; Yeh, Hui-Fang

2007-10-01

Hemodialysis patients usually have a sense of hopelessness. This can affect their physical, mental and spiritual health, and can even be life- threatening. This article discusses a nursing experience involving a dialysis patient who also suffered from cancer had and a sense of hopelessness due to the distress caused by the two severe illnesses. The author assessed the patient by means of Roy's theory during the nursing period (5/7/2005-6/18/2005). Data were collected through physical assessments, interviews, observation of interaction with family members and a medical history review. The patient had characteristics of hopelessness, such as pessimism, moodiness, frequent sighing, frowning, eye-closing and negative thinking. The author applied a safe, easy, and non-invasive complementary therapy program including music therapy, aromatherapy and massage with essential oil to improve the patient's physical and mental states. Through these approaches, the patient learned to release stress, and to express his feelings, so that he could adapt to his current life, changed as it was by the illnesses, and face the impact of those illnesses with a positive attitude. The author would like to share this case report to provide nursing professionals with a source of reference for healthcare quality improvement.

Theory versus practice in Strategic Environmental Assessment (SEA)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lobos, Víctor, E-mail: vlobosg@gmail.com; Centro de Estudios del Desarrollo, San Crescente 551, Las Condes, Santiago; Partidario, Maria

Could the theory of Strategic Environmental Assessment (SEA) be ahead of its time and decoupled from its practice? This paper evolved in search for this leading research question. Over the years the discourse on SEA experienced a gradual shift from the technocratic and rationalist thinking that supported its origin to more strategic approaches and integrated concepts, suggested since the mid 1990's. In this paper we share the results of our analysis of international thinking and practical experience with SEA. Results reveal that SEA practice changes very slowly when compared to advanced thinking supporting the noted shift. Current SEA practice showsmore » to be still predominantly rooted in the logic of projects' environmental impact assessment (EIA). It is strongly bound to legal and regulatory requirements, and the motivation for its application persists being the delivery of environmental (or final) reports to meet legal obligations. Even though advanced SEA theoretical thinking claim its potential to help decisions to look forward, change mind-sets and the rationale of decision-making to meet sustainability challenges and enhance societal values, we note a weak relationship between the theoretical development of SEA and its practice. Why is this happening? Which factors explain this apparent inertia, resistance to change, in the SEA practice? Results appear to demonstrate the influence of assumptions, understandings, concepts, and beliefs in the use of SEA, which in turn suggest the political sensitivity of the instrument. - Highlights: • Theoretical thinking in SEA is ahead of its time. • SEA international practice reveals inertia to move out of project’ EIA comfort zone. • World current SEA practice show similar understandings of 30 years ago. • 100 world reports and survey of practitioners supported world review. • SEA great challenge is to change paradigms into new scientific complexity theories.« less

Spatial Navigation Impairments Among Intellectually High-Functioning Adults With Autism Spectrum Disorder: Exploring Relations With Theory of Mind, Episodic Memory, and Episodic Future Thinking

PubMed Central

2013-01-01

Research suggests that spatial navigation relies on the same neural network as episodic memory, episodic future thinking, and theory of mind (ToM). Such findings have stimulated theories (e.g., the scene construction and self-projection hypotheses) concerning possible common underlying cognitive capacities. Consistent with such theories, autism spectrum disorder (ASD) is characterized by concurrent impairments in episodic memory, episodic future thinking, and ToM. However, it is currently unclear whether spatial navigation is also impaired. Hence, ASD provides a test case for the scene construction and self-projection theories. The study of spatial navigation in ASD also provides a test of the extreme male brain theory of ASD, which predicts intact or superior navigation (purportedly a systemizing skill) performance among individuals with ASD. Thus, the aim of the current study was to establish whether spatial navigation in ASD is impaired, intact, or superior. Twenty-seven intellectually high-functioning adults with ASD and 28 sex-, age-, and IQ-matched neurotypical comparison adults completed the memory island virtual navigation task. Tests of episodic memory, episodic future thinking, and ToM were also completed. Participants with ASD showed significantly diminished performance on the memory island task, and performance was positively related to ToM and episodic memory, but not episodic future thinking. These results suggest that (contra the extreme male brain theory) individuals with ASD have impaired survey-based navigation skills—that is, difficulties generating cognitive maps of the environment—and adds weight to the idea that scene construction/self-projection are impaired in ASD. The theoretical and clinical implications of these results are discussed. PMID:24364620

Everything you need to know to understand the current controversies you learned from psychological research. A comment on the Rind and Lilienfeld controversies.

PubMed

Sternberg, Robert J

2002-03-01

Psychological theory and research can help explain some of the aspects of the controversies that arose over articles written by B. Rind, P. Tromovitch, and R. Bauserman (1998) and by S. O. Lilienfeld (2002). In particular, one needs to distinguish between rational and intuitive thinking, to recognize the power of context, to be reflective in one's own thinking, and to realize the costs of defying the crowd. There are steps one can take to be wiser and more balanced in one's own thinking than one may have been in the past. One such step is to resolve conflicts among psychologists by attempting to defuse rather than to exacerbate or avoid them.

What If? Paths Not Taken

NASA Technical Reports Server (NTRS)

Logsdon, John M.

2005-01-01

I think the point of this exercise in counterfactual thinking is two-fold first, to recognize that not only have choices been made in the past that defined the character of what has happened and that different choices were possible and would have led to different outcomes, and, second, that we are currently making similar choices for the future. Today s choices obviously will have significant long-term consequences for space development. Decision-makers have an image of a desirable future when they make choices, but they also realize that the link between current choice and desired result is always uncertain. As the philosopher Yogi Berra is often quoted as having said, "making predictions is hard, especially when they are about the future."

Pathways of Knowing: Integrating Citizen Science and Critical Thinking in the Adult ELL Classroom

NASA Astrophysics Data System (ADS)

Basham, Melody

This action research study examines what common perceptions and constructs currently exist in educating adult immigrants in Arizona and considers how might the integration of citizen science with the current English curriculum promote higher order thinking and educational equity in this population. A citizen science project called the Mastodon Matrix Project was introduced to a Level 2 ELAA (English Language Acquisition for Adults) classroom and aligned with the Arizona Adult Standards for ELAA education. Pre and post attitudinal surveys, level tests, and personal meaning maps were implemented to assess student attitudes towards science, views on technology, English skills, and knowledge gained as a result of doing citizen science over a period of 8 weeks.

Current thinking in qualitative research: evidence-based practice, moral philosophies, and political struggle.

PubMed

Papadimitriou, Christina; Magasi, Susan; Frank, Gelya

2012-01-01

In this introduction to the special issue on current thinking in qualitative research and occupational therapy and science, the authors focus on the importance of rigorous qualitative research to inform occupational therapy practice. The authors chosen for this special issue reflect a "second generation of qualitative researchers" who are critical, theoretically sophisticated, methodologically productive, and politically relevant to show that working with disabled clients is political work. Three themes emerged across the articles included in this special issue: (1) recognizing and addressing social justice issues; (2) learning from clients' experiences; and (3) critically reframing occupational therapy's role. These themes can inform occupational therapy practice, research, and education to reflect a more client-centered and politically engaging approach. Copyright 2012, SLACK Incorporated.

Researching Academic Identity: Using Discursive Psychology as an Approach

ERIC Educational Resources Information Center

McLean, Neil

2012-01-01

Current thinking on academic identities is heavily influenced by developments in other disciplines, notably sociology. This accords with Haggis's (2007) challenge for educational researchers to engage with current theory and methods from across the social sciences. However, the traditional sister discipline to education, psychology, seems…

Guiding dental student learning and assessing performance in critical thinking with analysis of emerging strategies.

PubMed

Johnsen, David C; Lipp, Mitchell J; Finkelstein, Michael W; Cunningham-Ford, Marsha A

2012-12-01

Patient-centered care involves an inseparable set of knowledge, abilities, and professional traits on the part of the health care provider. For practical reasons, health professions education is segmented into disciplines or domains like knowledge, technical skills, and critical thinking, and the culture of dental education is weighted toward knowledge and technical skills. Critical thinking, however, has become a growing presence in dental curricula. To guide student learning and assess performance in critical thinking, guidelines have been developed over the past several decades in the educational literature. Prominent among these guidelines are the following: engage the student in multiple situations/exercises reflecting critical thinking; for each exercise, emulate the intended activity for validity; gain agreement of faculty members across disciplines and curriculum years on the learning construct, application, and performance assessment protocol for reliability; and use the same instrument to guide learning and assess performance. The purposes of this article are 1) to offer a set of concepts from the education literature potentially helpful to guide program design or corroborate existing programs in dental education; 2) to offer an implementation model consolidating these concepts as a guide for program design and execution; 3) to cite specific examples of exercises and programs in critical thinking in the dental education literature analyzed against these concepts; and 4) to discuss opportunities and challenges in guiding student learning and assessing performance in critical thinking for dentistry.

Engineering the path to higher-order thinking in elementary education: A problem-based learning approach for STEM integration

NASA Astrophysics Data System (ADS)

Rehmat, Abeera Parvaiz

As we progress into the 21st century, higher-order thinking skills and achievement in science and math are essential to meet the educational requirement of STEM careers. Educators need to think of innovative ways to engage and prepare students for current and future challenges while cultivating an interest among students in STEM disciplines. An instructional pedagogy that can capture students' attention, support interdisciplinary STEM practices, and foster higher-order thinking skills is problem-based learning. Problem-based learning embedded in the social constructivist view of teaching and learning (Savery & Duffy, 1995) promotes self-regulated learning that is enhanced through exploration, cooperative social activity, and discourse (Fosnot, 1996). This quasi-experimental mixed methods study was conducted with 98 fourth grade students. The study utilized STEM content assessments, a standardized critical thinking test, STEM attitude survey, PBL questionnaire, and field notes from classroom observations to investigate the impact of problem-based learning on students' content knowledge, critical thinking, and their attitude towards STEM. Subsequently, it explored students' experiences of STEM integration in a PBL environment. The quantitative results revealed a significant difference between groups in regards to their content knowledge, critical thinking skills, and STEM attitude. From the qualitative results, three themes emerged: learning approaches, increased interaction, and design and engineering implementation. From the overall data set, students described the PBL environment to be highly interactive that prompted them to employ multiple approaches, including design and engineering to solve the problem.

[Institution, primary nurse and projective identification].

PubMed

Usmial, Delphine

2013-01-01

Ayoung bipolar patient admitted to day hospital care questions the importance of institutional networking. His history, his behaviour and his words unsettle the thinking of the primary nurse. The support of the institution and the clinical work established around the patient are a reminder of the importance of the team in patient management.

Dual-modality impairment of implicit learning of letter-strings versus color-patterns in patients with schizophrenia.

PubMed

Chiu, Ming-Jang; Liu, Kristina; Hsieh, Ming H; Hwu, Hai-Gwo

2005-12-12

Implicit learning was reported to be intact in schizophrenia using artificial grammar learning. However, emerging evidence indicates that artificial grammar learning is not a unitary process. The authors used dual coding stimuli and schizophrenia clinical symptom dimensions to re-evaluate the effect of schizophrenia on various components of artificial grammar learning. Letter string and color pattern artificial grammar learning performances were compared between 63 schizophrenic patients and 27 comparison subjects. Four symptom dimensions derived from a Chinese Positive and Negative Symptom Scale ratings were correlated with patients' artificial grammar implicit learning performances along the two stimulus dimensions. Patients' explicit memory performances were assessed by verbal paired associates and visual reproduction subtests of the Wechsler Memory Scales Revised Version to provide a contrast to their implicit memory function. Schizophrenia severely hindered color pattern artificial grammar learning while the disease affected lexical string artificial grammar learning to a lesser degree after correcting the influences from age, education and the performance of explicit memory function of both verbal and visual modalities. Both learning performances correlated significantly with the severity of patients' schizophrenic clinical symptom dimensions that reflect poor abstract thinking, disorganized thinking, and stereotyped thinking. The results of this study suggested that schizophrenia affects various mechanisms of artificial grammar learning differently. Implicit learning, knowledge acquisition in the absence of conscious awareness, is not entirely intact in patients with schizophrenia. Schizophrenia affects implicit learning through an impairment of the ability of making abstractions from rules and at least in part decreasing the capacity for perceptual learning.

Improvement of emergency department patient flow using lean thinking.

PubMed

Sánchez, Miquel; Suárez, Montse; Asenjo, María; Bragulat, Ernest

2018-05-01

To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. A prospective interventional study. An ED of a tertiary care hospital. Triage acuity level-3 patients. To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff. Two periods were compared: (i) pre-lean: April-September, 2015; and (ii) post-lean: April-September, 2016. Variables included: median process time (time from beginning of nurse preparation to the end of nurse finalization after doctor disposition) of both discharged and transferred to observation patients; median length of stay; median waiting time; left without being seen, 72-h revisit and mortality rates, and daily number of visits. There was no additional staff or bed after lean implementation. Despite an increment in the daily number of visits (+8.3%, P < 0.001), significant reductions in process time of discharged (182 vs 160 min, P < 0.001) and transferred to observation (186 vs 176 min, P < 0.001) patients, in length of stay (389 vs 329 min, P < 0.001), and in waiting time (71 vs 48 min, P < 0.001) were achieved after lean implementation. No significant differences were registered in left without being seen rate (5.23% vs 4.95%), 72-h revisit rate (3.41% vs 3.93%), and mortality rate (0.23% vs 0.15%). Lean thinking is a methodology that can improve triage acuity level-3 patient flow in the ED, resulting in better throughput along with reduced waiting time.

The Language of Engagement: "Aha!" Moments from Engaging Patients and Community Partners in Two Pilot Projects of the Patient-Centered Outcomes Research Institute.

PubMed

Tai-Seale, Ming; Sullivan, Greer; Cheney, Ann; Thomas, Kathleen; Frosch, Dominick

2016-01-01

Compared with people living in the community, researchers often have different frameworks or paradigms for thinking about health and wellness. These differing frameworks are often accompanied by differences in terminology or language. The purpose of this commentary is to describe some of our "Aha!" moments from conducting two pilot studies funded by the Patient-Centered Outcomes Research Institute. Over time, we came to understand how our language and word choices may have been acting as a wedge between ourselves and our community research partners. We learned that fruitful collaborative work must attend to the creation of a common language, which we refer to as the language of engagement. Such patient-centered language can effectively build a bridge between researchers and community partners. We encourage other researchers to think critically about their cultural competency, to be mindful of the social power dynamics between patient and physician, to reflect on how their understanding might differ from those of their patient partners, and to find ways to use a common language that engages patients and other community partners.

[The Psychotic Thinking of Patrick Bateman].

PubMed

Fernando, Muñoz

2012-06-01

Literature is an inexhaustible source of study regarding mental illness which allows the academic exercise, whether dynamic oriented or not, that may help to understand the patient's inner world in the psychiatric clinical practice. Freudian, Post-Freudian and analytical examination of the main character in the U.S.A. novel AMERICAN PSYCHO. Review of sources and relevant theoretical currents. Analysis highlights the official nosologic classification boundaries, for conditions where symptoms are scattered across the spectrum of personality disorders and psychosis spectrum; usefulness and applicability of psychoanalytic concepts in psychiatric practice are also pointed out, thus granting flexibility to the clinical approach in order to justify its use. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Factors influencing stethoscope cleanliness among clinical medical students.

PubMed

Saunders, C; Hryhorskyj, L; Skinner, J

2013-07-01

This study aims to identify current stethoscope hygiene habits and attitudes in a UK medical school setting. Students completed a questionnaire using Likert-scale questions and free-text answers. A total of 308 questionnaires were completed from a potential 750 students (41%); 22.4% of respondents had never cleaned their stethoscope and only 3.9% cleaned their stethoscope after every patient. Significant correlations were identified between cleaning frequency and: others acting as role models (P = 0.001), students having confidence in how to clean stethoscopes (P = 0.001), and students thinking cleaning was important (P = 0.01), thereby highlighting inadequate education and role models as potential problems. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Considerations in the development of circulating tumor cell technology for clinical use

PubMed Central

2012-01-01

This manuscript summarizes current thinking on the value and promise of evolving circulating tumor cell (CTC) technologies for cancer patient diagnosis, prognosis, and response to therapy, as well as accelerating oncologic drug development. Moving forward requires the application of the classic steps in biomarker development–analytical and clinical validation and clinical qualification for specific contexts of use. To that end, this review describes methods for interactive comparisons of proprietary new technologies, clinical trial designs, a clinical validation qualification strategy, and an approach for effectively carrying out this work through a public-private partnership that includes test developers, drug developers, clinical trialists, the US Food & Drug Administration (FDA) and the US National Cancer Institute (NCI). PMID:22747748

Thinking in Pharmacy Practice: A Study of Community Pharmacists’ Clinical Reasoning in Medication Supply Using the Think-Aloud Method

PubMed Central

Croft, Hayley; Gilligan, Conor; Rasiah, Rohan; Levett-Jones, Tracy; Schneider, Jennifer

2017-01-01

Medication review and supply by pharmacists involves both cognitive and technical skills related to the safety and appropriateness of prescribed medicines. The cognitive ability of pharmacists to recall, synthesise and memorise information is a critical aspect of safe and optimal medicines use, yet few studies have investigated the clinical reasoning and decision-making processes pharmacists use when supplying prescribed medicines. The objective of this study was to examine the patterns and processes of pharmacists’ clinical reasoning and to identify the information sources used, when making decisions about the safety and appropriateness of prescribed medicines. Ten community pharmacists participated in a simulation in which they were required to review a prescription and make decisions about the safety and appropriateness of supplying the prescribed medicines to the patient, whilst at the same time thinking aloud about the tasks required. Following the simulation each pharmacist was asked a series of questions to prompt retrospective thinking aloud using video-stimulated recall. The simulated consultation and retrospective interview were recorded and transcribed for thematic analysis. All of the pharmacists made a safe and appropriate supply of two prescribed medicines to the simulated patient. Qualitative analysis identified seven core thinking processes used during the supply process: considering prescription in context, retrieving information, identifying medication-related issues, processing information, collaborative planning, decision making and reflection; and align closely with other health professionals. The insights from this study have implications for enhancing awareness of decision making processes in pharmacy practice and informing teaching and assessment approaches in medication supply. PMID:29301223