Life-Threatening Clinical Simulations for Nursing Students: Promoting Critical Thinking and Satisfaction.

BACKGROUND: Integrating life-threatening clinical simulations improves learning outcomes. This study assessed nursing students' critical thinking factors before and after simulation, evaluated nursing clinical reasoning ability and learning satisfaction at two time points, and explored relationships and predictions among critical thinking, clinical reasoning, and satisfaction before and after simulation. METHOD: Surveys and focus groups were used for this mixed-methods study. RESULTS: Quantitative findings revealed increased critical thinking scores for curiosity, skepticism, and systematicity; clinical reasoning; and satisfaction after simulation. Qualitative results supported these improvements and indicated enhanced curiosity for clinical knowledge and iterative phases of clinical reasoning. Students expressed satisfaction with the simulations. Objectivity significantly influenced clinical reasoning and satisfaction in nursing students following life-threatening simulations. CONCLUSION: Fostering a culture of critical thinking in life-threatening simulations is crucial. Educators must teach the importance of objectivity in clinical practice, encourage critical evaluation, and foster self-reflection in simulations. [J Nurs Educ. 2024;63(9):595-603.].

The Inventory of Personality Organization-Reality Testing Subscale and Belief in Science Scale: Confirmatory factor and Rasch analysis of thinking style measures.

The Inventory of Personality Organization-Reality Testing Subscale (IPO-RT) and Belief in Science Scale (BIS) represent indirect, proxy measures of intuitive-experiential and analytical-rational thinking. However, a limited appraisal of factorial structure exists, and assessment of person-item functioning has not occurred. This study assessed the IPO-RT and BIS using confirmatory factor analysis (CFA) and Rasch analysis with a sample of 1030 participants (465 males, 565 females). Correlation analysis revealed a negative, moderate relationship between the measures. CFA supported a bifactorial model of the IPO-RT with four bifactors (Auditory and Visual Hallucinations, Delusional Thinking, Social Deficits, and Confusion). A one-factor model best fitted the BIS. Satisfactory item/person reliability and unidimensionality was observed for both measures using Rasch analysis, and items generally exhibited gender invariance. However, IPO-RT items were challenging, whereas BIS items were relatively easy to endorse. Overall, results indicated that the IPO-RT and BIS are conceptually sound, indirect indices of intuitive-experiential and analytical-rational thinking. Acknowledging the breadth of these thinking styles, a useful future research focus includes evaluating the performance of IPO-RT and BIS alongside objective tests.

Assessing dimensions of thought disorder with large language models: The tradeoff of accuracy and consistency.

Natural Language Processing (NLP) methods have shown promise for the assessment of formal thought disorder, a hallmark feature of schizophrenia in which disturbances to the structure, organization, or coherence of thought can manifest as disordered or incoherent speech. We investigated the suitability of modern Large Language Models (LLMs - e.g., GPT-3.5, GPT-4, and Llama 3) to predict expert-generated ratings for three dimensions of thought disorder (coherence, content, and tangentiality) assigned to speech samples collected from both patients with a diagnosis of schizophrenia (n = 26) and healthy control participants (n = 25). In addition to (1) evaluating the accuracy of LLM-generated ratings relative to human experts, we also (2) investigated the degree to which the LLMs produced consistent ratings across multiple trials, and we (3) sought to understand the factors that impacted the consistency of LLM-generated output. We found that machine-generated ratings of the level of thought disorder in speech matched favorably those of expert humans, and we identified a tradeoff between accuracy and consistency in LLM ratings. Unlike traditional NLP methods, LLMs were not always consistent in their predictions, but these inconsistencies could be mitigated with careful parameter selection and ensemble methods. We discuss implications for NLP-based assessment of thought disorder and provide recommendations of best practices for integrating these methods in the field of psychiatry.

The recursive grammar of mental time travel.

One apparent feature of mental time travel is the ability to recursively embed temporal perspectives across different times: humans can remember how we anticipated the future and anticipate how we will remember the past. This recursive structure of mental time travel might be formalized in terms of a 'grammar' that is reflective of but more general than linguistic notions of absolute and relative tense. Here, I provide a foundation for this grammatical framework, emphasizing a bounded (rather than unbounded) recursive function that supports mental time travel to a limited temporal depth and to actual and possible scenarios. Anticipated counterfactual thinking, for instance, entails three levels of mental time travel to a possible scenario ('in the future, I will reflect on how my past self could have taken a different future action') and is centrally implicated in complex human decision-making. This perspective calls for further research into the mechanisms, ontogeny, functions and phylogeny of recursive mental time travel, and revives the question of links with other recursive forms of thinking such as theory of mind. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

Children's mental time travel into the future: a functional perspective.

Children's episodic future-thinking is typically assessed using experimental tasks that measure whether children select an item with future utility. Although these tasks-inspired by Tulving's seminal 'spoon test' (Tulving E. 2005 Episodic memory and autonoesis: uniquely human? In The missing link in cognition: origins of self-reflective consciousness [eds HS Terrace, J Metcalfe], pp. 3-56. Oxford, UK: Oxford University Press. [doi:10.1093/acprof:oso/9780195161564.001.0001])-are passed around age 4, they tell us little about the functional significance of children's episodic future-thinking in their day-to-day lives. We highlight how a naturalistic approach can shed light on this issue, and present a small study where we recruited mothers to report on their children's (N = 12, 3- and 4-year-olds and 6- and 7-year-olds) future-thinking over a 7-day period. We used a thematic analysis to understand why children express future thoughts and derived the following themes: (1) expressing future desires and/or intentions, (2) future-oriented information-seeking, (3) connecting present actions with future outcomes, and (4) predicting future mental/physiological states. We compare these themes with recent accounts of the functional significance of future-thinking in adults and conclude that children largely express their future-thinking verbally to request information or support from their parent-likely because they do not yet possess enough control/autonomy to independently act for their own future. Our findings both complement and extend an experimental approach and further elucidate the functional significance of mental time travel in children. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

Beyond the episodic-semantic continuum: the multidimensional model of mental representations.

Tulving's concept of mental time travel (MTT), and the related distinction of episodic and semantic memory, have been highly influential contributions to memory research, resulting in a wealth of findings and a deeper understanding of the neurocognitive correlates of memory and future thinking. Many models have conceptualized episodic and semantic representations as existing on a continuum that can help to account for various hybrid forms. Nevertheless, in most theories, MTT remains distinctly associated with episodic representations. In this article, we review existing models of memory and future thinking, and critically evaluate whether episodic representations are distinct from other types of explicit representations, including whether MTT as a neurocognitive capacity is uniquely episodic. We conclude by proposing a new framework, the Multidimensional Model of Mental Representations (MMMR), which can parsimoniously account for the range of past, present and future representations the human mind is capable of creating. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

Measuring episodic memory and mental time travel: crossing the species gap.

Mental time travel is the projection of the mind into the past or future, and relates to experiential aspects of episodic memory, and episodic future thinking. Framing episodic memory and future thinking in this way causes a challenge when studying memory in animals, where demonstration of this mental projection is prevented by the absence of language. However, there is good evidence that non-human animals pass tests of episodic memory that are based on behavioural criteria, meaning a better understanding needs to be had of the relationship between episodic memory and mental time travel. We argue that mental time travel and episodic memory are not synonymous, and that mental time travel is neither a requirement of, nor an irrelevance to, episodic memory. Mental time travel can allow improved behavioural choices based on episodic memory, and work in all species (including humans) should include careful consideration of the behavioural outputs being measured. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

The Emergence of Edgar Morin's Complex Thinking.

Edgar Morin is more than 100 years old and has produced numerous original ideas. Complex Thinking is his approach to complexity and took almost thirty years to be written. He developed it based on many other thinkers but chiefly, we argue, on Wiener's Cybernetics, von Bertalanffy's General System Theory and Shannon's Information Theory. This article describes and discusses how those latter theories have been incorporated into Morin's thought, especially in La Méthode, his magnum opus, and presents, in a comparative fashion, his pros and contras on each of them. In our conclusion, we discuss how some of Morin's criticisms of the founding theories might be unjust and also present a summary of some judgmental appraisals of Complex Thinking.

Harnessing technology to measure individual differences in spatial thinking in early childhood from a relational developmental systems perspective.

According to the Relational Developmental Systems perspective, the development of individual differences in spatial thinking (e.g., mental rotation, spatial reorientation, and spatial language) are attributed to various psychological (e.g., children's cognitive strategies), biological (e.g., structure and function of hippocampus), and cultural systems (e.g., caregiver spatial language input). Yet, measuring the development of individual differences in spatial thinking in young children, as well as the psychological, biological, and cultural systems that influence the development of these abilities, presents unique challenges. The current paper outlines ways to harness available technology including eye-tracking, eye-blink conditioning, MRI, Zoom, and LENA technology, to study the development of individual differences in young children's spatial thinking. The technologies discussed offer ways to examine children's spatial thinking development from different levels of analyses (i.e., psychological, biological, cultural), thereby allowing us to advance the study of developmental theory. We conclude with a discussion of the use of artificial intelligence.

Development and validation of a higher-order thinking skills (HOTS) scale for major students in the interior design discipline for blended learning.

Assessing and cultivating students' HOTS are crucial for interior design education in a blended learning environment. However, current research has focused primarily on the impact of blended learning instructional strategies, learning tasks, and activities on the development of HOTS, whereas few studies have specifically addressed the assessment of these skills through dedicated scales in the context of blended learning. This study aimed to develop a comprehensive scale for assessing HOTS in interior design major students within the context of blended learning. Employing a mixed methods design, the research involved in-depth interviews with 10 education stakeholders to gather qualitative data, which informed the development of a 66-item soft skills assessment scale. The scale was administered to a purposive sample of 359 undergraduate students enrolled in an interior design program at a university in China. Exploratory and confirmatory factor analyses were also conducted to evaluate the underlying factor structure of the scale. The findings revealed a robust four-factor model encompassing critical thinking skills, problem-solving skills, teamwork skills, and practical innovation skills. The scale demonstrated high internal consistency (Cronbach's alpha = 0.948-0.966) and satisfactory convergent and discriminant validity. This scale provides a valuable instrument for assessing and cultivating HOTS among interior design major students in blended learning environments. Future research can utilize a scale to examine the factors influencing the development of these skills and inform instructional practices in the field.

Thought-shape fusion in residential eating disorder treatment: Cognitive defusion as a mediator between thought-action fusion and treatment outcome.

An understudied cognitive bias within eating disorder (ED) psychopathology is Thought-Shape Fusion (TSF), which involves irrational beliefs about the likelihood and moral implications of feared outcomes related to shape, weight, and food. This phenomenon has received less attention within the context of ED treatment, with little known about potential processes of change to address TSF and ultimately promote ED recovery. We propose cognitive defusion as a process of change, a metacognitive process that emphasizes observing thoughts objectively rather than appraising thoughts as absolute truth. We explored whether cognitive defusion, that is, reductions in body image-related cognitive fusion, mediated the relationship between trait-level TSF and treatment outcomes in a transdiagnostic ED sample of adult and adolescent females (N = 130) presenting to residential care. We found that reductions in body image-related cognitive fusion mediates the association between trait-level TSF at baseline and ED severity at discharge. However, when the sample was separated into adolescent and adult subgroups, these results only remained significant for adolescents. These findings underscore the relevance of targeting cognitive defusion as a potential mechanism to address the impact of trait levels of TSF cognitions on ED psychopathology.

Beyond memory: The transcendence of episodic narratives.

Humans have a proclivity for storytelling and narration. Although a lot of attention in the field of episodic memory focuses on the mnemonic content of narratives, memory narratives are not just for conveying the past. Instead, narratives provide a vehicle for meaning-making, social connection, and other complex facets of human cognition and thinking. This short reflection piece discusses the importance of narratives in these diverse realms. In addition, it briefly touches on the role of memory narration in the modern digital era. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development of a Critical Reflection Mentorship Program to Enhance Critical Thinking Among Novice Nurses.

BACKGROUND: The increasing complexity of care and the decrease in overall nursing experience pose a threat to patient safety and clinical outcomes in health care. Within the local environment, a critical need was identified to connect expert bedside nurses with novice nurses to support the development of critical thinking. METHOD: This article describes the development and pilot evaluation of a critical reflection mentorship program, Beyond the Bedside. The program was developed and deployed in three inpatient units within an adult academic health center. Critical thinking was evaluated using the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) pre- and postprogram implementation. RESULTS: Five nurses participated in the pre- and postevaluation, and the N-CT-4 Practice mean scores were significantly higher after program implementation. CONCLUSION: Education leaders should prioritize programs that support critical thinking among novice nurses, and the Beyond the Bedside program can be adapted for use in other health care settings. [J Contin Educ Nurs. 2024;55(9):456-460.].

The relationship between difficulties in emotion regulation and solution-focused thinking in nursing students.

AIM: The aim of this study was to investigate the relationship between emotion regulation difficulty and solution-focused thinking in nursing students. BACKGROUND: It is essential for nursing students to possess solution-focused thinking and emotion regulation skills to cope effectively with stressors arising from their developmental processes, the nature of education and the profession. This is crucial for enhancing the quality of nursing care. DESIGN: The study design was cross-sectional descriptive and correlational design. METHODS: The convenience sample of the study consisted of 416 nursing students. The research was conducted between January 20 and February 15, 2024. Data were collected in Türkiye with the difficulties in emotion regulation scale-brief form and the solution focused inventory. Data were analyzed using multivariate linear regression analysis. RESULTS: An increase of 1 unit in the level of emotion regulation difficulty was associated with a decrease of 0.236 units in participant resource activation and 0.524 units in problem disengagement (p<.001). An increase of 1 unit in the level of emotion regulation difficulty was also associated with an increase of 0.876 units in participant goal orientation (p<.001). Grade point average, grade and age were identified as factors influencing the sub-dimensions of solution-focused thinking (p<.05). CONCLUSIONS: The study showed that emotion regulation difficulty is an important predictor of solution-focused thinking in nursing students. Therefore, students' emotion regulation difficulties and solution-focused thinking should be evaluated by academic nurses from the beginning of students' enrollment. Also, it is recommended that intervention programs focusing on developing emotion regulation and solution-focused thinking skills for nursing students should be included and implemented in the nursing curriculum.

Evidence-based scientific thinking and decision-making in everyday life.

In today's knowledge economy, it is critical to make decisions based on high-quality evidence. Science-related decision-making is thought to rely on a complex interplay of reasoning skills, cognitive styles, attitudes, and motivations toward information. By investigating the relationship between individual differences and behaviors related to evidence-based decision-making, our aim was to better understand how adults engage with scientific information in everyday life. First, we used a data-driven exploratory approach to identify four latent factors in a large set of measures related to cognitive skills and epistemic attitudes. The resulting structure suggests that key factors include curiosity and positive attitudes toward science, prosociality, cognitive skills, and openmindedness to new information. Second, we investigated whether these factors predicted behavior in a naturalistic decision-making task. In the task, participants were introduced to a real science-related petition and were asked to read six online articles related to the petition, which varied in scientific quality, while deciding how to vote. We demonstrate that curiosity and positive science attitudes, cognitive flexibility, prosociality and emotional states, were related to engaging with information and discernment of evidence reliability. We further found that that social authority is a powerful cue for source credibility, even above the actual quality and relevance of the sources. Our results highlight that individual motivating factors toward information engagement, like curiosity, and social factors such as social authority are important drivers of how adults judge the credibility of everyday sources of scientific information.

Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis.

Episodic future thinking (EFT) strengthens self-regulation abilities by increasing the perceived value of long-term reinforcements and reducing impulsive choice in delay discounting tasks. As such, EFT interventions have the potential to improve dietary and eating-related decision-making in individuals with obesity or binge eating symptoms, conditions associated with elevated delay discounting. Here, we meta-analyzed evidence from 12 studies that assessed whether EFT interventions improve delay discounting and real-world food choice compared to control interventions. Included studies involved 951 adults with overweight or obesity (body mass index [BMI] ≥25). There were no studies involving participants with binge eating disorder. EFT intervention pooled effects were significant, improving delay discounting with a medium effect, g = 0.55, p < 0.0001, and subsequent food choice outcomes with a small effect, g = 0.31, p < 0.01. Notably, our review is the first to analyze mechanisms of effect in this population, demonstrating that improvements were greater when temporal horizons of EFT episodes were aligned with delay discounting tasks and more distant horizons predicted far-transfer to subsequent dietary and eating-related choices. Our findings thus show that EFT is an effective intervention for individuals with higher weight at risk of adverse health consequences.

Characterizing human spontaneous thoughts and its application in major depressive disorder.

BACKGROUND: Spontaneous thought is a universal, complex, and heterogeneous cognitive activity that significantly impacts mental activity and strongly correlates with mental disorders. METHODS: Utilizing the think-aloud method, we captured spontaneous thoughts during rest from 38 diagnosed with depression, alongside 36 healthy controls and 137 healthy individuals. Through a comprehensive assessment of various dimensions of thought content, we compared thought content between individuals with depression and healthy controls, and between healthy women and men. Finally, we employed natural language processing (NLP) to develop regression models for multidimensional content assessment and a classification model to differentiate between individuals with and without depression. RESULTS: Compared to healthy controls, individuals with depression had more internally oriented and less externally oriented spontaneous thoughts. They focused more on themselves and negative things, and less on positive things, experiencing higher levels of negative emotions and lower levels of positive emotions. Besides, we found that compared to healthy men, healthy women's spontaneous thoughts focus more on interoception, the self, past events, and negative events, and they experience higher levels of negative emotions. Meanwhile, we identified the potential application of the think-aloud method to collect spontaneous thoughts and integrate NLP in the field of depression. CONCLUSIONS: This study offers direct insights into the stream of thought during individuals' resting state, revealing differences between individuals with depression and healthy controls, as well as sex differences in the content of spontaneous thoughts. It enhances our understanding of spontaneous thought and offers a new perspective for preventing, diagnosing, and treating depression.