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1.
Crit Care Clin ; 38(1): 113-127, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34794626

RESUMO

Effective and efficient critical thinking skills are necessary to engage in accurate clinical reasoning and to make appropriate clinical decisions. Teaching and promoting critical thinking skills in the intensive care unit is challenging because of the volume of data and the constant distractions of competing obligations. Understanding and acknowledging cognitive biases and their impact on clinical reasoning are necessary to promote and support critical thinking in the ICU. Active educational strategies such as concept or mechanism mapping can help to diagnose disorganized thinking and reinforce key connections and important clinical and pathophysiologic concepts, which are critical for inductive reasoning.


Assuntos
Unidades de Terapia Intensiva , Pensamento , Humanos
2.
Crit Care Clin ; 38(1): 89-101, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34794633

RESUMO

Diagnostic errors are considered a blind spot of health care delivery and occur in up to 15% of patient cases. Cognitive failures are a leading cause of diagnostic error and often occur as a result of overreliance on system 1 thinking. This narrative review describes why diagnostic errors occur by shedding additional light on systems 1 and 2 forms of thinking, reviews literature on debiasing strategies in medicine, and provides a framework for teaching critical thinking in the intensive care unit as a strategy to promote learner development and minimize cognitive failures.


Assuntos
Unidades de Terapia Intensiva , Pensamento , Cognição , Erros de Diagnóstico , Humanos
3.
Rev. colomb. anestesiol ; 49(4): e100, Oct.-Dec. 2021.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341235

RESUMO

The S.C.A.R.E. members assembly held on March 3ist, 2021, was quite revealing: its leitmotiv was the challenging work situation experienced by the colleagues across the country. The similarity with the very first assembly meeting I attended in Pasto in 1990 as a young anesthetist, invited by the tireless of doctor Jorge Osorio, was mystifying. It is rather striking to see how history repeats itself after 31 years, bringing back times that we thought were something of the past.


La asamblea de socios de la S.C.A.R.E. celebrada el 3 de marzo de 2021 fue bastante reveladora: su leitmotiv fue la desafiante situación laboral que viven los colegas de todo el país. La similitud con la primera asamblea a la que asistí en Pasto en 1990 como joven anestesista, invitado por el incansable del doctor Jorge Osorio, fue desconcertante. Es bastante llamativo ver cómo la historia se repite después de 31 años, trayendo de vuelta tiempos que creíamos que eran cosa del pasado.


Assuntos
Humanos , Anestesistas , Anestesiologia , Associação , Pensamento , Colômbia , História
4.
Br J Nurs ; 30(20): 1172-1176, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34761982

RESUMO

This is the second of two articles exploring assessment and clinical reasoning of conditions relating to the heart and cardiovascular system in the context of emergency care. In the last article, the structure and function of the heart was reviewed, and reference made to many of the conditions that may affect the heart. In addition, the common presenting complaints of cardiac conditions were highlighted, together with important aspects of the history for each symptom. The full cardiac examination was outlined. In this article, some of the common cardiac conditions will be discussed. These will be linked to common findings in the history, examination, and investigations.


Assuntos
Sistema Cardiovascular , Serviços Médicos de Emergência , Cardiopatias , Cardiopatias/diagnóstico , Humanos , Síncope , Pensamento
5.
Nurs Educ Perspect ; 42(6): E129-E130, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34698481

RESUMO

ABSTRACT: Caring for patients with chronic health conditions and providing them appropriate transitional care that provides positive outcomes and decreased rehospitalizations is essential in today's heath care environment. Nursing students must learn to think critically and communicate effectively in order to provide appropriate transitional care. This pedagogical challenge may be met in part by implementing a cross-course writing assignment that combines the concepts of chronic illness and community health as an effective tool to teach students about transitional care, stimulate critical thinking, and improve writing competencies.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Transição para Assistência do Adulto , Humanos , Transferência de Pacientes , Pensamento , Redação
7.
F1000Res ; 10: 312, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34631019

RESUMO

Introduction The Informed Health Choices (IHC) project developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore the educational context for teaching and learning critical thinking about health in Spanish primary schools. Methods During the 2020-2021 school year, we will conduct 1) a systematic assessment of educational documents and resources, and 2) semi-structured interviews with key education and health stakeholders. In the systematic assessment of educational documents and resources, we will include state and autonomous communities' curriculums, school educational projects, and commonly used textbooks and other health teaching materials. In the semi-structured interviews, we will involve education and health policy makers, developers of learning resources, developers of health promotion and educational interventions, head teachers, teachers, families, and paediatric primary care providers. We will design and pilot a data extraction form and a semi-structured interview guide to collect the data. We will perform a quantitative and a qualitative analysis of the data to explore how critical thinking about health is being taught and learned in Spanish primary schools. Conclusion We will identify opportunities for and barriers to teaching and learning critical thinking about health in Spanish primary schools. We will formulate recommendations-for both practice and research purposes-on how to use, adapt (if needed), and implement the IHC resources in this context.


Assuntos
Aprendizagem , Instituições Acadêmicas , Criança , Currículo , Educação em Saúde , Humanos , Pensamento
8.
FEMS Microbiol Lett ; 368(18)2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34617570

RESUMO

The Covid-19 pandemic has demanded modifications to undergraduates' learning experiences and promised a more challenging scientific world in which they will live. Bespoke evidence synthesis and critical appraisal skills modules are an opportunity to utilize our information-saturated world to our advantage. This program of study made use of a virtual journal club, structured literature searches, scoping review methods and a variety of online research tools to navigate and critique the literature. The program design is here outlined with sample learning objectives and reference to the resources used.


Assuntos
Educação Médica/métodos , Ensino , COVID-19/epidemiologia , Medicina Baseada em Evidências , Humanos , Jornalismo Médico , SARS-CoV-2 , Pensamento
9.
Proc Natl Acad Sci U S A ; 118(40)2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-34599096

RESUMO

The COVID-19 pandemic led to lockdowns in countries across the world, changing the lives of billions of people. The United Kingdom's first national lockdown, for example, restricted people's ability to socialize and work. The current study examined how changes to socializing and working during this lockdown impacted ongoing thought patterns in daily life. We compared the prevalence of thought patterns between two independent real-world, experience-sampling cohorts, collected before and during lockdown. In both samples, young (18 to 35 y) and older (55+ y) participants completed experience-sampling measures five times daily for 7 d. Dimension reduction was applied to these data to identify common "patterns of thought." Linear mixed modeling compared the prevalence of each thought pattern 1) before and during lockdown, 2) in different age groups, and 3) across different social and activity contexts. During lockdown, when people were alone, social thinking was reduced, but on the rare occasions when social interactions were possible, we observed a greater increase in social thinking than prelockdown. Furthermore, lockdown was associated with a reduction in future-directed problem solving, but this thought pattern was reinstated when individuals engaged in work. Therefore, our study suggests that the lockdown led to significant changes in ongoing thought patterns in daily life and that these changes were associated with changes to our daily routine that occurred during lockdown.


Assuntos
COVID-19/prevenção & controle , SARS-CoV-2 , Isolamento Social , Pensamento , Adolescente , Adulto , Afeto , Idoso , Idoso de 80 Anos ou mais , COVID-19/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resolução de Problemas , Cognição Social , Reino Unido/epidemiologia , Adulto Jovem
10.
BMJ Open ; 11(10): e049950, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34711594

RESUMO

OBJECTIVE: To analyse the critical thinking skills of students enrolled in the four academic years of the nursing degree at a public university belonging to the European Higher Education Area. DESIGN: Cross-sectional, quantitative, descriptive study. Using the Critical Thinking Questionnaire to analyse the critical thinking skills in their substantive and dialogic dimension. SETTING: Faculty of Nursing, Valladolid Public University in Spain, belonging to the European Higher Education Area. PARTICIPANTS: The sample consisted of 215 first-year, second-year, third-year and fourth-year undergraduate nursing students. MAIN OUTCOMES: The students of the four academic years were positively disposed towards critical thinking. The students of the final courses obtained higher average scores. RESULTS: The study sample was 215 students, 19.1% men/80.9% women. The average score in the substantive dimension (3.81±0.53 points) was higher than that in the dialogic dimension (3.48±0.51 points) (p<0.001). They had a greater ability in listening and speaking (3.77±0.61 points) with respect to writing (3.65±0.61 points) and reading (3.52±0.43 points) (p<0.001). There are significant differences in the critical thinking average scores across academic years. CONCLUSIONS: Nursing students displayed a greater critical thinking ability in its substantive dimension compared with the dialogic one. This reflects a greater ability in actions related to provide reasons and evidence that support their point of view. Identifying critical thinking skills in nursing students will help establish specific teaching methodologies focused on improving these skills.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Estudos Transversais , Feminino , Humanos , Masculino , Espanha , Pensamento , Universidades
12.
BMC Med Educ ; 21(1): 536, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34686161

RESUMO

BACKGROUND: Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns' patient management skills, ethical decision-making, and reflection skills. METHODS: A multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group's performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students' performances, and common achievements and mistakes of students. RESULTS: 133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill. CONCLUSION: The multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context.


Assuntos
Medicina de Emergência , Competência Clínica , Feminino , Pessoal de Saúde , Humanos , Aprendizagem , Pensamento
13.
Neuron ; 109(20): 3190-3192, 2021 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-34672976

RESUMO

In Korea, the pandemic has elevated scientists as trusted sources for both policy decisions and dinner table conversation. In an interview with Neuron, Eunji Cheong discusses how we need to support future generations by fostering scientific thinking, patience, and flexibility.


Assuntos
Neurociências , Formulação de Políticas , Papel Profissional , Pensamento , COVID-19 , Congressos como Assunto , Humanos , República da Coreia , SARS-CoV-2 , Mulheres Trabalhadoras , Equilíbrio Trabalho-Vida
14.
Elife ; 102021 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-34711304

RESUMO

The controllability of our social environment has a profound impact on our behavior and mental health. Nevertheless, neurocomputational mechanisms underlying social controllability remain elusive. Here, 48 participants performed a task where their current choices either did (Controllable), or did not (Uncontrollable), influence partners' future proposals. Computational modeling revealed that people engaged a mental model of forward thinking (FT; i.e., calculating the downstream effects of current actions) to estimate social controllability in both Controllable and Uncontrollable conditions. A large-scale online replication study (n=1342) supported this finding. Using functional magnetic resonance imaging (n=48), we further demonstrated that the ventromedial prefrontal cortex (vmPFC) computed the projected total values of current actions during forward planning, supporting the neural realization of the forward-thinking model. These findings demonstrate that humans use vmPFC-dependent FT to estimate and exploit social controllability, expanding the role of this neurocomputational mechanism beyond spatial and cognitive contexts.


Assuntos
Córtex Pré-Frontal/fisiologia , Interação Social , Pensamento/fisiologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Texas , Adulto Jovem
15.
Biochem Mol Biol Educ ; 49(6): 888-903, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34652877

RESUMO

Active teaching methodologies have been placed as a hope for changing education at different levels, transiting from passive lecture-centered to student-centered learning. With the health measures of social distance, the COVID-19 pandemic forced a strong shift to remote education. With the challenge of delivering quality education through a computer screen, we validated and applied an online course model using active teaching tools for higher education. We incorporated published active-learning strategies into an online construct, with problem-based inquiry and design of inquiry research projects to serve as our core active learning tool. The gains related to students' science learning experiences and their attitudes toward science were assessed by applying questionnaires before, during, and after the course. The course counted on the participation of 83 students, most of them (60.8%) from postgraduate students. Our results show that engagement provided by active learning methods can improve performance both in hard and soft skills. Students' participation seems to be more relevant when activities require the interaction of information, prediction, and reasoning, such as open-ended questions and design of research projects. Therefore, our data show that, in pandemic, active learning tools benefit students and improve their critical thinking and their motivation and positive positioning in science.


Assuntos
Atitude , COVID-19/epidemiologia , Educação à Distância/métodos , Pandemias , Estudantes de Medicina/psicologia , Pensamento , COVID-19/virologia , Educação à Distância/normas , Humanos , SARS-CoV-2/isolamento & purificação
16.
J Behav Addict ; 10(3): 759-766, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34469329

RESUMO

Backgrounds and aims: Internet addiction (IA) is a common internet-related addictive behavior. An enormous amount of previous research on IA disorders (IADs) have paid attention to the neural basis of abnormalities, while few studies have elucidated the neural distinctions of IA tendency in general population. Methods: The current study examined the neural basis of IA tendency combining with voxel-based morphometry (VBM) from the average student body (N = 244). Results: As the results presented, the gray matter density (GMD) of the left temporal-parietal junction (TPJ) was positively correlated with Internet Addiction Test (IAT) score. Further analysis revealed that critical thinking moderated the path between GMD in the TPJ and IA tendency. Specifically, the correlation between GMD in the TPJ and IA tendency was weaker for those with a higher critical thinking disposition. Discussion and conclusion: Higher critical thinking show a hindering effect in susceptibility to IA based on the neural basis of temporal-parietal junction differences.


Assuntos
Comportamento Aditivo , Transtorno de Adição à Internet , Substância Cinzenta , Humanos , Internet , Estudantes , Pensamento
17.
Hu Li Za Zhi ; 68(5): 18-23, 2021 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-34549404

RESUMO

The three-dimensional virtual world generated in virtual reality (VR) environments involves vision, hearing, touch, and potentially other user senses. VR environments are designed to closely simulate real situations/scenarios, allowing users to observe and engage in experiences free of time and space restrictions. Virtual patients are an extension of virtual reality. In recent years, virtual reality exercises have been widely used in various medical education and training programs to promote professional competence. The clinical practice of nurse practitioners is similar to physicians in some institutions. Nurse practitioners perform supplementary medical services such as physical assessment, medical history collection and consultation, problem detection, test result assessment, differential diagnosis, and patient health problem decision-making under the supervision of physicians. The critical thinking component in nurse practitioner education is largely similar to that taught in medical education. VR is often used in medical education to train medical students. Also, VR may be applied in critical thinking training for nurse practitioners to promote competence in reasoning and differential diagnosis. However, few studies in the literature have evaluated the effectiveness of VR-based training for nurse practitioners in Taiwan. In the future, this issue needs to be studied further.


Assuntos
Profissionais de Enfermagem , Realidade Virtual , Humanos , Taiwan , Pensamento
18.
Work ; 70(1): 1, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34487007
19.
Nurse Educ Today ; 107: 105153, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34562682

RESUMO

BACKGROUND: Guided Reciprocal Peer Questioning Strategy (GRPQS) restructures the classroom context from a passive into an engaging environment, where the students are empowered to actively participating in their learning process. OBJECTIVE: To investigate the impact of GRPQS on the pediatric nursing students' self-esteem and metacognitive awareness. DESIGN: A Quasi-experimental, pre-posttest, two groups research was carried out at University of Bahrain. A sample of 89 out of 112 pediatric nursing-students were divided into two groups. METHOD: Through GRPQS, the students mutually generated and responded to questions, activated their critical thinking, elicited ideas, and shared learning experiences within the team and the teachers act as facilitators. RESULTS: It is revealed that 75% of the students in the study group developed high self-esteem after their engagement in the GRPQS compared to only 48.8% among those in the control one. Students who practiced GRPQS showed an improvement in their knowledge about cognition. As the mean score of students in the study group is increased from 2.16 ± 0.45 to 2.89 + 0.35 for the procedural knowledge, from 2.33 ± 0.56 to 2.86 ± 0.41 for declarative and from 2.18 + 0.53 to 3.09 ± 0.29 for the conditional knowledge (p < 0.001 for each). Concerning the regulation of cognition, the mean score of the planning dimension was improved from2.21 ± 0.46 to 3.10 ± 0.31 among the students in the study group. Moreover, it is clear that applying GRPQS in the lectures helped in improving the students' information management strategies, comprehension monitoring, debugging strategies and evaluation (p < 0.001 for each) compared to the control group p = 0.169, p = 0.009, p = 0.117 and 0.887 respectively). CONCLUSION: The application of GRPQS provided an interactive and engaging learning experience that helped the students to develop the habit of organizing, judging, and summarizing information as well as focusing on the significant portions of the learning materials. Moreover, exchanging questions between the nursing students was effective in enhancing their self-esteem and metacognitive awareness. Hence, incorporating this innovative pedogeological approach in the nursing curricula is recommended.


Assuntos
Metacognição , Estudantes de Enfermagem , Criança , Currículo , Humanos , Enfermagem Pediátrica , Pensamento
20.
Nurse Educ Today ; 107: 105116, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34481313

RESUMO

BACKGROUND: Physical examination and health assessment skills are essential components of nursing practice, and the critical elements to be taught merit further investigation. OBJECTIVES: To develop and evaluate a physical examination and health assessment course based on a self-directed learning framework. DESIGN: An action research design was employed. SETTINGS: A baccalaureate nursing program of the university of science and technology in central Taiwan. PARTICIPANTS: A convenience sample comprising 23 teaching faculty members and 41 enrolled second-year students was recruited. METHODS: Structured questionnaires were developed for data collection. A paired t-test and the Kruskal-Wallis test were used for data analysis. RESULTS: The course consisted of four parts: health history taking from a holistic perspective, examination skills in diverse systems, case exercise and discussion, and final objective structured clinical examination. Statistical significance was found in the areas of physical examination skills, critical thinking, and case analysis. Participants with mid-to high-level self-directed learning had significantly higher scores than those with low-level self-directed learning on physical examination skills and problem assessment. Internal and discriminant validity were supported. CONCLUSION: The study results provide evidence supporting the use of self-directed learning framework in curriculum design. The course integrated necessary knowledge and skills enabled students to practice physical examination, and assessment skills may enhance student confidence in approaching patients in clinical encounters. However, the study was a descriptive design. The generalization of the results needs to be further validated by an experimental study.


Assuntos
Currículo , Estudantes de Enfermagem , Competência Clínica , Humanos , Aprendizagem , Exame Físico , Estudantes , Pensamento
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