UNASSIGNED: The development of critical thinking (CT) has been a universal goal in higher education. A systematic review of the literature was conducted to evaluate the effectiveness of currently used pedagogical practices to foster CT/ clinical reasoning (CR)/ clinical judgment (CJ) skills and/or dispositions in undergraduate medical students.
UNASSIGNED: PubMed, Web of Science and Scopus databases were searched from January 2010 to April 2021 with a predefined Boolean expression.
UNASSIGNED: Of the 3221 articles originally identified, 33 articles were included by using PICOS methodology. From these, 21 (64%) reported CR pedagogical practices and 12 (36%) CT pedagogical practices.
UNASSIGNED: Overall, pedagogical practices such as cognitive/visual representation, simulation, literature exposure, test-enhancing and team-based learning, clinical case discussion, error-based learning, game-based learning seem to enhance CT/CR skills and/or dispositions. Further research is required to identify the optimal timing, duration and modality of pedagogical interventions for effectively foster CT/CR in medical education.

BACKGROUND: Education in nursing has noticed a positive effect of simulation-based education. There are many studies available on the effects of simulation-based education, but most of those involve a single institution, nonrandomized controlled trials, small sample sizes and subjective evaluations of the effects. The purpose of this multicenter randomized controlled trial was to evaluate the effects of high-fidelity simulation, computer-based simulation, high-fidelity simulation combined with computer-based simulation, and case study on undergraduate nursing students.
METHODS: A total of 270 nursing students were recruited from five universities in China. Participants were randomly divided into four groups at each institution: the high-fidelity simulation group, the computer-based simulation group, the high-fidelity simulation combined with computer-based simulation group, and the case study group. Finally, 239 participants completed the intervention and evaluation, with 58, 67, 57, and 57 participants in each group. The data were collected at three stages: before the intervention, immediately after the intervention, and three months after the intervention.
RESULTS: The demographic data and baseline evaluation indices did not significantly differ among the four groups. A statistically significant difference was not observed between the four methods for improving knowledge, interprofessional collaboration, critical thinking, caring, or interest in learning. While skill improvement differed significantly among the different groups after the intervention (p = 0.020), after three months, no difference was observed (p = 0.139). The improvement in skill in the computer-based simulation group was significantly lower at the end of the intervention than that in the high-fidelity simulation group (p = 0.048) or the high-fidelity simulation combined with computer-based simulation group (p = 0.020).
CONCLUSIONS: Nursing students benefit equally from four methods in cultivating their knowledge, interprofessional collaboration, critical thinking, caring, and interest in learning both immediately and over time. High-fidelity simulation and high-fidelity simulation combined with computer-based simulation improve skill more effectively than computer-based simulation in the short term. Nursing educators can select the most suitable teaching method to achieve the intended learning outcomes depending on the specific circumstances.
BACKGROUND: This clinical trial was registered at the Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400084880, date of the registration: 27/05/2024).

Medical educators have adopted a number of teaching-learning methodologies to make their sessions interactive considering the need for active engagement of students to strengthen the process of learning. One among them is the use of serious games, wherein digital applications are used to enable the attainment of the intended learning objectives. A wide range of serious games can be designed to target different areas in healthcare training, which cumulatively provide a holistic and engaging approach for students to acquire knowledge and develop skills. Owing to the extensive areas and domains in medical education wherein we can use serious games, the benefits attributed to them are immense. The successful introduction of serious games into the medical curriculum depends on several factors and we must adopt a systematic approach to optimize the benefits. In conclusion, the introduction of serious games into medical education can benefit medical students by helping them master multiple skills required for successful clinical practice. Acknowledging the changing landscapes in medical education, there is an immense need that teachers and administrators to explore the possibility of integrating these games into medical schools.

The conventional mode of medical education is delivered using didactic lectures, wherein teachers disseminate the desired information to a large number of students in a structured manner. The purpose of the current review is to explore the scope and need of escape rooms in medical education and identify the potential considerations to be acknowledged while designing an escape room in a medical college for training undergraduate medical students. Escape rooms in principle refer to the learning environments that are interactive and immersive, in the sense that students who are part of these rooms are posed with a puzzle or a challenge or a task that must be solved by them within a defined period of timeframe to eventually escape from the room, which is the ultimate goal of such sessions. The success of escape rooms is determined depending by the way it has been designed, in terms of their ability to engage the involved participants and promote collaboration. In conclusion, the employment of escape rooms in medical education is an innovative teaching-learning method to overcome the limitations of conventional strategies. Acknowledging the merits of escape rooms in the development of critical thinking and teamwork skills, it is the need of the hour that every medical institution must explore the possibility and introduce it within their settings to ensure experiential and long-term learning among medical students.

This systematic review and meta-analysis examined the impact of evidence-based practice (EBP) education programs on undergraduate nursing students, focusing on enhancing EBP competency, critical thinking, and problem-solving ability.
METHODS: The search, conducted through PubMed, Cochrane Library, EMBASE, CINAHL, and Web of Science up to December 2023, included studies published in English and Korean and adhered to PRISMA guidelines. Qualitative appraisal of the studies was conducted using the revised ROB II for randomized trials and the ROBINS-I for non-randomized trials. For the meta-analysis, the effect size of the intervention was calculated as a standardized mean difference.
RESULTS: In our study, 11 studies met our inclusion criteria, and 8 studies of those were included in the meta-analysis. The effect sizes for EBP competency, critical thinking, and problem-solving ability were 1.55, 1.29, and 0.65, respectively. The meta-regression analysis indicated that tailored education programs of 4-7 weeks and being in the 4th grade significantly enhanced EBP competency.
CONCLUSIONS: These findings support the development of a customizable and applied EBP education actively for students, preparing nursing students to effectively implement EBP in clinical settings after graduation. Despite the significant effect size of the outcome variables, the high heterogeneity suggests the need for further investigation to validate the EBP educational outcomes for nursing students.

UNASSIGNED: This paper explores a significant shift in the field of mental health in general and psychotherapy in particular following generative artificial intelligence\'s new capabilities in processing and generating humanlike language. Following Freud, this lingo-technological development is conceptualized as the \"fourth narcissistic blow\" that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, interrelationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act following the emergence of what we term the artificial third in the field of psychotherapy. The introduction of an artificial third marks a critical juncture, prompting us to ask the following important core questions that address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships? (2) How does it reshape our perception of ourselves and our interpersonal dynamics? and (3) What remains of the irreplaceable human elements at the core of therapy? Given the ethical implications that arise from these questions, this paper proposes that the artificial third can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy.

Critical thinking is considered as the essential set of skills for medical practice, particularly during emergencies. However, there is lack of conceptual clarity around it and it was not explicitly included in the undergraduate medical curriculum in India. The present study has been planned to assess the critical thinking disposition and clinical reasoning skills among medical undergraduate students in a medical college in West Bengal, India. The perceived definition and attributes of critical thinking in medical education will be explored and the contexts where application of critical thinking skills may be crucial for medical practice will be identified. The content validity index, test-retest agreement; internal consistency and construct validity of the Critical Thinking Disposition Assessment Questionnaire (CTDAQ) will be assessed through step-by-step procedure. CTDAQ and the case-based objective-type questions for the clinical reasoning skills will be applied to around 200 medical undergraduate students. Their perception and experience on critical thinking in medical education will be assessed with structured open-ended questions. In-depth interviews with medical teachers of the second and third phases of undergraduate medical curriculum will be conducted to assess their perception and experiences on critical thinking. The quantitative analysis will be conducted with MS excel and R software using the relevant packages. The qualitative data will be transcribed and translated in English, close to the participants\' verbatim. The thematic analysis will be conducted with inductive coding and memoing. The study will be conducted maintaining ethical standards for epidemiological studies. The present study, one of the first a few studies in India, will help to meet the conceptual gap in understanding the attributes of critical thinking, its association with clinical reasoning and the contexts of preferred application in medical practice.

Thinking With a growing body of brain science, the research and technological interventions in neuroscience have led to the rise of some ethical, moral, legal, conceptual, and socioeconomic problems. These problems and the need to establish an intellectual framework to approach them framed the base of Neuroethics. Most conveniently, the normative definition of Neuroethics is declared as ethics of neuroscience and neuroscience of ethics. However, there are more critical issues to define and frame the conceptual structure of the field. The current naturalist-positivist vision in neuroscience will extend the concept that human behavior, such as decision-making, consciousness, character, and moral intuitions, are mechanical features of a machine. Arguments from philosophical and anthropological views arose around this definition, focusing on the reductionist nature of merely a positive view of the human mind and behavior. Thinking through the pearls of such an approach and what would be at stake if we fail to recognize the importance of the philosophical-anthropological aspect of neuroscience, we first review different definitions and critics of the field, then proceed to discuss two concepts of Ethicalization and Medicalization. These concepts clearly show the established positivist-naturalist view in bioethics and the issues it caused. To better understand these two concepts, we use existing discussions and literature around them in bioethics. By reviewing the existing literature and adding a philosophical view of the field, we aim to add a new approach to the field of Neuroethics. We focus on adopting an interdisciplinary approach to Neuroethics to provide the needed background vision and theory to discuss interdisciplinary issues and enable scholars and theorists to reframe the fundamental issues of the field, such as the nature and scope of Neuroethics.

BACKGROUND: There is a dire need to strengthen students\' critical thinking in clinical training since it is an essential skill in clinical practice to optimize patient care. Debriefing is a formal or informal post-activity discussion that aims to improve learning outcomes, including critical thinking in clinical practice. There is a lack of research that focuses on students\' experiences of debriefing to promote critical thinking in the South African context using experiential learning theory as a theoretical lens.
OBJECTIVE: This study aimed to explore South African students\' lived experiences of debriefing to improve critical thinking.
METHODS: The author employed a qualitative single-case study design within an interpretivist paradigm. A purposive sampling technique was adopted. Six participants were recruited for this study. The author invited the participants to participate in semi-structured interviews. Data were analyzed through the six-step data analysis framework proposed by Creswell. To ensure the trustworthiness, the author employed multiple techniques to improve the credibility, conformability, dependability, and transferability of this study. These techniques included a well-planned research design and methods, thick descriptions of data, and an audit trail that was audited by a second coder.
RESULTS: The findings revealed that participants shared positive experiences toward debriefing and furthermore debriefing through optimized student engagement and improved learning outcomes. This study also revealed that students experienced less stress in group debriefings. However, this study also identified some challenges in conducting debriefing. The challenges were primarily related to incompetent facilitators, inappropriate duration of debriefing sessions, and limited space in the clinic. Moreover, small group debriefing is recommended.
CONCLUSIONS: Debriefing is an effective pedagogical approach to optimize critical thinking in clinical practice. It is recommended that debriefing should be implemented as a norm in clinical training at higher education institutions. Further studies are recommended to be conducted at national and international levels.

Internal medicine is the specialty with the most semiological training and it is taught that the combination of a complete clinical history with a thorough physical examination allows for a diagnosis to be reached in the majority of cases. We present a clinical case where an incomplete physical examination interfered with the course of hospitalisation. In a growing technological world where complementary diagnostic tests often allow us to see what is impossible to the eye, the physical examination is often neglected.
CONCLUSIONS: Reinforce the importance of thorough physical examinations in a digital era.Encourage critical reflection on cases for continual improvement.