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.

This essay challenges the idea of progress as technological development in relation to medicine by focusing on people rather than things. It analyzes how the prevalence of such an idea of progress leads contemporary societies to a technofetishism that degrades community life and medical practice, contributing to the medicalization of social life. It is argued that the realization of technological potentialities depends on their forms of use, that the main motive of technological development is unlimited profit, and the priority developments are those that enhance social control which maintains the status quo. Intelligence as an intelligence quotient is criticized by proposing it as an attribute of the human being as a whole, manifested in the ways of thinking and acting of human beings in their circumstances, where affectivity and critical thinking are essential for their development; it is emphasized that its antecedent is the harmonic concert of planetary life, which contrasts with the prevailing human disharmony. It is proposed that artificial intelligence is the latest creation of technofetishism, which deposits vital attributes in technology, and that its use will accentuate the degradation of human and planetary life. Another idea of medical progress is proposed, based on forms of organization that is conducive to the development of inquisitive, critical, and collaborative skills that promote permanent improvement, whose distant horizon is dignified progress: the spiritual, intellectual, moral, and convivial sublimation of collectivities in harmony with the planetary ecosystem.
Este ensayo cuestiona, a propósito de la medicina, la idea de progreso como desarrollo tecnológico al centrarlo en las personas no en las cosas. Se analiza cómo el predominio de tal idea de progreso convierte a las sociedades actuales al tecno-fetichismo que degrada la vida comunitaria y la práctica médica contribuyendo a la medicalización de la vida social. Se argumenta: que la realización de las potencialidades tecnológicas depende de sus formas de uso; que el móvil principal del desarrollo tecnológico es el lucro sin límites y que los desarrollos prioritarios son los que potencian el control social que mantiene el statu quo. Se critica la idea de inteligencia como cociente intelectual al proponerla como atributo del ser humano como un todo, manifiesto en las formas pensar y proceder de las personas en sus circunstancias, donde la afectividad y el pensamiento crítico son imprescindibles para su desarrollo. Se destaca que su antecedente es el concierto armónico de la vida planetaria contrastante con la disarmonía humana imperante. Se plantea que la inteligencia artificial es la más reciente hechura del tecno-fetichismo que deposita en la tecnología atributos vitales y que sus formas de uso acentuarán la degradación de la vida humana y planetaria. Se propone otra idea de progreso médico basado en formas de organización propicias para el desarrollo de aptitudes inquisitivas, críticas y colaborativas que impulsen la superación permanente, cuyo horizonte lejano es el progreso dignificante: sublimación espiritual, intelectual, moral y convivencial de las colectividades en armonía con el ecosistema planetario.

This essay questions, with regard to medicine, the idea of progress as technological development by focusing on people rather than things. It analyzes how the predominance of such an idea of progress converts today\'s societies to techno-fetishism that degrades community life and medical practice, contributing to the medicalization of social life. It is argued that the realization of technological potentialities depends on their forms of use; that the main motive of technological development is unlimited profit and that priority developments are those that enhance the social control that maintains the status quo. The intelligence as an intelligence quotient is criticized by proposing it as an attribute of the human being as a whole, manifested in the ways of thinking and proceeding of people in their circumstances, where affectivity and critical thinking are essential for their development; it is emphasized that its antecedent is the harmonic concert of planetary life that contrasts with the prevailing human disharmony. It is proposed that artificial intelligence is the most recent creation of techno-fetishism that deposits vital attributes in technology and that its forms of use will accentuate the degradation of human and planetary life. Another idea of medical progress is proposed, based on forms of organization conducive to the development of inquisitive, critical and collaborative skills that promote permanent improvement, whose distant horizon is dignifying progress: spiritual, intellectual, moral and convivial sublimation of collectivities in harmony with the planetary ecosystem.
Este ensayo cuestiona, a propósito de la medicina, la idea de progreso como desarrollo tecnológico al centrarlo en las personas y no en las cosas. Se analiza cómo el predominio de tal idea de progreso convierte a las sociedades actuales al tecno-fetichismo que degrada la vida comunitaria y la práctica médica contribuyendo a la medicalización de la vida social. Se argumenta que la realización de las potencialidades tecnológicas depende de sus formas de uso, que el móvil principal del desarrollo tecnológico es el lucro sin límites, y que los desarrollos prioritarios son los que potencian el control social que mantiene el statu quo. Se critica la idea de inteligencia como cociente intelectual al proponerla como atributo del ser humano como un todo, manifiesto en las formas pensar y proceder de las personas en sus circunstancias, donde la afectividad y el pensamiento crítico son imprescindibles para su desarrollo. Se destaca que su antecedente es el concierto armónico de la vida planetaria contrastante con la disarmonía humana imperante. Se plantea que la inteligencia artificial es la más reciente hechura del tecno-fetichismo que deposita en la tecnología atributos vitales, y que sus formas de uso acentuarán la degradación de la vida humana y planetaria. Se propone otra idea de progreso médico basado en formas de organización propicias para el desarrollo de aptitudes inquisitivas, críticas y colaborativas que impulsen la superación permanente, cuyo horizonte lejano es el progreso dignificante: sublimación espiritual, intelectual, moral y convivencial de las colectividades en armonía con el ecosistema planetario.

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.

BACKGROUND: The unfolding case-study learning approach is a growing modernized learning strategy implemented in different health disciplines. However, there is a lack of existing research that examines the effects of unfolding case studies in advanced nursing courses.
OBJECTIVE: To examine the impact of applying an unfolding case-study learning approach on critical care nursing students\' knowledge, critical thinking, and self-efficacy.
METHODS: This posttest-only, quasi-experimental study was conducted at XXX University in Palestine. A single-stage cluster sampling was used to assign nursing students enrolled in the critical care nursing course into experiment and conventional groups. The intervention group (n= 91) underwent unfolding case-study learning for selected cardiovascular topics, whereas the conventional group (n= 78) was taught using the traditional teaching methods. The posttest assessment was conducted using Knowledge Acquisition tests, Yoon`s Critical Thinking Disposition Instrument (YCTD), and the Self-Efficacy for Learning and Performance instruments. The Social Constructivist Theoretical Framework was integrated into the study.
RESULTS: Homogeneity was achieved between both groups concerning Age, Gender, and GPA. The experiment group scored significantly higher than the conventional group regarding the posttest knowledge acquisition tests (7.12 vs. 5.49, respectively, t=-12.7, P<0.001, CI: -1.89 to -1.38), critical thinking (4.32 vs. 3.63 respectively, t=17.390, p<0.001, CI: -77 to -61) and self-efficacy (6.12 vs. 4.4 respectively, t=-30.897, p<0.001, CI: -1.82 to -1.60). Multivariate analysis revealed that 69 % of the variations of posttest scores were influenced by critical thinking scores (Adjusted R Squared=0.690, F=3.47, P=0002, η2=0.969). Similarly, self-efficacy has been shown to contribute by 74 % to the variations of scores after conducting the study program (Adjusted R Squared=0.743, F=4.21, P=0001, η2=0.974). However, the variations of both critical thinking and self-efficacy scores were not significantly influenced by the contribution of knowledge acquisition (p=0.772 and 0.857, respectively) and students\' GPA (p=0.305 and 0.956, respectively).
CONCLUSIONS: Irrespective of knowledge level and GPA, the unfolding case-study learning approach can enhance the critical thinking and self-efficacy of students enrolling in advanced nursing courses.

Analogies are used to make abstract topics meaningful and more easily comprehensible to learners. Incorporating simple analogies into STEM classrooms is a fairly common practice, but the analogies are typically generated and explained by the instructor for the learners. We hypothesize that challenging learners to create complex, extended analogies themselves can promote integration of content knowledge and development of critical thinking skills, which are essential for deep learning, but are challenging to teach. In this qualitative study, college biology students (n = 30) were asked to construct a complex analogy about the flow of genetic information using a familiar item. One week later, participants constructed a second analogy about the same topic, but this time using a more challenging item. Twenty participants worked on the challenging analogy in pairs, while the other 10 worked alone. Analysis of the 50 interviews resulted in a novel-scoring scheme, which measured both content knowledge (understanding of biology terms) and critical thinking (alignment of relationships between elements of the analogy). Most participants improved slightly due to practice, but they improved dramatically when working with a partner. The biggest gains were seen in critical thinking, not content knowledge. Having students construct complex, sophisticated analogies in pairs is a high-impact practice that can help students develop their critical thinking skills, which are crucial in academic and professional settings. The discussion between partners likely requires students to justify their explanations and critique their partner\'s explanations, which are characteristics of critical thinking.

OBJECTIVE: To evaluate the impact of a debate activity on pharmacy students\' knowledge of public health and health policy topics.
METHODS: Forty-six second-year pharmacy students in a required public health and health policy course debated universal healthcare coverage for Americans using the Lincoln-Douglas oral debate format. Demographic data, including age and gender, were collected. Knowledge (before/after) of universal healthcare principles was assessed via a rubric-embedded quiz related to the activity objectives. The students\' perceptions of the educational value of the debate were assessed before and after the debate using a 12-item Likert scale (1 = strongly disagree through 5 = strongly agree) and open-ended questions. Descriptive statistics and thematic analysis were conducted using SPSS v25 and Atlas.ti version 9, respectively. Wilcoxon t tests were conducted to compare preknowledge and postknowledge scores. An α level of 0.05 was utilized.
RESULTS: Forty-two students completed the perceptions survey, yielding a 96 % response rate. The mean age was 24 ± 4 years and primarily female (63 %). Most students had no previous experience with debates (80.4 %) and there was a statistically significant improvement in knowledge after the debate from 66.5 % ± 13.4 % to 80.7 % ± 12 % , for a total increase of 14.2 %. Open responses indicated that students believed their overall knowledge about other healthcare systems increased and they developed literature review and communications skills.
CONCLUSIONS: The debate activity enhanced the students\' knowledge and assessment of controversial public health issues that will be useful during their pharmacy education and careers. The students perceived that the debates enriched their learning.

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.