critical thinking

批判性思维
  • 文章类型: Journal Article
    背景:自我调节学习(SRL)是培养医疗保健专业人员和终身学习者的关键。iCARE(批判性思维的内化,评估,对Empower学习的反思)模型旨在提高护理专业学生的SRL。
    目的:本研究调查iCARE对护生反思实践的影响,SRL,与传统的集体反思相比,自我效能感和技能表现。
    方法:对某三级急症医院的49名最后一年的护理专业学生进行了一项准实验性探索性研究。iCARE组(n=24)接受每周反馈的每日引导反射日志,而小组反射组(n=25)接受小组反射。两者均由临床指导员协助。参与者SRL得分,在训练前和训练后测量自我效能水平和技能表现。组间比较了过帐反射日志的结尾。他们对这两种促进方法的经验和看法是通过问卷调查获得的。使用卡方检验和t检验对定量数据进行汇总和分析。使用主题编码和内容分析来分析定性响应。
    结果:与群体反射组相比,iCARE组报告SRL评分有统计学显著改善,反思性实践,为期四周的临床发布后,技能表现和技能表现中的自我效能感。两组参与者都认为反思有助于他们从同龄人和经验中学习,提高了他们的表现,激励他们学习。仅从iCARE小组中出现了三个独特的主题:iCARE帮助开发了SRL;评估的应用,规划,实施和评估(APIE)改进了临床推理;iCARE改进了反馈的使用。
    结论:研究结果表明iCARE模式在促进护生反思性实践发展方面的作用,SRL和临床学习结果。嵌入SRL指令的iCARE模型的设计,APIE框架和SRL聚焦反馈可以促进认知和元认知发展以及技能表现。
    BACKGROUND: Self-Regulated Learning (SRL) is key in developing healthcare professionals and lifelong learner. iCARE (internalization of Critical thinking, Assessment, Reflection to Empower learning) model was designed to enhance nursing students\' SRL.
    OBJECTIVE: This study investigated the effects of iCARE on nursing students\' reflective practice, SRL, self-efficacy and skill performance as compared to conventional group reflection.
    METHODS: A quasi-experimental exploratory study was employed on 49 final-year nursing students in a tertiary acute hospital. The iCARE group (n = 24) received guided daily reflective journal with weekly feedback while the group reflection group (n = 25) received group reflection. Both were facilitated by clinical instructors. Participants\' SRL score, self-efficacy level and skill performance were measured pre- and post- training. End of posting reflective journal between group was compared. Their experience and perception on both facilitation methods were obtained using questionnaires. Quantitative data were summarised and analysed using Chi-Square test and t-test. Theme coding and content analysis were used to analyse the qualitative responses.
    RESULTS: Compared to group reflection group, the iCARE group reported a statistically significant improvement in SRL score, reflective practice, skill performance and self-efficacy in skill performance after a four-week clinical posting. Participants from both groups perceived that reflection helped them learn from peers and experience, enhanced their performance and motivated them to learn. Three unique themes emerged only from the iCARE group: iCARE helped to developed SRL; application of assessment, planning, implementation and evaluation (APIE) improved clinical reasoning; iCARE improved the use of feedback.
    CONCLUSIONS: The findings demonstrated the effect of the iCARE model in enhancing the development of nursing students\' reflective practice, SRL and clinical learning outcomes. The design of iCARE model that embeds SRL instructions, APIE framework and SRL focused feedback can promote cognitive and metacognitive development as well as skill performance.
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  • 文章类型: Journal Article
    目的:本研究旨在评估ChatGPT在医学生批判性思维技能方面的有效性。
    方法:这项横断面调查研究招募了来自沙特阿拉伯三所公立大学的392名医学生。参与者完成了一份在线问卷,评估了ChatGPT对批判性思维技能的影响。使用SPSS对数据进行分析,采用描述性统计数据,t检验,方差分析,和克朗巴赫的阿尔法来评估可靠性。
    结果:在对ChatGPT的疗效的认知中发现了显著的基于性别的差异,特别是在产生不同的观点(P=0.0407*)和鼓励提问(P=0.0277*)方面。反思性实践感知因年龄而异(P=0.0302*),而学术背景在评估的所有因素中都有显著差异(P<0.0001*)。总的来说,92.6%的人认为整合ChatGPT将有利于批判性思维技能。大多数参与者(N=174)强烈同意ChatGPT改善了批判性思维。
    结论:将ChatGPT纳入医学教育可以为培养批判性思维能力提供宝贵的机会,尽管需要解决相关挑战并确保包容性。
    OBJECTIVE: This study aims to assess the effectiveness of ChatGPT in critical thinking skills among medical students.
    METHODS: This cross-sectional survey study recruited 392 medical students from three public universities in Saudi Arabia. Participants completed an online questionnaire assessing perceptions of ChatGPT\'s impact on critical thinking skills. Data were analyzed using SPSS, employing descriptive statistics, t-tests, analysis of variance, and Cronbach\'s alpha to evaluate reliability.
    RESULTS: Significant gender-based differences were found in perceptions of ChatGPT\'s efficacy, particularly in generating diverse perspectives (P = 0.0407*) and encouraging questioning (P = 0.0277*). Reflective practice perceptions varied significantly by age (P = 0.0302*), while academic backgrounds yielded significant differences across all factors assessed (P < 0.0001*). Overall, 92.6% believed integrating ChatGPT would benefit critical thinking skills. Most participants (N = 174) strongly agreed that ChatGPT improved critical thinking.
    CONCLUSIONS: Integrating ChatGPT into medical education could offer valuable opportunities for fostering critical thinking abilities, albeit with the need for addressing associated challenges and ensuring inclusivity.
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  • 文章类型: Journal Article
    中国的中等职业医学教育对于培训初级卫生保健人员和加强公共卫生应对措施至关重要。这一教育体系目前面临挑战,主要是由于它强调知识获取,掩盖了技能的开发和应用,特别是在新兴的人工智能(AI)技术的背景下。本文探讨了人工智能对医疗实践的影响,并利用这一分析提出了中国职业医学教育体系的改革建议。人工智能被发现显着增强诊断能力,治疗决策,和病人管理。然而,这也带来了潜在失业等问题,并需要医疗专业人员适应新技术。拟议的改革包括更加注重批判性思维,亲身体验,技能发展,医学伦理学,并将人文和人工智能整合到课程中。这些改革需要持续的评估和持续的研究,以有效地准备医学生在该领域的未来挑战。
    UNASSIGNED: China\'s secondary vocational medical education is essential for training primary health care personnel and enhancing public health responses. This education system currently faces challenges, primarily due to its emphasis on knowledge acquisition that overshadows the development and application of skills, especially in the context of emerging artificial intelligence (AI) technologies. This article delves into the impact of AI on medical practices and uses this analysis to suggest reforms for the vocational medical education system in China. AI is found to significantly enhance diagnostic capabilities, therapeutic decision-making, and patient management. However, it also brings about concerns such as potential job losses and necessitates the adaptation of medical professionals to new technologies. Proposed reforms include a greater focus on critical thinking, hands-on experiences, skill development, medical ethics, and integrating humanities and AI into the curriculum. These reforms require ongoing evaluation and sustained research to effectively prepare medical students for future challenges in the field.
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  • 文章类型: Journal Article
    这篇观点文章探讨了大型语言模型(LLM)在医学教育领域的变革作用,突出他们提高教学质量的潜力,促进个性化学习路径,加强临床技能培训,优化教学评估流程,提高医学研究的效率,并支持继续医学教育。然而,LLM的使用带来了某些挑战,例如关于信息准确性的问题,过度依赖技术的风险,缺乏情感识别能力,以及与道德相关的担忧,隐私,和数据安全。本文强调,要最大限度地发挥LLM的潜力并克服这些挑战,教育工作者必须在医学教育中发挥领导作用,灵活调整教学策略,培养学生批判性思维,并强调实践经验的重要性,从而确保学生能够正确有效地使用LLM。采取这样一种全面,均衡的做法,教育工作者可以培训精通使用先进技术并表现出扎实的职业道德和实践技能的医疗保健专业人员,从而为这些专业人员克服医疗保健行业未来的挑战奠定了坚实的基础。
    UNASSIGNED: This viewpoint article explores the transformative role of large language models (LLMs) in the field of medical education, highlighting their potential to enhance teaching quality, promote personalized learning paths, strengthen clinical skills training, optimize teaching assessment processes, boost the efficiency of medical research, and support continuing medical education. However, the use of LLMs entails certain challenges, such as questions regarding the accuracy of information, the risk of overreliance on technology, a lack of emotional recognition capabilities, and concerns related to ethics, privacy, and data security. This article emphasizes that to maximize the potential of LLMs and overcome these challenges, educators must exhibit leadership in medical education, adjust their teaching strategies flexibly, cultivate students\' critical thinking, and emphasize the importance of practical experience, thus ensuring that students can use LLMs correctly and effectively. By adopting such a comprehensive and balanced approach, educators can train health care professionals who are proficient in the use of advanced technologies and who exhibit solid professional ethics and practical skills, thus laying a strong foundation for these professionals to overcome future challenges in the health care sector.
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  • 文章类型: Journal Article
    目的:比较拼图和基于探究的学习(IBL)方法在不同牙科教育环境中促进有效学习成果的功效。
    方法:本研究共招募了188名牙科本科生,分为A批(n=96)和B批(n=92)。每批进行两次教学,一个使用Jigsaw方法,另一个使用IBL。使用五点李克特量表的结构化问卷评估了学生在两种方法之间的偏好。进行干预前和干预后测试以衡量知识获取。使用Studentt检验用STATA版本17进行统计学分析,p值<0.05被认为是显著的。
    结果:拼图和IBL方法都显著提高了学生的知识,干预前后的平均得分有显著差异(p<0.001)。IBL在综合主题覆盖率(99.46%)和增强主题理解方面更有效。两种方法在提高沟通技巧方面都产生了可比的结果。拼图方法更简单,更有趣,鼓励积极参与和提高沟通技巧。IBL提倡批判性思维,研究技能,和更深入的概念理解。
    结论:Jigsaw和IBL方法均可有效加强牙科教育。这些方法之间的选择取决于具体的学习目标,主题的复杂性,以及牙科教育者和学生的偏好。
    OBJECTIVE: To compare the efficacy of Jigsaw and Inquiry-Based Learning (IBL) methods in promoting effective learning outcomes within diverse dental educational settings.
    METHODS: A total of 188 dental undergraduate students were recruited for the study and divided into Batch A (n = 96) and Batch B (n = 92). Each batch underwent two teaching sessions, one using the Jigsaw method and the other using IBL. A structured questionnaire using five-point Likert scales assessed students\' preferences between the two methods. Pre- and post-intervention tests were conducted to measure knowledge acquisition. Statistical analysis was performed using Student\'s t-test with STATA version 17, with a p-value of < 0.05 considered significant.
    RESULTS: Both Jigsaw and IBL methods significantly improved students\' knowledge, with mean scores showing a significant difference before and after interventions (p < 0.001). IBL was more effective in comprehensive topic coverage (99.46%) and enhancing subject understanding. Both methods yielded comparable outcomes in terms of improving communication skills. The Jigsaw method was simpler and more enjoyable, encouraging active participation and enhancing communication skills. IBL promoted critical thinking, research skills, and deeper comprehension of concepts.
    CONCLUSIONS: Jigsaw and IBL methods are both effective in enhancing dental education. The choice between these methods depends on the specific learning objectives, the complexity of the topic, and the preferences of the dental educator and students.
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  • 文章类型: Journal Article
    背景:留学生教育已成为高等教育的重要组成部分,是衡量高等教育水平的重要标志。改变传统的教学模式,在这里,我们将基于案例的学习(CBL)和翻转课堂(FC)的组合引入了国际学生的病理生理学课程。本研究旨在探讨留学生的主动学习能力和批判性思维能力能否得到提高,基于这种新的教学模式,提高教师“团队”和“学生”对改革态度的创新能力。
    方法:将病理生理学中的心功能不全与细胞凋亡这两章设计为CBL+FC教学法。向留学生发放《主动学习与批判性思维自评量表》(SSACT)和满意度问卷,评价基于CBL+FC的教学改革。
    结果:与传统课堂相比,基于CBL的在线翻转课堂显著提高了学习积极性,由于这些学生需要独立完成文献综述,积极参与课堂教学,学习使用多种学习策略,并与其他学生合作完成PowerPoint(PPT)制作。同时,通过临床案例分析,学生提出问题和解决问题的能力有了很大提高;通过查阅文献,所学的理论知识可以更好地应用于临床分析。满意度调查的结果也表明,留学生更容易接受翻转课堂教学模式。
    结论:这种教学模式将激发国际学生的学习动机,增强教学吸引力,增加教学互动;同时,CBL+FC教学法可以加强对国际学生课堂内外和在线学习的评价,增强学生的主动学习能力和批判性思维能力,促进个性化学习的发展,与国际医学教育接轨。
    BACKGROUND: International student education has become an important part of higher education and an important symbol to measure the level of higher education. To change the traditional teaching model, here we introduced a combination of Case-Based Learning (CBL)and Flipped Classroom (FC) into the pathophysiology course for international students. This study aimed to explore whether the active learning ability and critical thinking ability of international students can be improved, based on this new teaching model, improving the innovation ability of teachers\' team and students\' attitude to the reform.
    METHODS: The two chapters of Cardiac Insufficiency and Apoptosis in Pathophysiology are designed as a CBL + FC teaching method. Distribute the Self-assessment Scale on Active Learning and Critical Thinking (SSACT) and satisfaction questionnaire to international students to evaluate teaching reform based on CBL + FC.
    RESULTS: Compared with the traditional classroom, the online flipped classroom based on CBL has significantly improved the learning enthusiasm, as these students are required to independently complete literature review, actively participate in classroom teaching, learn to use multiple learning strategies, and collaborate with other students to complete PowerPoint (PPT)production. At the same time, the students\' ability to raise problems and solve problems has been greatly improved by analyzing clinical cases; By consulting the literature, the theoretical knowledge learned can be better applied to clinical analysis. The results of the satisfaction survey also show that international students are more likely to accept the flipped classroom teaching mode.
    CONCLUSIONS: This teaching mode will stimulate the learning motivation of international students, enhance teaching attraction and increase teaching interaction; At the same time, the CBL + FC teaching method can strengthen the evaluation of international students\' in and out of class and online learning, enhance students\' active learning ability and critical thinking ability, promote the development of personalized learning, and integrate with international medical education.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨疼痛和功能水平与疼痛灾难的关系,沉思,决策,慢性颈部疼痛患者的批判性思维。
    方法:该研究纳入了62例慢性颈部疼痛患者,这些患者曾在物理治疗中心出现疼痛主诉至少3个月。疼痛严重程度的视觉模拟量表,功能级别的颈部残疾指数,疼痛灾难量表,反思思维量表,墨尔本决策量表I-II,和马尔马拉批判性思维清单用于评估。
    结果:活动疼痛,夜痛,和残疾与反思性呈正相关(rho:0.368,p=.003;rho:0.423,p=<.001;rho=0.334,p=.008)。夜间疼痛之间存在正相关,残疾,和痛苦灾难(rho=0.298,p=.019;rho=.434p<.001)。患者的疼痛严重程度和残疾与批判性思维得分呈负相关(rho=-0.393,p=.002;rho=-0.377p=.003,rho=-0.428p<.001,rho=-0.441p<.001)。
    结论:研究表明,疼痛严重程度和残疾与沉思和疼痛灾难之间存在正相关。此外,慢性颈痛与批判性思维得分呈负相关,表明对认知过程的潜在影响。这些发现可能为慢性疼痛和心理因素之间复杂的相互作用提供了见解。这可以为加强慢性疼痛管理的干预措施的发展提供信息。
    OBJECTIVE: This study aimed to investigate the relationship between pain and functional levels with pain catastrophizing, rumination, decision-making, and critical thinking in people with chronic neck pain.
    METHODS: The study included 62 patients with chronic neck pain who had presented to a physiotherapy center with pain complaints for at least 3 months. The visual analog scale for pain severity, the Neck Disability Index for functional level, the Pain Catastrophizing Scale, the Ruminative Thinking Scale, the Melbourne Decision-Making Scale I-II, and the Marmara Critical Thinking Inventory were used for assessments.
    RESULTS: Activity pain, night pain, and disability were positively correlated with rumination (rho: 0.368, p = .003; rho: 0.423, p = <.001; rho = 0.334, p = .008). There was a positive correlation between night pain, disability, and pain catastrophizing (rho = 0.298, p = .019; rho = .434 p < .001). A negative correlation was observed between patients\' pain severity and disability with critical thinking scores (rho = -0.393, p = .002; rho = -0.377 p = .003, rho = -0.428 p < .001, rho = -0.441 p < .001).
    CONCLUSIONS: The study suggested that there were positive correlations between pain severity and disability with rumination and pain catastrophizing. Additionally, chronic neck pain was found to have negative correlations with critical thinking scores, indicating potential impacts on cognitive processes. These findings may provide insights into the complex interplay between chronic pain and psychological factors, which can inform the development of interventions to enhance chronic pain management.
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  • 文章类型: Editorial
    最近的医学文献表明,人工智能(AI)模型在胃肠道病理学中的应用是一个指数增长的领域,有前途的模型,表现出非常高的性能。关于炎症性肠病(IBD),最近的评论证明了有希望的诊断和预后AI模型。然而,研究通常存在较高的偏差风险(特别是在基于图像的人工智能模型中)。创建特定的AI模型以提高诊断性能并允许在IBD中建立一般的预后预测非常感兴趣,因为它可以将患者分为亚组,反过来,允许为这些患者创建不同的诊断和治疗方案。关于手术模型,术后并发症预测模型在大规模研究中显示出巨大潜力.在这项工作中,作者介绍了基于随机森林模型的克罗恩病术后早期并发症预测算法的开发,该模型对队列中的并发症具有出色的预测能力.目前的工作,基于逻辑和推理,临床,和适用方面,为今后进一步开发IBD术后预后工具的前瞻性工作奠定了坚实的基础。下一步是以前瞻性和多中心的方式发展,这是一条优化这条研究路线并使其适用于我们的患者的协作路径。
    Recent medical literature shows that the application of artificial intelligence (AI) models in gastrointestinal pathology is an exponentially growing field, with promising models that show very high performances. Regarding inflammatory bowel disease (IBD), recent reviews demonstrate promising diagnostic and prognostic AI models. However, studies are generally at high risk of bias (especially in AI models that are image-based). The creation of specific AI models that improve diagnostic performance and allow the establishment of a general prognostic forecast in IBD is of great interest, as it may allow the stratification of patients into subgroups and, in turn, allow the creation of different diagnostic and therapeutic protocols for these patients. Regarding surgical models, predictive models of postoperative complications have shown great potential in large-scale studies. In this work, the authors present the development of a predictive algorithm for early post-surgical complications in Crohn\'s disease based on a Random Forest model with exceptional predictive ability for complications within the cohort. The present work, based on logical and reasoned, clinical, and applicable aspects, lays a solid foundation for future prospective work to further develop post-surgical prognostic tools for IBD. The next step is to develop in a prospective and multicenter way, a collaborative path to optimize this line of research and make it applicable to our patients.
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  • 文章类型: Journal Article
    背景:评估批判性思维倾向在护理教育中至关重要,以培养有效医疗实践所必需的分析技能。这项研究旨在评估伊朗护理学生的跨文化适应和对波斯语版本的批判性思维倾向量表的验证。
    方法:共有390名护生(平均年龄=21.74(2.1)岁;64%为女性)参加了这项研究。通过护理专业学生和专家的反馈,建立了面子和内容的有效性,分别。使用探索性因子分析(EFA)和验证性因子分析(CFA)评估结构效度。EFA用于探索因素的数量以及加载在其上的项目。CFA用于确认相同样品上的EFA的摆设。检验了收敛效度和判别效度,以及通过内部一致性和重测可靠性的可靠性。
    结果:EFA揭示了双因素结构,包括“批判性开放性”和“反思性怀疑论”,“解释了总方差的55%。CFA证实了模型的拟合(χ²=117.37,df=43,χ²/df=2.73,p<0.001;RMSEA=0.067;CFI=0.95;TLI=0.93,SRMR=0.041)。支持收敛效度和判别效度,显著的因子负荷(p<0.001)在0.61到0.77之间。CTDS表现出较强的内部一致性(α=0.87)和出色的重测可靠性(ICC=0.96)。
    结论:在波斯语环境中对CTDS的验证为评估伊朗护理专业学生的批判性思维倾向提供了可靠的工具。双因素结构与以前的研究一致,反映学生对批判性开放性和反思性怀疑论的倾向。研究结果强调了在护理教育中培养批判性思维技能的重要性。
    BACKGROUND: Assessing critical thinking disposition is crucial in nursing education to foster analytical skills essential for effective healthcare practice. This study aimed to evaluate the cross-cultural adaptation and validation of the Persian version of the Critical Thinking Disposition Scale among Iranian nursing students.
    METHODS: A total of 390 nursing students (mean age = 21.74 (2.1) years; 64% female) participated in the study. Face and content validity were established through feedback from nursing students and expert specialists, respectively. Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The EFA was used to explore the number of factors and the items that were loading on them. The CFA was used to confirmed the fidnings of the EFA on the same sample. Convergent and discriminant validity were examined, along with reliability through internal consistency and test-retest reliability.
    RESULTS: EFA revealed a two-factor structure, comprising \"Critical Openness\" and \"Reflective Skepticism,\" explaining 55% of the total variance. CFA confirmed the model\'s fit (χ² = 117.37, df = 43, χ²/df = 2.73, p < 0.001; RMSEA = 0.067; CFI = 0.95; TLI = 0.93, SRMR = 0.041). Convergent and discriminant validity were supported, with significant factor loadings (p < 0.001) ranging from 0.61 to 0.77. The CTDS exhibited strong internal consistency (α = 0.87) and excellent test-retest reliability (ICC = 0.96).
    CONCLUSIONS: The validation of the CTDS in Persian language settings provides a reliable tool for assessing critical thinking disposition among Iranian nursing students. The two-factor structure aligns with previous research, reflecting students\' propensity towards critical openness and reflective skepticism. The study\'s findings underscore the importance of nurturing critical thinking skills in nursing education.
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  • 文章类型: Journal Article
    批判性思维(CT)的发展已成为高等教育的普遍目标。对文献进行了系统回顾,以评估当前使用的教学实践在培养本科医学生的CT/临床推理(CR)/临床判断(CJ)技能和/或倾向方面的有效性。
    PubMed,从2010年1月到2021年4月,使用预定义的布尔表达式搜索了WebofScience和Scopus数据库。
    在最初确定的3221篇文章中,使用PICOS方法纳入33篇文章。从这些,21(64%)报告了CR教学实践,12(36%)报告了CT教学实践。
    总的来说,教学实践,如认知/视觉表现,模拟,文学曝光,测试增强和基于团队的学习,临床病例讨论,基于错误的学习,基于游戏的学习似乎可以增强CT/CR技能和/或倾向。需要进一步的研究来确定最佳时机,在医学教育中有效促进CT/CR的教学干预的持续时间和方式。
    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.
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