Judgment Skills Research Articles

EVALUATING THE LEARNING CURVE OF A NOVICE OPTOMETRY STUDENT IN SCLERAL LENS FITTING: A PROSPECTIVE QUANTITATIVE STUDY USING DELIBERATE PRACTICE AND CUMULATIVE SUMMATION (LC-CUSUM)

Background and Objective: To evaluate the learning curve of a novice optometry student in scleral lens fitting through deliberate practice and to objectively quantify the learning process using the LearningCurve-Cumulative Summation (LC-CUSUM) test, ensuring accurate and unbiased results. Method: The complexity of scleral contact lens fittings was assessed by categorizing subjects into regular and irregular cornea groups. A student enrolled in the Master of Optometry program conducted the fittings using a dedicated scleral lens record form (rubrics) designed to quantify the lens management approach. Prior to performing fittings independently, the student received four weeks of training from a contact lens expert, who also served as her guide for the study. This training period and the subsequent fittings were structured based on the principles of deliberate practice, with the student performing repeated diagnostic trials. A maximum of three diagnostic trials were performed for each subject to achieve the optimal fit. After each trial, the student completed a self-efficacy scale questionnaire to assess her perceived diffi-culty and clinical judgement skills, recording “FIRST trial scores” following the initial trial and ‘LAST trial scores’ after achieving the optimal fit. The guide consistently provided verbal feedback after each case throughout the fitting process as part of the deliberate practice methodology to enhance the student’s understanding of the fitting procedure while keeping the scores confidential to ensure unbiased self-as-sessment. Following the complete supervision of the fitting procedure, the guide evaluated the student’s clinical skills using a specially designed observation scale questionnaire, referred to as the ‘GUIDE scores.’ A seven-point Likert scale was used to rate the judgement for both the self-efficacy scale and observation scale questionnaire. The student’s LAST trial scores were subsequently compared with the GUIDE scores. Results: A total of 80 scleral lens fittings were evaluated. The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement between student-reported self-efficacy scores and guide-reported observation scores. The difference in self-efficacy scores between the initial and final lens fittings was statistically significant (p < 0.05), as determined by the Wilcoxon signed-rank test. The Learning Curve-Cumulative Summation (LC-CUSUM) chart revealed that learning stabilized after 26 fittings, marking a consolidation phase where minimal further improvement was observed beyond this point, and additional practice primarily helped to maintain proficiency. The average number of trials required per eye was higher in patients with irregular corneas than those with regular corneas. Conclusion: This study evaluated the learning curve of a novice optometry student in scleral lens fitting through deliberate practice, utilizing the LC-CUSUM test to quantify progress and assess skill acquisition objectively. Proficiency was achieved after 26 fittings, with additional trials needed for irregular corneas, underscoring the influence of patient characteristics on learning. These findings emphasize the importance of structured training, personalized feedback, and self-assessment in developing clinical competence. The insights contribute to advancing education and research in contact lens science by providing practical guid-ance for designing effective programs focused on planning, teaching, and learning about scleral lens fittings.

A comparison of staff training procedures to teach flexible prompt fading

AbstractQuality behavior intervention requires critical thinking skills, in‐the‐moment analysis, flexibility, and clinical judgment. Yet, there has been limited research on developing these complex skills. Flexible prompt fading (FPF) is a prompting procedure that requires the interventionist to continually analyze learner responding and make in‐the‐moment decisions to maximize learning during the teaching session, ultimately using clinical judgment while using prompting as a teaching strategy. FPF has consistently been demonstrated to be effective and in some cases more efficient than other prompting procedures. However, there has been no research demonstrating effective training procedures for the skills necessary to implement FPF. In order to more widely disseminate procedures that require these analytic skills, effective training procedures must be identified. The current study evaluated the effects of behavioral skills training (BST) and a progressive approach to staff training to teach staff to implement FPF with autistic individuals/individuals with ASD and the effects of each training method on development of clinical judgment skills. The results demonstrated that both training procedures were effective in teaching implementation of FPF.

Developing Clinical Judgment During Transition to Practice With Rapid-Cycle Deliberate Practice Simulation.

New-to-practice nurses (NPNs) make more errors than their experienced peers, affecting patient safety and contributing to sentinel events. Additionally, new nurses have a high attrition rate in their first year of practice. Simulation-based education may bridge the gap between education and practice by supporting the development of clinical judgment of NPNs. With quality improvement methods, an intradisciplinary team implemented a quality improvement project to improve NPNs' clinical judgment skills. A multipatient simulation that used rapid-cycle deliberate practice gave NPNs an opportunity to refine clinical decision-making and communication skills. In total, 24 NPNs participated in the pilot simulation. Pre- and postsurvey scores using the simulation effectiveness tool-modified showed self-reported improvement in clinical judgment and communication skills, among other competencies. Rapid-cycle deliberate practice simulation may support the development of essential nursing competencies, along with increased confidence and enhanced psychological safety among NPNs. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

How Can Nursing Faculty Create Case Studies Using AI and Educational Technology?

Applying artificial intelligence (AI) technology to the development of unfolding case studies in nursing education can reduce barriers to implementation of this educational strategy. Unfolding case studies are effective for improving nursing student outcomes related to clinical judgment skills, but these are often time consuming and difficult to develop. This article describes the use of AI in developing case studies for nursing education. Both students and faculty found case studies developed using an AI platform to be effective learning tools, and faculty especially found that using this platform greatly reduced the time required to develop cases. The use of AI to support development of unfolding case studies is an innovation that allows flexibility for faculty as well as improving student outcomes in practice domains that may otherwise be difficult to target.

Effect of Electronic Mind Map on Nursing Students' Clinical Judgment Skills

Effect of Electronic Mind Map on Nursing Students' Clinical Judgment Skills

Game Products: Innovative Pathways for Nursing Education and Clinical Training

To excel in their work, nurses must have specialized tools to support their tasks and professional development. Games, as a crucial pathway to achieving nursing education and clinical training goals, demonstrate significant potential and application value, making them an innovative product. Nursing education games come in various forms, including virtual reality, augmented reality, tabletop, and digital, and may be designed as needed for individual, two-player, or team play (Avşar et al., 2023; Bermejo et al., 2023; Tsai et al., 2024). These games, beyond their entertainment value, have clear educational objectives embedded in their design. Through levels, challenging tasks, and reward mechanisms, they stimulate learning enjoyment and promote nursing development. In this column, experts and scholars in the field of nursing engaged in game development share their experiences and achievements. Integrating games into nursing delivers a wealth of tools and resources for nursing education and clinical practice, offering immersive learning experiences, instant feedback, and individualized learning paths. For nursing students, gamified products offer safe and risk-free learning environments in which they can practice critical tasks and make decisions in simulated medical scenarios, increasing their clinical experience and confidence and enhancing their clinical judgment and decision-making skills (Wu et al., 2023). For patients, many therapeutic games have already been designed that use gameplay to improve health by facilitating user engagement in rehabilitation exercises, promoting healthy eating, and fostering social interactivity (Tsai et al., 2024). For nurses, various games are being used to promote continuous professional growth in an interactive and enjoyable learning environment, improving overall quality of care and job satisfaction (Hsieh et al., 2023). In summary, the application of game products in nursing education and clinical training has introduced new learning and training models that provide multifaceted benefits for nurses, nursing students, and patients. We hope that readers will gain a deeper understanding of related game products after reading this column and use games effectively to enhance nursing quality.

Using a Template to Develop Clinical Judgment Skills in Case-Based Learning.

Using a Template to Develop Clinical Judgment Skills in Case-Based Learning.

Learning analytics dashboard design: Workplace learner preferences for reference frames in immersive training in practice

AbstractBackgroundLearning analytics dashboards are increasingly being used to communicate feedback to learners. However, little is known about learner preferences for dashboard designs and how they differ depending on the self‐regulated learning (SRL) phases the dashboards are presented (i.e., forethought, performance, and self‐reflection phases) and SRL skills. Insight into design preferences for dashboards with different reference frames (i.e., progress, social, internal achievement and external achievement) is important because the effectiveness of feedback can depend upon how a learner perceives it.ObjectiveThis study examines workplace learner preferences for four dashboard designs for each SRL phase and how SRL skills relate to these preferences.MethodsSeventy participants enrolled in a chemical process apprenticeship program took part in the study. Preferences were determined using a method of adaptive comparative judgement and SRL skills were measured using a questionnaire. Preferences were tested on four dashboard designs informed by social and temporal comparison theory and goal setting theory. Multinomial logistic regressions were used to examine the relationship between dashboard preferences and SRL.Results and ConclusionsResults show that the progress reference frame is more preferred before and after task performance, and the social reference frame is less preferred before and after task performance. It was found that the higher the SRL skill score the higher the probability a learner preferred the progress reference frame compared to having no preference before task performance. The results are consistent with other findings, which suggest caution when using social comparison in designing dashboards which provide feedback.

Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine.

The objective was to study the effect of serial night shifts on the cognitive, psychomotor, and moral performance of emergency medicine residents of an academic Emergency Medicine Department. This prospective case-crossover study compared emergency medicine residents' sleep time, subjective sleepiness, cognitive function, moral judgment, and psychomotor skills after 5 consecutive days versus night shifts using sleep diaries, activity monitors, and multiple performance tests. Paired t-tests and Wilcoxon signed-rank tests were used to analyze data based on normality. Correlation analysis was done using Spearman's correlation test. Subgroup analysis was also performed to find any difference based on gender and year of residency. Twenty-seven emergency medicine residents participated (13 males, 48.1%). The distribution across residency years was as follows: 44.4% in their first year, 25.9% in their second year, and 29.6% in their third year. Following five consecutive night shifts, total sleep duration decreased significantly from 338.1 ± 67.8 to 307.4 ± 71.0 min (p < 0.001), while subjective sleepiness scores increased from 9.6 ± 3.3 to 13.6 ± 4.6. Psychomotor performance and reaction times did not significantly differ between night and day shifts. However, working memory declined, assessed by self-paced three-back test scores (median [IQR] 517.1 [471.9-546.7] vs. 457.6 [334.4-508.8]; p = 0.034) and interference test scores (445.5 ± 59.9 vs. 407.2 ± 56.8; p < 0.001), along with moral judgment (median [IQR] 19 [18-28] vs. 15 [11-21]; p = 0.010) after serial night shifts. No correlations existed between performance measures nor differences based on gender or residency year. Residents sleep less following night versus day shifts, reporting the highest sleepiness levels after 5 consecutive nights. Despite this, psychomotor performance and reaction times did not significantly differ. However, considerable reductions occurred in moral judgment, working memory, and interference test performance after serial night shifts.

Developing new healthcare practice learning environments through a third-space reflective practice approach: a case study

PurposeThe creation of new practice learning environments for healthcare students promotes the development of professional judgement skills and decision-making. Through the modelling of established practices across other subject disciplines, Healthcare Technicians designed and created the Clinical Skills Lounge to support student learning outside of scheduled classes.Design/methodology/approachThe design and development of a new learning and simulation space for healthcare students was created following feedback from students. Using a model of learning support for students across the creative subject disciplines, the creation of the Clinical Skills Lounge provided an opportunity to create a space where practical techniques could be practiced and support provided by Technicians.FindingsStudent feedback highlights the importance and flexibility of the Clinical Skills Lounge design and opportunities to learn and practice key skills outside of timetabled sessions. Greater confidence and opportunities to further develop decision-making skills were reported by students who use this space.Originality/valueThis particular type of learning environment promotes greater reflection, provides the opportunity for students to learn alongside their peers and encourages inter-professional learning. The opportunities for greater decision-making, confidence building and preparation for clinical placements.

Subjective Study on Pediatric Emergency Department Nurses′ Perceptions of Urgency Using Q Methodology

PurposeIn the emergency department (ED), triage significantly impacts patient safety. Therefore, triage nurses must make decisions accurately and timeously. This study aims to investigate how South Korean pediatric emergency nurses perceive urgency and classify severity using the Q methodology, which examines individuals’ subjectivity. MethodsWe collected 84 statements from a Q population based on a literature review and interviews, and selected 33 Q samples. The P samples included 30 pediatric emergency nurses at a Seoul tertiary-care hospital. The principal component factor analysis method was employed to analyze data using the PC-QUANL program. ResultsFour urgency perception types were identified among pediatric ED nurses. Type 1: “Experiential coping”; Type 2: “Careful reasoning”; Type 3: “Patient-centered thinking”; and Type 4: “Intuitive prediction.” These types appear to be an integrated process of knowledge and clinical experience that considers children’s characteristics and developmental stages. ConclusionsThis study may serve as a basis for future education to improve pediatric ED nurses’ urgency judgment and severity classification skills.

Fostering professional judgement and decision making in social work education: addressing dilemmas of equal treatment

ABSTRACT Since social workers are often confronted with dilemmas as insoluble conflicts, professional judgment and decision-making skills are necessary. Therefore, social workers must already be confronted with such conflicts during their education, especially with dilemmas challenging the value of equal treatment: While equality for all clients remains one of the highest mandates in social work, specific cases require unequal treatment for social justice. To assess social work students’ ability to recognize such conflicts, two dilemma stories were presented in two quantitative studies, involving a total of 156 participants. The task was to approve or disapprove of decisions, with different grades to filter out extreme views. The results reveal that students hold both perspectives on the equality-related conflicts. Furthermore, about half of the students rate a decision as extremely right or extremely wrong, which indicates that they do not recognize the dilemma as such. These findings highlight the need to address such dilemmas in education while promoting students’ ability to weigh up ethical considerations. This research invites us to adapt teaching methods by using the dilemma stories together with the related theoretical parts to foster an understanding of conflicts and prepare future social workers to navigate such ethical challenges.

Literary Works and Technology Aids Inclusion in Foreign Language Learning: Case of Kosovo Students’ Approach

Introduction: The research in this paper was adapted to provide insight into the expectations, prejudices, and openness of higher education students of the University of Prishtina to the inclusion of literary material in the teaching/learning of English and French as a second foreign language (FL2). Simultaneously, as the modern and technologically developed world requires, the paper deals with the opinion on the contribution of appealing teaching material and technology aids in the acceptance of literary works (LWs) in foreign language learning (FLL). Purpose: Apart from some excerpts in the course books, LW inclusion in foreign language learning (FLL) is almost non-existent in the Kosovo education system. Through this study, we concurrently aim to raise the awareness of the students of the advantages that literary works can bring into the foreign language classroom incurring learner-centred teaching/learning, progression of critical thinking and judgment skills as well as sharing experiences and opinions through non-linear and more spontaneous manner. Method: In this study, 69 respondents are freshmen at the University of Prishtina (UP), Faculty of Philology who are mainly future teachers of foreign languages and elected English and French language as their FL2. The method used in this paper consists of quantitative and qualitative approaches aiming for a more thorough analysis through the SPSS statistical computer program and descriptive statistics. Conclusion: The findings revealed that the students have a positive approach to the merge of LWs and foreign language learning, less through printed LWs and more through digitized literature. Hence, applying the merging of literature with language, in the new pedagogical practices and English/French language curricula can be optimistic expectations. Significance: The significance of the study lies in the fact that this under-investigated issue can help in creating insight into the current condition in FL classrooms and help FL curriculum changes in the Kosovo middle and upper high schools as well as higher education FL course curriculum. This study raises hope for merging language and literature in FL classrooms.

Clinical observation using virtual reality for dental education on surgical tooth extraction: A comparative study

BackgroundClinical observation conducted during the 3rd and 4th years of dental school is an important part of dental students’ clinical education. However, conventional clinical observation is associated with several problems, including the lack of opportunity for all students to assist during surgery. Virtual reality (VR) technologies and devices can be used to demonstrate clinical processes that dental students need to learn through clinical observation. This study aimed to evaluate the effectiveness of teaching dental students the surgical tooth extraction procedure through clinical observation using VR.MethodsWe recruited third- and fourth-year dental students and divided them into a VR clinical observation group (VR group) and a conventional clinical observation group (control group). The control group visited an outpatient clinic and observed an oral and maxillofacial specialist perform surgical tooth extraction, whereas the VR group watched a 360° video of surgical tooth extraction using a head-mounted display. After observation, both groups were surveyed regarding their satisfaction with the clinical observation and their understanding of the procedure.ResultsUnderstanding of the procedure and satisfaction with the observation were significantly higher in the VR group than in the control group (p = 0.001 and p = 0.047, respectively). Compared with conventional clinical observation, VR clinical observation improved learning motivation and medical thinking and judgment skills; however, interaction between professors and students was lacking.ConclusionsVR clinical observation using 360° videos might be an effective teaching method for students. However, to allow interaction between professors and students during clinical observations, using it along with conventional clinical observation is necessary.

Effectiveness of a Simulation-Based Education Program to Improve Novice Nurses' Clinical Judgment Skills.

We assessed the effectiveness of a simulation-based education program to improve novice nurses' clinical judgment skills. A simulation education program was implemented for 21 novice nurses. Surveys were conducted on program satisfaction, learning, and clinical judgment skills before, immediately after, and two months after the program. Novice nurses were highly satisfied with the simulation education program. The following nine categories were identified as learnings: provide psychological care for patients, conduct sufficient observation, conduct assessment and make judgment based on observational findings, consult and report appropriately to senior nurses, take response action calmly, collect necessary information, acquire knowledge, predict patients' conditions, and make environmental arrangements. The subscale score for theoretical and practical reasoning was significantly higher immediately after and two months after the program than before it. In addition, the subscale for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. The novice nurses learned to sufficiently observe, obtain necessary information, and prospectively assess patients' conditions by taking part in the simulation education program. The subscale score for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. After the simulation program, novicenurses were likely actively practicing nursing; therefore, this program may not be directly responsible for the improvement of these new nurses' clinical judgment. Nevertheless, we found that the completion of the simulation program was correlated with enhanced clinical judgment.

Effectiveness of simulation-based interprofessional education on teamwork and communication skills in neonatal resuscitation

BackgroundThe role of effective interprofessional teamwork is especially vital in the Neonatal Intensive Care Unit (NICU) where infants facing emergency situations are admitted. Proper neonatal resuscitation, facilitated by comprehensive resuscitation training, can significantly decrease the mortality rates associated with neonatal asphyxia and respiratory failure. This study aimed to develop a simulation-based interprofessional education (IPE) programme for medical staff working in a nursery and NICU and to assess its effectiveness on teamwork, communication skills, clinical performance, clinical judgement, interprofessional attitudes, and education satisfaction.MethodsThrough a demand survey, neonatal resuscitation was selected as the theme, and an IPE team comprised of one doctor and two nurses was formed. The education programme consisted of three sessions lasting a total of 140 min: two simulation exercises and one theoretical education session. Data were collected from 18 nurses working in the nursery and NICU and 9 doctors working in the paediatrics department.ResultsA comparison of the metrics before and after applying simulation-based IPE programmes revealed teamwork (Z=-2.67, p = .008), communication skills (Z=-2.68, p = .007), clinical performance (Z=-2.52, p = .012), clinical judgement (Z=-4.52, p < .001), and interprofessional attitude (Z=-3.64, p < .001) to have significantly improved. Education satisfaction scores were 4.73 points on average out of a maximum of 5. The simulation-based IPE programme was effective in improving the teamwork, communication, and clinical performance of resuscitation teams, individual clinical judgement, and interprofessional attitude.ConclusionsSimulation-based IPE is effective for enhancing teamwork, team communication, clinical judgement skills, and clinical performance in neonatal resuscitation. This programme has the potential to contribute to the improvement of patient safety and the quality of neonatal care. Additional studies are needed to longitudinally examine the effects of the programme on patient safety and quality of neonatal care.

Developing professional capital through technology-enabled university-school-enterprise collaboration: an innovative model for C-STEAM preservice teacher education in the Greater Bay area

Purpose Preservice teacher (PST) professional development programs are crucial for cultivating high-quality STEAM teachers of the future, significantly impacting the quality of regional STEAM education. The Guangdong-Hong Kong-Macao Greater Bay Area, as a region of cross-border cooperation, integrates the resources and advantages of Guangdong, Hong Kong, and Macao, possessing rich cultural heritage and innovative capabilities. Transdisciplinary Education for Cultural Inheritance (C-STEAM) is an effective approach to promoting educational collaboration within the Greater Bay Area, facilitating the integration of both technological and humanities education. This study aims to develop a Technology-Enabled University-School-Enterprise (T-USE) collaborative education model and implement it in the Greater Bay Area, to explore its role as a support mechanism in professional development and its impact on C-STEAM PSTs' professional capital. Design/methodology/approach Adopting a qualitative methodology, the study interviewed PSTs who participated in a C-STEAM teacher education course under the T-USE model. Thematic coding is used to analyze their knowledge acquisition, interaction benefits with community members, and autonomous thinking and decision-making in theoretical learning and teaching practice. Findings The findings show that the T-USE model significantly enhanced the PSTs' human capital, including teaching beliefs, knowledge, and skills. In terms of social capital, PSTs benefited from collaboration with PST groups, university teaching teams, in-service teachers, and enterprises, though challenges such as varying levels of expertise among in-service teachers and occasional technical instability emerged. For decisional capital, the T-USE model provided opportunities for autonomous thinking and promoted teaching judgment skills through real teaching challenges and scenarios. Reflective practice activities also supported PSTs' professional growth. Originality/value This study reveals the effectiveness and internal mechanism of the T-USE model in C-STEAM PST training, offering significant theoretical and practical references for future PST education.

Scaled performance on the Vascular Qualifying Examination does not correlate with Vascular Certifying Examination first attempt pass in a national cohort of residents and fellows

BackgroundSpecialty board certification is an important indicator of surgeon competence and necessary for residency and fellowship programs to maintain accreditation by the Accreditation Council for Graduate Medical Education. Thus, identification of trainees at risk of board certification failure is important for both vascular surgery graduates and their parent program. We sought to examine the correlation of Vascular Qualifying Examination (VQE) performance on first-time pass achievement of the Vascular Certifying Examination (VCE). MethodsWe used American Board of Surgery data to examine predictive associations of a national longitudinal cohort of all vascular surgery integrated residents (VIRs) and vascular surgery fellows (VSFs) who completed the VQE and VCE from 2016 through 2021. Descriptive statistics were used to examine trends. We used χ2 tests to examine proportional group differences. Predictive associations between VQE scaled score performance and first-time pass achievement on subsequent VCE attempts were examined using logistic regression. ResultsVQE scaled score performance and VCE pass rates were obtained for all VIRs and VSFs (n = 579; 175 residents and 404 fellows) from 151 programs (48 residency and 103 fellowship) during the study period. First-attempt pass rate for the VQE was 96% in the study cohort, and first-attempt pass rate for the VCE was 94%. There were no significant differences in pass-fail rates in VQE and VCE for VIR and VSF candidates (P = .210 and P = .116, respectively). Trainee scaled score performance on the VQE was not predictive of subsequent first-attempt pass achievement on VCE (odds ratio, 1.00; 95% confidence interval, 1.00-1.01; P = .077). Stratified subgroup analyses by VIR and VSF cohorts also showed no significant predictive first-attempt VCE pass achievement (P = .190 and P = .094, respectively). ConclusionsIn this national cohort of vascular trainees taking the VQE and VCE, VQE performance was not predictive of subsequent VCE first-time pass achievement. This finding highlights the necessity to identify other measures of trainee competence to indicate the preparedness of trainees for board certification examinations. Furthermore, this may be reflective of the ability to assess distinctive competencies between the two examinations, with the VQE focused on medical knowledge and the VCE on clinical judgment and interpersonal communication skills, thus broadening assessment of the Accreditation Council for Graduate Medical Education core competencies to ensure certification of vascular surgeons possessing both the knowledge and judgment necessary to maintain high-quality standards within our specialty.

The mediating role of flow in the relationship between simulation design and simulation educational satisfaction in korean nursing students: a cross-sectional study

BackgroundIn Korea, there has been recent interest in nursing simulation education. In nursing, simulation education has many advantages, such as improving nursing students’ problem-solving and judgment skills. Simulation education satisfaction is an indicator for evaluating educational performance from the learners’ perspective and an important criterion for the development and progress of nursing education. Therefore, based on NLN/Jeffries simulation theory, this study aims to identify the relationship between simulation design and educational satisfaction and to confirm the mediating effect of flow.MethodsThis cross-sectional study was conducted using 143 fourth-year nursing students who had participated in classes using simulations at three universities in Seoul, Daegu, and Jeonbuk. Data were collected from April 24 to May 3, 2023. Demographic data, simulation design scale (SDS), flow in simulation, and the educational satisfaction scale in simulation were collected via an online questionnaire. The collected data were analyzed through t-test, ANOVA, Scheffé test, and Pearson’s correlation coefficient using SPSS 25.0. The mediating effect of flow was analyzed through the three-stage mediation effect procedure using hierarchical regression analysis and the Sobel test.ResultsThe simulation educational satisfaction had a statistically significant positive correlation with simulation design (r = .65, p < .001) and flow (r = .47, p < .001), and simulation design was positively correlated with the flow (r = .55, p < .001). The simulation design had a statistically significant effect on flow, which was the mediating variable (β = 0.55, p < .001). Additionally, simulation design had a statistically significant effect on simulation educational satisfaction (β = 0.56, p < .001). The significance of the mediating effect of flow on the relationship between simulation design and simulation educational satisfaction was investigated using the Sobel test, and the mediating effect of flow was found to be statistically significant (Z = 5.36, p < .001).ConclusionThe significance of the current study lies in its confirmation of the link between simulation design and simulation educational satisfaction, as well as the mediating function of flow. Nursing students can achieve simulation educational satisfaction through simulation-based education if simulation educators follow best practices that improve flow through well-organized simulation design.

Developing Abstracting and Generalizing Thinking for Middle School Students in Teaching the Topic of Equations and Non-Equations

In the Vietnam general education curriculum, Mathematics subject has an important position, being a tool for many other subjects. Mathematics has great potential to help students develop their intellectual abilities and qualities, training them to think abstractly and generalize. Furthermore, Mathematics has its roots in practice and is the "key" in most human activities, as well as in learning other subjects. In teaching mathematics, teachers not only guide students to acquire knowledge and skills but also train them to think and learn. Therefore, training in abstract thinking and generalization thinking is necessary to help students not only understand and remember math more deeply but also develop problem-solving, logical thinking and judgment skills, thereby helping them develop more comprehensively in the learning process and life.