Thinking In Medical Education Research Articles

Critical Thinking and Clinical Reasoning in Undergraduate Medical Course: A Mixed-Methods Study in a Medical College in Kolkata, West Bengal, India.

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.

Design thinking in medical education to tackle real world healthcare problems: The MasterMinds Challenge

Educational challenge Medical education must equip future professionals with the necessary skills to navigate the complex healthcare landscape. Clinical knowledge is essential, and critical and creative thinking skills are vital to meet the challenges of the system. Design thinking offers a structured approach that integrates creativity and innovation, yet its application in medical education is absent. Solution and implementation The compulsory MasterMinds Challenge course at Leiden University Medical Center utilizes design thinking principles to address real world healthcare challenges. Final-year medical students participated in a two-day program. The course encompassed empathizing with stakeholders, problem definition, ideation, prototyping, and refining solutions. Presentation skills were emphasized, culminating in a symposium where teams showcase their outcomes. Implementation of the MasterMinds Challenge course was successful with 33 sessions delivered to 1217 medical students. Challenges covered various healthcare topics, yielding creative yet practical outcomes. Students appreciate the real world healthcare challenge, team-based approach, and the applicability of design thinking principles. Challenge owners expressed satisfaction with students’ commitment, creativity, and empathizing abilities. Lessons learned and next steps To further enhance the MasterMinds Challenge course, a more longitudinal format is being designed, enabling greater autonomy and emphasizing the refining and implementation phases. The course can be extended to medical postgraduate professionals and interdisciplinary collaborations, fostering innovative ideas beyond current practices. By developing problem-solving skills, the MasterMinds Challenge course contributes to a future-proof medical education program and prepares students to meet the evolving needs of healthcare.

Enhancing critical thinking in medical education: A narrative review of current practices, challenges, and future perspectives in context of infodemics

ObjectiveThe Covid-19 pandemic has been accompanied by a rampant spread of misinformation, posing significant risks to public health. This narrative review aims to assess the current state of critical thinking education in medical institutions, exploring its facilitators, barriers, and potential prospects. MethodsA systematic literature search was conducted to identify relevant studies. Six databases were searched using various keywords from 2007 to 2022, including articles in both English and French. The initial screening of abstracts and titles, as well as the subsequent full-text selection, were carried out through double reading. An inductive thematic approach was utilized for the analysis. ResultsOut of the 559 articles screened, 38 were included in this review. The selected articles exhibited considerable heterogeneity in terms of origin and study type. Following main themes emerged from the analysis: the challenge of defining critical thinking in the healthcare context, its integration into the curriculum, effective teaching methodologies, instructors' qualifications and approaches, methods for assessing its impact. Trainees reported a heightened sense of preparedness in navigating consultation situations impacted by controversies. They readily recognized the significance of cultivating critical thinking as an essential professional skill. ConclusionIn the post-COVID infodemic context, critical thinking in health education is gaining momentum, emphasizing both mindset and rational reasoning. This study provides a foundation for enhancing the implementation of critical thinking education.

Critical thinking in medical education

Technological advances in the modern world have led to a paradigm shift in medical education, identifying new challenges. The need to meet these challenges has required the implementation of evidence-based clinical practice, which allows the best quality evidence to be used to provide optimal patient care and improve healthcare efficiency. Obtaining evidence of the efficacy and safety of drugs and medical technologies, the diagnostic accuracy of interventions became possible due to the introduction of systematic reviews and meta-analyses. This methodology forms clinical thinking in parallel with the development of research and analytical competencies, which is one of the urgent tasks of modern medical education. The article reflects the experience of the Department of Internal Diseases of the Sechenov University in implementing a practice-oriented research module aimed at developing critical thinking using evidence-based medicine methods among students and residents. The inclusion of research competencies in the educational process will make it possible to qualitatively transform medical education and form a generation of competitive competent specialists in demand in the world of constantly developing technologies.

Understanding State-of-the-Art Literature Reviews.

Understanding State-of-the-Art Literature Reviews.

The impact of visual thinking in medical education

Abstract Background Considering medical humanities, medicine and art are two areas that resemble each other at several features. Clinical diagnosis involves the observation, description and interpretation of information of which visual ones take an important one. The skills described are important skills in the field of visual arts, as well. Underlying a good clinical practice; clinical examination and observation skills constitute an important place. Although in several studies, these skills are shown to be improved by analyzing visual art pieces, courses intended to improve visual thinking skills are not that much common in medical faculty curriculums. Methods In this article, we share our opinion about the use of visual thinking in medical education by providing preliminary reflection results of learners from the second year of medical education about the visual thinking course that we have recently started to apply in Faculty of Medicine in collaboration with Faculty of Fine Arts in Izmir University of Economics in order to improve the observational skills of learners. Results Reflection results of the learners support the view that training art-viewing skill is helpful to improve observational and descriptive skills. Conclusions Increasing interdisciplinary programs on visual thinking in medical curriculums have the potential to overcome several professional development challenges in clinics.

Editorial introductions

Current Opinion in Obstetrics and Gynecology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of obstetrics and gynecology is divided into nine sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Joseph AquilinaJoseph AquilinaJoseph Aquilina, FRCOG, MFFP, is a consultant obstetrician and gynaecologist at Barts Health NHS Trust based St. Bartholomew's and the Royal London Hospitals, UK, and Honorary Senior Lecturer in Obstetrics and Gynaecology at Queen Mary University of London, UK. He is the Lead Clinician for Fetal Medicine Clinical Academic Group and runs a one-stop menstrual disorders clinic at St Bartholomew's Hospital. Mr Aquilina obtained his primary medical degree in Malta and then moved to the UK for his basic postgraduate training in Bristol, and in London at King's College and Greenwich Hospitals, UK. He subsequently undertook research and subspecialty training in feto-maternal medicine/gynaecological ultrasound as a lecturer at St.Bartholomew's and Royal London Medical School, Queen Mary Westfield College, based at Homerton Hospital, UK. He is recognised as a preceptor for training in gynaecological scanning by the Royal College of Obstetricians and Gynaecologists, UK. His special interests include polycystic ovarian syndrome, prediction of pre-eclampsia and the application of ultrasound in the diagnosis and management of benign gynaecological conditions. Ruben AlveroRuben AlveroDr Ruben Alvero is Professor of Obstetrics and Gynecology at Stanford Medical School, USA, and is the Division Director of Reproductive Endocrinology and Infertility at the Lucille Packard Children's Hospital, USA. He is Board Certified in obstetrics and gynecology, and in reproductive endocrinology and infertility. He is a fellow of the American College of Obstetrics and Gynecology and the American College of Surgeons. Following undergraduate training at Harvard College, USA (BA, Economics, 1980), Dr Alvero received his medical degree from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA, in 1986. He completed his residency in Obstetrics and Gynecology at Walter Reed Army Medical Center, USA (1990), and a fellowship in Reproductive Endocrinology and Infertility at the National Institutes of Health, USA (NIH, 1995). Dr Alvero was the Division Director for Infertility Services at the National Naval Medical Center, Bethesda, USA, and Walter Reed Army Medical Center and faculty in the NIH-sponsored fellowship in Reproductive Endocrinology and Infertility. Dr Alvero remained a reserve Colonel in the US Army Medical Corps until 2012, and during 27 years in the Army was mobilized several times for missions around the world, including service in Iraq, Kuwait, Mongolia, Germany and various locations in the United States. Dr Alvero was Professor of Obstetrics and Gynecology and Vice Chair for Education at the University of Colorado Health Sciences Center, USA, and the Director of the Assisted Reproductive Technologies, and founding member of the Center for Surgical Innovation. Dr Alvero was Residency Program Director in Obstetrics and Gynecology at the University of Colorado, USA. He was subsequently Division and Fellowship Director at Brown University, USA. The Council in Residency Education in Obstetrics and Gynecology awarded him its National Faculty Award for Excellence three times. He has been NIH-funded, most recently as part of the Reproductive Medicine Network. Dr Alvero is currently the Vice President of the Society for Reproductive Endocrinology, the national organization of fertility specialists and will take over as President in October 2020. Dr Alvero's clinical interests include IVF, polycystic ovary syndrome, endometriosis and robotic surgery. Dr Alvero's research interests include non-invasive evaluation of embryo quality, cost-effectiveness analysis, and the role of critical thinking in medical education. A fluent Spanish-speaker, Dr Alvero is also dedicated to improving the health of the Latinx community.

Design Thinking in Medical Education: The Key Features and Practical Application.

Design thinking is a process that applies both creativity and innovation to iteratively develop and implement a new product. The design thinking process also enhances design thinking skills that are essential for personal and professional life in a complex world. Health care is increasingly being faced with complex problems, and the education of current and future doctors in design thinking is an important curricular challenge for all medical educators. Medical educators will need to enhance their own design thinking skills to enable them to effectively respond to this challenge.

Designing EthAKUL: a mobile just-in-time learning environment for bioethics in Pakistan

In developing countries such as Pakistan, bioethics has not been included in mainstream thinking in medical education. The authors’ experiences suggest that current methods of teaching bioethics are problematic as students are unable to translate theory to practice. Alternative pedagogies, such as just-in-time learning (JiTL) using mobile devices, may be able to foster the development and implementation of ethical reasoning among nurses, doctors, and medical and nursing students. This research was conceived to determine the effectiveness of mobile JiTL – anytime, anyplace learning through mobile devices – for teaching bioethics. After obtaining ethical clearance, a participatory design (PD) approach was adopted to ensure input from all stakeholders for the design of ‘EthAKUL’, comprising a mobile app, five modules and just-in-time pedagogy. The name of the app is an acronym evoking ethics, learning and the university where the project originated. As a part of the design process, three PD workshops were held with junior doctors, nurses, nursing students, medical students and bioethics teaching faculty, and five meetings were held with faculty members, to discuss functional specifications and user-acceptance testing of the app. The feedback related to the nature of common ethical issues encountered in clinical settings, the existing process of teaching and learning bioethics, and the requested features of the app were recorded. These data sets were analyzed and synthesized into functional and technical specifications for the mobile app. The software programmers developed the app with the close involvement of the stakeholders. The development of teaching content continued alongside this process. While this enabled EthAKUL’s developers to incorporate needs of all stakeholders, challenges were encountered in the process relating to the pragmatic and conceptual aspects of JiTL, ML and PD. We discuss the implications of this research in bringing about transformative changes in higher education.
 
 How to cite this article: 
 NASEEM, Azra; GHIAS, Kulsoom; BAWANI, Sohail; SHAHAB, Mohammad Ali; NIZAMUDDIN, Sameer; KASHIF, Waqar; KHAN, Kausar S; AHMAD, Tashfeen; KHAN, Murad. Designing EthAKUL: a mobile just-in-time learning environment for bioethics in Pakistan. Scholarship of Teaching and Learning in the South. v. 3, n. 1, p. 36-56, Apr. 2019. Available at: 
 https://sotl-south-journal.net/?journal=sotls&page=article&op=view&path%5B%5D=70&path%5B%5D=40
 
 This work is licensed under the Creative Commons Attribution 4.0 International License.
 To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

The Power of Design Thinking in Medical Education

A goal of medical education should be to optimize educational experiences of our learners. How can we better understand their experiences and design educational activities that inspire them to learn? Design Thinking is a powerful process that consists of five iterative phases: empathize, define, ideate, prototype, and test. Empathy with the user experience is at the core of Design Thinking. This helps define the right problem so that the right solutions can be developed. In this article, we share our experiences with using Design Thinking in radiology education. As educators, we are constantly learning and innovating. Design Thinking provides a powerful process and a growth mindset to help develop creative solutions as we move forward. We invite you to join us in this discovery quest for innovative solutions in medical education through the Design Thinking process.

Critical and courageous thinking in medical education: truth-telling, an antidote to tradition

Critical and courageous thinking in medical education: truth-telling, an antidote to tradition

Exploration and practice on the training of critical thinking in medical education

Critical thinking is one of the core professional competences for medical students. The ultimate goal of critical thinking is to combine the highly individualized experience and comprehension with the generally applicable scientific cognitive system. Therefore in medical education, the cultivation of critical thinking should embody the objective and the characteristics of critical thinking, such as rational restriction, dialectical thinking, empathy practice and scientific evaluation, and great attention to the principles and conditions of the application must be given. In the course of teaching design and implementation it's necessary to choose the appropriate point, to set up the teaching situation suitable for developing critical thinking, to optimize the structure of teaching content, to strengthen the practice of critical thinking methodology and to value asking questions and so on. Key words: Critical thinking; Medical education; global minimum essential requirements in medical education (GMER); Ability training; Medical humanity

The importance of design thinking in medical education

Design thinking provides a creative and innovate approach to solve a complex problem. The discover, define, develop and delivery phases of design thinking lead to the most effective solution and this approach can be widely applied in medical education, from technology intervention projects to curriculum development. Participants in design thinking acquire essential transferable life-long learning skills in dealing with uncertainty and collaborative team working.

Trust and risk: a model for medical education.

Health care delivery, and therefore medical education, is an inherently risky business. Although control mechanisms, suchas external audit and accreditation, are designed to manage risk in clinical settings, another approach is 'trust'. The use of entrustable professional activities (EPAs) represents a deliberate way in which this is operationalised as a workplace-based assessment. Once engaged with the concept, clinical teachers and medical educators may have further questions about trust. This narrative overview of the trust literature explores how risk, trust and control intersect with current thinking in medical education, and makes suggestions for potential directions of enquiry. Beyond EPAs, the importance of trust in health care and medical education is reviewed, followed by a brief history of trust research in the wider literature. Interpersonal and organisational levels of trust and a model of trust from the management literature are used to provide the framework with which to decipher trust decisions in health care and medical education, in which risk and vulnerability are inherent. In workplace learning and assessment, the language of 'trust' may offer a more authentic and practical vocabulary than that of 'competency' because clinical and professional risks are explicitly considered. There are many other trust relationships in health care and medical education. At the most basic level, it is helpful to clearly delineate who is the trustor, the trustee, and for what task. Each relationship has interpersonal and organisational elements. Understanding and considered utilisation of trust and control mechanisms in health care and medical education may lead to systems that maturely manage risk while actively encouraging trust and empowerment.

Process factors facilitating and inhibiting medical ethics teaching in small groups

PurposeTo examine process factors that either facilitate or inhibit learning medical ethics during case-based learning.MethodsA qualitative research approach using microanalysis of transcribed videotaped discussions of three consecutive small-group learning (SGL)...

A systematic review on critical thinking in medical education.

Critical thinking is the ability to raise discriminating questions in an attempt to search for better ideas, a deeper understanding and better solutions relating to a given issue. This systematic review provides a summary of efforts that have been made to enhance and assess critical thinking in medical education. Nine databases [Ovid MEDLINE(R), AMED, Academic Search Premier, ERIC, CINAHL, Web of Science, JSTOR, SCOPUS and PsycINFO] were searched to identify journal articles published from the start of each database to October 2012. A total of 41 articles published from 1981 to 2012 were categorised into two main themes: (i) evaluation of current education on critical thinking and (ii) development of new strategies about critical thinking. Under each theme, the teaching strategies, assessment tools, uses of multimedia and stakeholders were analysed. While a majority of studies developed teaching strategies and multimedia tools, a further examination of their quality and variety could yield some insights. The articles on assessment placed a greater focus on learning outcomes than on learning processes. It is expected that more research will be conducted on teacher development and students' voices.

Critical thinking and attitude of physicians toward evidence-based medicine in Alexandria, Egypt.

Evidence-based practice is important for developing countries and is expected to thrive in a questioning culture. Experienced physicians differ in the making of clinical judgements, which are often not based on evidence. Although this topic is of paramount importance to the quality of care provided in the university hospitals in Alexandria, little research has been done about attitudes towards evidence-based medicine (EBM), and the extent of physicians' skills to access and interpret evidence. This study aimed to investigate the relation between the attitude towards EBM and the indicators for questioning mind and critical appraisal skills among physicians in Alexandria, Egypt. In a cross-sectional study, physicians (N=549) were randomly selected from different clinical departments in three of the university hospitals in Alexandria, Egypt using the stratified proportionate random sampling technique. A self-administrated questionnaire modified from the questionnaire used by McColl and colleagues was used. A high percentage of physicians (83%) had positive attitude towards EBM. Feeling knowledge gap every day was reported by 34.2% of the physicians while 55.6% felt knowledge gap less frequently. The percentage of physicians who understood the meaning of different measures used to assess the importance of results and quality of evidence in meta-analysis studies ranged from 10.8 to 24.2%. Higher frequency of feeling knowledge gap in clinical practice and the ability to correctly answer different questions reflecting critical reading skills were all significantly associated with positive attitude towards EBM (P<0.05). A significant association (P<0.05) was also found between the frequency of feeling knowledge gap and the ability to answer questions related to critical reading of literature. This study has identified a significant relation between critical thinking skills and having a positive attitude towards EBM among physicians in the university hospitals in Alexandria. The study supported the hypothesis that strategies that encouraging critical thinking in medical education could improve the attitude of physicians towards EBM. Adopting teaching methods that encourage critical thinking in medical education as well as including the concepts and principals of critical appraisal of scientific research in the syllabus of both undergraduate and postgraduate medical students are recommended.

Concept map analysis in the assessment of speech-language pathology students’ learning in a problem-based learning curriculum: A longitudinal study

The aim of this study was to track students’ critical thinking performance longitudinally through concept map analysis in a problem-based learning (PBL) curriculum. Concept map analysis has been employed in the assessment of students’ critical thinking in medical education. Little is known concerning concept mapping (CM) in speech-language pathology (SLP) education. In this quantitative study, students in a 4-year SLP education program (N = 38) were followed until the completion of a fully-integrated PBL curriculum from Years 1 to 3. Students’ concept maps were analyzed using a tool developed for this study, the Concept Map Assessment Profile (CMAP). There was an increase in concept map scores across the 3 years at the beginning of the academic year. The CM performance over the 3 years predicted 21.0% to 33.6% of variance in three measures of learning outcomes. The CMAP is a reliable measure, with strong inter-rater and intra-rater reliability (r = 0.85 and r = 0.96, respectively). In addition to its use as an assessment tool, the CMAP might be used to facilitate students’ learning as feedback concerning strengths and weaknesses in the development of critical thinking can be provided.

Critical Thinking in Health Sciences

Critical thinking is defined as active, persistent and careful consideration of any belief or supposed form of knowledge. Although of paramount importance for medical and para-medical students, it has often been ignored in the medical curriculum. Structured thinking through knowledge of critical thinking can be helpful in a variety of clinical conditions, such as communicating with the patient, understanding the patient's complaints and research. Need for critical thinking in medical education, intellectual standards, critical thinking applied to clinical reasoning, fallacies in reasoning and steps to foster critical thinking skills in medical students are discussed in this article for educational forum.

The curriculum is dead! Long live the curriculum! Designing an undergraduate medicine and surgery curriculum for the future

Where changing social circumstances demand reform of medicine, this in turn provokes new thinking in medical education. Curriculum changes, however, are often ill conceived, consisting of syllabus (content) modification, rather than careful consideration of fundamental principles and theory shaping a curriculum process initiative. The undergraduate medicine and surgery curriculum of the future must address some basic fault lines in current provision, such as medical culture's failure to democratise work practices ensuring patient safety. While acquiring a reputation as innovative and progressive, and after a decade of success with current provision, Peninsula Medical School (UK) has recognised the need to develop its curriculum for the future. Such a curriculum will be guided by best evidence from medical education to inform pedagogical practices and by sophisticated curriculum theory. Drawing on social learning pedagogies and curriculum reconceptualisation models for guidance, and incorporating evaluation of its current provision and published evaluations of other curricula (particularly Longitudinal Integrated models), fundamental principles were conceived to guide curriculum reform.