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Christodoulakis A, Kritsotakis G, Linardakis M, Sourtzi P, Tsiligianni I. Emotional intelligence is more important than the learning environment in improving critical thinking. MEDICAL TEACHER 2023; 45:708-716. [PMID: 36966746 DOI: 10.1080/0142159x.2023.2193305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To examine the association of critical thinking (CT) and emotional intelligence (EI) versus CT and learning environment (LE) in order to investigate which has the greatest influence EI or LE. MATERIALS AND METHODS A cross-sectional study was conducted with 340 s-year healthcare university students in two nursing and one medical schools from three universities in Greece, between October and December 2020. Critical Thinking Disposition Scale, Dundee Ready Education Environment Measure, and Trait Emotional Intelligence Questionnaire-Short Form were administered. Hierarchical multiple linear regression analysis, with five steps, was used to compare the associations of CT and EI to CT and LE. RESULTS Participants' mean age (years) was 20.9 (6.6 SD); 82.6% female; 86.8% studying nursing. Students mean scores were moderate to high for CT disposition (44.7 ± 4.68). The general characteristics (age, gender, and school) were not significantly associated with CT (p > 0.05). However, CT was positively associated with LE (UCB = 0.064 & p < 0.001) and EI (UCB = 1.522 & p < 0.001). Moreover, CT seems to be associated in a higher degree (R2 change adj = 0.036 & p < 0.001) with emotional intelligence (UCB = 1.522) than with learning environment (UCB = 0.064). CONCLUSIONS Our findings suggest a different more optimal pathway for educators to improve the CT of their students through EI and not with LE as believed till now. By focusing on improving EI, educators may help their students become critical thinkers, who will provide better quality of care.
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Affiliation(s)
| | - George Kritsotakis
- Department of Business Administration & Tourism, Hellenic Mediterranean University, Heraklion, Greece
| | - Manolis Linardakis
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Panayota Sourtzi
- Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
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Zarei A, Mojtahedzadeh R, Mohammadi A, Sandars J, Hossein Emami SA. Applying digital storytelling in the medical oncology curriculum: Effects on students' achievement and critical thinking. Ann Med Surg (Lond) 2021; 70:102528. [PMID: 34540209 PMCID: PMC8441090 DOI: 10.1016/j.amsu.2021.102528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/27/2021] [Accepted: 06/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Digital storytelling (DST), which combines traditional storytelling with digital tools, can provide a narrative pedagogy that promotes critical thinking (CT). However, we found no previous study in medical education. Materials and methods The aim of the study was to investigate if DST can promote CT and, if so, which CT skills were improved. Thirty-two students participated in a non-equivalent control group pretest-posttest research study, with 16 in each group. The participants were fifth-year medical students on a hematology rotation. We compared the routine instructional method (control group) with DST (intervention group). The measures of CT used for the pre- and post-test in both groups was the Health Science Reasoning Test (HRST) and knowledge test. We also evaluated the satisfaction of the students in DST group. We used Paired and independent t-tests for comparing the mean scores. To eliminate the confounding effect of pre-test on the results of the intervention, the ANCOVA test was used. Results There was no significant difference in the overall CT pretest scores (P-value = 0.51) between the control and intervention groupsbut the difference was significant for the post-test scores (P-value = 0.03). Although post-test scores showed a significant increase (P-value = 0.002) compared to pre-test scores in the intervention group, no significant increase was observed in the control group (P-value = 0.26). Most students considered that DST improved their CT, deep learning, communication skills and team-working. Conclusions The study demonstrated that DST promoted CT. We recommend the use of DST to promote CT in clinical education placements. Critical thinking (CT) is a vital ability for medical students. Digital storytelling (DST) is a narrative approach to promote CT. DST promote CT as well as analysis skill in clinical setting. For medical students who deal with everyday patient's stories, DST is a powerful teaching and learning method in clinical education.
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Affiliation(s)
- Afagh Zarei
- Department of Medical Education, Medical School, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - John Sandars
- Edge Hill University, Medical School, Ormskirk, UK
| | - Seyed Amir Hossein Emami
- Department of Internal Medicine, Associate Professor in Hematology/ Medical Oncology Ward, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Pervaz Iqbal M, Velan GM, O’Sullivan AJ, Balasooriya C. The collaborative learning development exercise (CLeD-EX): an educational instrument to promote key collaborative learning behaviours in medical students. BMC MEDICAL EDUCATION 2020; 20:62. [PMID: 32122344 PMCID: PMC7052979 DOI: 10.1186/s12909-020-1977-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 02/20/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Modern clinical practice increasingly relies on collaborative and team-based approaches to care. Regulatory bodies in medical education emphasise the need to develop collaboration and teamwork competencies and highlight the need to do so from an early stage of medical training. In undergraduate medical education, the focus is usually on collaborative learning, associated with feedback and reflection on this learning This article describes a novel educational instrument, the Collaborative Learning Development Exercise (CLeD-EX), which aims to foster the development of key collaborative learning competencies in medical students. In this article we report on the effectiveness, feasibility and educational impact of the CLeD-EX. METHODS In this study, the "educational design research" framework was used to develop, implement and evaluate the CLeD-EX. This involved adopting a systematic approach towards designing a creative and innovative instrument which would help solve a real-world challenge in developing collaborative learning skills. The systematic approach involved a qualitative exploration of key collaborative learning behaviours which are influential in effective collaborative learning contexts. The identified competencies were employed in the design of the CLeD-EX. The design of the CLeD-EX included features to facilitate structured feedback by tutors to students, complemented by self-evaluation and reflection. The CLeD-EX was field-tested with volunteer junior medical students, using a controlled pre-test post-test design. Analysis of the completed CLeD-EX forms, self-perception surveys (i.e. pre-test and post-test surveys) and analyses of reflective reports were used to explore the educational impact of CLeD-EX, as well as its utility and practicality. RESULTS After using the CLeD-EX, students showed a significant improvement in critical thinking and group process as measured by a previously validated instrument. Both students and tutors recognised CLeD-EX as an effective instrument, especially as a structured basis for giving and receiving feedback and for completing the feedback loop. CLeD-EX was also found to be feasible, practical and focused, while promoting learning and effective interactions in small group learning. CONCLUSION The findings of this study support the introduction of an effective and feasible educational instrument such as the CLeD-EX, to facilitate the development of students' skills in collaborative learning.
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Affiliation(s)
- Maha Pervaz Iqbal
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Gary M. Velan
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | | | - Chinthaka Balasooriya
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Sydney, Australia
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Chen Q, Liu D, Zhou C, Tang S. Relationship between critical thinking disposition and research competence among clinical nurses: A cross-sectional study. J Clin Nurs 2020; 29:1332-1340. [PMID: 31971305 DOI: 10.1111/jocn.15201] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/21/2019] [Accepted: 01/10/2020] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationship between critical thinking disposition and research competence among clinical nurses. BACKGROUND The development of the nursing discipline and evidence-based practice calls for research competence and critical thinking disposition among clinical nurses. The verification of the relationship between critical thinking disposition and research competence could make contributions to promoting related knowledge building and providing practical implications for nurses, nurse educators and nurse managers. However, there is a lack of evidence exploring the relationship between critical thinking disposition and research competence in clinical nurses. DESIGN A cross-sectional study. METHODS A total of 156 clinical nurses from two tertiary hospitals participated in this study. The Chinese Version of Critical Thinking Disposition Inventory and Research Competence Scale for Clinical Nurses were used to measure critical thinking disposition and nursing research competence, respectively. Data were collected in September 2017. Descriptive statistics, bivariate correlation and linear regression were used to analyse data. The STROBE checklist was used in reporting this study. RESULTS The clinical nurses surveyed showed a positive inclination to general critical thinking but reported an overall low level of nursing research competence. A moderate degree of positive correlation was found between critical thinking disposition and research competence among clinical nurses. Educational degree was also found as an influencing factor of nursing research competence of clinical nurses. CONCLUSION The critical thinking disposition of clinical nurses is positively related to their research competence. RELEVANCE TO CLINICAL PRACTICE Nurses with a passion for nursing research should pay attention to improving their critical thinking dispositions. Nurse educators and managers should provide better learning, working and research environments and more supports to cultivate critical thinking disposition and improve nursing research competence in nursing research education and practice.
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Affiliation(s)
- Qirong Chen
- Xiangya School of Nursing, Central South University, Hunan, China
| | - Dan Liu
- Xiangya School of Nursing, Central South University, Hunan, China
| | - Chuyi Zhou
- Xiangya School of Nursing, Central South University, Hunan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Hunan, China
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Wang X, Sun X, Huang T, He R, Hao W, Zhang L. Development and validation of the critical thinking disposition inventory for Chinese medical college students (CTDI-M). BMC MEDICAL EDUCATION 2019; 19:200. [PMID: 31196183 PMCID: PMC6567520 DOI: 10.1186/s12909-019-1593-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 05/03/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND This study aimed to develop and conduct psychometric testing of the Critical Thinking Disposition Inventory to measure the critical thinking disposition of Chinese medical college students. METHODS The study was conducted in two stages: (a) item generation, reliability analysis and exploratory factor analysis (EFA) and (b) confirmatory factor analysis (CFA) and testing of psychometric properties (Cronbach' s alpha, test-retest reliability and convergent validity). The subjects included 1035 Chinese medical college students. The test-retest reliability of the instrument was determined at a two-week interval (n = 61). A general linear regression model was developed to examine the predictive effects of gender, age and major on CT disposition. The data were analysed with SPSS 22.0 and Amos 21.0 during item development and the reliability and validity analyses. Vista was utilized for parallel analysis during the principal axis analysis. RESULTS Eighteen final items were sorted into 3 factors, which were identified as "Open-mindedness", "Systematicity/Analyticity" and "Truth-seeking", with cumulative variance of 41.37, 46.00 and 49.59%, respectively. The Cronbach's alpha was 0.924, and the factors' alphas ranged from 0.824 to 0.862. The correlational analysis indicated significant correlations between the subscales of the CTDI-CM and the total scores of the CTDI-CV, indicating modest evidence for the convergent validity of the CTDI-CM. Gender, age and education significantly predicted the CT disposition of Chinese medical students. Open-mindedness and Systematicity/Analyticity were higher for medical students than for nursing students. CONCLUSIONS This study presents a reliable and valid instrument for clinical thinking disposition. Future studies should explore other predictive factors of CT dispositions (e.g., cognitive/motivational) and criterion validity.
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Affiliation(s)
- Xiaoxia Wang
- Department of Basic Psychology, School of Psychology, Army Medical University, Chongqing, 400038 China
| | - Xiaoxiao Sun
- Department of Psychological Nursing, School of Nursing, Army Medical University, Chongqing, 400038 China
| | - Tianhao Huang
- Department of Basic Psychology, School of Psychology, Army Medical University, Chongqing, 400038 China
| | - Renqiang He
- Department of Basic Psychology, School of Psychology, Army Medical University, Chongqing, 400038 China
| | - Weina Hao
- Department of Basic Psychology, School of Psychology, Army Medical University, Chongqing, 400038 China
| | - Li Zhang
- Department of Basic Psychology, School of Psychology, Army Medical University, Chongqing, 400038 China
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Silvério Rodrigues D, Sousa PF, Basílio N, Antunes A, Antunes MDL, Santos MI, Heleno B. Primary care physicians' decision-making processes in the context of multimorbidity: protocol of a systematic review and thematic synthesis of qualitative research. BMJ Open 2019; 9:e023832. [PMID: 30948566 PMCID: PMC6500233 DOI: 10.1136/bmjopen-2018-023832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Good patient outcomes correlate with the physicians' capacity for good clinical judgement. Multimorbidity is common and it increases uncertainty and complexity in the clinical encounter. However, healthcare systems and medical education are centred on individual diseases. In consequence, recognition of the patient as the centre of the decision-making process becomes even more difficult. Research in clinical reasoning and medical decision in a real-world context is needed. The aim of the present review is to identify and synthesise available qualitative evidence on primary care physicians' perspectives, views or experiences on decision-making with patients with multimorbidity. METHODS AND ANALYSIS This will be a systematic review of qualitative research where PubMed, CINAHL, PsycINFO, Embase and Web of Science will be searched, supplemented with manual searches of reference lists of included studies. Qualitative studies published in Portuguese, Spanish and English language will be included, with no date limit. Studies will be eligible when they evaluate family physicians' perspectives, opinions or perceptions on decision-making for patients with multimorbidity in primary care. The methodological quality of studies selected for retrieval will be assessed by two independent reviewers before inclusion in the review using the Critical Appraisal Skills Programme (CASP) tool. Thematic synthesis will be used to identify key categories and themes from the qualitative data. The Confidence in the Evidence from Reviews of Qualitative research approach will be used to assess how much confidence to place in findings from the qualitative evidence synthesis. ETHICS AND DISSEMINATION This review will use published data. No ethical issues are foreseen. The findings will be disseminated to the medical community via journal publication and conference presentation(s). PROSPERO REGISTRATION NUMBER ID 91978.
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Affiliation(s)
| | - Paulo Faria Sousa
- Family Medicine Unit, Nova Medical School, Nova University of Lisbon, Lisboa, Portugal
| | - Nuno Basílio
- Family Medicine Unit, Nova Medical School, Nova University of Lisbon, Lisboa, Portugal
| | - Ana Antunes
- Nova Medical School, Nova University of Lisbon, Chronic Diseases Research Center (CEDOC), Lisboa, Portugal
| | - Maria da Luz Antunes
- Instituto Politecnico de Lisboa, Escola Superior de Tecnologia da Saude de Lisboa, Lisboa, Portugal
| | - Maria Isabel Santos
- Family Medicine Unit, Nova Medical School, Nova University of Lisbon, Lisboa, Portugal
| | - Bruno Heleno
- Family Medicine Unit, Nova Medical School, Nova University of Lisbon, Lisboa, Portugal
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Seshia SS, Bryan Young G, Makhinson M, Smith PA, Stobart K, Croskerry P. Gating the holes in the Swiss cheese (part I): Expanding professor Reason's model for patient safety. J Eval Clin Pract 2018; 24:187-197. [PMID: 29168290 PMCID: PMC5901035 DOI: 10.1111/jep.12847] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Although patient safety has improved steadily, harm remains a substantial global challenge. Additionally, safety needs to be ensured not only in hospitals but also across the continuum of care. Better understanding of the complex cognitive factors influencing health care-related decisions and organizational cultures could lead to more rational approaches, and thereby to further improvement. HYPOTHESIS A model integrating the concepts underlying Reason's Swiss cheese theory and the cognitive-affective biases plus cascade could advance the understanding of cognitive-affective processes that underlie decisions and organizational cultures across the continuum of care. METHODS Thematic analysis, qualitative information from several sources being used to support argumentation. DISCUSSION Complex covert cognitive phenomena underlie decisions influencing health care. In the integrated model, the Swiss cheese slices represent dynamic cognitive-affective (mental) gates: Reason's successive layers of defence. Like firewalls and antivirus programs, cognitive-affective gates normally allow the passage of rational decisions but block or counter unsounds ones. Gates can be breached (ie, holes created) at one or more levels of organizations, teams, and individuals, by (1) any element of cognitive-affective biases plus (conflicts of interest and cognitive biases being the best studied) and (2) other potential error-provoking factors. Conversely, flawed decisions can be blocked and consequences minimized; for example, by addressing cognitive biases plus and error-provoking factors, and being constantly mindful. Informed shared decision making is a neglected but critical layer of defence (cognitive-affective gate). The integrated model can be custom tailored to specific situations, and the underlying principles applied to all methods for improving safety. The model may also provide a framework for developing and evaluating strategies to optimize organizational cultures and decisions. LIMITATIONS The concept is abstract, the model is virtual, and the best supportive evidence is qualitative and indirect. CONCLUSIONS The proposed model may help enhance rational decision making across the continuum of care, thereby improving patient safety globally.
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Affiliation(s)
- Shashi S Seshia
- Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada
| | - G Bryan Young
- Clinical Neurological Sciences and Medicine (Critical Care), Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada, Grey Bruce Health Services, Owen Sound, Canada
| | - Michael Makhinson
- Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at the University of California, Los Angeles, USA.,Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, USA
| | - Preston A Smith
- College of Medicine, University of Saskatchewan, Health Sciences Building, Saskatoon, Canada
| | - Kent Stobart
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Pat Croskerry
- Critical Thinking Program, Division of Medical Education, Dalhousie University Medical School, Halifax, Canada
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Loughlin M, Wyer P, Tanenbaum SJ. Teaching by (bad) example: what a confused attempt to "advance" EBM reveals about its underlying problems: commentary on Jenicek, M. (2015). Do we need another discipline in medicine? From epidemiology and evidence-based medicine to cognitive medicine and medical thinking. Journal of evaluation in clinical practice, 21:1028-1034. J Eval Clin Pract 2016; 22:628-33. [PMID: 27225855 DOI: 10.1111/jep.12552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 01/26/2023]
Abstract
Professor Jenicek's paper is confused in that his proposal to 'integrate' what he means by 'evidence-based scientific theory and cognitive approaches to medical thinking' actually embodies a contradiction. But, although confused, he succeeds in teaching us more about the EBM debate than those who seem keen to forge ahead without addressing the underlying epistemological problems that Jenicek brings to our attention. Fundamental questions about the relationship between evidence, knowledge and reason still require resolution if we are to see a genuine advance in this debate.
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Affiliation(s)
- Michael Loughlin
- Department of Interdisciplinary Studies, MMU Cheshire, Crewe, UK
| | - Peter Wyer
- Columbia University Medical Center, New York, NY, USA.
| | - Sandra J Tanenbaum
- Department of Health Services Management and Policy College of Public Health, The Ohio State University, Columbus Ohio, USA
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Enhancing critical thinking in clinical practice: implications for critical and acute care nurses. Dimens Crit Care Nurs 2016; 33:207-14. [PMID: 24895950 DOI: 10.1097/dcc.0000000000000053] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The complexity of patients in the critical and acute care settings requires that nurses be skilled in early recognition and management of rapid changes in patient condition. The interpretation and response to these events can greatly impact patient outcomes. Nurses caring for these complex patients are expected to use astute critical thinking in their decision making. The purposes of this article were to explore the concept of critical thinking and provide practical strategies to enhance critical thinking in the critical and acute care environment.
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Jenicek M. Do we need another discipline in medicine? From epidemiology and evidence-based medicine to cognitive medicine and medical thinking. J Eval Clin Pract 2015; 21:1028-34. [PMID: 26032666 DOI: 10.1111/jep.12381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Milos Jenicek
- Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Université de Montréal, Montréal, Québec, Canada
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Spiegel R, Johnston M, Ercleve T, Nickson CP. Final frontier. Emerg Med Australas 2015; 27:92-4. [DOI: 10.1111/1742-6723.12381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Rory Spiegel
- Department of Emergency Medicine; Newark Beth Israel Medical Center; Newark New Jersey USA
| | - Michelle Johnston
- Emergency Department; Royal Perth Hospital; Perth Western Australia Australia
| | - Tor Ercleve
- Department of Emergency Medicine; Sir Charles Gairdner Hospital; Perth Western Australia Australia
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van Haselen RA. Towards improving the reporting quality of clinical case reports in complementary medicine: assessing and illustrating the need for guideline development. Complement Ther Med 2015; 23:141-8. [PMID: 25847551 DOI: 10.1016/j.ctim.2015.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/12/2014] [Accepted: 01/09/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Case reports have had a varying level of recognition as a source of evidence throughout the history of medicine. In recent years, there has been a revival of interest in clinical case reports in both conventional and complementary medicine. There is a need to further improve the reporting quality of clinical case reports of different Complementary and Alternative Medicine (CAM) therapies. OBJECTIVES To provide an overview of the different objectives for clinical case reports, identify those that are most relevant for CAM, and to develop a conceptual framework for purpose orientated clinical case reporting guidelines for CAM therapies. To practically illustrate the chosen approach by developing a clinical case reporting guideline for homeopathic cases. METHODS The various objectives of clinical case reports were described by Prof. Milos Jenicek, and the potential relevance of these objectives for CAM were discussed and graded by a mixed panel of experts. A conceptual framework for developing clinical case reporting guidelines for CAM treatments with specific objectives is proposed. The aim is to integrate both 'generic' and 'CAM therapy specific' quality items. This framework has been practically applied to the development of a reporting guideline for clinical case reports in homoeopathy which will be reported in a second article. RESULTS An overview is given of the clinical case reporting literature. The conceptual framework for the development of purpose orientated CAM clinical case reporting guidelines is presented. This framework is based on alignment with the recently published 'generic' CARE guideline for reporting of clinical case reports, whilst addressing the CAM specific elements at the same time. CONCLUSIONS The scope and importance of clinical case reporting guideline development in CAM is illustrated. A conceptual framework for developing CAM specific clinical case reporting guidelines was established. It has been implemented using homoeopathy as an illustration, and this will be reported in a separate article. Further improvements in clinical case reporting in CAM will greatly contribute to CAM research and education, as well as to improved patient care.
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Affiliation(s)
- R A van Haselen
- International Institute for Integrated Medicine, 22 Eden Street, Suite 467, Kingston KT1 1DN, United Kingdom.
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Farrokhi-Khajeh-Pasha Y, Nedjat S, Mohammadi A, Rad EM, Majdzadeh R, Monajemi F, Jamali E, Yazdani S. The validity of Iran's national university entrance examination (Konkoor) for predicting medical students' academic performance. BMC MEDICAL EDUCATION 2012; 12:60. [PMID: 22840211 PMCID: PMC3461424 DOI: 10.1186/1472-6920-12-60] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 07/12/2012] [Indexed: 05/30/2023]
Abstract
BACKGROUND In Iran, admission to medical school is based solely on the results of the highly competitive, nationwide Konkoor examination. This paper examines the predictive validity of Konkoor scores, alone and in combination with high school grade point averages (hsGPAs), for the academic performance of public medical school students in Iran. METHODS This study followed the cohort of 2003 matriculants at public medical schools in Iran from entrance through internship. The predictor variables were Konkoor total and subsection scores and hsGPAs. The outcome variables were (1) Comprehensive Basic Sciences Exam (CBSE) scores; (2) Comprehensive Pre-Internship Exam (CPIE) scores; and (3) medical school grade point averages (msGPAs) for the courses taken before internship. Pearson correlation and regression analyses were used to assess the relationships between the selection criteria and academic performance. RESULTS There were 2126 matriculants (1374 women and 752 men) in 2003. Among the outcome variables, the CBSE had the strongest association with the Konkoor total score (r = 0.473), followed by msGPA (r = 0.339) and the CPIE (r = 0.326). While adding hsGPAs to the Konkoor total score almost doubled the power to predict msGPAs (R2 = 0.225), it did not have a substantial effect on CBSE or CPIE prediction. CONCLUSIONS The Konkoor alone, and even in combination with hsGPA, is a relatively poor predictor of medical students' academic performance, and its predictive validity declines over the academic years of medical school. Care should be taken to develop comprehensive admissions criteria, covering both cognitive and non-cognitive factors, to identify the best applicants to become "good doctors" in the future. The findings of this study can be helpful for policy makers in the medical education field.
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Affiliation(s)
| | - Saharnaz Nedjat
- School of public health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aeen Mohammadi
- Center for Educational Research in Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Malakan Rad
- Division of Pediatric Cardiology, Department of Pediatrics, Children’s Medical Center (Pediatric Center of Excellence), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- School of public health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Jamali
- National Organization of Educational Testing, Tehran, Iran
| | - Shahryar Yazdani
- Educational development center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jancso Z, Halmy E, Rurik I. Differences in weight gain in hypertensive and diabetic elderly patients primary care study. J Nutr Health Aging 2012; 16:592-6. [PMID: 22660003 DOI: 10.1007/s12603-011-0360-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Treatment and care of elderly patients with diabetes and hypertension means a hard task in primary care. Patients with these two components of metabolic syndrome are often overweight or obese. Although some parameters of metabolic syndrome are usually measured in a medical setting, checking body weight is usually done by the patients. AIM The aim of this study is to analyse the patients' self-recorded data on weight and compare them according to hypertension and diabetes. PATIENTS AND METHODS Five hundred and forty people (225 men and 315 women) between 60 and 75 years of age were eventually selected in primary care settings. Retrospective self-recorded data on recent weights and every decade since the age of 20, as well as the decade prior to diagnosis were collected. The data of patients with and without diabetes and/or hypertension were compared. RESULTS The current mean body weight was significantly higher in all groups than at the age of 20. Compared with the control group, hypertensive men and women were approximately of the same weight in their twenties and, also, recently, but they gained more weight in the 4th and 5th decades of their life. Diabetics started at higher weights. The greatest weight gain was observed as follows: between 20-30 years and 30-40 years in men and women, respectively, as well as between 50-60 years of age and in the last decade prior to diagnosis in both genders. Weight gain in the control group was steady at a lower rate. CONCLUSIONS Weight gain between 20-40 years of age could be an important factor in the aetiology of diabetes. Stable or at least limited weight gain may be a preventive factor. Considering the limitations of the study, further and decades long epidemiological evaluations are suggested in a larger study population.
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Affiliation(s)
- Z Jancso
- Department of Family and Óccupational Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Nagyerdei krt. 98, Debrecen, Hungary
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