Differentiates between clinical reasoning for diagnosis, etiology, prognosis, and for interventions. Includes basic knowledge about clinical reasoning and more in-depth knowledge, illustrated with videos. Helps to understand and to critical appraise the common research designs in healthcare scientific literature.
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BackgroundIt can be very challenging for practitioners to talk with autistic children, especially when the conversation calls for self-regulation. Self-regulation is inextricably linked to awareness of oneself and others in social contexts. Encouraging the need for autonomy could help increase self-awareness and awareness of others in social events, which in turn could strengthen self-regulation. However, little is known about how autonomy influences competence in reasoning about self and others when regarding social events in which autistic children participate. This study explores the reasoning of self-other awareness on a microlevel timescale using ipsative, dynamic approaches to autism. The central question in this study is: to what extent can autonomy-provided scaffolding (APS) elicit high levels of reasoning about self-others in social events (RSS) over time?MethodWe used video-taped interaction data from three sessions between one autistic child and a practitioner, contextualized by a set of animated DSM-5-based items of social events on which the child was asked to reflect. Interaction variables were the child's level of RSS and the practitioner's level of APS. We coded the real-time interaction.ResultsFirst, when exploring the dynamics of the microdata, we found contingency over time within sessions. Second, over the sessions, the practitioner showed a stable high level of APS, whereas the child's level of RSS increased. Third, a coupling effect between the level of APS and RSS was found within and over sessions. Salient is that the child and practitioner increasingly adapted to each other over the three sessions, and over time, high-level APS of the practitioner elicited higher levels of RSS of the child.DiscussionBecause the child showed a significant improvement in RSS over time, our research question provides a promising perspective. Contrary to what one might expect in autism, APS supported the performance of the child in reasoning about self-others in social situations. These outcomes underline the importance of giving voice to autistic children. The results may encourage researchers to develop strategies and tools that can help give a voice to children, to gain more insight into the child's reasoning. This may further develop self-other awareness and self-regulation in the social events of autistic children.
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Introduction: Given the complexity of teaching clinical reasoning to (future) healthcare professionals, the utilization of serious games has become popular for supporting clinical reasoning education. This scoping review outlines games designed to support teaching clinical reasoning in health professions education, with a specific emphasis on their alignment with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for effective learning. Methods: A scoping review using systematic searches across seven databases (PubMed, CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics, technical requirements, and incorporation of clinical reasoning cycle steps were analyzed. Additional game information was obtained from the authors. Results: Nineteen unique games emerged, primarily simulation and escape room genres. Most games incorporated the following clinical reasoning steps: patient consideration (step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7). Processing information (step 3) and understanding the patient’s problem (step 4) were less prevalent, while goal setting (step 5) and reflection (step 8) were least integrated. Conclusion: All serious games reviewed show potential for improving clinical reasoning skills, but thoughtful alignment with learning objectives and contextual factors is vital. While this study aids health professions educators in understanding how games may support teaching of clinical reasoning, further research is needed to optimize their effective use in education. Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially reflection, limiting its role in reflective practice. Hence, we recommend prioritizing a systematic clinical reasoning model with explicit reflective steps when using serious games for teaching clinical reasoning.
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Background: Clinical reasoning skills are considered to be among the key competencies a physiotherapist should possess. Yet, we know little about how physiotherapy students actually learn these skills in the workplace. A better understanding will benefit physiotherapy education.Objectives: To explore how undergraduate physiotherapy students learn clinical reasoning skills during placements.Design: A qualitative research design using focus groups and semi-structured interviews.Setting: European School of Physiotherapy, Amsterdam, the Netherlands.Participants: Twenty-two undergraduate physiotherapy students and eight clinical teachers participated in this study.Main outcome measures: Thematic analysis of focus groups and semi-structured interviews.Results: Three overarching factors appeared to influence the process of learning clinical reasoning skills: the learning environment, the clinical teacher and the student. Preclinical training failed to adequately prepare students for clinical practice, which expected them to integrate physiotherapeutic knowledge and skills into a cyclic reasoning process. Students’ basic knowledge and assessment structure therefore required further development during the placements. Clinical teachers expected a holistic, multifactorial problem-solving approach from their students. Both students and teachers considered feedback and reflection essential to clinical learning. Barriers to learning experienced by students included time constraints, limited patient exposure and patient communication.Conclusions: Undergraduate physiotherapy students develop clinical reasoning skills through comparison of and reflection on different reasoning approaches observed in professional therapists. Over time, students learn to synthesise these different approaches into their own individual approach. Physiotherapy programme developers should aim to include a wide variety of multidisciplinary settings and patient categories in their clinical placements.
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Special relativity theory (SRT) has recently gained popularity as a first introduction to “modern” physics thinking in upper level secondary physics education. A central idea in SRT is the absolute speed of light, with light propagating with uniform speed relative to the reference frame of the observer. Previous research suggests that students, building on their prior understandings of light propagation and relative motion, develop misunderstandings of this idea. The available research provides little detail on the reasoning processes underlying these misunderstandings. We therefore studied secondary education students’ preinstructional reasoning about the speed of light in a qualitative study, probing students’ reasoning through both verbal reasoning and drawing. Event diagrams (EDs) were used as a representational tool to support student reasoning. Results show that students productively use EDs to reason with light propagation. In line with previous research, we found two alternative reference frames students could use for uniform light propagation. Most students show a flexibility in their use of reference frame: They not only evaluate light propagation in their preferred frame of reference, but also relative to other frames. Some students experienced conflict between an alternative reference frame and the speed of light and changed their reasoning because of that. This finding suggests promising directions for designing education.
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“Teaching is both an art and a science” (Harrison & Coll, 2008 p.1). Good teaching excites students and cultivates their curiosity to learn more than they are asked. But what if students’ blank faces tell you that the teaching did not land, what can you do? Using an analogy or metaphor to explain the principle helps students visualize and comprehend the knowledge of difficult, abstract concepts by making it familiar. The National Academy of Engineers issued a report in 2008 emphasizing the need for design engineers to develop 21st century skills, such as ingenuity and creativity, and to create innovative products and markets. However, designers have a hard time ignoring evident constraints on their concepts during their design process. This is especially difficult for novice designers when attempting to use analogical reasoning (Osborn, 1963; Hey et al. 2008). Hey et al. explains how the multitude of design considerations is even more difficult for novice as compared to expert designers who are more able to focus on the important features of a problem. Kolodner (1997) iterates how novice designers have difficulty sifting through the mass of information they encounter. They need help with the transfer of knowledge that analogical reasoning requires. When students can clearly extract and articulate what they have learned, this helps them to internalize this. Biomimicry education teaches the clear extraction and articulation while learning to decipher and transfer function analogies from biology to design. This transfer can also improve reasoning when solving problems (Wu and Weng, 2013), reacting to the challenge in a more ‘out-of-the-box’ manner (Yang et al. 2015). However, not being able to fully understand this “conceptual leap between biology and design” in an accurate manner, is sited as a key obstacle of this field (Rowland, 2017; Rovalo and McCardle 2019, p. 1). Therefore, didactics on how to teach this analogical leap to overcome the hurdles is essential. There is insufficient research on the effectivity of biomimicry education in design to help establish ‘best practices’. This thesis offers advice to fill this pedagogical gap to find out how to overcome the obstacle of analogical reasoning for novice designers, while practicing biomimicry. The contribution to science is a not earlier tested methodology that leads to a clearer understanding of the translation of biological strategies and mechanisms found in scientific research. This translation from biology to design in visual and textual manner, is called the Abstracted Design Principle (ADP) and is introduced and explained in detail in chapters 4, 5 and 6 of this thesis. Together with the proposed instructions, we sketch the net-gain of positive mind-set for novice designers on their path to design for a sustainable future.
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When physicians and nurses are looking at the same patient, they may not see the same picture. If assuming that the clinical reasoning of both professions is alike and ignoring possible differences, aspects essential for care can be overlooked. Understanding the multifaceted concept of clinical reasoning of both professions may provide insight into the nature and purpose of their practices and benefit patient care, education and research. We aimed to identify, compare and contrast the documented features of clinical reasoning of physicians and nurses through the lens of layered analysis and to conduct a simultaneous concept analysis. The protocol of this systematic integrative review was published doi: 10.1136/bmjopen-2021-049862. A comprehensive search was performed in four databases (PubMed, CINAHL, Psychinfo, and Web of Science) from 30th March 2020 to 27th May 2020. A total of 69 Empirical and theoretical journal articles about clinical reasoning of practitioners were included: 27 nursing, 37 medical, and five combining both perspectives. Two reviewers screened the identified papers for eligibility and assessed the quality of the methodologically diverse articles. We used an onion model, based on three layers: Philosophy, Principles, and Techniques to extract and organize the data. Commonalities and differences were identified on professional paradigms, theories, intentions, content, antecedents, attributes, outcomes, and contextual factors. The detected philosophical differences were located on a care-cure and subjective-objective continuum. We observed four principle contrasts: a broad or narrow focus, consideration of the patient as such or of the patient and his relatives, hypotheses to explain or to understand, and argumentation based on causality or association. In the technical layer a difference in the professional concepts of diagnosis and the degree of patient involvement in the reasoning process were perceived. Clinical reasoning can be analysed by breaking it down into layers, and the onion model resulted in detailed features. Subsequently insight was obtained in the differences between nursing and medical reasoning. The origin of these differences is in the philosophical layer (professional paradigms, intentions). This review can be used as a first step toward gaining a better understanding and collaboration in patient care, education and research across the nursing and medical professions.
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Process Mining can roughly be defined as a data-driven approach to process management. The basic idea of process mining is to automatically distill and to visualize business processes using event logs from company IT-systems (e.g. ERP, WMS, CRM etc.) to identify specific areas for improvement at an operational level. An event log can be described as a database entry that signifies a specific action in a software application at a specific time. Simple examples of these actions are customer order entries, scanning an item in a warehouse, and registration of a patient for a hospital check-up.Process mining has gained popularity in the logistics domain in recent years because of three main reasons. Firstly, the logistics IT-systems' large and exponentially growing amounts of event data are being stored and provide detailed information on the history of logistics processes. Secondly, to outperform competitors, most organizations are searching for (new) ways to improve their logistics processes such as reducing costs and lead time. Thirdly, since the 1970s, the power of computers has grown at an astonishing rate. As such, the use of advance algorithms for business purposes, which requires a certain amount of computational power, have become more accessible.Before diving into Process Mining, this course will first discuss some basic concepts, theories, and methods regarding the visualization and improvement of business processes.
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Author supplied: "Abstract—Software architecture compliance checking (SACC) is an approach to monitor the consistency between the intended and the implemented architecture. In case of static SACC, the focus is mainly on the detection of dependencies that violate architectural relation rules. Interpretation of reported violations may be cumbersome, since the violations need to be connected to architectural resolutions and targeted qualities such as maintainability and portability. This paper describes an SACC case study which shows that inclusion of different types of rules in the SACC process enhances reasoning on architecture violations, especially if a rule type is related to specific architectural pattern. The SACC is performed with HUSACCT, an SACC-tool that provides rich sets of module and rule types in support of patterns such as layers, facade, and gateway. The case system is a governmental system developed in C#, which follows the .NET common application architecture. Even though the system appeared to be well-structured, the SACC revealed that 10 of the 17 architectural rules were violated."
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To evaluate the effect of the educational program "Guided Clinical Reasoning" (GCR) and the introduction of an intelligent electronic nursing documentation system (e-doc) on the quality of the nursing process.Evaluation was conducted at three measurement points and rated with the instrument "Quality of Nursing Diagnoses, Interventions and Outcomes" (Q-DIO).GCR showed the best Q-DIO-scores. No long-term effect was found after GCR cessation. The e-doc delivered the lowest scores, while showing adequate support in using nursing diagnoses.E-docs can support conducting the nursing process, but for meaningful e-doc use, clinical reasoning is essential.High-quality nursing documentation requires recognition of factors obstructing or supporting nurses in the use of e-docs while conducting the nursing process.
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