Objective： This study investigated and compared the clinical thinking ability of undergraduate nursing students of different grades, and searched for influencing factors of clinical thinking ability of nursing underg...Objective： This study investigated and compared the clinical thinking ability of undergraduate nursing students of different grades, and searched for influencing factors of clinical thinking ability of nursing undergraduate students. Methods： The convenience sampling method was used to select the Subject of the study. In total, 180 third-year, fourth-year, and fifth-year nursing undergraduate students were enrolled in this study. A self-designed scale of clinical thinking ability was used to collect the data. SPSS17.0 was used to analyze the data. Results： The average scores of clinical thinking ability of undergraduate nursing students were 68.14±9.13. In addition, 71.1% of the students have a higher level of clinical thinking ability, and only 7.2% of the students have the best level. The ANOVA test showed that the fourth-year students had the highest scores（72.96±8.64）, and the third-year students had the lowest scores（62.35±8.09）, which indicated a significant difference in the scores of the three groups（ F= 26. 79, P〈0.05）. Multiple linear regression analysis indicated that the frequency of academic activities and the frequency of department rounds were significantly correlated to clinical thinking ability（P〈0.05）. Conclusion： We must pay attention to the changes and influencing factors of clinical thinking ability of nursing undergraduate students. Thus, traditional teaching methods need to evolve and be revised to host the capacity of clinical practice most effectively and, eventually, promote the development of clinical thinking ability of nursing undergraduate students.展开更多
Clinical thinking have the uncertainty, by which there are not a few mistakes caused. So it is necessary to discuss how to deal with the uncertainty of clinical thinking, which originates from the uncertainty of the o...Clinical thinking have the uncertainty, by which there are not a few mistakes caused. So it is necessary to discuss how to deal with the uncertainty of clinical thinking, which originates from the uncertainty of the objective world, social world and medicine knowledge, and can be seen all over clinical activities;Critical thinking which cautious about the interpretation and prediction of scientific theory is the best practice to explore the uncertainty. The essential purpose of medicine is rescuing people, So it is necessary and scientific to take “excluding life-threatening symptoms first” as the first principle of clinical thinking, which is also the primary method to deal with the uncertainty of clinical thinking;By the limited certainty of clinical thinking, procedural thinking is conducive to building a safer health system that is “easy to do right and difficult to do wrong”.展开更多
This aim is to clarify thinking process of nursing students’ clinical judgment, i.e., how nursing students act and think and what influences this thinking process of identifying approaches necessary for the children ...This aim is to clarify thinking process of nursing students’ clinical judgment, i.e., how nursing students act and think and what influences this thinking process of identifying approaches necessary for the children under their care in pediatric nursing practicum. By the analysis of M-GTA, students concurrently performed “A: Analytically contemplating the state of this child’s body” and “B: Contextually contemplating this child’s?individuality”. As a result, they acquired “C: Understandingof this child as a familiar existence.” This allows students to enable them to “D: Identify the necessary approach using judgment criteria for this child.” Furthermore, as situations that promote thinking by relating to all processes of thinking, students experienced “E: Attempts to solve problems through various measures” and “F: Encouragement of thinking through reflection.” Meanwhile, “G: Stagnation of thinking because of concerning matters” inhibited the progress of thinking. We found a need for education after grasping the process of student thought.展开更多
Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the exper...Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the experience of doctors, we will combine them according to the procedure of ＂problem-solution＂, to study Professor Wang＇s treatment experience and his clinical thinking.展开更多
The objective of this work is to explore how to realize the homogenization of emergency clinical decision, and it means that patients receive the same effect of clinical decisions and the treatment in a different hosp...The objective of this work is to explore how to realize the homogenization of emergency clinical decision, and it means that patients receive the same effect of clinical decisions and the treatment in a different hospital. In order to achieve that, emergency doctors should first have the same clinical thinking and thinking mode which is the biggest challenge for homogenization of emergency clinical decision. The task of emergency medicine is to give priority to the treatment of critically ill patients, so step-down thinking of “excluding life-threatening symptoms first” is the basis, the preemptive thinking is the means, and Process thinking is the key of homogenization;The initial diagnosis and treatment mode of symptom-oriented is the starting point for emergency decision;establishing a unified “checklist” can not only broaden the lateral thinking of emergency doctors, but also unify the thinking of differential diagnosis of emergency;dynamic observation should run through the whole diagnosis and treatment process, which is necessary for the homogenization of emergency decision.展开更多
this first paper focuses on seeking conceptual clarity;the second paper will focus on how nurses use critical thinking in clinical cases;and the third paper will focus on how advanced nurse practitioners use critical ...this first paper focuses on seeking conceptual clarity;the second paper will focus on how nurses use critical thinking in clinical cases;and the third paper will focus on how advanced nurse practitioners use critical thinking to provide safe and high quality care to patients and families.We welcome nursing colleagues in China respond our paper.展开更多
目的构建一种基于人工智能大语言模型(large language model,LLM)技术、可用于医学教育的新型虚拟患者(virtual patient,VP)系统,评价该系统在基层医生进修学习全科医学临床思维中的应用效果。方法选取2021年1月至2024年2月在东南大学...目的构建一种基于人工智能大语言模型(large language model,LLM)技术、可用于医学教育的新型虚拟患者(virtual patient,VP)系统,评价该系统在基层医生进修学习全科医学临床思维中的应用效果。方法选取2021年1月至2024年2月在东南大学附属中大医院进修的基层社区医生为研究对象,随机分为试验组和对照组,分别采用基于LLM的VP系统教学、传统教学方法进行授课,通过临床思维理论知识考核、临床思维能力考核、课程满意度调查评估教学效果,并对结果进行相应的统计学分析。结果共纳入124名基层社区医生,其中试验组60例、对照组64例,两组在一般基线资料上差异无统计学意义,具有可比性。课程结束后,试验组临床思维理论知识考核成绩显著高于对照组(83.83±3.15 vs.79.92±4.52,P<0.01),且不及格率显著低于对照组(0.00%vs.9.38%,P<0.05);试验组在临床思维能力3个维度(批判性、系统性、循证思维)方面教学后分数均显著高于教学前,而对照组仅在批判性思维维度上教学前后差异有统计学意义;教学后试验组在系统思维、循证思维方面分数均显著高于对照组(P<0.05),但在批判性思维上两组分数差异无统计学意义。试验组对授课的总体满意度也显著高于对照组(93.33%vs.85.48%,P<0.05)。结论基于LLM的VP系统提升了学员对临床思维理论知识的掌握程度,也促进了其临床思维能力的培养,该教学方法可为其他医学教育群体提供新的教学工具和思路。展开更多
基金supported by the Project of Department of Science & Technology of Shandong province(2012 YD 18033)
文摘Objective： This study investigated and compared the clinical thinking ability of undergraduate nursing students of different grades, and searched for influencing factors of clinical thinking ability of nursing undergraduate students. Methods： The convenience sampling method was used to select the Subject of the study. In total, 180 third-year, fourth-year, and fifth-year nursing undergraduate students were enrolled in this study. A self-designed scale of clinical thinking ability was used to collect the data. SPSS17.0 was used to analyze the data. Results： The average scores of clinical thinking ability of undergraduate nursing students were 68.14±9.13. In addition, 71.1% of the students have a higher level of clinical thinking ability, and only 7.2% of the students have the best level. The ANOVA test showed that the fourth-year students had the highest scores（72.96±8.64）, and the third-year students had the lowest scores（62.35±8.09）, which indicated a significant difference in the scores of the three groups（ F= 26. 79, P〈0.05）. Multiple linear regression analysis indicated that the frequency of academic activities and the frequency of department rounds were significantly correlated to clinical thinking ability（P〈0.05）. Conclusion： We must pay attention to the changes and influencing factors of clinical thinking ability of nursing undergraduate students. Thus, traditional teaching methods need to evolve and be revised to host the capacity of clinical practice most effectively and, eventually, promote the development of clinical thinking ability of nursing undergraduate students.
文摘Clinical thinking have the uncertainty, by which there are not a few mistakes caused. So it is necessary to discuss how to deal with the uncertainty of clinical thinking, which originates from the uncertainty of the objective world, social world and medicine knowledge, and can be seen all over clinical activities;Critical thinking which cautious about the interpretation and prediction of scientific theory is the best practice to explore the uncertainty. The essential purpose of medicine is rescuing people, So it is necessary and scientific to take “excluding life-threatening symptoms first” as the first principle of clinical thinking, which is also the primary method to deal with the uncertainty of clinical thinking;By the limited certainty of clinical thinking, procedural thinking is conducive to building a safer health system that is “easy to do right and difficult to do wrong”.
文摘This aim is to clarify thinking process of nursing students’ clinical judgment, i.e., how nursing students act and think and what influences this thinking process of identifying approaches necessary for the children under their care in pediatric nursing practicum. By the analysis of M-GTA, students concurrently performed “A: Analytically contemplating the state of this child’s body” and “B: Contextually contemplating this child’s?individuality”. As a result, they acquired “C: Understandingof this child as a familiar existence.” This allows students to enable them to “D: Identify the necessary approach using judgment criteria for this child.” Furthermore, as situations that promote thinking by relating to all processes of thinking, students experienced “E: Attempts to solve problems through various measures” and “F: Encouragement of thinking through reflection.” Meanwhile, “G: Stagnation of thinking because of concerning matters” inhibited the progress of thinking. We found a need for education after grasping the process of student thought.
文摘Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the experience of doctors, we will combine them according to the procedure of ＂problem-solution＂, to study Professor Wang＇s treatment experience and his clinical thinking.
文摘The objective of this work is to explore how to realize the homogenization of emergency clinical decision, and it means that patients receive the same effect of clinical decisions and the treatment in a different hospital. In order to achieve that, emergency doctors should first have the same clinical thinking and thinking mode which is the biggest challenge for homogenization of emergency clinical decision. The task of emergency medicine is to give priority to the treatment of critically ill patients, so step-down thinking of “excluding life-threatening symptoms first” is the basis, the preemptive thinking is the means, and Process thinking is the key of homogenization;The initial diagnosis and treatment mode of symptom-oriented is the starting point for emergency decision;establishing a unified “checklist” can not only broaden the lateral thinking of emergency doctors, but also unify the thinking of differential diagnosis of emergency;dynamic observation should run through the whole diagnosis and treatment process, which is necessary for the homogenization of emergency decision.
文摘this first paper focuses on seeking conceptual clarity;the second paper will focus on how nurses use critical thinking in clinical cases;and the third paper will focus on how advanced nurse practitioners use critical thinking to provide safe and high quality care to patients and families.We welcome nursing colleagues in China respond our paper.
文摘目的构建一种基于人工智能大语言模型(large language model,LLM)技术、可用于医学教育的新型虚拟患者(virtual patient,VP)系统,评价该系统在基层医生进修学习全科医学临床思维中的应用效果。方法选取2021年1月至2024年2月在东南大学附属中大医院进修的基层社区医生为研究对象,随机分为试验组和对照组,分别采用基于LLM的VP系统教学、传统教学方法进行授课,通过临床思维理论知识考核、临床思维能力考核、课程满意度调查评估教学效果,并对结果进行相应的统计学分析。结果共纳入124名基层社区医生,其中试验组60例、对照组64例,两组在一般基线资料上差异无统计学意义,具有可比性。课程结束后,试验组临床思维理论知识考核成绩显著高于对照组(83.83±3.15 vs.79.92±4.52,P<0.01),且不及格率显著低于对照组(0.00%vs.9.38%,P<0.05);试验组在临床思维能力3个维度(批判性、系统性、循证思维)方面教学后分数均显著高于教学前,而对照组仅在批判性思维维度上教学前后差异有统计学意义;教学后试验组在系统思维、循证思维方面分数均显著高于对照组(P<0.05),但在批判性思维上两组分数差异无统计学意义。试验组对授课的总体满意度也显著高于对照组(93.33%vs.85.48%,P<0.05)。结论基于LLM的VP系统提升了学员对临床思维理论知识的掌握程度,也促进了其临床思维能力的培养,该教学方法可为其他医学教育群体提供新的教学工具和思路。
