Games to support teaching clinical reasoning in health professions education: a scoping review

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.

Episodic future thinking and delay of gratification in children: Is imagining reward pay-off helpful?

Previous studies have failed to show an effect of episodic future thinking (EFT) on children's delay of gratification (DoG), contrasting strikingly with adult findings. Recent findings from a sample of 8-11-year-old children by Canning et al. (J. Exp. Child Psychol., 228, 2023, 105618) indicate that EFT cueing is not effective compared to a no-cue control even when it is reward related. Canning et al. suggest children's DoG performance, unlike that of adults, may be negatively affected by the cognitive load of cueing, but this leaves unexplained why EFT reward-related cueing produced significantly better performance than cueing that did not involve EFT in their study. The current study attempted to further delineate the importance of linking future thinking cues to rewards. A reward-related EFT condition was compared to a reward-unrelated EFT condition and a no-cue control on a delay choice task. No significant differences were observed between the three conditions. This suggests that even reward-related future thinking is ineffective at improving children's delayed gratification. Further research is needed to determine why children struggle to benefit from EFT cues.

The legacy of social anxiety-linked negative expectancy: A pathway from pre-event negative expectancies to post-event negative thinking

BACKGROUND AND OBJECTIVES

Following engagement in a social event people with heightened vulnerability to social anxiety report elevated levels of negative thinking about the event, and this post-event negative thinking is implicated in the maintenance of social anxiety vulnerability. It has also been established that heightened social anxiety vulnerability is associated with disproportionately negative expectations of upcoming social events. However, contribution of social anxiety-linked pre-event negative expectancy to post-event negative thinking has not been directly investigated. The objective of the present study was to test the hypothesis that the relationship between social anxiety vulnerability and post-event negative thinking is mediated by pre-event negative expectancies that drive increased state anxiety at the time of encountering the event.

METHODS

One-hundred and ten participants who varied in social anxiety vulnerability completed a simulated job interview. Participants reported negativity of expectancies before the event, state anxiety experienced at the time of encountering the event, and post-event negative thinking across the seven days following the event.

RESULTS

Analyses revealed elevated social anxiety predicted increased negative post-event thinking. The association between social anxiety and post-event negative thinking was fully mediated by a mediation pathway involving pre-event negative expectancies and state anxiety at the time of encountering the interview event.

LIMITATIONS

The study used a laboratory-based social experience, and conclusions could usefully be tested in the context of natural social events.

CONCLUSIONS

The findings suggest that social anxiety-linked variation in pre-event negative expectancy may contribute to post-event negative thinking following a social event via its impact on state anxiety.

Undergraduate Biology Lecture Courses Predominantly Test Facts about Science Rather than Scientific Practices

Scientific practices are the skills used to develop scientific knowledge and are essential for careers in science. Despite calls from education and government agencies to cultivate scientific practices, there remains little evidence of how often students are asked to apply them in undergraduate courses. We analyzed exams from biology courses at 100 institutions across the United States and found that only 7% of exam questions addressed a scientific practice and that 32% of biology exams did not test any scientific practices. The low occurrence of scientific practices on exams signals that undergraduate courses may not be integrating foundational scientific skills throughout their curriculum in the manner envisioned by recent national frameworks. Although there were few scientific practices overall, their close association with higher-order cognitive skills suggests that scientific practices represent a primary means to help students develop critical thinking skills and highlights the importance of incorporating a greater degree of scientific practices into undergraduate lecture courses and exams.

The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial

BACKGROUND

Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients.

OBJECTIVES

To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students.

DESIGN

A single-blind, randomized controlled trial with a parallel group.

SETTINGS

This study was conducted in a nursing school and hospitals covered by it in Iran.

PARTICIPANTS

98 students studying in the fourth semester of the Bachelor of Nursing course.

METHODS

Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests.

RESULTS

The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion.

CONCLUSIONS

Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.

Diabetes and obesity pathophysiology as a teaching tool to emphasize physiology core concepts

Diabetes mellitus and obesity are major public health issues that significantly impact the health care system. The next generation of health care providers will need a deep understanding of the pathophysiology of these diseases if we are to prevent, treat, and eventually cure these diseases and ease the burden on patients and the health care system. Physiology core concepts are a set of core principles, or "big ideas," identified by physiology educators that are thought to promote long-term retention, create a deeper understanding, and help with formation of critical thinking skills. Here we describe our scaffolded teaching approach in an upper year undergraduate pathophysiology course to educate students about these two diseases and discuss how learning about the basis of these highly integrative diseases from the biochemical to whole body level is a meaningful tool in the physiology educator toolbox to reinforce physiology core concepts. This teaching strategy is designed to engage students in the scientific process and hone their problem-solving skills such that they are hopefully equipped to treat and eventually cure these diseases as they move forward in their careers.NEW & NOTEWORTHY Students often struggle with integration of physiological systems. Type 2 diabetes mellitus and obesity are two related diseases that are useful to explore the interdependence of physiological systems and multiple physiology core concepts. Deep learning about these diseases has the potential to dramatically improve the health care system of the future.

From mindreading to originality: Exploring the relationship between Theory of Mind and Creativity across the lifespan

In the previous psychoeducational literature, many theorists have argued that creativity and originality require the ability to make predictions and assumptions regarding other individuals' ideas. Thus, it has been widely hypothesized that social cognition and theory of mind (ToM) might be a fundamental component or even a prerequisite of creativity. Despite their common grounds, the empirical evidence examining the potential link between ToM and creative thinking throughout their development seems to be indirect, limited, and fragmented. In this respect, this scoping review aimed to collect and synthesize the existing knowledge about the relationship between ToM and creativity at different ages to identify significant literature gaps and generate updated research questions that might guide future research. The search process led to the inclusion, analysis, and collation of 6 relevant studies only, indicating that this research topic has been poorly investigated. Results demonstrated that ToM and creativity are strongly correlated even after partialling out significant mediators, such as age and intelligence. Such a strong association should be further investigated and explained.

Teaching critical thinking in nutritional sciences: a model course and assignments

Critical thinking is a common and important learning outcome in college curricula. Case-based and problem-based learning can be used to assess and foster critical thinking skills. HNF 250-Contemporary Issues in Human Nutrition is a critical thinking course developed during the redesign of a nutritional sciences major program. Course assignments were designed to assess the course and nutritional sciences major learning outcomes. The nutrition and health claim assignment is scaffolded across the academic semester as three assignments: 1) bibliography assignment; 2) poster presentation; and 3) paper. Course lectures and materials have been designed to prepare students for completion of each assignment. The assignments have been modified over time based on classroom observations and student performance. In 2021, the course learning outcomes were examined by assessing several assignments including the nutrition and health claim poster and paper. Course learning outcome benchmarks using these assessments generally included 80% of students achieving an 80% for each criterion. Results revealed that students were not meeting most of these assessment benchmarks during the 2021 iteration, although benchmark data from other course assessments were more satisfactory. It is possible that the transition from a virtual to an in-person format negatively influenced student performance on these course learning outcomes. This course and the nutrition and health claim assignment example can provide a course design and learning outcome assessment framework for other higher education critical thinking courses.NEW & NOTEWORTHY This paper describes how a scaffolded nutrition and health claim assignment is used to teach critical thinking skills among nutritional sciences students and examine the program's learning outcomes. Further, this course example is to serve as an model for STEM majors on how to incorporate case-based and problem-based learning strategies into an undergraduate course.

Factors Affecting Nursing Students' Reflective Thinking During Simulation Debriefing

BACKGROUND

Although reflective thinking is regarded as an important learning aspect of debriefing, the factors that can affect reflective thinking during simulation debriefing remain unclear.

PURPOSE

This study aimed to identify factors affecting reflective thinking during simulation debriefing among nursing students.

METHODS

This study used a cross-sectional descriptive survey design with a convenience sample of 198 Korean nursing students. Participants completed a structured web-based self-administered questionnaire regarding the reflective learning continuum, psychological safety, learner communications skills, and debriefing process design. Multiple regression analyses were used to identify the factors affecting reflective thinking.

RESULTS

Significant factors were debriefing process design, learner communication skills, student-to-student interactions, and instructor-to-student interactions. Psychological safety did not affect the reflective thinking of nursing students.

CONCLUSIONS

Nurse educators should design and implement strategies to maintain effective debriefing processes, improve communication skills, and facilitate student-to-student and instructor-to-student interactions to promote reflective thinking during simulation debriefing.

Preschoolers negatively evaluate conventional norm violations in pretend play

A growing body of research demonstrates that children's pretend play is largely influenced by their understanding of reality. The current work took a novel approach to testing children's understanding of pretense by investigating whether children apply and uphold their knowledge of conventional norms in pretend play. In this study, 3- to 5-year-old children (N = 200) were introduced to a series of pretend play scenarios (e.g., pretending to eat breakfast) in which a puppet pretended to follow a norm (e.g., pretended to eat cereal for breakfast) or violate a norm (e.g., pretended to eat a hamburger for breakfast). These pretend play scenarios were presented as either fantastical or realistic in nature. Consistent with our hypotheses, children evaluated pretend norm violation more negatively than pretend norm adherence and reported liking norm violators less than norm followers. Contrary to our hypothesis, the manipulation of play context (fantastical vs. realistic) did not affect children's evaluations. That is, children were just as negative about pretend norm violations (relative to pretend norm adherence) in fantastical pretend play scenarios as they were in realistic pretend play scenarios. Furthermore, individual differences in children's fantasy orientation did not predict their evaluations. This study is the first to establish that children maintain their real-world understanding of conventional norms in pretend play, providing further evidence that children's pretense is largely realistic in nature.

Collectives closer to the self are anticipated to have a brighter future: Self-enhancement in collective cognition

Collective future thinking is a budding research field concerned with the act of imagining possible events in the future of a collective-typically one's nation. Prior research has shown that people imagine more positive than negative events in the personal future but more negative than positive events in the collective future. This interaction has been interpreted as a valence-based dissociation between collective and personal cognition. We examine if degrees of self-relatedness may account for these effects. In Study 1, participants (N = 299) imagined events in the future of their country and family, rated how central they viewed these collectives to their self and identity and rated the collectives' futures for positive and negative valence. Positive and negative valence of the imagined collective futures was strongly associated with how central the collectives were viewed to the self. In Study 2, participants (N = 306) rated self-centrality, personal agency, and moral decline perceived for their country. All three measures explained independent variance in how positive the future was for their country. In Study 3, participants (N = 310) self-nominated collectives that they viewed as highly versus minimally central to their self and identity. The futures of highly central collectives were rated more positive than negative, whereas such positive bias was absent for the futures of minimally self-central collectives. Overall, the findings indicate that a continuum of different degrees of self-relatedness may explain the Valence × Domain interaction in previous work, and suggest a need to integrate research on collective future thinking with self-serving biases in social cognition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effectiveness of Problem-Based Learning on Development of Nursing Students' Critical Thinking Skills: A Systematic Review and Meta-analysis

BACKGROUND

Problem-based learning (PBL) is a student-centered approach to teaching that has been applied in medical and nursing education. The effectiveness of PBL in promoting critical thinking in nursing students has been studied extensively with mixed results.

PURPOSE

The meta-analysis aimed to investigate the impact of PBL interventions on critical thinking skills of nursing students.

METHODS

PubMed, Embase, Cochrane, and CINAHL databases were electronically searched. Methodological quality was examined using the Newcastle-Ottawa Scale and version 2 of the Cochrane risk-of-bias tool. Data were analyzed with 95% confidence intervals based on random-effect models.

RESULTS

Nineteen studies involving 1996 nursing students were included in the analysis. The results of the analysis demonstrated greater improvement in critical thinking skills compared with the control group (overall critical thinking scores: standardized mean difference [SMD] = 0.47, 95% CI = 0.33-0.61, P < .01).

CONCLUSIONS

The meta-analysis indicates that PBL can help nursing students to improve their critical thinking.

Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning

OBJECTIVE

Critical thinking and accurate case analysis is difficult to quantify even within the context of routine morbidity and mortality reporting. We designed and implemented a HIPAA-compliant adverse outcome reporting system that collects weekly resident assessments of clinical care across multiple domains (case summary, complications, error analysis, Clavien-Dindo Harm, cognitive bias, standard of care, and ACGME core competencies). We hypothesized that incorporation of this system into the residency program's core curriculum would allow for identification of areas of cognitive weakness or strength and provide a longitudinal evaluation of critical thinking development.

DESIGN

A validated, password-protected electronic platform linked to our electronic medical record was used to collect cases weekly in which surgical adverse events occurred. General surgery residents critiqued 1932 cases over a 4-year period from 3 major medical centers within our system. These data were reviewed by teaching faculty, corrected for accuracy and graded utilizing the software's critique algorithm. Grades were emailed to the residents at the time of the review, collected prospectively, stratified, and analyzed by post-graduate year (PGY). Evaluation of the resident scores for each domain and the resultant composite scores allowed for comparison of critical thinking skills across post-graduate year (PGY) over time.

SETTING

Data was collected from 3 independently ACGME-accredited surgery residency programs over 3 tertiary hospitals within our health system.

PARTICIPANTS

General surgery residents in clinical PGY 1-5.

RESULTS

Residents scored highest in properly identifying ACGME core competencies and determining Clavien-Dindo scores (p < 0.006) with no improvement in providing accurate and concise clinical summaries. However, residents improved in recording data sufficient to identify error (p < 0.00001). A positive linear trend in median scores for all remaining domains except for cognitive bias was demonstrated (p < 0.001). Senior residents scored significantly higher than junior residents in all domains. Scores > 90% were never achieved.

CONCLUSIONS

The use of an electronic standardized critique algorithm in the evaluation and assessment of adverse surgical case outcomes enabled the measure of residents' critical thinking skills. Feedback in the form of teaching faculty-facilitated discussion and emailed grades enhanced adult learning with a steady improvement in performance over PGY. Although residents improved with PGY, the data suggest that further improvement in all categories is possible. Implementing this standardized critique algorithm across PGY allows for evaluation of areas of individual resident weakness vs. strength, progression over time, and comparisons to peers. These data suggest that routine complication reporting may be enhanced as a critical thinking assessment tool and that improvement in critical thinking can be quantified. Incorporation of this platform into M&M conference has the potential to augment executive function and professional identity development.

Exploring clinical judgment ability in second-degree baccalaureate of science nursing students: A mixed methods study

BACKGROUND

As they have not yet embarked on clinical practice, most students who already have a bachelor's degree but require a bachelor's degree in nursing occasionally perceive the educator's instruction on clinical situations as abstract and challenging for making accurate clinical judgments.

OBJECTIVES

This study aims to implement a clinical judgment model and case scenarios in classroom teaching to evaluate improvements in students' clinical judgment and critical thinking abilities.

DESIGN

A mixed-method design.

SETTING

A second-degree Bachelor of Science in Nursing at a university in Taiwan.

PARTICIPANTS

First-year undergraduate nursing students.

METHODS

This mixed-methods study featured a survey at the beginning and end of a course, followed by one-on-one online interviews. A purposive sample of sophomore nursing students was recruited from a university in northern Taiwan between March 2020 and May 2021. Semi-structured interviews were conducted after a preliminary analysis of the collected quantitative data.

RESULTS

In total, 48 participants completed the study questionnaire, and 20 were interviewed. The results show that the students' ability to make clinical judgment and identify individual health problems from case scenarios significantly improved after completing the course. However, critical thinking did not differ significantly after the course. Qualitative data analysis revealed three key themes relevant to the participants' learning experiences: (1) establishing the context of clinical judgment, (2) building a bridge between basic medical science and clinical nursing, and (3) having a broader perspective.

CONCLUSIONS

Incorporating clinical judgment measurement model and case scenarios in the curriculum may benefit second-degree Bachelor of Science in Nursing students who have not yet begun their clinical practice. Additionally, the result provides educators with valuable learning goals and evaluation strategies in the classroom and clinical practice.

Evaluating Critical Thinking Disposition, Emotional Intelligence, and Learning Environment of Nursing Students: A Longitudinal Study

BACKGROUND

The COVID-19 pandemic may have inhibited the development of critical thinking and emotional intelligence of nursing students due to the transition from traditional to online learning environments.

OBJECTIVE

The objective was to evaluate the development of critical thinking, emotional intelligence, and the perceived learning environment of nursing students during the pandemic from their first to second year.

METHODS

This was a longitudinal study of 82 nursing students from 2 universities in Greece. We measured critical thinking disposition, emotional intelligence, and the students' perceptions of the learning environment in 2 phases, separated by a 10 month interval, before and during the pandemic.

RESULTS

Students had moderate-to-high critical thinking and emotional intelligence and perceived the learning environment as more positive than negative in both phases. However, there were no statistically significant changes between phases in critical thinking disposition (mean score 44.3 vs 45.1, p = .224) and emotional intelligence (mean score 5.05 vs 5.06, p = .950) between the 2 phases. Nevertheless, students rated the online learning environment (phase 2) higher than the traditional (mean score 137.8 vs 132.2, p = .005).

CONCLUSIONS

Critical thinking and emotional intelligence did not change, but students favored the online learning environment over the traditional. These findings suggest that nurse educators persevered, adapted, and maintained the quality of the learning environment despite the pandemic. Moreover, the utilization of an online learning environment may have led to enhanced enjoyment and engagement for students, which could potentially result in improved learning outcomes.

Work With ChatGPT, Not Against: 3 Teaching Strategies That Harness the Power of Artificial Intelligence

BACKGROUND

Technological advances have expanded nursing education to include generative artificial intelligence (AI) tools such as ChatGPT.

PROBLEM

Generative AI tools challenge academic integrity, pose a challenge to validating information accuracy, and require strategies to ensure the credibility of AI-generated information.

APPROACH

This article presents a dual-purpose approach integrating AI tools into prelicensure nursing education to enhance learning while promoting critical evaluation skills. Constructivist theories and Vygotsky's Zone of Proximal Development framework support this integration, with AI as a scaffold for developing critical thinking.

OUTCOMES

The approach involves practical activities for students to engage with AI-generated content critically, thereby reinforcing clinical judgment and preparing them for AI-prevalent health care environments.

CONCLUSIONS

Incorporating AI tools such as ChatGPT into nursing curricula represents a strategic educational advancement, equipping students with essential skills to navigate modern health care.

"It doesn't matter if you are in charge of the trees, you always miss the trees for the forest": Power and the illusion of explanatory depth

Power can increase overconfidence and illusory thinking. We investigated whether power is also related to the illusion of explanatory depth (IOED), people's tendency to think they understand the world in more detail, coherence, and depth than they actually do. Abstract thinking was reported as a reason for the IOED, and according to the social distance theory of power, power increases abstract thinking. We linked these literatures and tested construal style as a mediator. Further, predispositions can moderate effects of power and we considered narcissism as a candidate because narcissism leads to overconfidence and may thus increase the IOED especially in combination with high power. In three preregistered studies (total N = 607), we manipulated power or measured feelings of power. We found evidence for the IOED (regarding explanatory knowledge about devices). Power led to general overconfidence but had only a small impact on the IOED. Power and narcissism had a small interactive effect on the IOED. Meta-analytical techniques suggest that previous findings on the construal-style-IOED link show only weak evidential value. Implications refer to research on management, power, and overconfidence.

Application of flipped classroom teaching method based on ADDIE concept in clinical teaching for neurology residents

BACKGROUND

As an important medical personnel training system in China, standardized residency training plays an important role in enriching residents' clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents' independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching.

METHODS

The participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed.

RESULTS

The theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P < 0.001). The scores of independent learning ability and critical thinking ability of the observation group were better than those of the control group, showing statistically significant differences (P < 0.001). The observation group was better than the control group in all indicators in terms of Mini-Cex score (P < 0.05). In addition, the observation group had better teaching quality compared to the control group (P < 0.001).

CONCLUSION

Based on the concept of ADDIE combined with flipped classroom teaching method can effectively improve the teaching effect of standardized training of neurology residents, and had a positive effect on the improvement of residents' autonomous learning ability, critical thinking ability, theoretical knowledge and clinical comprehensive ability.

Earworms-A Narrative Review of Infectious Music

This Arts and Medicine feature reviews the clinical and neurophysiologic features of earworms, music fragments heard in the mind that repeat over and over as if jammed in playback mode.

Development and validation of a delirium care critical-thinking scale for intensive care unit nurses: A mixed-method study

AIM AND OBJECTIVES

To develop a Delirium Care Critical-Thinking Scale for nurses caring for patients in the intensive care unit and examine the scale's psychometric properties.

BACKGROUND

There is a tool to evaluate nurses' critical thinking skills to determine nursing competency when delirium care is required.

DESIGN

This cross-sectional, mixed-methods study.

METHODS

The Delphi method was applied for collection and analysis of data during conceptualization and item generation of the tool (Phase I). Item analysis, assessment of validity and reliability of the scale (Phase II) involved 318 nurses recruited by convenience sampling from nine adult intensive care units in medicine and surgery at one medical centre. Confirmatory factor analysis assessed construct validity. Internal consistency and 2-week test-retest stability measured reliability. A Critical Thinking Disposition Inventory Scale examined concurrent validity.

RESULTS

After three rounds, the Delphi method resulted in 31 scale items. Item analysis demonstrated construct reliability ranged from 9.23 to 16.18. Confirmatory factor analysis eliminated one item and extracted five factors: applying knowledge, confirming the problem and accuracy of information, reasoning logically, choosing appropriate strategies and remaining open-minded. Average variance extracted values of all factors indicated good convergent validity. Cronbach's α for internal consistency was .96 with good test-retest reliability. The correlation coefficient for concurrent validity was .301.

CONCLUSION

The new Delirium Care Critical-Thinking Scale for intensive care nurses was demonstrated to be a reliable and valid tool for evaluating their ability to assess patients with delirium.

RELEVANCE TO CLINICAL PRACTICE

This new scale could be used to assess outcomes of education interventions and the effectiveness of nursing care quality involving patients with delirium in intensive and critical care units.

REPORTING METHOD

The COSMIN checklist was used as the reporting guideline for this study.

PATIENT OR PUBLIC CONTRIBUTION

None.

Effects of episodic future thinking in health behaviors for weight loss: A systematic review and meta-analysis

BACKGROUND

Obesity and related diseases have become one of the leading causes of death worldwide, which has been linked to biopsychosocial effects such as type 2 diabetes, cardiovascular disease, various cancers, depression, and weight stigma. Episodic future thinking (EFT) has been found to support the development of changes in health behaviors. However, the effectiveness of EFT in enhancing weight loss behavior and health outcomes is not well supported.

OBJECTIVE

To establish implementation options for the EFT intervention, and critically synthesize the data that assesses the impact of EFT on weight loss behavior and health outcomes.

METHODS

Searches were performed across 5 Chinese and 9 English databases systematically from inception to March 2023. Randomized controlled trials, written in English or Chinese were included. Two independent reviewers evaluated all relevant studies, who also assessed the risk of bias, and extracted the data. Meta-analyses were conducted using Review Manager 5.4.1. The quantity of evidence's certainty was assessed using the Risk bias assessment tool RoB2 (revised version 2019). This study was registered in PROSPERO.

RESULTS

A total of 1740 participants were included, and 18 studies were eligible for inclusion. Meta-analysis reported a statistically significant effect size favoring EFT on delay discounting (AUC) (MD = 0.1, 95 % CI: [0.02, 0.17], P = 0.01; I2 = 73 %), delay discounting (K) (MD = -0.85, 95 % CI: [-1.44, -0.26], P = 0.005; I2 = 77 %), energy intake (MD = -107.59, 95 % CI: [-192.21, -22.97], P = 0.01; I2 = 57 %), grocery purchased (SMD: -0.91, 95 % CI:[-1.48, -0.34], P = 0.002; I2 = 63 %), and BMI (MD = -2.73, 95 % CI: [-5.13, -0.32], P = 0.03; I2 = 0 %, two studies).

CONCLUSIONS

EFT was found to have favorable effects on delay discounting, energy intake, grocery purchased, and BMI of individuals. The presence of high heterogeneity is evident in most of the outcomes. The modalities of EFT intervention are still in the exploratory phase, there is no consensus on the valence, context type, longest delay time, and practice strategy, and it needs to be further explored for different populations. It is anticipated that additional well-designed studies will continue developing high-quality evidence in this field.

Cognitive style of field dependence-independence modulates the working memory storage of biological motion

The biological motion refers to the continuous configuration movement of live agents in space. The perceptual processing of biological motion has the specificity of the dissociation between body form and body motion. However, there is limited evidence for whether such specificity continues when holding biological motion in working memory. We explored this question from the perspective of field dependence (FD) and field independence (FI) cognitive styles in the current study. Three categories of biological motion have been developed: intact movement, motion feature, and form feature. We examined the working memory capacity of motion features, form features, intact movements (Experiments 1-3), and the recognition of three categories of biological motion when remembering intact movements (Experiment 4). The results showed that for the motion features, FI individuals had better memory performance when remembering five items and showed greater working memory capacity and recognition compared with FD individuals, whereas the opposite pattern was observed between FI and FD individuals for the form features. The cognitive style could modulate the working memory storage of biological motion when the task becomes demanding, suggesting that body form and body motion are dissociable in working memory. Our study provided additional evidence for the specificity of biological motion processing in working memory, extending the hierarchical neural model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development and validation of a case study to aid in the diagnostic reasoning of nursing students and nurses

PURPOSE

The aim of this study is to develop and validate a case study to aid in the diagnostic reasoning of nursing students and nurses.

METHODS

It is a validation study using a case study based on Lunney's method including (1) content validation of the case study by nurse experts through the Delphi technique, (2) identification of nursing diagnoses (NDs) in the case, (3) evaluation of diagnostic accuracy, and (4) establishment of a priority diagnosis by nurse experts.

FINDINGS

The case study was developed from the findings of a narrative literature review on the cues of the NDs with a prevalence > 50% in patients with peripheral arterial occlusive disease. Two rounds of expert evaluation were required to validate the case study. The experts identified 18 NDs with different degrees of accuracy. The highly accurate diagnoses most frequently identified by the experts were: Ineffective peripheral tissue perfusion (100%), impaired walking (83%), impaired comfort (50%), and chronic pain (50%). The diagnosis considered a priority by all experts was ineffective peripheral tissue perfusion.

CONCLUSIONS

The case study was developed and had its content validated. High-accuracy diagnoses were identified, and a priority was determined.

IMPLICATIONS FOR NURSING PRACTICE

The validated case study may be used by students and nurses to facilitate the development of diagnostic reasoning and critical thinking in practice, teaching or research.

Examining the relationship between metacognitive trust in thinking styles and supernatural beliefs

Conflicting findings have emerged from research on the relationship between thinking styles and supernatural beliefs. In two studies, we examined this relationship through meta-cognitive trust and developed a new: (1) experimental manipulation, a short scientific article describing the benefits of thinking styles: (2) trust in thinking styles measure, the Ambiguous Decisions task; and (3) supernatural belief measure, the Belief in Psychic Ability scale. In Study 1 (N = 415) we found differences in metacognitive trust in thinking styles between the analytical and intuitive condition, and overall greater trust in analytical thinking. We also found stronger correlations between thinking style measures (in particular intuitive thinking) and psychic ability and paranormal beliefs than with religious beliefs, but a mixed-effect linear regression showed little to no variation in how measures of thinking style related to types of supernatural beliefs. In Study 2, we replicated Study 1 with participants from the United States, Canada, and Brazil (N = 802), and found similar results, with the Brazilian participants showing a reduced emphasis on analytical thinking. We conclude that our new design, task, and scale may be particularly useful for dual-processing research on supernatural belief.

Introduction of the Development Nurse Role to Advance Critical Thinking Skills of New Nurses

This article explores the development and implementation of an innovative method for advancing critical thinking and skill development among new nurses after initial orientation. By creating a development nurse role, this pediatric intensive care unit was able to better train and retain its staff. Features of this program are generalizable to nursing units across various settings. A key for this unit was a structure that allowed for individualization based on each nurse's needs. [J Contin Educ Nurs. 2024;55(4):169-174.].

The Effects of Group Composition and Dynamics on Collective Performance

As organizations gravitate to group-based structures, the problem of improving performance through judicious selection of group members has preoccupied scientists and managers alike. However, which individual attributes best predict group performance remains poorly understood. Here, we describe a preregistered experiment in which we simultaneously manipulated four widely studied attributes of group compositions: skill level, skill diversity, social perceptiveness, and cognitive style diversity. We find that while the average skill level of group members, skill diversity, and social perceptiveness are significant predictors of group performance, skill level dominates all other factors combined. Additionally, we explore the relationship between patterns of collaborative behavior and performance outcomes and find that any potential gains in solution quality from additional communication between the group members are outweighed by the overhead time cost, leading to lower overall efficiency. However, groups exhibiting more "turn-taking" behavior are considerably faster and thus more efficient. Finally, contrary to our expectation, we find that group compositional factors (i.e., skill level and social perceptiveness) are not associated with the amount of communication between group members nor turn-taking dynamics.

Divergent thinking modulates interactions between episodic memory and schema knowledge: Controlled and spontaneous episodic retrieval processes

The ability to generate novel ideas, known as divergent thinking, depends on both semantic knowledge and episodic memory. Semantic knowledge and episodic memory are known to interact to support memory decisions, but how they may interact to support divergent thinking is unknown. Moreover, it is debated whether divergent thinking relies on spontaneous or controlled retrieval processes. We addressed these questions by examining whether divergent thinking ability relates to interactions between semantic knowledge and different episodic memory processes. Participants completed the alternate uses task of divergent thinking, and completed a memory task in which they searched for target objects in schema-congruent or schema-incongruent locations within scenes. In a subsequent test, participants indicated where in each scene the target object had been located previously (i.e., spatial accuracy test), and provided confidence-based recognition memory judgments that indexed distinct episodic memory processes (i.e., recollection, familiarity, and unconscious memory) for the scenes. We found that higher divergent thinking ability-specifically in terms of the number of ideas generated-was related to (1) more of a benefit from recollection (a controlled process) and unconscious memory (a spontaneous process) on spatial accuracy and (2) beneficial differences in how semantic knowledge was combined with recollection and unconscious memory to influence spatial accuracy. In contrast, there were no effects with respect to familiarity (a spontaneous process). These findings indicate that divergent thinking is related to both controlled and spontaneous memory processes, and suggest that divergent thinking is related to the ability to flexibly combine semantic knowledge with episodic memory.

Debating: effective and satisfactory learning method in dentistry

BACKGROUND

Education in the modern world of health needs diverse methods of learning and teaching. The traditional education model has limited capacity for developing abilities such as critical thinking, problem-solving, and reasoning skills. Therefore, improving the quality of teaching-learning processes requires implementing educational innovations in the classroom and evaluating them. This study aimed to determine the impact of the debate teaching method on improving the abilities of general dentistry doctoral students.

METHODS

The research was a semi-experimental study with pre-tests and post-tests to measure the knowledge and abilities of students. The study included 60 dental students who completed the fall 2022 session of the Community Oral Health (COH) 2 practical course. This course, one of three practical components within the Community Oral Health curriculum, aligns with the educational framework of general dentistry. Challenging topics on which there is no consensus in dentistry were chosen for the debate. The descriptive statistics indicators include an independent t-test and variance analysis test with a significance level of 5%. Were used to analyze the data.

RESULTS

The results of the study showed that the average total knowledge (P < 0.001), 'perception of critical thinking skills (P < 0.001), expression power (P < 0.001), reasoning skills (P = 0.003), interpretation and Information analysis power (P < 0.001), the ability to find and use scientific databases (P < 0.001) and the ability to analyze and evaluate evidence (P < 0.001) increased significantly after intervention in students. 95% of students agreed/strongly agreed that this method enhances their ability to answer people's questions. From an instructor's point of view, students had 93.1% of the ability to reason and analyze information after intervention and 88.5% of the ability to think critically.

CONCLUSION

The results of the study showed that the use of debate in the classroom is an effective way to present content. The process of evaluating data-driven arguments promotes higher-level cognitive skills and teaches students about the knowledge base and the use of scientific databases.

TRIAL REGISTRATION

Registration date: 21/11/2022, Registration number: IRCT20141128020129N3.

Thought habits and processing modes among Japanese university students do not influence dynamic associations between rumination and negative affect

The integrated model of rumination argues that two trait factors-negative thinking habits and processing modes-get people stuck in maladaptive rumination. There is little evidence showing whether these factors influence the daily dynamic associations between rumination and negative moods. To address this, in this study, we conducted an experience-sampling method on Japanese university students. We recruited 92 Japanese university students and assessed their daily rumination and negative affect (NA) eight times a day for seven days. We examined the effects of habits and processing modes on the dynamic associations between rumination and negative moods using dynamic structural equation modeling. We found that individuals were more likely to ruminate when they experienced NA. However, contrary to previous findings, this study's participants did not experience NA after engaging in rumination. Moreover, we did not detect any significant trait factor effect on these dynamic associations. Our findings imply that individuals are more likely to engage in rumination after experiencing NA, but the reverse association, particularly the autoregression of rumination, may not be maintained in natural daily life. Furthermore, negative thinking habits and processing modes may not influence the daily dynamic associations between rumination and NA among Japanese university students.

Not a passive learner but an active one: a focus on the efficacy of philosophy-based language instruction and its consequences on EFL learners' critical thinking, engagement, and academic achievement

This study investigates the impact of Philosophy-Based Language Teaching (PBLT) on the critical thinking skills and learner engagement of English as a Foreign Language (EFL) students. A concurrent mixed-methods approach, including semi-structured interviews, document analysis, and academic achievement tests, was employed with an experimental group (EG) exposed to PBLT and a control group (CG) receiving traditional instruction. The results reveal a substantial positive effect of PBLT on the critical thinking abilities of EFL learners, as evidenced by thematic analyses of interviews and document content. Themes include heightened critical thinking awareness, collaborative knowledge construction, and increased learner engagement. Academic achievement tests further demonstrate significant improvement in the experimental group's performance. A comparison with existing literature underscores the novelty of our mixed-methods approach. Implications for language teachers, materials developers, syllabus designers, and policy-makers are discussed, highlighting the potential of PBLT in cultivating critical thinking and learner engagement.

Understanding the role of digital immersive technology in educating the students of english language: does it promote critical thinking and self-directed learning for achieving sustainability in education with the help of teamwork?

PURPOSE

Universities are constantly searching for best practices to promote sustainability when it comes to educating students of the English language. Although this area of study has recently gained the attention of scholars around the world there is still a need to explore it from various perspectives.

OBJECTIVE

This study aims to comprehensively investigate the impact of digital immersive technology on the education of English language students, specifically focusing on its potential to promote critical thinking and self-directed learning for achieving sustainability in education through teamwork. The research will assess the influence of digital immersive experiences on enhancing learning outcomes, examining their role in fostering critical thinking skills and encouraging self-directed learning practices. Additionally, the study explores the collaborative aspects of digital immersive technology, evaluating its contribution to teamwork among students.

METHODOLOGY

The objective was achieved by using a survey questionnaire to collect data from 304 registered students in various universities in Beijing. Data analysis was conducted by applying Mplus 7.0 software.

FINDINGS

The findings revealed that the use of digital immersive technology was pivotal for achieving sustainable education both directly and indirectly to an extent. In addition, team working moderated all the respective paths except the path involving the use of digital immersive technology and critical thinking.

IMPLICATIONS

These results generated implications for teachers and policymakers to promote and facilitate the use of digital technology for teaching the English language to students, encouraging them to develop critical skills and self-directed learning strategies. The study also offered guidance and deeper understanding for researchers to address the concerns linked to the use of digital technology and sustainable education particularly in their future endeavors.

Applying explainable artificial intelligence methods to models for diagnosing personal traits and cognitive abilities by social network data

This study utilizes advanced artificial intelligence techniques to analyze the social media behavior of 1358 users on VK, the largest Russian online social networking service. The analysis comprises 753,252 posts and reposts, combined with Big Five personality traits test results, as well as assessments of verbal and fluid intelligence. The objective of this research is to understand the manifestation of psychological attributes in social media users' behavior and determine their implications on user-interaction models. We employ the integrated gradients method to identify the most influential feature groups. The partial dependence plot technique aids in understanding how these features function across varying severity degrees of the predicted trait. To evaluate feature stability within the models, we cluster calculated Shapley values. Our findings suggest that the emotional tone (joy, surprise, anger, fear) of posts significantly influences the prediction of three personality traits: Extraversion, Agreeableness, and Openness to Experience. Additionally, user social engagement metrics (such as friend count, subscribers, likes, views, and comments) correlate directly with the predicted level of Logical thinking. We also observe a trend towards provocative and socially reprehensible content among users with high Neuroticism levels. The theme of religion demonstrates a multidirectional relationship with Consciousness and Agreeableness. Further findings, including an analysis of post frequency and key text characteristics, are also discussed, contributing to our understanding of the complex interplay between social media behavior and psychological traits. The study proposes a transition from the analysis of correlations between psychological (cognitive) traits to the analysis of indicators of behavior in a social network that are significant for diagnostic models of the corresponding traits.

Art-delivered episodic future thinking reduces delay discounting: A phase IIa proof-of-concept trial

INTRODUCTION

High rates of delay discounting (DD), or the preference for immediate rewards over delayed rewards, is associated with substance use disorder (SUD). Lower rates of DD predict better treatment outcomes, and thus strategies that reduce DD may support SUD recovery. The process of vividly imagining a future event, known as episodic future thinking (EFT), may be a particularly viable approach to reduce DD. Some limited research has examined delivery of EFT in treatment settings, using verbal prompts that are typical of studies in non-treatment settings. We propose that the creation of visual art represents a unique alignment of the purpose of EFT with an innovative delivery modality in treatment settings.

METHODS

This single arm, proof-of-concept trial evaluated art-delivered EFT (ArtEFT) to reduce DD in a sample of women (N = 39) in a residential SUD treatment center. Participants engaged in a single, 1-h ArtEFT session during which they engaged in EFT and created a visual representation using art materials. The study collected DD measures for hypothetical money ($50 and $1000 magnitude conditions) before and after ArtEFT.

RESULTS

Using area-under-the-curve (AUCord) as the index of DD, the study observed predicted changes following the ArtEFT session. The ANOVA revealed statistically significant main effects of both magnitude [F(1,38) = 11.184, p = .002] and time [F(1. 38) = 4.731, p = .036], with a non-significant interaction [F(1,38) = 3.821, p = .058].

CONCLUSION

This study reveals promising preliminary indicators that art may be an effective modality to deliver EFT, with particular advantages for implementation given the popularity of art programming in SUD treatment programs.

Epistemic discourses concerning the competence developed in a norwegian master's degree program in health science

It has been claimed that various discourses related to competence influence higher education, but there is limited understanding of the discourses underlying competence development. The specific aim of this study was to explore epistemic discourses concerning the development of competence of health professionals with a master's degree in health science. Accordingly, the study was qualitative and adopted discourse analysis. Twelve participants, all of whom were Norwegian health professionals aged between 29 and 49 years, participated in this study. Four participants were in the final stage of study for their master's degree with three months left before completion, four had completed their degree two weeks before their participation, and four had been working for one year after the completion of their degree. Data were collected in three group interviews. Three epistemic discourses were revealed: (1) a critical thinking competencies discourse, (2) a scientific thinking competencies discourse, and (3) a competence-in-use discourse. The former two discourses were considered the dominant discourses and indicated that a knowing "that" discourse connected the specialized competence of different health professionals with a wider field of competence. This wider field transcended the boundaries of various health disciplines and represented a novel competence developed through a synergizing process between critical and scientific thinking competencies, which seems to drive continued competence development. A competence-in-use discourse was formed in the process. This discourse can be viewed as a unique outcome that contributes to health professionals' specialized competence and suggests that a knowing "how" discourse was also an underlying background discourse.

Addressing global cognition and ineffective depressogenic discrimination strategies with clinical hypnosis

It is a fundamental truth in living that the quality of your decisions shapes the quality of your life. One's cognitive style determines whether one is more likely to be detailed and linear in thinking or more general and impressionistic, obvious influences on the way experiences are interpreted and reactions formed. Global thinking, also referred to as over-general thinking, has been linked to depression for several reasons. These include the lack of detail in making important discriminations that would reduce or eliminate the kind of self-injurious and depressogenic decisions described in the "stress generation" model of depression. The importance of having meaningful strategies for making effective decisions on a situation-by-situation basis cannot be overstated. Cognitive psychologists and cognitive neuroscientists use the term "discrimination" to describe the process of making distinctions between different situations that give rise to one's reactions. In this article, hypnosis is described as a vehicle for teaching global thinkers to be more skilled in making important discriminations. A sample hypnosis script is provided to illustrate the process.

An idea to explore: Introduction of "biochemical tales" in medical education-Learning made fun

Innovations in medical education, including the integration of narrative-based tales, are transforming the way complex biochemical concepts are taught and understood. In this "Idea to Explore", the essence of integrating tales that personify molecules and depict biochemical processes as engaging stories to enhance student engagement, promote active learning, and improve knowledge retention is discussed. It also explores the effectiveness of scientific discovery games and traditional scientific stories in deepening students' interest in biochemistry. Highlighting the potential of narrative methods to make biochemistry more accessible and engaging, educators are encouraged to adopt creative teaching tools that promote critical thinking, problem-solving, and communication skills, thereby inspiring active participation, and lifelong learning in biochemistry.

A challenge-based interdisciplinary undergraduate concept fostering translational medicine

Translational medicine (TM) is an interdisciplinary branch of biomedicine that bridges the gap from bench-to-bedside to improve global health. Fundamental TM skills include interdisciplinary collaboration, communication, critical thinking, and creative problem-solving (4Cs). TM is currently limited in undergraduate biomedical education programs, with little patient contact and opportunities for collaboration between different disciplines. In this study, we developed and evaluated a novel interdisciplinary challenge-based educational concept, grounded in the theoretical framework of experimental research-based education, to implement TM in undergraduate biomedicine and medicine programs. Students were introduced to an authentic clinical problem through an interdisciplinary session with patients, medical doctors, and scientists. Next, students collaborated in groups to design unique laboratory-based research proposals addressing this problem. Stakeholders subsequently rewarded the best proposal with funding to be executed in a consecutive interdisciplinary laboratory course, in which mixed teams of biomedicine and medicine students performed the research in a fully equipped wet laboratory. Written questionnaires and focus groups revealed that students developed 4C skills and acquired a 4C mindset. Working on an authentic patient case and the interdisciplinary setting positively contributed to communication, collaboration, critical thinking, and creative problem-solving skills. Furthermore, students were intrinsically motivated by (i) the relevance of their work that made them feel taken seriously and competent, (ii) the patient involvement that highlighted the societal relevance of their work, and (iii) the acquisition of a realistic view of what doing science in a biomedical research laboratory is. In conclusion, we showcase a widely applicable interdisciplinary challenge-based undergraduate concept fostering TM.

Innovative Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise (SPLICE) modules promote critical thinking skills, early clinical exposure, and contextual learning among first professional-year medical students

Medical education is undergoing various transformations to promote a more personalized and contextual way of learning. In light of this, the innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) modules were designed, implemented, and evaluated for medical students in the first professional year as a strategy for early clinical exposure in a collaborative and self-directed way of learning. This is a mixed methods study involving first-year medical students. Students were divided randomly into the control and the intervention groups. Six SPLICE modules were administered to the intervention while the control group followed the traditional curricula. The educational outcome was compared using an end-of-module assessment. In addition, 13-item and 8-item questionnaires were administered to students to evaluate the SPLICE and plenary sessions on a 5-point Likert scale. Furthermore, students' feedback was obtained on a 10-point rating scale and in in-depth small-group interviews. The majority of students perceived that the SPLICE module improved their communication and encouraged meaningful, active learning. Students found the plenary sessions to be well organized, with sufficient interaction with professionals. Students also gave excellent scores for feedback on SPLICE modules, demonstrating the effectiveness of the innovation. In terms of test scores used in assessing learning outcomes, the intervention group outperformed the control group (P < 0.0001). The innovative SPLICE curriculum facilitated early clinical exposure and active self-directed learning. Students perceived SPLICE modules to be highly helpful in terms of promoting meaningful learning and the future application of knowledge.NEW & NOTEWORTHY The very essence of this innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) curriculum is the team-based learning of integrated pre-, para-, and clinical learning objectives right from the first professional year of study serving as an early clinical exposure. This unique way of learning creates a holistic educational environment by combining both academic and professional development thereby empowering the next generation of physician leaders to take autonomy of their own learning strategies and emerge as competent lifelong learners.

Goal characteristics predict the occurrence of goal-related events through belief in future occurrence

While previous studies have highlighted the role of episodic future thinking in goal pursuit, the underlying cognitive mechanisms remain unexplored. Episodic future thinking may promote goal pursuit by shaping the feeling that imagined events will (or will not) happen in the future - referred to as belief in future occurrence. We investigated whether goal self-concordance (Experiment 1) and other goal characteristics identified as influential in goal pursuit (Experiment 2) modulate belief in the future occurrence of goal-related events and predict the actual occurrence of these events. Results showed that goal self-concordance, engagement, and expectancy had an indirect effect on the actual occurrence of events, which was (partially) mediated by belief in future occurrence. The mediating role of belief supports the view that belief in future occurrence when imagining events conveys useful information, allowing us to make informed decisions and undertake adaptive actions in the process of goal pursuit.

Enriching Thinking Through Discourse

Great effort is invested in identifying ways to change people's minds on an issue. A first priority should perhaps be enriching their thinking about the issue. With a goal of enriching their thinking, we studied the views of community adults on the DACA issue-young adults who entered the United States illegally as children. A dialogic method was employed, offering dual benefits in providing participants the opportunity to further develop their own ideas and to consider differing ideas. Yet, participants engaged in dialog only vicariously by observing the talk of a pair of actors who held opposing positions on DACA. The effect on participants' thinking was greatest in the condition in which they viewed a dialog between the two actors, rather than a comparison condition in which the actors individually expressed their positions. In control conditions, no presentation was observed. Probing questions included in all conditions encouraged a participant to examine and clarify for themselves their own position, potentially enriching it. This condition proved unsuccessful in enriching thinking; participants' justifications for their own positions in fact became simpler and less qualified. In contrast, observing a video of a like-minded and opposing other did enrich observers' thinking, yet to a greater degree in the dialogic than nondialogic condition. The findings thus suggest observed dialog as a promising practical approach in promoting deeper thinking.