Effectiveness of case-based learning among medical interns using microbiology laboratory report as a tool

Background: Due to lack of consensus of teaching learning methods during undergraduate period, intern doctors face many challenges in clinical settings. Knowledge gaps related to clinical application of laboratory medicine leads to poor case management. Active learner centered training with real clinical cases is a need to help the interns to link their basic science knowledge into a practical context. Aims and Objectives: The present study was done to evaluate the effect of case based learning (CBL) on the interns’ knowledge and clinical decision-making skill of interpretation of laboratory investigation reports and to assess perception of participants about CBL. Materials and Methods: CBL method was used to train the interns in clinical application microbiology reports. This is a pre- and post-test type study, carried out for 2 months with 43 Medical interns, willing to participate. The process included evaluation of CBL by pre-validated questionnaires by multiple choice questions, clinical case scenarios before, immediately after and 10 days after the intervention and perception toward CBL was assessed. Statistical analysis was done using Student’s t-test and SPSS 17 software. The value of P < 0.05 was considered as significant. Results: A significant improvement in the interns’ knowledge and problem solving following CBL sessions had been observed in present study. The post-test scores of all the CBL sessions were significantly higher than pre-test scores (P < 0.05). The perception of interns toward CBL was assessed and it was responded positively. It helped in strengthening the critical skills of interns such as problem solving, critical thinking, and teamwork. Conclusion: The present study proved that interns during internship require to be trained in laboratory medicine. CBL is an effective teaching method to train interns in enhancing their problem solving skill with correct use of laboratory test results and strengthening critical thinking, teamwork, and time management skills.

Estratégias de ensino para desenvolvimento do pensamento crítico na graduação em enfermagem: overview de revisões sistemáticas / Educational strategies for development of clinical reasoning and critical thinking in nursing undergraduate students: overview protocol of systematic reviews

Resumo: O objetivo desta pesquisa foi sumarizar as evidências de revisões sistemáticas sobre a efetividade das estratégias de ensino para o desenvolvimento do raciocínio clínico ou pensamento crítico em estudantes da graduação em Enfermagem. Trata-se de uma overview de revisões sistemáticas, guiada pelas recomendações do Cochrane Handbook. O protocolo de pesquisa foi registrado na plataforma Prospero sob o número 187785, sendo este estudo inédito. O uso do protocolo possibilita a replicação ou atualização dessa overview. A pergunta de pesquisa foi: Quais as evidências de efetividade oriundas de revisões sistemáticas sobre as estratégias de ensino, isoladas, comparadas ou associadas, para o desenvolvimento do pensamento crítico dos estudantes de graduação em Enfermagem, em qualquer ambiente de aprendizagem? A busca por revisões Cochrane e não Cochrane foi realizada em oito bases de dados e bibliotecas, e na literatura cinzenta. Não houve restrições de idioma e ano de publicação. Foi recuperado um total de 13.936 estudos, com 6.620 participantes. Dois revisores independentes aplicaram os critérios de inclusão e exclusão, fizeram a extração dos dados e a análise de qualidade das revisões. Foram incluídas 11 revisões, com 65 estudos primários. As sínteses foram descritivas e por metanálises. A análise do risco de viés das revisões sistemáticas foi realizada por meio do instrumento ROBIS (Risk of Bias in Systematic Reviews); a qualidade metodológica foi avaliada pelo instrumento AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews); e a análise da força da evidência seguiu as recomendações do sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation). Quatorze estudos, com 1.350 participantes, forneceram evidências para metanálise. As evidências, ainda que classificadas como de certeza muito baixa, sugerem que a aprendizagem baseada em problemas e a simulação são estratégias de ensino que possibilitam o desenvolvimento do pensamento crítico em estudantes de graduação em enfermagem. Risco de viés, heterogeneidade elevada, número limitado de estudos, número de participantes reduzido contribuíram para o rebaixamento do nível de certeza das evidências. Recomenda-se que os docentes avaliem as características dos estudantes antes de optarem por uma ou outra estratégia de ensino, e ponderem o uso diversificado. São importantes a frequência e duração da aplicação das estratégias, uma vez que o desenvolvimento do pensamento crítico ocorre de forma processual e contínua. Recomenda-se aos pesquisadores que o relato seja aprimorado, incluindo informações relevantes, como dados estatísticos, características do estudante e do ambiente de ensino. O uso de ferramentas que orientem um relato de qualidade é indicado. No planejamento dos ensaios clínicos, é relevante prever e padronizar o tempo de exposição à estratégia de ensino e a quantidade de sessões; utilizar pelo menos duas escalas de mensuração do pensamento crítico e aplicá-las no mínimo antes e após a intervenção. Tais cuidados promovem robustez aos resultados. A contribuição social dessa tese inédita é a identificação de estratégias de ensino - aprendizagem baseada em problemas e simulação - eficazes para o desenvolvimento do pensamento crítico em estudantes de enfermagem, o que possibilita, consequentemente, aprimorar a qualificação dos futuros enfermeiros para a prática profissional segura e baseada em evidências.

Abstract: The aim of this study was to summarize evidence from systematic reviews on the effectiveness of teaching strategies for the development of clinical reasoning or critical thinking in undergraduate nursing students. This is an overview of systematic reviews guided by the Cochrane Handbook recommendations. The research protocol was registered on the Prospero platform under number 187785 and this study is unprecedented. The use of the protocol makes it possible to replicate or update this overview. The research question was: What is the evidence of effectiveness from systematic reviews on teaching strategies, isolated, compared or associated, for the development of critical thinking of undergraduate nursing students in any learning environment? The search for Cochrane and non-Cochrane reviews was performed in eight databases and libraries, and in the gray literature. There were no language and year of publication restrictions. A total of 13,936 studies with 6,620 participants were retrieved. Two independent reviewers applied inclusion and exclusion criteria and performed data extraction and quality analysis of the reviews. Eleven reviews with 65 primary studies were included. The syntheses were descriptive and by meta-analyses. Analysis of the risk of bias of systematic reviews was performed using the ROBIS instrument (Risk of Bias in Systematic Reviews); methodological quality was assessed using the AMSTAR 2 instrument (A MeaSurement Tool to Assess Systematic Reviews); and analysis of the strength of evidence followed the recommendations of the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). Fourteen studies of 1,350 participants provided evidence for meta-analysis. Despite the very low certainty of the evidence, findings suggest that the teaching strategies of problem-based learning and simulation enable the development of critical thinking in undergraduate nursing students. Risk of bias, high heterogeneity, limited number of studies, and reduced number of participants contributed to lower the level of certainty of the evidence. It is recommended that professors assess students' characteristics before choosing one or another teaching strategy and consider diversified use. The frequency and duration of the application of strategies is important, since the development of critical thinking occurs in a procedural and continuous way. It is recommended that researchers improve the report, including relevant information such as statistical data and characteristics of students and the teaching environment. The use of tools that guide a quality report is indicated. When planning clinical trials, it is important to predict and standardize the time of exposure to the teaching strategy and the number of sessions; use at least two clinical reasoning measurement scales and apply them at least before and after the intervention. These precautions bring robustness to the results. The social contribution of this unpublished thesis is the identification of effective teaching strategies for the development of critical thinking in nursing students, problem-based learning and simulation, thereby making it possible to improve the qualification of future nurses for a safe and evidence-based professional practice.

Filosofia e processo de enfermagem: uma reflexão das bases teórico filosóficas / Na prática clínica de enfermagem philosophy in the nursing process: an reflection of theoretical philosophical bases in the clinical nursing practice / Filosofía en el proceso de enfermería: una reflexión de las bases teórico filosóficas na práctica clínica de enfermería

Objetivo: refletir sobre a aproximação e influência de pressupostos filosóficos na aplicação do processo de enfermagem na prática clínica. Métodos: trata-se de uma reflexão teórico crítica, para a qual serviram de base produções científicas sobre Filosofia e processo de enfermagem publicadas em periódicos nacionais e internacionais. Resultados: a partir da análise das produções científicas identificou-se as contribuições dos pressupostos filosóficos e do pensamento crítico para a qualidade do processo de Enfermagem; e a aplicação prática da filosofia no processo de enfermagem e desafios a serem enfrentados. Conclusão: os pressupostos filosóficos alicerçam as práticas em enfermagem e saúde denotando a qualidade e a sensibilidade necessárias nos cuidados de enfermagem prestados aos indivíduos. o pensamento filosófico é um dos caminhos que possibilita a compreensão da totalidade das diferentes realidades concretas e que no processo de enfermagem traz reflexões importantes para a qualidade do cuidado prestado aos usuários dos diferentes serviços de saúde. (AU)

Objective: reflect on the approach and influence of philosophical assumptions in the application of the nursing process in clinical practice. Methods: it is an article of theoretical reflection, for which scientific productions on Philosophy and nursing process published in national and international journals were used as basis. Results: from the analysis of scientific productions, the contributions of philosophical assumptions and critical thinking to the quality of the nursing process were identified; and the practical application of philosophy in the nursing process and challenges to be faced. Conclusion: the philosophical assumptions underpin nursing and health practices, denoting the necessary quality and sensitivity in caring of nursing for individuals. philosophical thinking is one of the ways that enables the comprehension of all the different concrete realities and that in the nursing process brings important reflections for the quality of care provided to users of different health services. (AU)

Objetivo: reflexionar sobre el abordaje e influencia de los supuestos filosóficos en la aplicación del proceso de enfermería en la práctica clínica. Métodos: se trata de un artículo de reflexión teórica, para lo cual se basaron las producciones científicas sobre Filosofía y procesos de enfermería publicados en revistas nacionales e internacionales. Resultados: a partir del análisis de las producciones científicas, se identificaron los aportes de los supuestos filosóficos y el pensamiento crítico a la calidad del proceso de enfermería; y la aplicación práctica de la filosofía en el proceso de enfermería y desafíos a enfrentar. Conclusion: los supuestos filosóficos sustentan las prácticas de enfermería y salud, denotando la calidad y sensibilidad necesarias en el cuidado de enfermería prestado a las personas. El pensamiento filosófico es una de las vías que posibilita la comprensión de todas las diferentes realidades concretas y que en el proceso de enfermería trae importantes reflexiones sobre la calidad de la atención brindada a los usuarios de los diferentes servicios de salud. (AU)

Educación y conocimiento liberador / Education and liberating knowledge

Resumen Este ensayo inicia con un aforismo sobre la educación: «forjadora de las fuerzas liberadoras hacia el progreso de la condición humana¼, en su connotación espiritual, intelectual, moral y convivencial en armonía con el ecosistema planetario (progreso dignificante). Se realza la coincidencia de las mayores cotas históricas de educación profesional con la extrema degradación de la cultura occidental, reveladora del papel de la educación que favorece la pasividad ante el conocimiento y el orden imperante. Se contrastan los caracteres de la educación pasiva con los de la participativa basada en el desarrollo del pensamiento crítico. Se define el pensamiento crítico y se argumenta el tipo de ambiente educativo que lo estimula y encauza, en particular, el pensamiento complejo e integrador alusivo al sí mismo proyectado al quiénes somos y dónde estamos, ignorado por la ciencia reduccionista. Se especifican el conocimiento liberador y su finalidad: «entendernos como humanidad fraterna y encontrar nuestro lugar en armonía con el concierto infinitamente diverso del mundo viviente¼. Se sintetizan las revoluciones teóricas -hoy desestimadas-, simientes del conocimiento liberador que develaron al antropocentrismo y a los etnocentrismos como «prisiones del espíritu¼. Se concluye que el conocimiento liberador cumple el papel utópico de orientar y señalizar el caminar interminable hacia el progreso dignificante.

Abstract This essay begins with an aphorism on education: "forger of the liberating forces towards the progress of the human condition", in its spiritual, intellectual, moral and convivial connotation in harmony with the planetary ecosystem (dignifying progress). It highlights the coincidence of the highest historical levels of professional education with the extreme degradation of Western culture, which reveals the role of education that favors passivity in the face of knowledge and the prevailing order. The characteristics of passive education are contrasted with those of participatory education based on the development of critical thinking. Critical thinking is defined and the type of educational environment that stimulates and channels it is argued, in particular the complex and integrative thinking alluding to the self projected to who we are and where we are, absent in reductionist science. Liberating knowledge is specified and its purpose defined as "to understand ourselves as fraternal humanity and to find our place in harmony with the infinitely diverse concert of the living world". The theoretical revolutions -now dismissed- being seeds of liberating knowledge that revealed anthropocentrism and ethnocentrisms as "prisons of the spirit" are synthesized. It is concluded that liberating knowledge fulfills the utopian role of signaling the endless walking towards dignifying human progress.

Pós-modernidade e decadência ideológica: "O sono da razão desperta monstros" / Post-modernity and ideological decay: "The sleep of reason awakens monsters" / Postmodernidad y decadencia ideológica: "El sueño de la razón despierta monstruos"

RESUMO O presente ensaio objetivou apresentar o dossiê sobre epistemologia da Educação Física, produzido pela RBCE. Como viés de apresentação, optou-se por trazer elementos que permitem entrar no debate dos fundamentos norteadores das críticas à chamada pós-modernidade. Sem pretensão de esgotar esse debate, foi mostrada uma expressão do pensamento pós-moderno com caracterizações que acabam por desconsiderar categorias centrais do pensamento marxiano. Detivemo-nos, em especial, em uma delas: a categoria da totalidade. Esperamos, assim, contribuir para que, diante do combate às manifestações autoritárias e mesmo de corte fascista que visualizamos na atualidade contemporânea do capitalismo, a nossa "batalha das ideias" decorra em ambiente fértil e profícuo.

ABSTRACT This essay aimed to present the dossier about epistemology of Physical Education, produced by the RBCE. As a presentation bias, it was decided to bring elements that allow us to enter into the debate on the guiding foundations of criticism of the so-called postmodernity. Without intending to exhaust this debate, an expression of postmodern thought was shown with characterizations that end up disregarding central categories of Marxian thought. We focused, in particular, on one of them: the category of totality. We hope, therefore, to contribute so that, in times of fight against authoritarian and even fascist manifestations that we see in contemporary capitalism, our "battle of ideas" takes place in a fertile and fruitful environment.

RESUMEN Este ensayo tuvo como objetivo presentar el dossier sobre epistemología de la Educación Física", elaborado por la RBCE. Como sesgo de presentación, optamos por traer elementos que nos permitan entrar en el debate sobre los fundamentos rectores de la crítica a la llamada posmodernidad. Sin pretender agotar este debate, se mostró una expresión del pensamiento posmoderno con caracterizaciones que terminan por desconocer categorías centrales del pensamiento marxista. Nos centramos, en particular, en uno de ellos: la categoría de totalidad. Esperamos, por tanto, contribuir para que, frente a la lucha contra las manifestaciones autoritarias e incluso fascistas que vemos en el capitalismo contemporáneo, nuestra "batalla de ideas" se desarrolle en un ambiente fértil y fructífero.

Brazilian undergraduate nursing students' critical thinking need to be increased: a cross-sectional study / O pensamento crítico dos estudantes de graduação em enfermagem brasileiros precisa ser ampliado: estudo transversal / Es necesario aumentar el pensamiento crítico de los estudiantes brasileños de graduación en enfermería: estudio transversal

ABSTRACT Objectives: to map Brazilian undergraduate nursing students' critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains. Methods: in this descriptive cross-sectional study, participants' (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient. Results: the overall results showed a moderate level of participants' critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001). Conclusions: poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students' critical thinking skills during nursing education.

RESUMO Objetivos: mapear o nível de pensamento crítico de estudantes brasileiros de graduação em enfermagem e investigar a correlação entre os dados sociodemográficos selecionados e os domínios do pensamento crítico. Métodos: neste estudo transversal descritivo, o pensamento crítico dos participantes (N=89) foi avaliado por meio do Health Science Reasoning Test. A correlação entre os domínios do pensamento crítico e os dados sociodemográficos foi avaliada pelo coeficiente de correlação de Pearson. Resultados: os resultados gerais mostraram um nível moderado de pensamento crítico dos participantes (média=70,7; desvio padrão 5,7). Foi identificado um desempenho ruim em 5 dos 8 domínios do pensamento crítico. Foi encontrada correlação positiva significativa entre escolaridade e o pensamento crítico (p<0,001). Conclusões: baixos níveis nos domínios de pensamento crítico em estudantes podem levar a consequências negativas para seus resultados de aprendizagem. Novos estudos devem ser realizados para confirmar nossos resultados, além da investigação de métodos de ensino que incentivem e garantam o desenvolvimento das habilidades de pensamento crítico dos estudantes durante a formação em enfermagem.

RESUMEN Objetivos: mapear el nivel de pensamiento crítico de los estudiantes brasileños de pregrado en enfermería e investigar la correlación entre los datos sociodemográficos seleccionados y los dominios del pensamiento crítico. Métodos: en este estudio transversal descriptivo, el pensamiento crítico de los participantes (N=89) fue evaluada mediante el Health Science Reasoning Test. La correlación entre los dominios de pensamiento crítico y los datos sociodemográficos se evaluó mediante el coeficiente de correlación de Pearson. Resultados: los resultados generales mostraron un nivel moderado de pensamiento crítico de los participantes (media=70,7; desviación estándar 5,7). Se identificó un desempeño deficiente en 5 de los 8 dominios del pensamiento crítico. Se encontró una correlación positiva significativa entre educación y pensamiento crítico (p<0,001). Conclusiones: los bajos niveles de los dominios del pensamiento crítico en los estudiantes pueden tener consecuencias negativas para sus resultados de aprendizaje. Se deben realizar más estudios para confirmar nuestros resultados, además de la investigación de métodos de enseñanza que fomenten y aseguren el desarrollo de habilidades de pensamiento crítico de los estudiantes durante su formación en enfermería.

Challenges and perspectives in research and teaching of host pathogen interaction topics: new post-pandemic times to Brazil and other South American countries

Here is our proposal to improve learning in biomedical sciences for graduate and undergraduate courses with a broad vision integrating disciplines such as molecular cell biology, biochemistry, and biophysics around concepts of pathogen interaction within vertebrate and invertebrate hosts. Our paradigm is based on the possibility offered by the pandemic to have remote activities that give access to students and researchers from different places in Brazil and Latin American countries to discuss science. A multidisciplinary view of host-pathogen interaction allows us to understand better the mechanisms involved in the pathology of diseases, as well as to formulate broad strategies for the diagnosis, treatment, and control of thereof. The approach to integrating heterogeneous groups in science involves the critical analysis of national scientific resource distribution, where only some have the possibilities to conduct competitive scientific research. Solid theoretical training, contact, collaboration with groups of excellence, and training within a multidisciplinary network are our proposals for a permanent platform of scientific strengthening and dissemination for Latin America. Here we will review the concept of host-pathogen interaction, the type of institutions where it is taught and researched, new trends in active teaching methodologies, and the current political context in science.

Influence of the teaching model based on the synergy of medical education on the objective structured clinical examination scores and critical thinking ability of interns in emergency department / 中华医学教育探索杂志

Objective:To investigate the influence of the teaching model based on the synergy of medical education on the objective structured clinical examination (OSCE) scores and critical thinking ability of interns in emergency department.Methods:A total of 84 students who studied as interns in Emergency Department of our hospital from January 2020 to 2021 were selected as research subjects, and they were divided into observation group and control group using a random number table, with 42 students in each group. The students in the control group were taught using traditional methods, while those in the observation group were taught based on the synergy of medical education. Both groups received an OSCE examination, and the two groups were compared in terms of OSCE score, critical thinking ability, and evaluation of teaching. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the observation group had significantly higher scores of theoretical assessment, disease assessment, first aid measures, special skills, use of medical instruments, communication skills with SP, and medical record writing and a significantly higher total score of OSCE assessment ( P<0.05). After teaching, both groups had a significant increase in the score of critical thinking ability, and the observation group had a significantly higher score than the control group [(306.38±25.76) vs. (280.39±20.17)]. The observation group had a significantly higher degree of satisfaction with teaching than the control group ( P<0.05). Conclusion:The teaching model based on the synergy of medical education can improve the OSCE score of interns in emergency department and cultivate their critical thinking ability, and there is a relatively high degree of satisfaction with this teaching model.

Observation on the teaching effect of mind mapping on interns in nephrology department / 中华医学教育探索杂志

Objective:To improve the critical thinking ability of interns in nephrology department based on electronic "Spot" mind mapping teaching method.Methods:In the control group, the traditional clinical teaching method was adopted. Each kidney disease unit was divided into 3 courses. ①The clinical practice teacher dictated or demonstrated his/her experience to the student in the first class. ②Students could exchange questions and answers in the second class. ③In the third class, according to the homework situation, the teacher presided over the discussion, guided the students to express their difficulties and help them solve the problems. The research group adopted the electronic "Spot" mind mapping teaching method: ①Grouping: the students were divided into groups, 6 to 8 people in each group, a total of 16 groups. ②Preparation: each group established a WeChat group, and teachers guided them download the Mindmanager software and learn its mapping method. ③In class: each kidney disease unit was divided into 3 sessions. In the first class, based on what the instructor taught, the students summarized the contents and drew a mind map, and then explain their understanding according to the map. In the second class, "Spot" in the group was conducted based on standards, reading each other in the group, actively discussing with each other, further improving and reconstructing the core knowledge points of the chapter, and encouraging each student to actively participate in enhancing their subjective initiative in learning. In the third class, teachers evaluated students according to their learning situation, and students filled in the gaps according to their opinions, perfected their mind maps, and finally posted to the WeChat group. ④Review: the final versions were sent to the WeChat groups as review materials, which was convenient for learning together. SPSS 24.0 was used for Chi-square test.Results:There was no significant difference between the two groups before study ( P>0.005). After the research, the scores of theory test ( t=2.52, P=0.015), clinical skill test ( t=2.22, P=0.034) and total score ( t=3.53, P=0.003) in the experimental group were significantly higher than those in the control group ( P<0.05). There was no significant difference in the scores of critical thinking ability between the two groups before research ( P>0.05). Six months after research, the total scores of critical thinking ability in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:The introduction of electronic "Spot" mind mapping teaching method into clinical practice teaching can realize the cross-linking of related knowledge points and systematize the knowledge. At the same time, it is interesting and can stimulate students' learning interest, and is helpful to cultivate the clinical critical thinking ability of students.

A presença de Paulo Freire em periódicos estrangeiros de terapia ocupacional: Uma revisão de escopo / Pulo Freire's presence in foreign occupational therapy journals: A scope review / Presencia de Paulo Freire em revistas extranjeras de terapia ocupacional: Una revisión de alcance

Introdução: As obras de Paulo Freire ganharam amplitude global e vêm sendo descritas na Terapia Ocupacional como um importante referencial para leituras e formas de interação- intervenção com as realidades complexas. Objetivo: Identificar como os referenciais teórico- metodológicos propostos por Paulo Freire são utilizados na produção científica de Terapia Ocupacional publicada em periódicos estrangeiros da área. Método: Pesquisa de revisão de escopo que incluiu artigos publicados em revistas especificas da área, não brasileiras, até o ano de 2020, em inglês, português e espanhol, que abordaram a Terapia Ocupacional e citaram pelo menos uma obra de Paulo Freire. A busca foi realizada por duas pesquisadoras, diretamente nos sites de 31 revistas e no Google Acadêmico. Os dados, coletados com utilização de uma planilha e um formulário, foram apresentados de forma descritiva. Resultados: Entre as 3840 ocorrências, 66 artigos foram incluídos. Identificou-se que 43% dos textos foram publicados após 2015, sendo 42% em periódicos da América do Norte. Encontrou-se citações de 17 obras de Paulo Freire, com destaque para o livro Pedagogia do Oprimido. O referencial é majoritariamente utilizado em abordagens metodológicas, com algum nível de aprofundamento, a partir de 9 concepções/construtos: Educação, relações de poder, pesquisa, diálogo, práxis, empoderamento, conscientização, cultura e libertação. Conclusão: A presença de Paulo Freire na Terapia Ocupacional, em diferentes partes do mundo, vem permitindo maior articulação e aprofundamento teórico-metodológico deste referencial em nível global, a fim de estabelecer pactuações éticas e políticas para o real compromisso da área com as demandas cada vez mais complexas da vida social.

Introduction: Paulo Freire's works have gained global scope and have been described in Occupational Therapy as an important reference for readings and forms of interaction-intervention with complex realities. Aim: Identify how the theoretical-methodological references proposed by Paulo Freire are used in the scientific production of Occupational Therapy published in foreign journals in the area. Method: Scope review research that included articles published in specific journals in the non-Brazilian area until 2020, in English, Portuguese and Spanish, which addressed . Occupational Therapy and cited at least one work by Paulo Freire. The search was carried out directly on the websites of 31 magazines and on Google Scholar. The data, collected using a spreadsheet and a form, were presented descriptively. Results: Among the 3840 occurrences, 66 articles were included. It was identified that 43% of the texts were published after 2015, being 42% in North American journals. Citations of 17 works by Paulo Freire were found, with emphasis on the book Pedagogia do Oprimido. The framework is mostly used in methodological approaches, Pwaitlhavsoramse-clhevaevleo:fEdnespintho,Obnalsineed. oTner9apcioanOcecuptpsa/cionsatlr.uAcptsr:enEdiuzacagteimon.,CpOoVwIeDr-r1e9l.ations, research, dialogue, praxis, empowerment, awareness, culture and liberation. Conclusion: The presence of Paulo Freire in Occupational Therapy in different parts of the world has allowed greater articulation and theoretical-methodological deepening of this framework at a global level, in order to establish ethical and political pacts for the area's real commitment to the ever-increasing demands more complex aspects of social life.

Introducción: Las obras de Paulo Freire han ganado alcance global y han sido descritas en Terapia Ocupacional como un referente importante en las realidades complejas. Objetivo: Identificar cómo se utilizan los referentes teórico-metodológicos propuestos por Paulo Freire en la producción científica de Terapia Ocupacional publicada en revistas extranjeras del área.. Método: Investigación de revisión de alcance que incluyó artículos publicados en revistas específicas del área no brasileña hasta 2020, en inglés, portugués y español, que abordó la Terapia Ocupacional y citó al menos un trabajo de Paulo Freire. La búsqueda se realizó directamente en los sitios web de 31 revistas y en Google Scholar. Los datos, recopilados mediante una hoja de cálculo y un formulario, se presentaron de forma descriptiva. Resultados: Entre las 3840 ocurrencias, se incluyeron 66 artículos. Se identificó que el 43% de los textos fueron publicados después de 2015, el 42% en revistas norteamericanas. Se encontraron citas de 17 obras de Paulo Freire, con énfasis en el libro Pedagogia do Oprimido. El marco se utiliza mayoritariamente en enfoques metodológicos, con cierto nivel de profundidad, basados en 9 conceptos / constructos: Educación, relaciones de poder, investigación, diálogo, praxis, empoderamiento, conciencia, cultura y liberación. Conclusión: La presencia de Paulo Freire en Terapia Ocupacional en diferentes partes del mundo ha permitido una mayor articulación y profundización teórico-metodológica de este marco a nivel global, con el fin de establecer pactos éticos y políticos para el compromiso real del área con la eternidad. cada vez más exige aspectos más complejos de la vida social.

Formación posgraduada y modos hegemônicos de análisis de políticas públicas

Objetivo Caracterizar los modos de enseñar e investigar políticas públicas a nivel de posgrado en Colombia. Métodos Investigación cualitativa de tipo análisis documental. Inicialmente, se realiza una caracterización general de autores, enfoques teóricos empleados, temáticas de interés, entre otros. En un segundo momento, y a partir del contenido de los programas académicos de los posgrados de donde emergieron las tesis analizadas, se identificaron significantes centrales del discurso curricular. Resultados Se analizaron 313 tesis y 8 programas de posgrado en políticas públicas. Se destaca una marcada preferencia por el empleo de enfoques pospositivistas y estrategias tipo problemsolving; cuestionamientos débiles a determinantes estructurales de opresión, exclusión y explotación, y mantenimiento de relaciones de dominación en la toma de decisiones entre investigadores de ciencias políticas/administrativas y sujetos con otros saberes. Conclusiones Los hallazgos del estudio problematizan el campo del Análisis de Políticas Públicas, sus posturas epistemológicas y métodos predominantes, así como el papel que asume el analista, invitando al lector a reflexionar sobre la necesidad de incursionar en enfoques críticos alternativos.

Objective To describe the methods used at a postgraduate level to teach and research public policies in Colombia. Methods Documentary analysis as part of a qualitative study. Among other things, a broad characterisation of authors, theoretical techniques employed, and areas of interest was accomplished in a first instance. Then, the main significants of the programmatic discourse were recognized based on the postgraduate curriculum from the universities from which the investigated thesis came. Results 313 theses and 8 postgraduate programs in public policy analysis were studied. There is a clear preference for post-positivist mainstream approaches and problem-solving strategies; weak challenges to structural determinants of oppression, exclusion, and exploitation; and the preservation of dominant relationships in decision-making between political/administrative science researchers and subjects with other knowledge. Conclusions The research's findings challenge the discipline of Public Policy Analysis, its epistemological views, and its dominant study methodologies, as well as the analyst's role, encouraging the reader to consider the need for alternative critical approaches.

Implementation of case-based learning method for teaching biochemistry for undergraduate medical students

Background: First year MBBS curriculum in Biochemistry is taught by the conventional methods of teaching in which didactic lectures share almost 70% of the total content load, in which students fail to grasp the importance of biochemistry and its significant contribution in medical laboratory science. Hence, case-based learning (CBL) is being used in the medical curriculum, so that students are exposed to the real-life medical problems. Aim and Objectives: The study aimed implementation of CBL sessions in 1st year MBBS students and to analyze perception of students and faculty about the effectiveness of CBL method. Materials and Methods: A group of 150 students of Phase 1 MBBS course was selected for interventional study comprising two teaching-learning sessions on two core topics in biochemistry. Pre-test and post-test were conducted before and after the CBL session. A third test was conducted 1 month after the post-test to assess retention of knowledge gained by the students. The performance of the students was analyzed. Results: Pre-test and post-test analysis showed a very significant improvement in performance of the students after the CBL sessions. About 95% of the students and 90% of faculty reported that CBL sessions were useful to facilitate critical thinking through active learning. About 85% of students and 80% of faculty expressed that CBL helped in bridging the gap between theory and practice. Conclusion: It is evident from the present study that CBL in biochemistry can be implemented as innovative and effective teaching module to achieve the learning objectives. Case studies encourage active learning, promote critical thinking, and instill motivation in the subject.

Guidance of critical thinking of clinical medical students in disease-centered PBL integrated course: taking diabetes as example / 中华医学教育探索杂志

Disease-centered problem-based learning (PBL) integrated course inspires the thinking of medical students in the case scenario to stimulate students' motivation of active learning. In this paper, the study of diabetes cases was taken as an example. Through the design of PBL cases, the scenario was reconstructed and information was provided step by step, so as to induce the students to discuss and learn the related knowledge of glucose metabolism and understand the predisposing factors of diabetes. Furthermore, students' critical thinking could be inspired through the information of the misdiagnose and mistreatment to recognize the clinical presentation and inducement of diabetic ketoacidosis. This teaching model is conducive to the cultivation of medical students' questioning spirit and critical thinking, laying a foundation for the cultivation of innovative medical talents.

Application of blended learning in the teaching of undergraduate nursing research / 中华医学教育探索杂志

Objective:To explore the application effect of blended learning on the teaching of nursing research course for undergraduate nursing students.Methods:From March to July 2019, a total of 118 undergraduate nursing students from Batch 2016 of a university in Xinjiang were collected in this study and divided into two groups randomly: the experimental group ( n = 60) and the control group ( n = 58). At the end of the course, the final examination scores of the nursing students were compared, and questionnaires were used to evaluate the critical thinking, self-directed learning ability and satisfaction of nursing students. SPSS 21.0 was used for independent-sample t-test and chi-square test. Results:After the implementation of the course, the scores of nursing research theory and practice of nursing students in the experimental group were (78.97±6.57) points and (83.02±3.50) points respectively, which were better than those of nursing students in the control group (75.48±7.76) points and (81.48±3.86) points. The total scores of critical thinking ability and self-directed learning ability of nursing students in the experimental group (294.67±25.15) and self-directed learning ability (277.67±30.84) were higher than those in the control group (222.03±18.77) and (203.81±33.19). The satisfaction degree of nursing students in the experimental group (93.33%) was better than that in the control group (60.34%), with statistical significance ( P<0.05). Conclusion:The application of blended learning in nursing research teaching can improve the final examination results of nursing students, and contribute to the improvement of nursing students' critical thinking ability, self-directed learning ability and course satisfaction.

Effect of magnetic nursing concept on improving nurses' ECMO nursing ability / 中华医学教育探索杂志

Objective:To study the effect of magnetic nursing concept on improving nurses' nursing ability of extracorporeal membrane oxygenation (ECMO).Methods:In the study, 33 nurses of emergency intensive care unit of The First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2020 were selected as the research objects. From January 2019 to December 2019, the Department carried out routine nursing management, and from January 2020 to December 2020, the Department implemented the management mode of magnetic nursing concept. The mastery of nursing knowledge of ECMO was analyzed by using scale, and the critical thinking ability and self-study ability of the nurses were compared before and after intervention. SPSS 22.0 was used to perform t test on the data. Results:After the intervention, nurses' mastery of respiratory system nursing, circulatory system nursing, fluid balance nursing, skin nursing, digestive system nursing, bleeding, anticoagulant problem nursing, hospital infection prevention and control, and pipeline nursing related knowledge of ECMO patients was significantly better than that before the intervention ( P<0.05). After the intervention, nurses' truth-seeking, open thinking, systematic ability, analytic ability, thinking self-confidence, thirst for knowledge, cognitive maturity and total scale scores were significantly higher than those before the intervention ( P<0.05). After the intervention, nurses' self motivation belief, task analysis, self-monitoring and regulation, self-evaluation and total score were significantly higher than those before the intervention ( P<0.05). Conclusion:The nursing management mode of magnetic nursing concept is of value in improving nurses' autonomous learning ability and critical thinking ability.

Application of evidence-based nursing teaching mode in clinical teaching for undergraduate nursing students in surgical ward / 中国实用护理杂志

Objective:To examined the effects of the evidence-based nursing teaching mode for undergraduate nursing students on evidence-based practice ability, critical thinking and creativity.Methods:From July 2019 to November 2021, 79 undergraduate nursing students from 14 groups who practiced in Department of Colorectal Surgery/Thyroid Surgery of Qilu Hospital of Shandong University were randomly assigned to evidence-based nursing teaching group (33 cases) and traditional teaching group (46 cases) by random number method. The traditional teaching group conducts one-to-one teaching according to the general clinical practice plan, the teaching plan of the department, and the list of training items; the evidence-based nursing teaching group, on the basis of traditional teaching, implements three courses and corresponding practice guidance of evidence-based nursing teaching for 4 weeks. The evidence-based practice ability, critical thinking and creativity tendency of undergraduate nursing students were evaluated by the Evidence-Based Practice Competence Questionnaire, Critical Thinking Disposition Inventory-Chinese Version, and Williams Creativity Tendency Scale before and immediately after the intervention. Generalized linear models (repeated measures) were used in the analyses.Results:After the intervention, the scores of evidence-based practical knowledge, truth seeking (the dimension of critical thinking) and creative tendency in evidence-based nursing teaching group were 22.09 ± 3.15, 39.61 ± 5.26, and 109.88 ± 11.76, respectively, the traditional teaching group was 20.56 ± 3.00, 37.93 ± 4.38, and 109.37 ± 10.78, respectively. Before the intervention, the scores of evidence-based practical knowledge, truth seeking (the dimension of critical thinking) and creative tendency in evidence-based nursing teaching group were 19.54 ± 3.54, 39.24 ± 3.54 and 104.88 ± 10.97, respectively, the traditional teaching group were 19.89 ± 3.15, 40.48 ± 4.12, and 108.72 ± 10.72, respectively. The increased scores of evidence-based practical knowledge, truth-seeking (dimension of critical thinking), and creativity tendency after the intervention in the evidence-based nursing teaching group were significantly higher than those of the traditional teaching group ( F=4.51, 10.03, 4.21, all P<0.05). Conclusions:The evidence-based nursing teaching mode is conducive to the increase of evidence-based practical knowledge, improvement of the critical thinking ability and creativity of undergraduate nursing students.

O compromisso social da psicologia e a possibilidade de uma profissão abrangente / The social commitment of psychology and the possibility of a comprehensive profession / El compromiso social de la psicología y la posibilidad de una profesión amplia

As origens da Psicologia brasileira se relacionam ao projeto de modernização do país, com que ela contribuiu por meio de uma concepção universal de sujeito e de processos de classificação e categorização, pouco atentos às necessidades da realidade social. No processo de redemocratização do país, condições históricas possibilitaram uma ruptura com essa perspectiva, operada pelo Projeto do Compromisso Social. Este texto apresenta uma reflexão sobre o caminho de construção dessa ruptura e de um projeto ético-político comprometido com a realidade brasileira. Analisa o percurso impulsionado na virada do século XX para o século XXI por meio da atuação de entidades da profissão, notadamente os Conselhos de Psicologia, em articulação com importantes mudanças na atuação das psicólogas. Tal percurso permitiu uma revisão crítica da Psicologia, sendo apresentado em cinco eixos: produção de sujeitos democráticos e defesa da democracia; construção de resistência à alienação e combate ao pensamento colonizado; perspectiva de serviços profissionais comprometidos com a garantia de direitos; aprimoramento da qualidade da prática profissional das psicólogas; e expansão das fronteiras da psicologia. Em cada um, são apresentadas ações, estratégias e projetos que levaram à ampliação e ao reconhecimento social da Psicologia, organizada, democrática, ousada e acessivelmente à maioria da população. Ao mesmo tempo, apresenta desafios para a continuidade desse projeto na realidade atual, apostando que, com 60 anos de regulamentação, a Psicologia é capaz de enfrentar novas questões que se colocam no país por meio da atuação das profissionais que levam adiante o projeto de compromisso social.(AU)

Psychology in Brazil is born alongside the country's modernization project, to which the science contributed by establishing a universal conceptualization of the individual and classification and categorization processes, hardly attentive to social reality. The historical conditions set forth by the country's re-democratization allowed a breaking from this perspective, operated by the Social Commitment Project. This paper reflects on the paths that led to this transformation and the ensuing ethical-political project committed to Brazil's reality. It analyzes the trajectory started in the turn of 20th to the 21st century, led by professional entities, namely the Psychology Councils, along with important changes in the psychologist's work. Such trajectory allowed for a critical review of Psychology in five axes: 1) production of democratic individuals and the defense of democracy; 2) construction of resistance against alienation and the fight against a colonized thought; 3) perspectives of professional services committed to ensuring rights; 4) enhanced quality of the psychologist's professional practice; 5) the broadening of the scope of psychology. For each axis, the text presents actions, strategies, and projects that led to the organized and democratic growth and social acknowledgment of Psychology, becoming accessible to most of the population. But it also points out the challenges for this project's current continuity, believing that with 60 years of regulation, Psychology is capable of facing new issues arising in the country by means of professionals who carry on the social commitment project.(AU)

Los orígenes de la Psicología brasileña están relacionados con el proyecto de modernización del país al que contribuyó a través de una concepción universal del sujeto y de procesos de clasificación y categorización poco atentos a las necesidades de la realidad social. En el proceso de redemocratización del país, las condiciones históricas permitieron romper con esta perspectiva, operada por el Proyecto de Compromiso Social. Este texto presenta una reflexión sobre el camino de construcción de esa ruptura y de un proyecto ético-político comprometido con la realidad brasileña. Se analiza la ruta promovida en la transición del siglo XX al siglo XXI, por medio de la acción de entidades de la profesión, en particular los Consejos de Psicología, en articulación con cambios importantes en la actuación de las psicólogas. Este camino permitió una revisión crítica de la Psicología y se presenta en cinco ejes: producción de sujetos democráticos y defensa de la democracia; construcción de resistencia a la alienación y combate al pensamiento colonizado; perspectiva de servicios profesionales comprometidos con la garantía de derechos; mejora de la calidad de la práctica profesional de las psicólogas; y ampliación de las fronteras de la psicología. El texto plantea desafíos para la continuidad de este proyecto en la realidad actual, apostando que con 60 años de regulación la Psicología esté en condiciones de hacer frente a las nuevas cuestiones que se presentan en el país gracias al trabajo de las profesionales que llevan adelante el proyecto de compromiso social.(AU)

Efeito de guia para raciocínio clínico na acurácia diagnóstica de estudantes de enfermagem: ensaio clínico / Effect of a guide for clinical reasoning on Nursing students' diagnostic accuracy: A clinical trial / Efecto de una guía de razonamiento clínico sobre la precisión diagnóstica de estudiantes de enfermería: ensayo clínico

Resumo Objetivo avaliar o efeito do Guia Autoinstrucional para Raciocínio Clínico na acurácia diagnóstica de estudantes de Bacharelado em Enfermagem. Método ensaio clínico randomizado, paralelo, duplo cego (pesquisadores e avaliadores dos desfechos), realizado com graduandos de Enfermagem. Aplicaram-se, em duas fases, estudos de caso validados para a identificação de diagnóstico de enfermagem/problema do paciente, etiologia e pistas, sendo utilizado o Guia com o grupo intervenção na segunda fase. Os desfechos - acurácia diagnóstica, etiológica e número de pistas - foram avaliados por meio de rubricas validadas. Para análise, utilizou-se estatística descritiva para dados demográficos; teste exato de Fisher para similaridades na educação prévia e confiança; teste de Mann-Whitney para idade; teste ANOVA não paramétrico na avaliação da hipótese de diferenças no desempenho. Resultados amostra final composta por 24 estudantes no grupo controle e 27 no intervenção; sem diferença quanto ao sexo, idade e educação. Houve diferença para acurácia diagnóstica (p=0,041) e etiológica (p=0,0351) no grupo intervenção, mostrando efeito negativo da utilização do Guia. Conclusão a autoinstrução implementada uma única vez não foi efetiva em impactar a acurácia diagnóstica de estudantes solucionando estudos de caso. A aplicação repetida do Guia como ferramenta didática pode ser efetiva para melhorar tal desfecho. REBEC: RBR-4bhr78.

Abstract Objective to evaluate the effect of the Self-Instructional Guide for Clinical Reasoning on the diagnostic accuracy of undergraduate Nursing students. Method a randomized, parallel and double-blind (researchers and outcome evaluators) clinical trial, carried out with undergraduate Nursing students. Validated case studies were applied in two phases to identify the patient's Nursing diagnosis/problem, etiology and clues, using the Guide with the intervention group in the second phase. The outcomes - diagnostic and etiological accuracy and number of clues - were evaluated using validated rubrics. Descriptive statistics were used to analyze demographic data; Fisher's exact test for similarities in prior education and confidence; Mann-Whitney's test for age; and non-parametric ANOVA test in the evaluation of the hypothesis of differences in performance. Results final sample composed of 24 students in the control group and 27 in the intervention group; no difference as to gender, age and schooling. There was a difference in diagnostic (p=0.041) and etiological (p=0.0351) accuracy in the intervention group, showing a negative effect of using the Guide. Conclusion the one-time self-instruction was not effective in impacting the diagnostic accuracy of students solving case studies. Repeated application of the Guide as a teaching tool can be effective in improving such outcome. REBEC: RBR-4bhr78.

Resumen Objetivo evaluar el efecto de la Guía Autoinstruccional de Razonamiento Clínico en la precisión diagnóstica de estudiantes de Licenciatura en Enfermería. Método ensayo clínico aleatorizado, paralelo, doble ciego (investigadores y evaluadores de resultados), realizado con estudiantes de la carrera de enfermería. Se aplicaron estudios de casos validados en dos fases para identificar el diagnóstico de enfermería/problema del paciente, etiología y pistas, utilizando la Guía con el grupo experimental en la segunda fase. Los resultados (precisión diagnóstica, etiológica y número de pistas) se evaluaron utilizando rúbricas validadas. Para el análisis se utilizó estadística descriptiva para datos demográficos; prueba exacta de Fisher para similitudes en educación previa y confianza; prueba de Mann-Whitney para la edad; prueba ANOVA no paramétrica en la evaluación de la hipótesis de diferencias en el desempeño. Resultados muestra final compuesta por 24 estudiantes en el grupo control y 27 en el grupo experimental; no había diferencias en cuanto al sexo, la edad y educación. Hubo diferencia en la precisión diagnóstica (p=0,041) y etiológica (p=0,0351) en el grupo experimental, que mostraron un efecto negativo del uso de la Guía. Conclusión la autoinstrucción implementada por única vez no fue efectiva para generar un impacto en la precisión diagnóstica de los estudiantes que resolvieron los estudios de casos. La aplicación repetida de la Guía como herramienta de enseñanza puede ser eficaz para mejorar dicho resultado. REBEC: RBR-4bhr78.

The role of physical activity promoting thinking skills and emotional behavior of preschool children

Objectives: Physical activity is critical, not only for the normal growth and development of children, but also for emotional and social behavior. The purpose of the article is to determine the relationship between physical education and social and emotional development of preschool children. Methods: The study involved 366 children (188 boys and 178 girls) at the ages of 5 (N = 191) and 6 (N = 174), who study in public kindergartens in Beijing (China). Within 3 months, additional physical education and fitness classes were held. Before and after the study, a test was conducted: Ages & Stages Questionnaires: Social-Emotional (ASQ:SE), which was completed by the parents. The research process did not affect the performance or development of children participants. Results: As a result of the study, the main regularities of the influence of physical education on social and emotional behavior of children were established. Based on the results of the study, it was determined that there is a positive correlation between age, physical education, and social-emotional behavior (r +—= 0.668). Conclusion: Gender differences are not statistically significant when it comes to physical activity's effect on social and emotional behavior (p-value = 0.004). The results can be applied to programs for the prevention of psychosocial and social-emotional development delays of children in kindergartens. (AU)

Effects of concept map combined with TBL teaching method on the examination results, critical thinking ability and teaching satisfaction of nursing interns / 中华医学教育探索杂志

Objective:To explore the effects of concept map combined with team-based learning (TBL) teaching method on the examination results, critical thinking ability and teaching satisfaction of nursing interns.Methods:A total of 67 nursing interns in Guangyuan Central Hospital from March to October 2019 were selected and randomly divided into study group and control group. TBL teaching method was used in the control group, and concept map combined with TBL teaching method was used in the study group. The assessment results, critical thinking ability and teaching satisfaction of the two groups were compared. SPSS 22.0 was used for chi-square test and t test. Results:The theoretical knowledge and final examination scores of the study group were higher than those of the control group ( P<0.05); after teaching, the scores of curiosity, truth seeking, systematic ability and self-confidence and total scores of the study group were higher than those before teaching and those of the control group ( P<0.05); the satisfaction scores on having great value to clinical practice, improving learning initiative, helping to understand teaching content, cultivating cooperative learning ability and stimulating learning competitiveness in the study group were higher than those in the control group ( P<0.05). Conclusion:Concept map combined with TBL teaching method is beneficial for nursing interns to master learning knowledge, improve critical thinking ability and increase teaching satisfaction.