Testing the interrater reliability of integrated interpretations using a problem-solving model.

[Purpose] A method for evaluating integrated interpretation skills, which is an important educational goal in clinical practice, is yet to be established. This study examined the interrater reliability of a problem-solving model that was developed as a novel assessment method. [Participants and Methods] Three students created problem-solving models using fictitious case data. Ten clinical practice supervisors with at least 3 years of experience were asked to score the models, and the intraclass correlation coefficient (2, 1) was calculated. [Results] The intraclass correlation coefficient was 0.88, which indicates a good result. [Conclusion] Good interrater reliability was obtained using the problem-solving model, which suggests that this model may be used to assess integrated interpretation skills in clinical practice.

Is a Problem-Solving Intervention with Workplace Involvement for Employees on Sickness Absence Due to Common Mental Disorders More Effective, than Care as Usual, in Reducing Sickness Absence Days? Results of a Cluster-Randomised Controlled Trial in Primary Health Care.

PURPOSE: The aim was to evaluate the effectiveness of a problem-solving intervention with workplace involvement (PSI-WPI) added to care as usual (CAU) in reducing sickness absence days among employees with common mental disorders compared to CAU alone in Swedish primary health care on a monthly basis over 18-months follow-up. METHODS: We conducted a cluster-randomised controlled trial including 197 employees blinded to allocation (85 PSI-WPI and 112 CAU). As sickness absence data was skewed and over-dispersed, generalised estimating equations was used to enable a comparison between the intervention and control group for each month of the follow-up period. RESULTS: The median number of sickness absence days over the 18-month follow-up was 78 days, inter-quartile range (IQR) 18-196 for employees receiving PSI-WPI and 64 days, IQR 18-161 for employees receiving CAU. The time x group generalised estimating equations analysis showed no statistically significant difference in sickness absence days per month. CONCLUSION: The addition of a PSI-WPI to CAU was not more effective in reducing sickness absence days. This may be explained by the primary health care context, lack of specialisation in occupational health and the Swedish social insurance system with specific time limits. TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov, identifier: NCT03346395 on January 12th, 2018.

Protocol of a multisite randomized controlled trial of bright IDEAS-young adults: Problem-solving skills training to reduce distress among young adults with Cancer.

BACKGROUND: Young adults with cancer diagnosed between the ages of 18 to 39 are recognized as a vulnerable group with unique emotional, social, and practical needs that put them at risk of poor psychosocial outcomes and impaired health-related quality of life (HRQOL). This study describes the protocol of a randomized controlled trial to evaluate the efficacy of Bright IDEAS-Young Adults (Bright IDEAS-YA), a problem-solving skills training intervention, on psychosocial outcomes of young adults newly diagnosed with cancer. METHODS: Bright IDEAS-YA is a two-arm, parallel, randomized controlled trial. Young adults are eligible if they are 18-39 years of age, within four months of a first cancer diagnosis, and receiving systemic therapy with life expectancy of at least six months. Participants are randomized 1:1 to Bright IDEAS-YA or enhanced usual care. Survey measures are completed at enrollment and 3, 6, 12, and 24 months. The primary endpoint will be the estimated change from baseline to 6 months in symptoms of depression, anxiety, and psychosocial HRQOL. The other time points are secondary endpoints. Mediators and moderators will be examined. CONCLUSIONS: This randomized trial will determine the efficacy of Bright IDEAS-YA on psychosocial outcomes for young adults newly diagnosed with cancer. Analyses will also examine mechanisms of action and potentially identify subgroups for whom the intervention is particularly useful. TRIAL REGISTRATION: clinicaltrials.gov #NCT04585269.

Potential of active learning in dentistry: A comparative study of Jigsaw versus inquired-based learning.

OBJECTIVE: To compare the efficacy of Jigsaw and Inquiry-Based Learning (IBL) methods in promoting effective learning outcomes within diverse dental educational settings. METHODS: A total of 188 dental undergraduate students were recruited for the study and divided into Batch A (n = 96) and Batch B (n = 92). Each batch underwent two teaching sessions, one using the Jigsaw method and the other using IBL. A structured questionnaire using five-point Likert scales assessed students' preferences between the two methods. Pre- and post-intervention tests were conducted to measure knowledge acquisition. Statistical analysis was performed using Student's t-test with STATA version 17, with a p-value of < 0.05 considered significant. RESULTS: Both Jigsaw and IBL methods significantly improved students' knowledge, with mean scores showing a significant difference before and after interventions (p < 0.001). IBL was more effective in comprehensive topic coverage (99.46%) and enhancing subject understanding. Both methods yielded comparable outcomes in terms of improving communication skills. The Jigsaw method was simpler and more enjoyable, encouraging active participation and enhancing communication skills. IBL promoted critical thinking, research skills, and deeper comprehension of concepts. CONCLUSION: Jigsaw and IBL methods are both effective in enhancing dental education. The choice between these methods depends on the specific learning objectives, the complexity of the topic, and the preferences of the dental educator and students.

Investigating social media addiction and impact of social media addiction, loneliness, depression, life satisfaction and problem-solving skills on academic self-efficacy and academic success among university students.

Introduction: The negative effects of post-COVID-19 restrictions have been detected in students' mental well-being due to internet addiction, changing habits, despair and uncertainty. Students' academic success is expected to be affected by social media addiction, loneliness, depression, life satisfaction, problem solving skills and academic self-efficacy factors. This study aimed to determine the level of social media addiction and the effects of these factors on the academic success of university students and define their interactions with each other. Methods: Four hundred nineteen questionnaires were collected between October-December 2022 at Bingöl University, Türkiye. Descriptive statistics, independent t-test, One-Way ANOVA, correlation and multiple linear regression methods were used to analyze data with the help of the SPSS 22 software. Results: Middle level grade (GPA) average (71,17 ± 9,69 out of 100), low level social support from friends and family members (34,6%), spending more than 4 h on social media (42,5%), middle level social media addiction, moderate depression level (51,31%-PHQ > 10), mild loneliness and slight dissatisfaction with life were found among students. Furthermore, high academic self-efficacy, moderate agreement with academic performance and good problem-solving skills were indicated in the survey results. Significant differences, such as higher life satisfaction among males and higher depression among females, were measured. Academic self-efficacy scale, problem solving skills and satisfaction with life had a negative correlation with social media addiction and depression, while a positive correlation with academic performance measures. Problem solving skills, satisfaction with life, fourth class vs. others and living alone vs. others were positive predictors of the academic self-efficacy. Meanwhile, loneliness was a negative predictor of the academic self-efficacy, while higher problem-solving skills and being female were positive factors leading to a higher GPA. Discussion: The fact that the participants were only students from Bingöl University limits the ability to generalize the results. Policymakers could implement social and problem-solving skills training to develop better academic programs and cognitive-behavioral therapy for students' academic success.

The mathematical word problem-solving performance gap between children with and without math difficulties: does working memory mediate and/or moderate treatment effects?

This study determined the extent to which working memory (WM) played a moderating and/or mediating role in word-problem-solving (WPS) instructional outcomes between children with and without math difficulties (MD). A randomized pretest-posttest control group study investigated the effects of 8-week strategy instruction in one of four treatment conditions on WPS accuracy of third graders with MD (N = 136) when compared to children with (N = 28) and without MD (N = 43). Comparisons were made of three strategy conditions that included overt cues (e.g. underlining key sentences, filling in diagrams), another treatment condition that removed the overt cues (material-only), and two control conditions (children with and without MD). Four important findings emerged. First, posttest WM significantly predicted posttest WPS, computation, and schema accuracy independent of pretest and treatment conditions. Second, posttest WM mediated posttest WPS treatment outcomes when the control conditions included children without MD. Third, strategy conditions that included overt cues (e.g. crossing out irrelevant sentences) decreased WM demands compared to the Materials-Only condition (without overt cues) for children with MD. Finally, incremental attention allocation training within treatment conditions improved posttest WM in children with MD but not posttest WPS. Results indicated that WPS differences between children with and without MD across treatment conditions were mediated by posttest WM performance.

Relationship Between Prone Skills and Motor-Based Problem-Solving Abilities in Full-Term and Preterm Infants During the First 6 Months of Life.

Motor experiences shape cognitive development in infancy, with the prone position being one such crucial motor experience in the first 6 months of life. Although the motor benefits of the prone position are well-documented, its influence on early cognitive abilities remains insufficiently explored. This study quantified the relationship between prone motor skills and motor-based problem-solving abilities in 48 full-term and preterm infants aged 3-6 months. Prone skills were assessed using the Alberta Infant Motor Scale's prone domain. The Assessment of Problem-Solving in Play was utilized to measure motor-based problem-solving by observing how motor actions were used to solve toys. Advanced prone motor skills were correlated with an increase in sophisticated exploration skills and a concurrent decline in lower order exploration skills in all infants, with correlations being stronger in preterm infants. Notably, a 1-point increase in prone skills was associated with a 1.3-point increase in total motor-based problem-solving abilities in all infants. Our findings provide preliminary evidence for the contribution of prone play to cognitive development in infants, prompting considerations for assessment and intervention strategies. Further research is needed to ascertain if the delayed acquisition of prone motor skills is indicative of poor early problem-solving abilities in preterm infants.

Effects of M-DEPTH Model of Depression Care on Maternal Functioning and Infant Developmental Outcomes in the Six Months Post Delivery: Results from a Cluster Randomized Controlled Trial.

Perinatal depression has been shown to have deleterious effects on maternal post-partum functioning, as well as early child development. However, few studies have documented whether depression care helps to mitigate these effects. We examined the effects of the M-DEPTH (Maternal Depression Treatment in HIV) depression care model (including antidepressants and individual Problem Solving Therapy) on maternal functioning and infant development in the first 6 months post-delivery in an ongoing cluster randomized controlled trial of 391 HIV-infected women with at least mild depressive symptoms enrolled across eight antenatal care clinics in Uganda. A subsample of 354 (177 in each of the intervention and control groups) had a live birth delivery and comprised the analytic sample, of whom 69% had clinical depression at enrollment; 70% of women in the intervention group (including 96% of those with clinical depression) received depression treatment. Repeated-measures multivariable regression models found that the intervention group reported better infant care, lower parental burden, and greater perceived adequacy of parental support, compared to the control group. These findings suggest that depression care for pregnant women living with HIV is important not only for maternal mental health, but it also helps women to better manage parenting and care for their infant.

Evaluating prompt engineering on GPT-3.5's performance in USMLE-style medical calculations and clinical scenarios generated by GPT-4.

This study was designed to assess how different prompt engineering techniques, specifically direct prompts, Chain of Thought (CoT), and a modified CoT approach, influence the ability of GPT-3.5 to answer clinical and calculation-based medical questions, particularly those styled like the USMLE Step 1 exams. To achieve this, we analyzed the responses of GPT-3.5 to two distinct sets of questions: a batch of 1000 questions generated by GPT-4, and another set comprising 95 real USMLE Step 1 questions. These questions spanned a range of medical calculations and clinical scenarios across various fields and difficulty levels. Our analysis revealed that there were no significant differences in the accuracy of GPT-3.5's responses when using direct prompts, CoT, or modified CoT methods. For instance, in the USMLE sample, the success rates were 61.7% for direct prompts, 62.8% for CoT, and 57.4% for modified CoT, with a p-value of 0.734. Similar trends were observed in the responses to GPT-4 generated questions, both clinical and calculation-based, with p-values above 0.05 indicating no significant difference between the prompt types. The conclusion drawn from this study is that the use of CoT prompt engineering does not significantly alter GPT-3.5's effectiveness in handling medical calculations or clinical scenario questions styled like those in USMLE exams. This finding is crucial as it suggests that performance of ChatGPT remains consistent regardless of whether a CoT technique is used instead of direct prompts. This consistency could be instrumental in simplifying the integration of AI tools like ChatGPT into medical education, enabling healthcare professionals to utilize these tools with ease, without the necessity for complex prompt engineering.

Approaches for sustainable professional skill development for vocational education students in Thailand.

Background: This article presents a research study that aims to explore sustainable approaches for developing professional skills in vocational education students in Thailand. This is the second phase of the research, which utilizes a qualitative research methodology. Methodology: The key informants in this study are administrators of vocational education institutions, teachers, and students currently enrolled in vocational education institutions in Thailand, totaling 36 participants. The research uses a purposive sampling method and snowball sampling method. Data collection methods include document analysis, in-depth structured interviews, and observation. The results of the interviews are analyzed, and the content analysis is summarized. The research process consists of 4 steps: 1) literature review, 2) data collection, 3) data analysis, and 4) verification and confirmation. Results: The research findings highlight several key considerations, including: 1) factors influencing the development of professional skills among vocational education students, such as curriculum design, support and counseling, practical training in workplaces, interactive learning, problem-solving and analytical thinking skills development, practical learning, and supportive learning environments, 2) approaches for sustainable professional skill development involve employing the appropriate approaches for self-development. The steps include setting clear goals and plans, active learning and training, technology skill development, experiential learning, problem-solving skill development, participation in professional activities, self-reflection, and continuous self-improvement. Conclusion: These approaches aim to enhance the competencies of vocational education students, ensuring quality and efficiency as part of lifelong learning and sustainable development.

Problem-solving model guided by stimulus-organism-response theory: State of mind and coping styles of depressed mothers after cesarean delivery.

BACKGROUND: The use of a problem-solving model guided by stimulus-organism-response (SOR) theory for women with postpartum depression after cesarean delivery may inform nursing interventions for women with postpartum depression. AIM: To explore the state of mind and coping style of women with depression after cesarean delivery guided by SOR theory. METHODS: Eighty postpartum depressed women with cesarean delivery admitted to the hospital between January 2022 and October 2023 were selected and divided into two groups of 40 cases each, according to the random number table method. In the control group, the observation group adopted the problem-solving nursing model under SOR theory. The two groups were consecutively intervened for 12 weeks, and the state of mind, coping styles, and degree of post-partum depression were analyzed at the end of the intervention. RESULTS: The Edinburgh Postnatal Depression Scale and Hamilton Depression Scale-24-item scores of the observation group were lower than in the control group after care, and the level of improvement in the state of mind was higher than that of the control group (P < 0.05). The level of coping with illness in the observation group after care (26.48 ± 3.35) was higher than that in the control group (21.73 ± 3.20), and the level of avoidance (12.04 ± 2.68) and submission (8.14 ± 1.15) was lower than that in the control group (15.75 ± 2.69 and 9.95 ± 1.20), with significant differences (P < 0.05). CONCLUSION: Adopting the problem-solving nursing model using SOR theory for postpartum depressed mothers after cesarean delivery reduced maternal depression, improved their state of mind, and coping level with illness.

The effect of problem-solving and decision-making education on problem-solving and decision-making skills of nurse managers: A randomized controlled trial.

OBJECTIVES: This study was conducted to determine the effect of an education program developed to improve the problem-solving and decision-making skills of nurse managers through both self- and subordinate evaluations and to compare it with a control group without training. BACKGROUND: The most basic skill that managers should have is effective problem-solving and decision-making skills. Nevertheless, studies indicate that nurse managers' problem-solving and decision-making skills are at a moderate level and need to be improved. DESIGN: Randomized controlled, pre-test-post-test, intervention and control group design. The study was conducted at a tertiary hospital in Istanbul, Türkiye. The sample consisted of 60 nurse managers (30 intervention and 30 control groups) and 300 nurses or nurse managers working as subordinates. METHODS: After assessing the problem-solving and decision-making skills of nurse managers in the intervention and control groups by themselves and their subordinates, educational intervention was provided to the intervention-group. The problem-solving and decision-making education consists of two full days of interactive training based on case studies. Subsequent to the training, nurse managers in the intervention-group underwent a second follow-up. The third follow-up for the intervention-group, as well as the second follow-up for the control-group and all subordinates, were conducted in the third month after the training. Data were analysed using descriptive tests, independent sample t-test and dependent sample t-test for comparisons and repeated measures analysis of variance for the effectiveness of the training program. RESULTS: Significant differences were found between the mean scores of the intervention-group nurse managers in problem-solving and decision-making pre and post-test (t=-11.005, p<.001) and case evaluations (t=-10.03, p<.001). Moreover, significant differences were identified in the assessment of pre-training, post-training and 3-month post-training average scores of overall problem-solving (F=93.643, p<.001) and rational (F=7.331, p=.007), dependent (F=13.607, p<.001), avoidant (F=11.543, p<.001) and spontaneous decision-making style (F=4.393, p<.001). When evaluated by the subordinates of the nurse managers in the intervention-group, there was a notable difference in the mean scores of overall problem-solving (t=-16.237, p=.001) and rational (t=-3.472, p=.001) and dependent decision-making styles (t=4.161, p=.001) before and 3-months after the training. CONCLUSIONS: The study uncovered that the problem-solving and decision-making training provided to nurse managers led to enhancements in their respective abilities, a progression that was also noted by their subordinates. The findings underscore the significance of case-based training programs tailored to enhance the problem-solving and decision-making competencies of nurse managers.

Acute Effect of Simultaneous Exercise and Cognitive Tasks on Cognitive Functions in Elderly Individuals with Mild Cognitive Impairment.

The increasing prevalence of age-related cognitive decline, alongside the aging global population, underscores the urgent need for innovative and effective preventative strategies. While the advantages of combining physical and cognitive exercises have been recognized as a promising approach to address these socioeconomic challenges, the acute effects of such interventions on cognitive functions remain understudied. This study aimed to investigate whether simultaneous physical and cognitive exercise has a greater beneficial impact on the cognitive functions of older adults with mild cognitive impairment (MCI) than physical exercise alone or reading activities. A total of 44 MCI patients (75% females aged between 65 and 75 years) were randomly assigned to one of three groups: aerobic exercise alone (EG group, n = 15), aerobic combined with cognitive exercises (CEG group, n = 15), or a reading task for controls (CG group, n = 14). Attention, memory, and problem solving were assessed before and after the acute intervention using the Tower of Hanoi, Digit Span, and Stroop tasks, respectively. Statistical analysis revealed that both of the experimental interventions appeared to enhance cognitive function scores (p < 0.05), except for the number of moves in the Tower of Hanoi task, where no improvement was noted. In contrast, no significant differences in any cognitive performance measures were observed following the reading session. Notably, the CEG group exhibited a more pronounced positive impact, especially on working memory. This advantage was specifically evident in the digit span tasks, where significantly greater percentage gains were found in the CEG than in the CG (p = 0.02), while no significant difference existed between the EG and CG. Simultaneous combined exercise has proven to be a more effective method than aerobic physical exercise alone for improving cognitive function. The results of this study are recommended for inclusion in clinical practice guidelines to maintain the mental health of older adults, as simultaneous exercise seems to offer a time-efficient strategy to enhance cognitive performance in adults with MCI.

Evaluating the effects of action learning on the research competency of undergraduate nursing students: A mixed-methods study.

BACKGROUND: Research skills in nursing are crucial for guiding evidence-based practice and enhancing health care. However, undergraduate nursing students often encounter challenges in skill development because of curriculum constraints that prioritize clinical education. Bridging this skill gap is imperative for preparing students for evidence-based practice and nursing scholarship. AIM: This study aimed to investigate the impact of incorporating action learning into undergraduate nursing research classes to improve the quality of nurse education. DESIGN: A mixed-methods approach was employed using pre- and post-online surveys for quantitative analysis and reflective journals for qualitative analysis. SETTINGS: The study was conducted at a college of nursing in Seoul, South Korea. PARTICIPANTS: A convenience sample of 19 fourth-year nursing students participated in the study. METHODS: Action learning-based nursing research classes were implemented over ten sessions, integrating lectures and team activities. Pre- and post-assessment data on communication skills, critical thinking tendencies, and problem-solving abilities were analyzed using paired t-tests. The qualitative analysis involved content analysis of individual and team reflective journals. RESULTS: Participants in action learning-based nursing research classes showed significant improvements in their communication skills (t = 3.46, p = 0.002), critical thinking tendencies (t = 3.80, p = 0.001), and problem-solving abilities (t = 1.82, p = 0.043). From the analysis of reflective journals four main themes were developed: organized team projects, dynamics of learning goal achievement, extended application of learning outcomes, and recommendations for better action learning-based classes. CONCLUSIONS: This study highlights action learning as an effective educational method that integrates theory and practice in nurse education, helping students prepare for their future roles as nursing professionals. The findings underscore the effectiveness of action learning in improving undergraduate nursing students' research competency and support the need for continued development of such pedagogical approaches.

Effectiveness of Simultaneous Combined Intervention for Enhancing Cognitive Function in Patients with Moderate Alzheimer's Disease.

Background: The evidence supporting the effectiveness of combined interventions in Alzheimer's disease (AD) patients remains inconclusive. Objective: The aim of this study was to evaluate the mid- and long-term effectiveness of physical training, alone or combined with cognitive games, on cognitive performance in patients with moderate AD. Methods: Seventy-nine AD patients (≈73% females, age of ≈70±1 years) were randomly divided into three groups: aerobic-based training (AT-group, n = 27), aerobic-based training plus cognitive games (ACT-group, n = 25), and a control group engaged in reading (CG, n = 26), two sessions per week. Cognitive performance was evaluated at the start, 4th week (W4), end of the 8th week (W8), and after a 4-week detraining period (W12), using problem-solving (Tower-of-Hanoi), selective attention (Stroop-test), and working memory (Digit-Span-test) assessments. Stress levels and quality of life were also evaluated.Results:: Aerobic and combined training induced a positive effect on all cognitive functions tested at W4 (except problem-solving) and W8 (all p < 0.001) with greater improvements in working-memory and problem-solving in ACT-group (p < 0.05). Depression levels also decreased significantly, and quality of life improved at W8 (p < 0.001) in both groups. After 4 weeks of detraining, the beneficial effect of AT and ACT was still observed. The CG did not show any significant improvements at all time points.Conclusions:: Physical and cognitive interventions appear effective for improving cognitive-functions, quality-of-life, and reducing depression in AD patients. Combined training emerges as a more effective strategy to mitigate AD progression. Further research is necessary to validate these results and explore their potential for preventing early cognitive decline.

Factors Affecting Leadership in Pharmacy Students: A Nationwide Survey.

Purpose: Leadership is increasingly becoming a priority in the forms of higher education associated with the Fourth Industrial Revolution; however, few studies have examined it in the context of pharmacy education. This study investigated the levels of communication competence, critical thinking disposition, problem-solving ability, and leadership of pharmacy students, and identified factors related to leadership. Methods: This study was conducted using a nationwide cross-sectional online survey with a self-administered questionnaire. A total of 416 third-to-sixth-year pharmacy students from all 35 pharmacy schools in South Korea, completed the survey from September 1 to 15, 2019. Data were analyzed using descriptive statistics, t-tests, Pearson's correlations, and multiple regression analysis. We verified construct validity by performing an exploratory factor analysis. Results: The pharmacy students revealed a moderate level of communication skills, critical thinking disposition, problem-solving ability, and leadership. Significant positive correlations were found among communication competence (r=0.724, p<0.001), critical thinking disposition (r=0.615, p<0.001), problem-solving ability (r=0.599, p<0.001), and leadership. After adjustment for control variables, communication competence (ß=0.319, p<0.001) was found to be the most significant predictor of leadership (F=104.12, p<0.001, R2=0.756). Conclusion: This study showed that the students' leadership was influenced by their competence in communicating effectively, thinking critically, and solving problems. Pharmacy educators should acknowledge and implement innovative curriculum and assessment approaches in preparing pharmacy students for their professional paths.

Effectiveness of Problem-Solving Therapy in Improving Patient Mental Health, Function, Quality of Life, and Mortality Post-Stroke: A Systematic Review.

Problem-solving therapy (PST) is a potential psychological intervention aimed at preventing and treating psychological issues in stroke patients, although its efficacy is not clearly established. This systematic review assessed the effectiveness of PST in improving mental health, functioning, quality of life, and mortality in this population. Six databases were searched for literature indexed through March 2024, including the Cochrane Library, PubMed, Scopus, CINAHL, NeuroBITE, and OTseeker. This review (CRD42023483757) followed the PRISMA guidelines and the Cochrane Library Handbook, utilizing the RoB 2 tool and GRADE system to assess the quality of the evidence. It included eight randomized controlled trials (RCTs) involving 1249 patients with stroke. Among them, five RCTs showed that PST might improve depression. Additionally, individual RCTs demonstrated the efficacy of PST in addressing patient anxiety, apathy, and coping. With respect to mental health, PST might affect patient quality of life and mortality. However, the results of four RCTs demonstrated no effect of PST on patient functioning. The quality of evidence for the outcomes ranged from very low to high. PST may improve mental health, quality of life, and mortality in patients with stroke.

[Artificial intelligence (AI) in diagnostic and therapeutic decision-making-a tool or communication partner?] / Künstliche Intelligenz (KI) bei Diagnostik- und Therapieentscheidungen ­ Einsatz als Werkzeug oder als Kommunikationspartner?

Artificial intelligence (AI) is a tool that is only as good as its user. In the case of humanoid robots, an AI system can be seen as a social counterpart. Decision intelligence (DI) is a term that stems from engineering. DI as a science is used to process data with findings from the social sciences and decision theories. The aim is to improve decision-making processes. However, AI should be categorized as a tool and not as a communication partner. AI analyzes information from studies, guidelines, and textbooks from the outset-taking individual patient information into account. Physicians with a high level of clinical expertise can ask more specific questions about the latter. ChatGPT is trained with millions of texts from the internet, social media, online forums, journal articles, and books; it covers almost all areas of life.

External constraints that led to physiology lab improvements.

The modifications were in response to changing constraints, including time, money, space, student background, and my knowledge and comfort. The lab went from emphasizing experiments with the attendant troubleshooting and data analysis skills to a lab focused more on giving prehealth professional students the motivation to learn physiology problem-solving skills by providing real cases. In the lab, students watched and listened to a random student try to use these problem-solving skills to solve the problem. This made them appreciate how much others also struggle in solving the problem. Some students with imposter syndrome think their classmates immediately know how to solve a problem, and therefore, seeing others also struggle has the potential to reduce imposter syndrome. Rather than having the students do experiments, they did kinesthetic activities with mechanical models to generate data without biological variation. They then graphed their data, thus improving their ability to actually read graphs rather than memorize patterns.NEW & NOTEWORTHY I learned to explicitly recognize the current and projected constraints of instructor comfort, money, space, student background (poor graph reading and problem-solving skills), student safety, and time and energy on the possible goals and methods to attain them for an undergraduate physiology lab. I cannot decide if changing constraints allowed me to reexamine my goals or whether it forced me to reexamine my goals. In either case, the reexamination of my goals (and their priorities), within the context of the constraints, allowed me to redesign the labs to better meet my new goals within this new context.

Problem solving is embedded in context so how do we measure it?

Problem solving encompasses the broad domain of human, goal-directed behaviors. Though we may attempt to measure problem solving using tightly controlled and decontextualized tasks, it is inextricably embedded in both reasoners' experiences and their contexts. Without situating problem solvers, problem contexts, and our own experiential partialities as researchers, we risk intertwining the research of information relevance with our own confirmatory biases about people, environments, and ourselves. We review each of these ecological facets of information relevance in problem solving, and we suggest a framework to guide its measurement. We ground this framework with concrete examples of ecologically valid, culturally relevant measurement of problem solving.