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Background: This article is dedicated to the 100-year anniversary of the birth of N.F. Talyzina and contains an assessment of the prospects for developing ways to master a scientific concept, in theories of learning according to the activity approach. The assessment takes into account achievements following the approach of L.S. Vygotsky, the "conceptual changes" approach, and theories of the psychology of insightful problem solving. Objective: To demonstrate the necessity and productivity of the activity approach to scientific concepts that students learn as forms of constructive criticism. Method: A comparative analysis of the theories of the activity approach to learning, the approach of L.S. Vygotsky, the "conceptual changes" approach, and theories of the psychology of insightful problem solving, from the standpoint of identifying the most effective way of mastering scientific concepts. Results: The main substantiated thesis of the article is that mastery of a scientific concept is most effective when it is presented as a form of constructive criticism of another concept. Conclusion: Taking into account the conceptual forms of constructive criticism allows us to outline the actual paths of development of the activity approach to learning. These forms were developed, on the one hand, through the methodology of science, and on the other, in a less developed way, through the psychology of insightful problem solving, with reliance on certain forms of "critical" action. In particular, when using a special kind of obstacle to teach a task, it is proposed to use the analysis of "full insight" to reveal a special type of reason for an erroneous action.
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Evidence-based medicine (EBM) is the use of high-quality clinical research in making decisions about the care of patients. Its formal origin dates back to the mid-nineteenth century, and since then, it has continued to evolve. The best research evidence, clinical expertise, and patient values are described as the foundations of EBM. However, several tools and skills have been developed and added over time. EBM has faced a lot of criticism, and the pitfalls are widely discussed and published in the medical literature. The biggest challenge is the changing paradigm of healthcare, cost-effectiveness, and changing evidence which has led to controversies and challenges in the rapid adaptation of the EBM. This review article discusses the history, conception, and evolution of modern-day EBM. In addition, we discuss why EBM has been criticized and highlight the pitfalls.
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BACKGROUND: Simulation is part of the training provided to nurses enrolled in the master's degree for critical care nursing programmes at our institution. Although the students are practicing nurses, many still make mistakes when performing nursing procedures related to critical care during simulation sessions, and these mistakes must be addressed during the debriefing session. The aim of the study is to compare the knowledge and skills acquired by groups of postgraduate critical care nursing students who were exposed to high-fidelity simulation (HFS) by using different debriefing structures. METHODS: A quasi-experimental crossover design was utilised during the post-tests and objective structured clinical examinations (OSCEs). The students were divided into two groups: one was exposed to HFS with a 3-phase debriefing, and the other was exposed to HFS with a multiphase debriefing. Both groups involved facilitator-guided and video-assisted debriefings. RESULTS: Overall, the post-test scores (p-value: Phase 1 = 0.001 and Phase 2 = 0.000) and post-OSCE scores (p-value: Phase 1 = 0.002 and Phase 2 = 0.002) support that the group of postgraduate students who underwent HFS with a multiphase debriefing structure gained significantly higher scores compared to the group who underwent HFS with a 3-phase debriefing structure. CONCLUSION: Debriefing is a critical component of successful simulation. Learning requires assessment that creates constructive criticism based on feedback and reflection. A multiphase debriefing structure, specifically the healthcare simulation after-action review, provides a significant advantage for knowledge and skills acquisition.
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Junior doctors rotating through departments arrive with fresh perspectives and are particularly suited for identifying problems and providing creative solutions to improve patient care. They may, however, be unfamiliar with the process of implementing an idea into practice. We recognize the need to support foundation year doctors to develop successful quality improvement projects (QIPs). We developed a new initiative to host an annual event that gives foundation year doctors a platform to develop QIPs for their department. These ideas were pitched to an audience comprising trauma consultants from the Oxford University Hospitals and multidisciplinary staff from hospitals across the region. It offered a dedicated time away from clinical pressure to propose and receive immediate expert feedback from members of the trauma multidisciplinary team. With this refinement and supervisor project matching, it facilitated multiple areas of targeted change for the department in just one evening. In total, eight QIPs were developed from the event. Here we outline our approach and the structure of our event, which can serve as a tool for similar initiatives to be replicated in other hospitals.