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\"Preparing a learning portfolio has become a mandatory part of the course work in most clinical professions. Students and educators alike sometimes complain that these mandatory assignments become repetitive and uninspired. However, we all need to be able to speak and write clearly as we work with our colleagues, students and those we care for. In Portfolio To Go, Allan D. Peterkin insists that reflective capacity, critical thinking, creative expression, and narrative competence are attributes that should be developed in every health professional - regardless of the discipline or specialty. Trainees will find over 1000 prompts organized under themes highly relevant to students and educators, including those not formally addressed in class, such as coping with uncertainty and ambiguity, team conflict, and resilience through good self-care. Practical tips for writing effectively and for discussing and evaluating narratives in a helpful, respective manner are provided throughout. Peterkin is a pioneer in emphasizing patient-centered, humanistic care and Portfolio To Go will help to train and develop more reflective practitioners.\"-- Provided by publisher.

Traditional obstetric nursing training faces limitations in inadequate interactivity and nonrepeatable demonstrations, limiting students' development of clinical thinking. Virtual reality (VR) offers a solution for complex health care education, enhancing nursing students' clinical thinking. This study applied the Nonimmersive Virtual Reality System for Clinical Thinking in Obstetric Nursing (NIVRSCTON), grounded in salutogenesis theory, to examine its effects on nursing students. The NIVRSCTON was applied under the auspices of the Nursing Virtual Teaching Hub in the Coastal Area (NVTHCA). In September 2023, a convenience sample of 88 undergraduate nursing students from 4 partner institutions participated in the study. A single-group pre-post design and an explanatory sequential mixed methods design were used to measure changes in clinical thinking ability following the training and to assess the system's performance. The quantitative assessment tools included the general information questionnaire, the Clinical Thinking Ability Evaluation Scale (CTAES), and the Evaluation Instrument for Virtual Reality System (EIVRS). Each student was required to submit one reflective journal developed in accordance with the Bass model. Quantitative data were analyzed using IBM SPSS (version 22.0), and qualitative data were thematically coded using NVivo (version 12; QSR International Pty Ltd). After the NIVRSCTON training was completed, the students' overall clinical thinking score increased from 49.08 (SD 11.30) to 80.50 (SD 11.01), indicating a significant improvement (t =-18.76; Cohen d=-2.82, 95% CI -34.74 to -28.08). All clinical thinking dimension scores improved, and the improvements were all statistically significant (P<.001). Critical thinking scores increased from 13.98 (SD 3.76) to 24.77 (SD 3.11; t =-20.37; Cohen d=-3.13, 95% CI -11.85 to -9.74), system thinking scores increased from 26.82 (SD 6.40) to 44.51 (SD 6.24; t =-19.18; Cohen d=-2.80, 95% CI -19.53 to -15.86), and evidence-based thinking scores improved from 18.10 (SD 4.40) to 27.31 (SD 4.61; t =-13.42; Cohen d=-2.04, 95% CI -10.57 to -7.84). The variable df is all 87. In terms of application effectiveness, the students provided the following ratings: 0.82 (SD 0.15; rated as good) for interface design, 0.82 (SD 0.15; rated as good) for technical performance, 0.83 (SD 0.14; rated as good) for learning content, and 0.85 (SD 0.15; rated as excellent) for learning function. The overall evaluation was 0.82 (SD 0.15; rated as good). Qualitative data revealed that the training not only improved the clinical thinking and decision-making skills of the nursing students but also fostered their professional attitudes, values, and emotions. NIVRSCTON training enhances students' clinical thinking and professionalism. It was well received, confirming its effectiveness. As an obstetric nursing teaching tool, it enhances clinical thinking and professional competence. It may also promote equity and access in nursing education, offering an innovative model for digital nursing education.

Objective To investigate the efficacy of situational simulation teaching (SST) in enhancing clinical thinking competencies among residents. Methods A randomized controlled trial was conducted with second-year residents ( n  = 121) during their rotation (May-August 2025). Participants were allocated to either an intervention group ( n  = 57, receiving SST) or a control group ( n  = 64, conventional training). Pre- and post-intervention assessments evaluated clinical thinking performance. Faculty assessments using the entrust able professional activities (EPAs) and Mini-clinical evaluation exercise (Mini-CEX) were completed within 2 weeks post-training, supplemented by resident satisfaction surveys. Results Both groups demonstrated significant post-intervention improvement in overall clinical thinking scores (all P  < 0.05), except for the “Ethics and Professionalism” domain in controls ( P  = 0.12).The intervention group outperformed the control group in total clinical thinking scores and all sub-dimensions ( P  < 0.05), with higher EPAs scores, EPA pass rates, and Mini-CEX total scores (all P  < 0.05). Resident satisfaction (content, resources, interaction, and teaching methods) was also significantly higher in the intervention group ( P  < 0.05). Conclusion SST significantly enhances clinical thinking development in residency programs.

Background Problem-based learning (PBL) is a widely adopted educational approach in medical education that aims to promote critical thinking and problem-solving in authentic learning situations. However, the impact of PBL educational mode on undergraduate medical students’ clinical thinking ability has been limitedly investigated. This study aimed to assess the influence of an integrated PBL curriculum on clinical thinking ability of medical students prior to clinical practice. Methods Two hundred and sixty-seven third-year undergraduate medical students at Nantong University were recruited in this study and were independently assigned to either the PBL or control group. The Chinese version of the Clinical Thinking Ability Evaluation Scale was used to assess clinical thinking ability, and the students’ performance in the PBL tutorials was assessed by tutors. All participants in both groups were required to complete the pre-test and post-test questionnaires to self-report their clinical thinking ability. A paired sample t-test, independent sample t-test and one-way analysis of variance test (ANOVA) were used to compare the difference in clinical thinking scores among different groups. Multiple linear regression was conducted to analyze the influencing factors correlated with clinical thinking ability. Results The clinical thinking ability of most third-year undergraduate medical students at Nantong University was at a high level. The PBL group had a higher proportion of students with high-level clinical thinking ability in the post-test compared to the control group. The pre-test scores of clinical thinking ability were similar between the PBL and control groups, but the post-test scores of clinical thinking ability in the PBL group were significantly higher than those in the control group. Additionally, there was a significant difference in clinical thinking ability between the pre-test and post-test in the PBL group. The post-test scores of sub-scales of critical thinking ability were significantly higher than the pre-test in the PBL group. Furthermore, the frequency of reading literature, time of PBL self-directed learning, and PBL performance score ranking were influencing factors on the clinical thinking ability of medical students in the PBL group. Moreover, there was a positive correlation between clinical thinking ability and the frequency of reading literature, as well as the scores of the PBL performance. Conclusions The integrated PBL curriculum model has an active impact on improving undergraduate medical students' clinical thinking ability. This improvement in clinical thinking ability may be correlated with the frequency of reading literature, as well as the performance of the PBL curriculum.

Shaoting Feng,1,* Daya Yang,1,* Kunsong Zhang,1,* Gang Yuan,1 Hao Tang,1 Denise Findlay,2 Adam R Thomas,2 Lewis S MacKinnon,2 Ming Kuang,1 Haipeng Xiao,1 Dan Xu1,2 1First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Australia*These authors contributed equally to this workCorrespondence: Dan Xu, Email daniel.xu@curtin.edu.au Ming Kuang, Email kuangm@mail.sysu.edu.cnBackground: General practice (GP) placement teaching can be challenging because of time constraints, ineffective teaching models, and a lack of consensus approaches. GP clinics are more frequently used for undergraduate students’ learning to translate theoretical knowledge into clinical practice. Evidence suggests that a learner-centred approach is essential for facilitating deeper learning. “Student-led consultation under supervision” is one such learner-centred teaching model applied during GP placement, engaging both trainers and trainees in applying the core values of clinical thinking. This qualitative study intends to explore students’ learning outcomes when implementing the innovative teaching model “Student-led consultation under supervision during GP clinical placement” for potential quantitative introduction as a formal GP placement curriculum.Methods: A convergent mixed-method approach was applied using validated surveys and pre-designed questionnaires for individual reflection when implementing innovative teaching models in medical students’ GP placements. Thirty-five medical students from China and Australia participated in the study. Survey and reflection data were collected for descriptive and semantic analysis.Results: “Student-led consultation under supervision in a consultant’s chair with discussion” was the students’ most highly rated teaching model. Students’ reflections on the use of these teaching models were semantically analysed using a validated questionnaire. The students’ reflections highlighted the perceived academic benefits with identifying the enablers of and barriers to developing the formal GP placement curriculum.Conclusion: This study shows that “Student-led consultation under supervision in a consultant’s chair with discussion” is innovative in GP teaching. The demonstrated innovation embraces the concept of cognitive apprenticeship for improving learning outcomes. These teaching models incorporate students’ reflection in curriculum design and extend the definitions of “cognitive apprenticeship” and “transfer of learning” in modern clinical teaching to improve trainees’ placement learning. The identified enablers of and barriers to implementing these innovative teaching models will pave the way for future studies to confirm the practicality of implementing them in real-life clinical practice.Keywords: innovative training methods, general practice placement teaching, clinical thinking, clinical education, cognitive apprenticeship, action learning

Background Case-Based Learning (CBL) and Problem-Based Learning (PBL) are popular methods in medical education. However, we do not fully understand how they affect the clinical thinking skills of Assistant General Practitioner (AGP) trainees. This randomised controlled trial aimed to assess the effectiveness of combining CBL and PBL and compare their impact on the clinical thinking skills of AGP trainees with that of traditional lecture-based learning (LBL). Methods This randomised controlled trial involved 70 second-year AGP trainees who were randomly assigned to either the CBL-PBL group or the LBL group using a simple randomisation method. The CBL-PBL group engaged in a curriculum that integrated case-based and problem-based learning, whereas the LBL group followed a traditional lecture-based format, as described in the syllabus. To evaluate clinical thinking skills, the participants were assessed using the Clinical Thinking Skills Evaluation Scale (CTSES) and an assistant general practitioner’s professional knowledge test. In addition, this study analysed various factors that influence clinical thinking skills. Results Compared with the LBL group, the CBL-PBL group showed significantly improved performance in all domains assessed by the CTSES in post-course tests ( p  < 0.001). Specifically, the mean scores for critical, systematic, and evidence-based thinking showed notable improvement in the CBL-PBL group. Additionally, the scores on the professional knowledge test reflected a substantial increase in this group. Furthermore, multiple linear regression analysis showed that both CBL-PBL curriculum performance scores and number of weekly article readings significantly influenced the development of clinical thinking skills. Conclusion The CBL-PBL teaching method positively influenced the clinical thinking skills of assistant general practitioner trainees, with a positive correlation between these skills and course performance in the CBL-PBL curriculum. Trial registration Not applicable.

Background Standardized training for resident physicians (STRP) is essential for improving their clinical skills. The standardized training for resident physicians in emergency medicine differs from other disciplines, focusing more on knowledge related to medical emergencies and emergency care skills requiring urgency and real-time response. There are specific differences in knowledge content, teaching methods, curriculum design, and career development compared to other specialties. As a national-level teaching base for emergency medicine, our hospital continuously explores and innovates in teaching models, discovering a model more suitable for emergency medicine. Objective This study summarizes practical experience in teaching and assessment integration (TAA), evaluates teaching training effectiveness with the Clinical Thinking Training System (CTTS), and examines integrating this system with innovative teaching and assessment models' impact on resident physicians' clinical abilities. Methods In our study, we selected residents who rotated in our department from July-December 2023 and randomly divided them into a reform group ( n  = 106) and a control group ( n  = 104). The reform group received training using the Clinical Thinking Training System (CTTS) while the control group received standard training consistent with the existing STRP framework. We integrate innovative teaching and assessment (TAA) models and the Entrustable Professional Activities (EPAs) scale to assess students' abilities, stratifying by grade level, background, and major to evaluate students' departmental rotation examination (DRE) and EPAs scores. Result The DRE scores and Mini-CEX scores were significantly higher in the reformed group compared to the control group. The final assessments showed the reform group scored significantly higher in first-case documentation and overall clinical thinking decision-making. Specifically, the reform group had significantly higher scores in first-case documentation for second-year, third-year, undergraduate, and graduate students, and non-emergency specialty students. The clinical thinking decision-making scores of the reform group were significantly higher across different years, specialties, and educational backgrounds. All the EPAs results indicated the CTTS improved treatment decision-making abilities among students with different years of training, educational backgrounds, and specialties. Moreover, the ability for continuous patient management improved to some extent among students in different years and with different educational backgrounds. Conclusion The integration of innovative teaching and assessment models with the CTTS is more conducive to improving the examination performance and confidence in professional behavior of resident physicians.

This article presents the outcomes of a pedagogical experiment conducted to assess the efficacy of incorporating experimental logical tasks and exercises within the curriculum of the discipline “Medical Informatics” as a means to foster the development of logical thinking among future medical professionals. The study emerged from the observation of deficient logical reasoning skills among medical students, prompting an investigation into the role of logical thinking in the diagnostic process of physicians. The research involved diverse groups, including medical students, experienced doctors, and educators. The following methods of research were used to achieve the goal of the experiment: Theoretical, in particular, modeling method to identify pedagogical conditions and develop the technology of forming logical thinking of future doctors; empirical, in particular, pedagogical experiment, which allowed to check the effectiveness of technology and developed methodological support of the formation of logical thinking of future doctors and statistical methods of research for quantitative processing of research results and confirmation of their authenticity. The analysis of the results of the pedagogical experiment revealed a decrease in the number of students at a low level and an increase in the number of students at satisfactory and high levels of logical thinking development. The results of statistical data confirm the effectiveness of pedagogical technology in introducing a system of tasks aimed at the development of logical thinking in future doctors.

Background Modernizing medical education by using artificial intelligence and other new technologies to improve the clinical thinking ability of medical students is an important research topic in recent years. Prominent medical universities are actively conducting research and exploration in this area. In particular, given the shortage of human resources, the need to maintain social distancing to prevent the spread of the epidemics, and the increase in the cost of medical education, it is critical to harness online learning to promote medical education. A virtual case learning system that uses natural language processing technology to process and present a hospital’s real medical records and evaluate student responses can effectively improve medical students’ clinical thinking abilities. Objective The purpose of this study is to develop a virtual case system, AIteach, based on actual complete hospital medical records and natural language processing technology, and achieve clinical thinking ability improvement through a contactless, self-service, trial-and-error system application. Methods Case extraction is performed on a hospital’s case data center and the best-matching cases are produced through natural language processing, word segmentation, synonym conversion, and sorting. A standard clinical questioning data module, virtual case data module, and student learning difficulty module are established to achieve simulation. Students can view the objective examination and inspection data of actual cases, including details of the consultation and physical examination, and automatically provide their learning response via a multi-dimensional evaluation system. In order to assess the changes in students’ clinical thinking after using AIteach, 15 medical graduate students were subjected to two simulation tests before and after learning through the virtual case system. The tests, which included the full-process case examination of cases having the same difficulty level, examined core clinical thinking test points such as consultation, physical examination, and disposal, and generated multi-dimensional evaluation indicators (rigor, logic, system, agility, and knowledge expansion). Thus, a complete and credible evaluation system is developed. Results The AIteach system used an internal and external double-cycle learning model. Students collect case information through online inquiries, physical examinations, and other means, analyze the information for feedback verification, and generate their detailed multi-dimensional clinical thinking after learning. The feedback report can be evaluated and its knowledge gaps analyzed. Such learning based on real cases is in line with traditional methods of disease diagnosis and treatment, and addresses the practical difficulties in reflecting actual disease progression while keeping pace with recent research. Test results regarding short-term learning showed that the average score ( P  < 0.01) increased from 69.87 to 85.6, the five indicators of clinical thinking evaluation improved, and there was obvious logical improvement, reaching 47%. Conclusion By combining real cases and natural language processing technology, AIteach can provide medical students (including undergraduates and postgraduates) with an online learning tool for clinical thinking training. Virtual case learning helps students to cultivate clinical thinking abilities even in the absence of clinical tutor, such as during pandemics or natural disasters.

Traditional Case-Based Learning (CBL) methods in clinical medical education are often hindered by limitations in scalability and student engagement. In response, interactive video-based CBL integrates decision tree scenarios with interactive technology, offering a novel approach to enhance students' clinical reasoning and learning outcomes. This study aims to evaluate the effectiveness of an interactive video-based CBL teaching method in improving clinical knowledge, thinking ability, course experience and satisfaction among undergraduate medical students. A single-center, single-blind, randomized controlled trial was conducted with 64 fourth-year clinical medicine undergraduates, who were randomly assigned to either the intervention group (interactive video-based CBL, = 32) or the control group (traditional CBL, = 32). The primary outcomes included basic knowledge test scores, which were assessed both before and after intervention. Secondary outcomes encompassed clinical thinking abilities (critical thinking, systematic thinking, evidence-based thinking) and course experience, measured using validated scales. Data were analyzed using paired and independent tests. Sixty-two students completed the study. The intervention group showed significant improvement in post-intervention basic knowledge test scores compared to both their baseline ( < 0.001) and the control group ( < 0.001). Conversely, the control group showed a significant decline in post-intervention scores ( < 0.001). Critical and systematic thinking abilities in the intervention group significantly improved after the intervention ( = 0.045 and = 0.048), while no significant changes were observed in the control group. No significant changes were observed in evidence-based thinking. Course experience scores were significantly higher in the intervention group across dimensions including good teaching ( = 0.041), classroom quality ( = 0.033) and classroom gains ( = 0.032). The intervention group was significantly more satisfied than the control group overall ( = 0.011). Interactive video-based CBL significantly enhances basic knowledge, critical thinking, and students' course experience and satisfaction compared to traditional CBL, highlighting its potential as an innovative teaching method in clinical medical education. Further research is needed to explore its long-term impacts and optimize its application for fostering evidence-based thinking. https://clinicaltrials.gov/, identifier ChiCTR2300073773.