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Background and Aims The Karafs application, a popular mobile health tool in Iran with nearly 5 million users, supports personalized diet plans, healthy cooking, and sports training. This study aimed to evaluate the usability of the Karafs application using the think‐aloud method to identify user interaction challenges and enhance its effectiveness. Methods Fifteen participants (2 men, 13 women; mean age 22 years) evaluated the Karafs application using the think‐aloud method. Usability problems were identified, categorized, and assessed for severity. The evaluation process was analyzed, with an average duration of 10.58 ± 3.46 min. Results Multiple usability issues were identified, primarily related to unclear system messages and navigation challenges. The severity of problems was classified, with most being minor but impacting user efficiency. Conclusion The think‐aloud method effectively identified usability issues in the Karafs application, providing insights for improving user experience. Addressing these issues can enhance the application's functionality and support healthier lifestyle choices.

Teaching and assessing metacognitive activities are important educational objectives, and teachers are calling for efficient instruments. The advantages of questionnaires in measuring metacognitive activities are obvious, but serious validity issues appear. For example, correlations of questionnaire data with think-aloud measures are generally moderate to low. An explanation may be that these questionnaires are not constructed in line with the metacognitive activities measured by the think-aloud method. In the present study, a questionnaire is constructed based directly on a taxonomy for coding think-aloud protocols. Twenty ninth-graders studied a text while thinking aloud, after which they immediately received the questionnaire. The overall correlation between the questionnaire and the think-aloud protocols (r=0.63) was promising. However, scale and item analyses clearly demonstrate some new validity issues. Comparing the questionnaire and the think-aloud results, the students seem to report overt metacognitive activities corresponding more with their behavior reported in the protocols than covert ones. In-depth explorations are presented.

Readers increasingly attempt to understand and learn from information sources they find on the Internet. Doing so highlights the crucial role that evaluative processes play in selecting and making sense of the information. In a prior study, Wiley et al. (2009, Experiment 1) asked undergraduates to perform a web-based inquiry task about volcanoes using multiple Internet sources. A major finding established a clear link between learning outcomes, source evaluations, and reading behaviors. The present study used think-aloud protocol methodology to better understand the processing that learners engaged in during this task: 10 better learners were contrasted with 11 poorer learners. Results indicate that better learners engaged in more sense-making, self-explanation, and comprehension-monitoring processes on reliable sites as compared with unreliable sites, and did so by a larger margin than did poorer learners. Better learners also engaged in more goal-directed navigation than poorer learners. Case studies of two better and two poorer learners further illustrate how evaluation processes contributed to navigation decisions. Findings suggest that multiple-source comprehension is a dynamic process that involves interplay among sense-making, monitoring, and evaluation processes, all of which promote strategic reading.

The importance of English reading proficiency in overall language mastery is unquestionable. Recently, scholars and educators have gradually recognized the significance of applying think-aloud method to improving English reading proficiency. This systematic review aimed to investigate the application of think-aloud method in enhancing English reading proficiency. The analysis of this review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Through the application of specific searching keywords, 40 studies relevant to the application of think-aloud method in improving English reading proficiency were retrieved from the databases, including ERIC, PsycINFO, Scopus, Web of Science, and Google Scholar. In the analysis of the 40 studies, think-aloud method consistently showed its benefits in improving learners' English reading proficiency from different perspectives, including reading comprehension, metacognitive awareness, reading fluency, retention, and motivation, particularly in EFL/ESL contexts, while also facilitating critical thinking and independent strategy application. This study emphasizes scaffolding and tailored teaching practices to maximize think-aloud method's benefits. Overall, the study confirms think-aloud method's potential as a transformative tool to address EFL/ESL learners' challenges in reading, and to incorporate theoretical insights into practical strategies for improving EFL/ESL learners' reading ability and metacognitive development.

Caregivers are responsible for the type and amount of food young children are served. However, it remains unclear what considerations caregivers make when serving snacks to children. The aim of the study was to explore mothers’ decisions and portion control strategies during snack preparation in the home environment. Forty mothers of children aged 24–48 months participated in the study. Mothers prepared five snack foods for themselves and their child whilst verbalizing their actions and thoughts. Mothers were then asked about their portion size decisions in a semi-structured interview. Transcripts were imported into NVivo and analyzed thematically. Three key themes were identified: (1) portion size considerations, (2) portion control methods, and (3) awareness and use of portion size recommendations. Transient, food-related situational influences influenced mothers and disrupted planning and portion control. Food packaging and dishware size were used as visual cues for portion control; however, these vary widely in their size, thus emphasizing mothers’ uncertainty regarding appropriate portion sizes. Mothers called for portion size information to be accessible, child-centered, and simple. These findings reveal multiple considerations when deciding on the correct snack portion sizes for children. These decisions are complex and vary across situations and time, and according to the types of snacks offered.

While portfolios are increasingly used to assess competence, the validity of such portfolio-based assessments has hitherto remained unconfirmed. The purpose of the present research is therefore to further our understanding of how assessors form judgments when interpreting the complex data included in a competency-based portfolio. Eighteen assessors appraised one of three competency-based mock portfolios while thinking aloud, before taking part in semi-structured interviews. A thematic analysis of the think-aloud protocols and interviews revealed that assessors reached judgments through a 3-phase cyclical cognitive process of acquiring, organizing, and integrating evidence. Upon conclusion of the first cycle, assessors reviewed the remaining portfolio evidence to look for confirming or disconfirming evidence. Assessors were inclined to stick to their initial judgments even when confronted with seemingly disconfirming evidence. Although assessors reached similar final (pass–fail) judgments of students’ professional competence, they differed in their information-processing approaches and the reasoning behind their judgments. Differences sprung from assessors’ divergent assessment beliefs, performance theories, and inferences about the student. Assessment beliefs refer to assessors’ opinions about what kind of evidence gives the most valuable and trustworthy information about the student’s competence, whereas assessors’ performance theories concern their conceptualizations of what constitutes professional competence and competent performance. Even when using the same pieces of information, assessors furthermore differed with respect to inferences about the student as a person as well as a (future) professional. Our findings support the notion that assessors’ reasoning in judgment and decision-making varies and is guided by their mental models of performance assessment, potentially impacting feedback and the credibility of decisions. Our findings also lend further credence to the assertion that portfolios should be judged by multiple assessors who should, moreover, thoroughly substantiate their judgments. Finally, it is suggested that portfolios be designed in such a way that they facilitate the selection of and navigation through the portfolio evidence.

The need to cultivate students’ use of metacognitive strategies in critical thinking has been emphasized in the related literature. The present study aimed at examining the role of metacognitive strategies in critical thinking. Ten university students with comparable cognitive ability, thinking disposition and academic achievement but with different levels of critical thinking performance participated in the study (five in the high-performing group and five in the low-performing group). They were tested on six thinking tasks using think-aloud procedures. Results showed that good critical thinkers engaged in more metacognitive activities, especially high-level planning and high-level evaluating strategies. The importance of metacognitive knowledge as a supporting factor for effective metacognitive regulation was also revealed. The contribution of metacognitive strategies to critical thinking and implications for instructional practice are discussed.

Background Developing clinical reasoning within entry to practice physiotherapy education is essential to safe and competent practice. For example, identifying the need for referral if the diagnostic process identifies red flags (e.g., serious spinal pathology). The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework supports evidence-based clinical reasoning in assessment and management of the cervical spine region, considering the potential for vascular pathology. Objective To explore the influence of the Framework on clinical reasoning processes of students enrolled in an entry to practice physiotherapy program. Methods The COnsolidated criteria for REporting Qualitative research informed the design and reporting of this qualitative think aloud case study using interpretive description. Participants (students enrolled in an entry to practice physiotherapy program) learned about the Framework through standardized teaching. Clinical reasoning was explored using two cervical spine cases. Elstein’s diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model guided transcript coding and analysis. Thematic analysis employed a hybrid approach (inductive and deductive) to understand the use of the Framework at key steps in clinical reasoning processes. Multiple strategies enhanced trustworthiness (e.g., regular team debriefs, reflexive engagement). Results For all participants ( n  = 10), the Framework supported hypothetico-deductive clinical reasoning processes, reflecting a continuum of novice proficiency. The Framework informed generating a vascular hypothesis in the patient history and testing this hypothesis using patient history questions and appropriate physical examination tests. Variable sequences of logic and difficulties with cue interpretation and synthesis were common, leading to a lack of clarity and support for diagnosis and management for some students. Clinical reasoning processes were informed by variable depth and breadth of Framework knowledge and supported by limited personal characteristics (e.g., reflection on action). Conclusions The Framework is a valuable learning resource in entry to practice physiotherapy education to initiate structured clinical reasoning processes for assessing and managing cervical spine presentations, considering the potential for vascular pathology. Owing to a continuum of novice clinical reasoning, using the Framework in entry to practice physiotherapy education requires tailoring to the level of the learner. Future research should explore students’ perspectives of the value of the Framework to inform their clinical reasoning.

This article puts forward the case that survey questionnaires, which are a type of measuring instrument, can and should be tested to ensure they meet their purpose. Traditionally survey researchers have been pre-occupied with 'standardising' data collection instruments and procedures such as question wording and have assumed that experience in questionnaire design, coupled with pilot testing of questionnaires, will then ensure valid and reliable results. However, implicit in the notion of standardisation are the assumptions that respondents are able to understand the questions being asked, that questions are understood in the same way by all respondents, and that respondents are willing and able to answer such questions. The development of cognitive question testing methods has provided social researchers with a number of theories and tools to test these assumptions, and to develop better survey instruments and questionnaires. This paper describes some of these theories and tools, and argues that cognitive testing should be a standard part of the development process of any survey instrument.

Scientific hypothesis generation is a critical step in scientific research that determines the direction and impact of any investigation. Despite its vital role, we have limited knowledge of the process itself, thus hindering our ability to address some critical questions. This study aims to answer the following questions: To what extent can secondary data analytics tools facilitate the generation of scientific hypotheses during clinical research? Are the processes similar in developing clinical diagnoses during clinical practice and developing scientific hypotheses for clinical research projects? Furthermore, this study explores the process of scientific hypothesis generation in the context of clinical research. It was designed to compare the role of VIADS, a visual interactive analysis tool for filtering and summarizing large data sets coded with hierarchical terminologies, and the experience levels of study participants during the scientific hypothesis generation process. This manuscript introduces a study design. Experienced and inexperienced clinical researchers are being recruited since July 2021 to take part in this 2×2 factorial study, in which all participants use the same data sets during scientific hypothesis-generation sessions and follow predetermined scripts. The clinical researchers are separated into experienced or inexperienced groups based on predetermined criteria and are then randomly assigned into groups that use and do not use VIADS via block randomization. The study sessions, screen activities, and audio recordings of participants are captured. Participants use the think-aloud protocol during the study sessions. After each study session, every participant is given a follow-up survey, with participants using VIADS completing an additional modified System Usability Scale survey. A panel of clinical research experts will assess the scientific hypotheses generated by participants based on predeveloped metrics. All data will be anonymized, transcribed, aggregated, and analyzed. Data collection for this study began in July 2021. Recruitment uses a brief online survey. The preliminary results showed that study participants can generate a few to over a dozen scientific hypotheses during a 2-hour study session, regardless of whether they used VIADS or other analytics tools. A metric to more accurately, comprehensively, and consistently assess scientific hypotheses within a clinical research context has been developed. The scientific hypothesis-generation process is an advanced cognitive activity and a complex process. Our results so far show that clinical researchers can quickly generate initial scientific hypotheses based on data sets and prior experience. However, refining these scientific hypotheses is a much more time-consuming activity. To uncover the fundamental mechanisms underlying the generation of scientific hypotheses, we need breakthroughs that can capture thinking processes more precisely. DERR1-10.2196/39414.