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1

Konopasky, Abigail, Steven J. Durning, Anthony R. Artino, Divya Ramani, and Alexis Battista. "The Linguistic Effects of Context Specificity: Exploring Affect, Cognitive Processing, and Agency in Physicians’ Think-Aloud Reflections." Diagnosis 7, no. 3 (2020): 273–80. http://dx.doi.org/10.1515/dx-2019-0103.

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AbstractBackgroundThe literature suggests that affect, higher-level cognitive processes (e.g. decision-making), and agency (the capacity to produce an effect) are important for reasoning; however, we do not know how these factors respond to context. Using situated cognition theory as a framework, and linguistic tools as a method, we explored the effects of context specificity [a physician seeing two patients with identical presentations (symptoms and findings), but coming to two different diagnoses], hypothesizing more linguistic markers of cognitive load in the presence of contextual factors
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Abduganiyeva, Djamila. "MACHINE TRANSLATION POST-EDITING THROUGH A HERMENEUTIC LENS." Ижтимоий-гуманитар фанларнинг долзарб муаммолари / Актуальные проблемы социально-гуманитарных наук / Actual Problems of Humanities and Social Sciences. 5, S/4 (2025): 145–51. https://doi.org/10.47390/spr1342v5si4y2025n23.

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This article explores how hermeneutic principles – contextual reading, the hermeneutic circle, and interpreter subjectivitycan enrich the post-editing of statistical and neural machine translation (SMT/NMT). A mixed-method study combined hermeneutic textual analysis, think-aloud protocols, and error annotation on parallel SMT/NMT outputs. Results show that while NMT reduces surface errors, both paradigms still require human intervention to restore omitted meanings, pragmatic tone, and cultural references. Experienced post-editors drew consciously on hermeneutic reasoning, supporting the claim
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Wahyudi, Wahyudi, Stevanus Budi Waluya, Hardi Suyitno, and Isnarto Isnarto. "Schemata and creative thinking ability in cool-critical-creative-meaningful (3CM) learning." International Journal of Sustainability in Higher Education 22, no. 1 (2020): 1–28. http://dx.doi.org/10.1108/ijshe-06-2019-0198.

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Purpose This study aims to describe how creative thinking ability could be improved through correcting the thinking schemata using cool-critical-creative-meaningful (3CM) learning model. Design/methodology/approach This study implemented mixed methods with explanatory sequential, which means a study that was conducted by collecting quantitative and qualitative data, consecutively. The creative thinking ability was measured through tests and then triangulated with the student teachers answers in the interviews. The qualitative data consisted of creative thinking schemata that were collected wit
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Kafa, Antonios, and Petros Pashiardis. "Exploring school principals’ personal identities in Cyprus from a values perspective." International Journal of Educational Management 33, no. 5 (2019): 886–902. http://dx.doi.org/10.1108/ijem-03-2018-0102.

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Purpose The purpose of this paper is to explore a broader understanding of the role of Cypriot school principals’ personal identities, through a values system perspective, when exercising their leadership. Design/methodology/approach A multicase study methodology was followed with five school principals, representing five different leadership styles. In each case, an in-depth investigation of the school principal’s personal identity was undertaken. School principals’ personal values were explored during interviews, staff meetings and daily activities observations, as well as through the use of
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Konopasky, Abigail, Divya Ramani, Megan Ohmer, et al. "It Totally Possibly Could Be: How a Group of Military Physicians Reflect on Their Clinical Reasoning in the Presence of Contextual Factors." Military Medicine 185, Supplement_1 (2020): 575–82. http://dx.doi.org/10.1093/milmed/usz250.

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ABSTRACT Introduction Contextual factors (eg, diagnostic suggestion and burnout) can affect physician clinical reasoning performance, leading to diagnostic error. Yet, contextual factors have only recently been studied and none of that work focused on how physicians appraise (ie, evaluate) the clinical situation as they reason. The purpose of this qualitative study was to use appraisal to describe the effect of contextual factors on clinical reasoning. Materials and Methods Physicians (n = 25) either viewed two video cases or participated in two live scenarios, one with contextual factors and
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Bulatovna Garipova, Alina, and Niyaz Rastamovich Latypov. "THINK-ALOUD PROTOCOLS, EYE-TRACKING AND KEY-LOGGING IN IDENTIFICATION AND ADDRESSING TRANSLATION CHALLENGES." Humanities & Social Sciences Reviews 7, no. 6 (2019): 98–101. http://dx.doi.org/10.18510/hssr.2019.7621.

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Purpose of the study: The research is focused on studying the translation process using the methods of allied sciences for improving a translation end product. This article deals with the identification of the most challenging prospective translation difficulties and analysis of the main macro- and micro strategies of translation on the basis of conducted experiments with combination of eye-tracking and think-aloud protocols and an experiment using keystroke logging. In the article we also make an attempt to undercover the basic principles which influence decision-making.
 Methodology: Co
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Samosir, Christina Monika, Tatang Herman, Sufyani Prabawanto, Rini Melani, and Syifa Ananda Mefiana. "Students' Difficulty in Understanding Problems in the Contextual Problem-Solving Process." PRISMA 13, no. 1 (2024): 20. http://dx.doi.org/10.35194/jp.v13i1.3726.

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The main procedure that students need to master in the problem-solving process is understanding the problem before proceeding to the next steps. This research aims to investigate students' difficulties and the factors causing these difficulties in understanding the problem. This research is qualitative in nature and is based on the philosophy of phenomenology. The research was conducted in an eighth-grade class at one of the Junior High Schools in Bandung, consisting of 28 students. Data collection techniques included tests, interviews, and think-aloud methods. The data collection instruments
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Luo, Shaoqian, and Xiaohui Sun. "A Case Study on Intermediate CSL Learners’ Word Recognition Processes and Strategies in Contextual Reading Settings." Chinese Journal of Applied Linguistics 41, no. 3 (2018): 288–305. http://dx.doi.org/10.1515/cjal-2018-0023.

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Abstract This study investigates word recognition processes and strategies of intermediate learners of Chinese as a Second Language (CSL) in contextual reading settings. Two intermediate CSL learners were chosen as research participants, and think-aloud methods and retrospective interviews were used to collect data. The data were analyzed by using Moustakas’ data analysis procedure, Creswell’s three steps and Bogdon and Biklen’s data analysis methods. Results indicated that intermediate CSL learners go through different processes of word recognition as it might be automatic, based on context,
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Lobach, David F., Mary E. Cooley, Barbara Halpenny, Hayley Dunnack Yackel, Aziz Boxwala, and Janet Lee Abrahm. "Capturing the patient’s voice to inform advanced clinical decision support for guideline-based cancer symptom management." JCO Oncology Practice 19, no. 11_suppl (2023): 510. http://dx.doi.org/10.1200/op.2023.19.11_suppl.510.

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510 Background: Electronic patient reported outcomes (ePROs) have become routine in cancer care; however, ePROs alone do not provide sufficient information to enable informed symptom management. Informed symptom management requires an awareness of patient context to reduce inappropriate or erroneous advice. In this project we asked: how can information be collected directly from patients to provide clinicians with detailed, contextually-informed, patient-specific, evidence-based recommendations to manage distressing symptoms, especially among patients with complex comorbidities. Methods: The l
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Øfsti, Ruth, Siri Andreassen Devik, Ingela Enmarker, and Rose Mari Olsen. "“Looking for Deviations”: Nurses’ Observations of Older Patients With COPD in Home Nursing Care." Global Qualitative Nursing Research 7 (January 2020): 233339362094633. http://dx.doi.org/10.1177/2333393620946331.

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Nurses working in home care play a significant role in observing and identifying changes in the health status of patient with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore and describe nurses’ observations of older patients with COPD when providing home nursing care. In this qualitative explorative study, data were collected through observations of 17 home care visits using the think-aloud technique, followed up with individual interviews with the nurses. Qualitative content analysis was used to analyze the data. The findings showed that the nurses’ observa
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Vromans, Ruben D., Mies C. van Eenbergen, Gijs Geleijnse, Steffen Pauws, Lonneke V. van de Poll-Franse, and Emiel J. Krahmer. "Exploring Cancer Survivor Needs and Preferences for Communicating Personalized Cancer Statistics From Registry Data: Qualitative Multimethod Study." JMIR Cancer 7, no. 4 (2021): e25659. http://dx.doi.org/10.2196/25659.

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Background Disclosure of cancer statistics (eg, survival or incidence rates) based on a representative group of patients can help increase cancer survivors’ understanding of their own diagnostic and prognostic situation, and care planning. More recently, there has been an increasing interest in the use of cancer registry data for disclosing and communicating personalized cancer statistics (tailored toward personal and clinical characteristics) to cancer survivors and relatives. Objective The aim of this study was to explore breast cancer (BCa) and prostate cancer (PCa) survivor needs and prefe
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Eiger, Bettina, Michael Skovdal Rathleff, Kelly Ickmans, Emma Rheel, and Christian Lund Straszek. "Pain Science Education for Patients with Chronic Pain Referred to Community-Based Rehabilitation: Translation, Adaptation, and Clinical Feasibility Testing of PNE4Adults." Journal of Clinical Medicine 14, no. 3 (2025): 771. https://doi.org/10.3390/jcm14030771.

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Background/Objectives: Pain science education accommodating low health literacy is needed for people with chronic pain. The purpose of this study was to translate PNE4Kids, contextually adapt it into PNE4Adults, and test the feasibility of the newly developed pain science education program (PNE4Adults) for adult patients with chronic musculoskeletal pain in the municipality. Methods: A three-step approach was used to (1) translate PNE4Kids into Danish, (2) adapt to age and context (PNE4Adults), and (3) test the feasibility. (1) Translation was performed by a native Dane fluent in Dutch. (2) Tw
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Sanger, Patrick C., Andrea Hartzler, Ross J. Lordon, et al. "A patient-centered system in a provider-centered world: challenges of incorporating post-discharge wound data into practice." Journal of the American Medical Informatics Association 23, no. 3 (2016): 514–25. http://dx.doi.org/10.1093/jamia/ocv183.

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Objective The proposed Meaningful Use Stage 3 recommendations require healthcare providers to accept patient-generated health data (PGHD) by 2017. Yet, we know little about the tensions that arise in supporting the needs of both patients and providers in this context. We sought to examine these tensions when designing a novel, patient-centered technology – mobile Post-Operative Wound Evaluator (mPOWEr) – that uses PGHD for post-discharge surgical wound monitoring. Materials and Methods As part of the iterative design process of mPOWEr, we conducted semistructured interviews and think-aloud ses
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Omar, Shumaila, and Wan Nazihah Wan Mohamed. "Exploring Cognitive, Emotional and Psychomotor Processes of Critical Reading Skills: A Comparative Analysis of Fluent and Novice Readers." International Journal of Research and Innovation in Social Science VIII, IIIS (2025): 6150–64. https://doi.org/10.47772/ijriss.2024.803459s.

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Critical reading is a vital academic skill that involves carefully engaging with texts to explore the assumptions, arguments, and implications presented by authors. To fully grasp its importance, it is necessary to understand how critical thinking interacts with different dimensions of learning. Using Bloom’s Taxonomy as a framework, this approach evaluates students’ engagement with texts, ranging from basic recall to advanced cognitive skills, while considering the interplay between cognitive abilities, emotional involvement, and physical actions. Many students struggle with reading comprehen
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Güner, Sevde, and Leman Figen Gül. "Evaluating Virtual Game Design for Cultural Heritage Interpretation: An Exploratory Study on arkeOyun." Heritage 8, no. 6 (2025): 208. https://doi.org/10.3390/heritage8060208.

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The interpretation of archaeological heritage encounters inherent challenges due to the fragmentation and contextual loss of the physical site. Virtual reality has emerged as an innovative medium for enhancing user engagement and promoting meaningful dissemination of culture. This exploratory study investigates the design and preliminary expert-based evaluation of arkeOyun, a virtual reality game created to better understand archaeological sites’ spatial and cultural significance, by sampling the Kültepe Archaeological Site. The aim of this study is to evaluate the usefulness of virtual game-b
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Hartmann, Miriam, Sarah T. Roberts, Noah Triplett, et al. "Development of a relationship counselling website to identify and mitigate risk of intimate partner violence in the context of women’s PrEP use." PLOS Digital Health 2, no. 8 (2023): e0000329. http://dx.doi.org/10.1371/journal.pdig.0000329.

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Discreet, accessible interventions are urgently needed to mitigate the risk of intimate-partner violence (IPV) and other relationship barriers that women encounter to using HIV prevention methods such as pre-exposure prophylaxis (PrEP). We adapted a counsellor-administered intervention, CHARISMA, into a mobile-optimized website to enhance accessibility and reduce human resources required for HIV prevention and relationship counseling. Using human-centered design and participatory methods, CHARISMA was adapted through workshops with former CHARISMA in-person intervention participants (n = 14; a
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Bussert, Leslie. "Millennial Students’ Online Search Strategies are Associated With Their Mental Models of Search." Evidence Based Library and Information Practice 6, no. 3 (2011): 77. http://dx.doi.org/10.18438/b8wp7c.

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Objective – To examine first-year college students’ information seeking behaviours and determine whether their mental models of the search process influence their ability to effectively search for and find scholarly materials.
 
 Design – Mixed methods including contextual inquiry, concept mapping, observation, and interviews.
 
 Setting – University of Baltimore, a public institution in Maryland, United States of America, offering undergraduate, graduate, and professional degrees.
 
 Subjects – A total of 21 first-year undergraduate students, ages 16 to 19 years,
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Robinson, Claire H., and Laura J. Damschroder. "A pragmatic context assessment tool (pCAT): using a Think Aloud method to develop an assessment of contextual barriers to change." Implementation Science Communications 4, no. 1 (2023). http://dx.doi.org/10.1186/s43058-022-00380-5.

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Abstract Background The Consolidated Framework for Implementation Research (CFIR) is a determinant framework that can be used to guide context assessment prior to implementing change. Though a few quantitative measurement instruments have been developed based on the CFIR, most assessments using the CFIR have relied on qualitative methods. One challenge to measurement is to translate conceptual constructs which are often described using highly abstract, technical language into lay language that is clear, concise, and meaningful. The purpose of this paper is to document methods to develop a free
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Hartmann, Eva Maria, Alisa Küper, Jessica Swoboda, et al. "Requirements for a dashboard optimized for melanoma patient care through user-centered context exploration." Scientific Reports 14, no. 1 (2024). http://dx.doi.org/10.1038/s41598-024-67857-2.

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AbstractFor time-sensitive treatment of a patient with malignant melanoma, physicians must obtain a rapid overview of the patient’s status. This study aimed to analyze context-specific features and processes at the point of care to derive requirements for a dashboard granting more straightforward access to information. The Think-Aloud method, contextual inquiries, and interviews were performed with physicians from the Department of Dermatology at the University Hospital Essen in Germany. The user statements and observations that were obtained were grouped and categorized using an affinity diag
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Ke, Yu, Ivy Cheng, Gretchen Ser Hua Tan, et al. "Development and pilot testing of a decision aid for navigating breast cancer survivorship care." BMC Medical Informatics and Decision Making 22, no. 1 (2022). http://dx.doi.org/10.1186/s12911-022-02056-5.

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Abstract Background The predominant oncologist-led model in many countries is unsustainable to meet the needs of a growing cohort of breast cancer survivors (BCS). Despite available alternative models, adoption rates have been poor. To help BCS navigate survivorship care, we aimed to systematically develop a decision aid (DA) to guide their choice of follow-up care model and evaluate its acceptability and usability among BCS and health care providers (HCPs). Methods We recruited BCS aged ≥ 21 years who have completed primary treatment and understand English. BCS receiving palliative care or wi
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Van Der Heijde, CM, D. L. Arts, and P. Vonk. "howtostayfocused.org Addressing attention-related health problems in higher education with an eTool." European Journal of Public Health 30, Supplement_5 (2020). http://dx.doi.org/10.1093/eurpub/ckaa166.052.

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Abstract Background 20 to 30% of university students consistently report attention-related health problems (studenthealthcheck), such as depression, a less healthy lifestyle (e.g. alcohol/ drugs, sleep, etc.) or adhd. Students are healthcare avoiders and as such ideal candidates for eHealth. To sort out their attention problems, increase their knowledge and guide them to solutions, howtostayfocused.org/ has to be scientifically evaluated. Methods A qualitative study was conducted in 2019 at the Student Health Service of the UvA. A prototype eTool and interview guide were developed in accordanc
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Monaca, Clara, Matthias Weigl, Holger Pfaff, and Antje Hammer. "Safety Culture Through Patient Voice: Qualitative Validation of the Patients' Perceptions of Safety Culture Scale (PaPSC) in Cardiology and Cardiothoracic Surgery." Health Expectations 28, no. 2 (2025). https://doi.org/10.1111/hex.70213.

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ABSTRACTObjectiveThe 11‐item Patients' Perception of Safety Culture Scale (PaPSC) measures patients' perceptions of the safety culture within healthcare organizations. While patients can respond to these items, factors such as limited knowledge, unclear roles and insufficient information may influence their assessments. Despite previous research on the PaPSC, no qualitative validation has been conducted. This study addresses this gap by exploring patients' perspectives on safety culture.MethodsA qualitative, exploratory approach was adopted, employing problem‐centred interviews with patients f
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Garabedian, Pamela M., Michael P. Gannon, Skye Aaron, Edward Wu, Zoe Burns, and Lipika Samal. "Human-centered design of clinical decision support for management of hypertension with chronic kidney disease." BMC Medical Informatics and Decision Making 22, no. 1 (2022). http://dx.doi.org/10.1186/s12911-022-01962-y.

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Abstract Background Primary care providers face challenges in recognizing and controlling hypertension in patients with chronic kidney disease (CKD). Clinical decision support (CDS) has the potential to aid clinicians in identifying patients who could benefit from medication changes. This study designed an alert to control hypertension in CKD patients using an iterative human-centered design process. Methods In this study, we present a human-centered design process employing multiple methods for gathering user requirements and feedback on design and usability. Initially, we conducted contextua
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Singaraju, Raj C., Steven J. Durning, Alexis Battista, and Abigail Konopasky. "Exploring procedure-based management reasoning: a case of tension pneumothorax." Diagnosis, August 4, 2022. http://dx.doi.org/10.1515/dx-2022-0028.

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Abstract Objectives Management reasoning has not been widely explored but likely requires broader abilities than diagnostic reasoning. An enhanced understanding of management reasoning could improve medical education and patient care. We conducted a novel exploratory study to gain further insights into procedure-based management reasoning. Methods Participant physicians managed a simulated patient who acutely decompensates in a team-based, time-pressured, live scenario. Immediately following the scenario, physicians perform a think-aloud protocol by watching video recordings of their performan
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Johansen, Simon Kristoffer, Anne Marie Kanstrup, Janus Laust Thomsen, Mads Norre Christensen, and Michael Skovdal Rathleff. "Exploring the barriers and facilitators for supporting adolescents with knee pains adherence to mobile health apps: A think-aloud study." DIGITAL HEALTH 9 (January 2023). http://dx.doi.org/10.1177/20552076231205750.

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Background Mobile health (mHealth) applications have the potential to support adolescents’ self-management of knee pain. However, ensuring adherence remains a barrier when designing mHealth concepts for adolescents. Objective This study aimed to explore barriers and facilitators for adhering to mHealth interventions to inform design principles. Methods Think-aloud tests were conducted with 12 adolescents (aged 12.5 years median) with knee pain, using a low-fidelity prototype. The prototype was informed by the authors previous work, rapid prototyping sessions with seven health professionals, an
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Rohrbach, Tobias, and Philomen Schönhagen. "Gender on the mind? Gender heuristics and rationalizations in candidate evaluations." Political Psychology, September 14, 2024. http://dx.doi.org/10.1111/pops.13036.

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AbstractAs more women enter politics, public and scholarly narratives about the extent and nature of gender bias in mediated campaigning environments diversify. Yet there is still little understanding of how voters substantively think about gender in their evaluations of women and men candidates and how voters' thoughts are affected by different types of media coverage. Drawing on literature on gender stereotyping and rationalization, this paper distinguishes two roles in which gender manifests in the candidate evaluation process—as a heuristic and as a rationalization. We empirically investig
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Sutton, Amanda, Jacob Collen, Steven J. Durning, and Eulho Jung. "Does management reasoning display context specificity? An exploration of sleep loss and other distracting situational (contextual) factors in clinical reasoning." Diagnosis, April 10, 2025. https://doi.org/10.1515/dx-2025-0007.

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Abstract Objectives Context specificity occurs when a health professional sees two patients with identical signs and symptoms yet arrives at two different diagnoses due to other existing factors. For example, one patient speaks English as a first language, while the other patient has limited English proficiency. It is not known if context specificity extends beyond diagnosis and also affects management reasoning. Our study explored whether reduced sleep and other distracting contextual factors (e.g., limited English proficiency) lead to context specificity, resulting in suboptimal management r
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Clary, Cody, Adam Cohen, Shelley Kumar, et al. "The effect of a provisional diagnosis on intern diagnostic reasoning: a mixed methods study." Diagnosis, January 1, 2025. https://doi.org/10.1515/dx-2024-0097.

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Abstract Objectives Competency in diagnostic reasoning is integral to medical training and patient safety. Situativity theory highlights the importance of contextual factors on learning and performance, such as being informed of a provisional diagnosis prior to a patient encounter. This study aims to determine how being informed of a provisional diagnosis affects an intern’s approach to diagnostic reasoning. Methods This mixed methods study was conducted in a real-time workplace learning environment at a large teaching hospital. Interns were randomized to the Chief Complaint (CC) only or chief
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Payne, Liz, Daniela Ghio, Elisabeth Grey, et al. "Optimising an intervention to support home-living older adults at risk of malnutrition: a qualitative study." BMC Family Practice 22, no. 1 (2021). http://dx.doi.org/10.1186/s12875-021-01572-z.

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Abstract Background In the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those at risk may help to reduce malnutrition risk, reduce the resulting need for healthcare use and improve quality of life. Interventions are needed to raise older adults’ risk awareness, offer relevant and meaningful strategies to address risk and support general practices to deliver treatment and support. Methods Using the Person-based Approach and input from Patient and Public Involvement representatives, we
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