The Clinical Reasoning Cycle: The 8 Phases and their Significance

In previous posts, we’ve already talked about what Clinical Reasoning is and why it is important. We’ve explored as well how Clinical Reasoning and Critical Thinking are intimately tied together. Now, let’s talk about the clinical reasoning process.

A concept called the Clinical Reasoning Cycle, promoted by Tracy-Levett Jones, a professor of Nursing at Newcastle, organizes the clinical reasoning process...

Read More

How to Use the Coherence Principle in E-learning

It is thought that today’s generation, who grew up amidst YouTube and role-playing video games, need more motivational stimuli when it comes to learning. Many e-learning modules include visuals, sounds, and pieces of information for the sole purpose of making the lesson more interesting. What some people don’t know is that some of these materials do not support learning. What’s more, many of...

Read More

Clinical Reasoning and Critical Thinking: Integrated and Complementary

When you hear the phrase “critical thinking” what usually comes to mind is having deep, insightful and analytical thoughts about an issue or phenomenon. Critical thinking is actually essential for nurses and doctors as it is the avenue through which complex cases are solved and appropriate medical care is provided for a patient’s specific healthcare needs.

What is Critical Thinking?


Read More

The Modality Principle: Rationale and Limitations

In multimedia presentations that consist of both verbal explanations along with visuals like animations and still frames, is there a significance in the way words are presented? Would there be a difference if words were presented as on-screen text compared to spoken text?

Mayer and his colleagues have emphasized over and over the significance of presenting modules and information in...

Read More

What is Clinical Reasoning and Why is it Important?

If you’re a medical or nursing student, you may have frequently heard of the term “clinical reasoning.” So what does this term mean? Clinical reasoning refers to all the cognitive processes employed by nurses, clinicians, and other health professionals in analyzing a clinical case or a patient’s condition, reaching an accurate diagnosis, and proffering the appropriate treatment plan.

Clinical reasoning...

Read More

Applying the Principle of Temporal Contiguity

The Contiguity Principle, which was mentioned in earlier articles, emphasizes the need for elements in a lesson to be in close proximity to each other. The first principle under this, referred to as the Principle of Spatial Contiguity, discusses ways by which elements can be arranged closely together to save on cognitive load. The second principle, which is the...

Read More

The Principle of Spatial Contiguity

Instructional design for e-learning does not simply consist of multimedia elements interspersed with learning topics. In contrast, it involves the application of several principles that can enhance learning by presenting information in such a way that complements how the human mind works.

One such principle is the Spatial Contiguity principle. This principle is also referred to as Contiguity Principle 1,...

Read More

Is It Worth It to Invest in Adaptive E-learning Technology?

Adaptive e-learning technology has been proven to be an excellent method in addressing different concerns in the current education system. Personalized learning is the center of interest when it comes to adaptive technology. With all the benefits you can get, you might ask yourself, is it worthwhile to invest in adaptive technology?

If you’re part of an institution, be it...

Read More

Why Nursing Students Should Care about Clinical Practice Guidelines

A blind man can’t guide another blind man, can he? The same is true in the medical field. One needs a clear instruction from experienced mentors to help guide professionals with their tasks. Clinical Practice Guidelines (CPG) are exactly this. They’re a set of “how to” guides systematically developed to serve as a direction for nurses or other health...

Read More

Selecting Visuals that Support e-Learning

As Mayer states in his Multimedia Principle, learning is more effective when people see a presentation containing both text and graphics, rather than text alone. Visuals or graphics, when found together with text, help reinforce an idea or concept since they encourage active learning and processing through the visual channel as well. Visuals also help reinforce verbal knowledge by...

Read More

Adaptive Learning Tools for Healthcare Professionals

Being a healthcare provider means continuous and comprehensive learning! Updating your knowledge and keeping up with breakthroughs should not stop when you leave your workplace or the classroom.

As a healthcare professional, you will always encounter different cases and scenarios. Each one may have its own unique need that requires a different approach, method and understanding. You never know when...

Read More

Fostering engagement in e-learning

E-learning, as with all other types of learning, requires engagement. What is engagement, anyway? Engagement is defined as the act of being fully occupied or involved in some kind of activity. In learning, engagement is deemed to be the act of being totally engrossed in the material or concept being learned.

As e-learning has come to be widely known and...

Read More

5 Reasons Why E-learning is Great for Nurses and Nursing Students

Imagine studying with no classroom, no professors, and a more flexible time frame! This is what e-learning is all about! If you’re hearing about it only now, let’s do a recap.

E-learning is a system that combines the advantages of technology with what we know about how people learn. To put it simply, it’s teaching you what you need to...

Read More

Tips for Nurses: Choosing a Nursing Specialization

If you plan to take up a Nursing degree, or are already in Nursing School, you may have to start thinking about choosing a nursing specialization. Thinking about what’s next after finishing your nursing degree can help you be more prepared when it will be time to decide on specializing in a certain field.

Consequently, not everyone who wants to...

Read More

How E-lessons Can Optimize Human Learning

Aside from being able to hurdle the barriers of costly education and inflexible schedules, e-learning has evolved into a method that strives to take learning to a whole new level. At EHA, each e-learning module is designed in ways that optimize learning and support the processes needed to enhance the learning process. Various instructional methods are used, each contributory...

Read More

Adaptive Learning in Medical Education

Have you purchased any clothing item that says “free size”? In learning, “one size fits all” is now believed to be something that isn’t as efficient as we believed it to be.

During the 1970’s, the artificial intelligence movement became popular and adaptive learning or intelligent tutoring was born. It was admitted that our ability to adapt will be more...

Read More

Updating Your Nursing Clinical Skills

Anywhere in the world, nurses usually make up the largest percentage of health care professionals. Many of them work in hospital or institutional settings. The rest are based in nursing care facilities, doctor’s offices, clinics, home care settings, and schools, among others.

This wide array of settings make today’ nursing roles require various sophisticated interventions and evidence-based clinical skills. Such...

Read More

European Medical Education: Issues From Lack of Standardization

The widely differing cultures across European countries may be a good thing, but when it comes to medical education, such wide differences pose certain issues across the continent.

Many universities in various European countries offer quality medical education. Yet the widely differing curricula and training systems between these countries pose a large challenge to today’s students and future health care...

Read More

The Different E-learning Architectures

E-learning courses may vary in content and depth, and various courses are designed based on different viewpoints and techniques in learning. The past century has birthed various learning views, each used in different e-courses in today’s modern era. Currently, there are three learning architectures where these views are based, namely, receptive based on an information acquisition point of view,...

Read More

The Promises and Downsides of E-learning

For the past 12 years, the value and popularity of e-learning has steadily risen. Companies and organizations seeking more cost-effective means of training people, as well as students seeking more flexibility in learning, have driven e-learning to the revolutionary tool that it is today. A myriad of reasons make e-learning an attractive alternative to face-to-face instructor-led classes, especially today...

Read More

The Principles and Processes of e-Learning

Over the decades, studies on cognitive science and how it affects learning have come up with the cognitive theory and the knowledge construction view. These two theories complement each other in that they are the most comprehensive explanation and bases of how learning works. Based on these postulates and together with other learning theories, there are three assumptions that...

Read More

Mayer’s Cognitive Theory of Multimedia Learning: E-lessons and Human Learning

Online medical e-learning courses by the EHA are designed according to various learning theories and models. In particular, the Cognitive Theory of Multimedia Learning is one of the main tools taken into consideration during the creation of our modules.

Richard Mayer, Professor of Psychology at the University of California in Santa Barbara, has intensively studied and...

Read More

The Three Metaphors of Learning

Learning works in different ways, and various views on learning have emerged throughout the decades. Education and instruction methods have been patterned after these views, which are summed up into the three metaphors of learning. These three are: learning as response strengthening, learning as information acquisition, and finally, learning as knowledge instruction.

Response Strengthening


Read More

E-learning vs. Traditional Classroom Learning – Are They Totally Different?

Not all learning settings are created equal. In today’s modern times, many factors have an impact on effective learning, be it the methods used, how the content is designed, or simply other factors like tools and media employed to enhance the learning experience. Though studies have continually shown that learning in an online setting is as effective...

Read More

Too many cooks in the kitchen syndrome

There’s a new epidemic sweeping American hospitals, and a cure is desperately needed. It’s highly contagious and causes the sufferer much anxiety and psychological suffering. It also costs the healthcare system millions, if not billions, of dollars a year. You may never have heard of it. You won’t find it in the medical textbooks nor will you hear any...

Read More

Is E-learning Better than Traditional Classroom Learning?

In this day and age, with increased proliferation of online courses and programs, the question of whether e-learning or classroom learning is better has been asked a thousand times and has sparked many debates. But based on facts and studies and reality, the real question is being overlooked.

Ever since the first comparative study in 1947 aimed at testing which...

Read More

Medical e-Learning: Technology-centered vs. Learner-centered Approach

Nowadays, we are heavily reliant on technology. Wherever we go and whatever we do, every task and role seems to require the use of devices and networks powered by the most hi-tech systems. In learning, it tends to be the same. E-learning is now evolving into a more sophisticated platform where the learner has access to software, videos, and...

Read More

AMA interview with Dr. Wible at TEDMED

Christine Sinsky, M.D., from the American Medical Association interviews Pamela Wible, M.D., after her TEDMED talk. Watch periscope video here. Fully transcribed below:

Dr. Sinsky: This afternoon we’re here in Palm Springs, and I’m delighted to be here with Dr. Pamela Wible who gave a terrific TED talk last night. I’m Dr. Christine Sinsky, the Vice President of Professional Satisfaction...

Read More

What is the link between meat and cancer?

Last week the World Health Organization (WHO) released a statement classifying processed meats as “carcinogenic to humans” and red meats as “probably carcinogenic to humans.” Although there was widespread media coverage of this statement, I still felt compelled to write about it.

Delicious hanging links of freshly-processed meat.

Let’s start with a few definitions, quoted from the WHO paper:

Processed meat: “meat that...

Read More

What If My CHA2DS2-VASc Score Is One?

By Dr. David Mann

There is nothing simple about atrial fibrillation; it is a complicated, often overwhelming disease, both for patient and physician. One question that invariably comes up early on is the question of prophylactic anticoagulation for prevention of stroke. Who should receive anticoagulation? Which anticoagulant? How should anticoagulation be handled around the time of surgical...

Read More

Using Twitter to Treat Stroke

Yesterday, a 97 year old woman arrived in our emergency department after suddenly becoming unable to speak, and having weakness over the right side of her body. She was brought in by her husband, also in his 90s. We needed to make some immediate decisions about our options for treatment of this devastating condition, but it was necessary to...

Read More

Too Many Cooks in the Kitchen Syndrome

There’s a new epidemic sweeping American hospitals, and a cure is desperately needed. It’s highly contagious and causes the sufferer much anxiety and psychological suffering. It also costs the healthcare system millions, if not billions, of dollars a year. You may never have heard of it. You won’t find it in the medical textbooks nor will you hear any...

Read More

Should Patients Adjust Blood Pressure Medicines?

We are no longer surprised when a patient is asked if they take their blood pressure medicines every day, and we are told “it depends”. Yes, it can be amusing to hear how one member of a couple decides that they know more than their physician, and makes decisions based on home blood pressure measurements. Sample quotes may include...

Read More

Saving The World Through Better Coding! ICD-10 is HERE!

Thank goodness we made it to October 1st!  Finally ICD-10 codes have arrived in your doctor’s office and local hospitals!

Luckily we now all have a new medical coding system in place for our patients and their medical problems. Just by the fact that I now have the ability to code for an orca bite or (God forbid) an accident...

Read More

Right Call, Wrong Reason

There were several news stories last week that reported that Pfizer had abandoned its efforts to have its Lipitor brand of atorvastatin made available over the counter, without a prescription. I was never a big fan of OTC statins (more on that later) but I was struck by the reason that Pfizer put out:

The study did not meet...

Read More

Replacing a Heart Valve Without Opening the Heart

Here is a behind-the-scenes peek into an operating room in the midst of Silicon Valley.

Here, routinely there is a groundbreaking intersection of technology and medicine that’s blurring the lines between what’s possible today and what you’ll come to expect as routine in the future.

Imagine two experienced surgeons working side by side to replace a calcified, stenotic and...

Read More


Knowledge is power. Information is power. The secreting or hoarding of knowledge or information may be an act of tyranny camouflaged as humility. – Robin Morgan

Fifteen years into the future, in 2030, a patient returns home after a stay in the hospital. He powers up his mobile device and finds a file that was created during his surgery.

“Let’s see,” he...

Read More

Physician-assisted Suicide is our Moral Indicator

On September 12, 2015, the California Legislature passed a very controversial bill legalizing physician assisted suicide. If Gov. Jerry Brown signs the bill, California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana. During the debate over the passage of the bill, everybody...

Read More

Do proton pump inhibitors cause heart attacks?

There has been concern for several years about commonly prescribed antacid drugs called proton pump inhibitors (PPIs) and the heart.  PPIs are used to treat gastroesophageal reflux disease (GERD), peptic ulcer disease, and other acid-related diseases.  Common drugs in the PPI class are omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), lansoprazole (Prevacid), and dexlansoprazole (Dexilant), among others.


Specifically, there...

Read More

Chest pain, ST elevation, and an elevated troponin: Should we activate the Cath Lab?

This was written by Sam Ghali (@EM_RESUS), with a few edits by me.

52-year-old lady presents to the Emergency Department with 2 hours of chest pain, palpitations & SOB. She is somewhat hypertensive, but her vital signs are otherwise normal. Here is her 12-Lead ECG:

There’s a sinus rhythm at around 70 bpm. There are Q-waves in the inferior leads...

Read More