Choosing work and care : four Australian women negotiating return to paid work in the first year of motherhood

Australian women make decisions about return to paid work and care for their child within a policy environment that presents mixed messages about maternal employment and child care standards. Against this background an investigation of first-time mothers’ decision-making about workforce participation and child care was undertaken. Four women were studied from pregnancy through the first postnatal year using interview and diary methods. Inductive analyses identified three themes, all focused on dimensions of family security: financial security relating to family income, emotional security relating to child care quality, and pragmatic security relating to child care access. The current policy changes that aim to increase child care quality standards in Australia present a positive step toward alleviating family insecurities but are insufficient to alleviate the evidently high levels of tension between workforce participation and family life experienced by women transitioning back into the workforce in Australia.

Knowledge-Intensive Business Processes: Proceedings of the 1st International Workshop on Knowledge-intensive Business Processes [CEUR Workshop Proceedings, Volume 861]

Nowadays, Workflow Management Systems (WfMSs) and, more generally, Process Management Systems (PMPs) are process-aware Information Systems (PAISs), are widely used to support many human organizational activities, ranging from well-understood, relatively stable and structures processes (supply chain management, postal delivery tracking, etc.) to processes that are more complicated, less structured and may exhibit a high degree of variation (health-care, emergency management, etc.). Every aspect of a business process involves a certain amount of knowledge which may be complex depending on the domain of interest. The adequate representation of this knowledge is determined by the modeling language used. Some processes behave in a way that is well understood, predictable and repeatable: the tasks are clearly delineated and the control flow is straightforward. Recent discussions, however, illustrate the increasing demand for solutions for knowledge-intensive processes, where these characteristics are less applicable. The actors involved in the conduct of a knowledge-intensive process have to deal with a high degree of uncertainty. Tasks may be hard to perform and the order in which they need to be performed may be highly variable. Modeling knowledge-intensive processes can be complex as it may be hard to capture at design-time what knowledge is available at run-time. In realistic environments, for example, actors lack important knowledge at execution time or this knowledge can become obsolete as the process progresses. Even if each actor (at some point) has perfect knowledge of the world, it may not be certain of its beliefs at later points in time, since tasks by other actors may change the world without those changes being perceived. Typically, a knowledge-intensive process cannot be adequately modeled by classical, state of the art process/workflow modeling approaches. In some respect there is a lack of maturity when it comes to capturing the semantic aspects involved, both in terms of reasoning about them. The main focus of the 1st International Workshop on Knowledge-intensive Business processes (KiBP 2012) was investigating how techniques from different fields, such as Artificial Intelligence (AI), Knowledge Representation (KR), Business Process Management (BPM), Service Oriented Computing (SOC), etc., can be combined with the aim of improving the modeling and the enactment phases of a knowledge-intensive process. The 1st International Workshop on Knowledge-intensive Business process (KiBP 2012) was held as part of the program of the 2012 Knowledge Representation & Reasoning International Conference (KR 2012) in Rome, Italy, in June 2012. The workshop was hosted by the Dipartimento di Ingegneria Informatica, Automatica e Gestionale Antonio Ruberti of Sapienza Universita di Roma, with financial support of the University, through grant 2010-C26A107CN9 TESTMED, and the EU Commission through the projects FP7-25888 Greener Buildings and FP7-257899 Smart Vortex. This volume contains the 5 papers accepted and presented at the workshop. Each paper was reviewed by three members of the internationally renowned Program Committee. In addition, a further paper was invted for inclusion in the workshop proceedings and for presentation at the workshop. There were two keynote talks, one by Marlon Dumas (Institute of Computer Science, University of Tartu, Estonia) on "Integrated Data and Process Management: Finally?" and the other by Yves Lesperance (Department of Computer Science and Engineering, York University, Canada) on "A Logic-Based Approach to Business Processes Customization" completed the scientific program. We would like to thank all the Program Committee members for the valuable work in selecting the papers, Andrea Marrella for his valuable work as publication and publicity chair of the workshop, and Carola Aiello and the consulting agency Consulta Umbria for the organization of this successful event.

Eliciting metacognitive experiences and reflection in a year 11 chemistry classroom : an activity theory perspective

Concerns regarding students' learning and reasoning in chemistry classrooms are well documented. Students' reasoning in chemistry should be characterized by conscious consideration of chemical phenomenon from laboratory work at macroscopic, molecular/sub-micro and symbolic levels. Further, students should develop metacognition in relation to such ways of reasoning about chemistry phenomena. Classroom change eliciting metacognitive experiences and metacognitive reflection is necessary to shift entrenched views of teaching and learning in students. In this study, Activity Theory is used as the framework for intepreting changes to the rules/customs and tools of the activity systems of two different classes of students taught by the same teacher, Frances, who was teaching chemical equilibrium to those classes in consecutive years. An interpretive methodolgy involving multiple data sources was employed. Frances explicitly changed her pedagogy in the second year to direct students attention to increasingly consider chemical phenomena at the molecular/sub-micro level. Additonally, she asked students not to use the textbook until toward the end of the equilibrium unit and sought to engage them in using their prior knowledge of chemistry to understand their observations from experiments. Frances' changed pedagogy elicited metacognitive experiences and reflection in students and challenged them to reconsider their metacognitive beliefs about learning chemistry and how it might be achieved. While teacher change is essential for science education reform, students are not passive players in the change efforts and they need to be convinced of the viability of teacher pedagogical change in the context of their goals, intentions, and beliefs.

Validating the design science research roadmap : through the lens of "the idealised model for theory development"

Design Science Research (DSR) has emerged as an important approach in Information Systems (IS) research. However, DSR is still in its genesis and has yet to achieve consensus on even the fundamentals, such as what methodology / approach to use for DSR. While there has been much effort to establish DSR methodologies, a complete, holistic and validated approach for the conduct of DSR to guide IS researcher (especially novice researchers) is yet to be established. Alturki et al. (2011) present a DSR ‘Roadmap’, making the claim that it is a complete and comprehensive guide for conducting DSR. This paper aims to further assess this Roadmap, by positioning it against the ‘Idealized Model for Theory Development’ (IM4TD) (Fischer & Gregor 2011). The IM4TD highlights the role of discovery and justification and forms of reasoning to progress in theory development. Fischer and Gregor (2011) have applied IM4TD’s hypothetico-deductive method to analyze DSR methodologies, which is adopted in this study to deductively validate the Alturki et al. (2011) Roadmap. The results suggest that the Roadmap adheres to the IM4TD, is reasonably complete, overcomes most shortcomings identified in other DSR methodologies and also highlights valuable refinements that should be considered within the IM4TD.

Assessing of circuit breaker restrike risks using computer simulation and wavelet analysis

A breaker restrike is an abnormal arcing phenomenon, leading to a possible breaker failure. Eventually, this failure leads to interruption of the transmission and distribution of the electricity supply system until the breaker is replaced. Before 2008, there was little evidence in the literature of monitoring techniques based on restrike measurement and interpretation produced during switching of capacitor banks and shunt reactor banks in power systems. In 2008 a non-intrusive radiometric restrike measurement method and a restrike hardware detection algorithm were developed by M.S. Ramli and B. Kasztenny. However, the limitations of the radiometric measurement method are a band limited frequency response as well as limitations in amplitude determination. Current restrike detection methods and algorithms require the use of wide bandwidth current transformers and high voltage dividers. A restrike switch model using Alternative Transient Program (ATP) and Wavelet Transforms which support diagnostics are proposed. Restrike phenomena become a new diagnostic process using measurements, ATP and Wavelet Transforms for online interrupter monitoring. This research project investigates the restrike switch model Parameter „A. dielectric voltage gradient related to a normal and slowed case of the contact opening velocity and the escalation voltages, which can be used as a diagnostic tool for a vacuum circuit-breaker (CB) at service voltages between 11 kV and 63 kV. During current interruption of an inductive load at current quenching or chopping, a transient voltage is developed across the contact gap. The dielectric strength of the gap should rise to a point to withstand this transient voltage. If it does not, the gap will flash over, resulting in a restrike. A straight line is fitted through the voltage points at flashover of the contact gap. This is the point at which the gap voltage has reached a value that exceeds the dielectric strength of the gap. This research shows that a change in opening contact velocity of the vacuum CB produces a corresponding change in the slope of the gap escalation voltage envelope. To investigate the diagnostic process, an ATP restrike switch model was modified with contact opening velocity computation for restrike waveform signature analyses along with experimental investigations. This also enhanced a mathematical CB model with the empirical dielectric model for SF6 (sulphur hexa-fluoride) CBs at service voltages above 63 kV and a generalised dielectric curve model for 12 kV CBs. A CB restrike can be predicted if there is a similar type of restrike waveform signatures for measured and simulated waveforms. The restrike switch model applications are used for: computer simulations as virtual experiments, including predicting breaker restrikes; estimating the interrupter remaining life of SF6 puffer CBs; checking system stresses; assessing point-on-wave (POW) operations; and for a restrike detection algorithm development using Wavelet Transforms. A simulated high frequency nozzle current magnitude was applied to an Equation (derived from the literature) which can calculate the life extension of the interrupter of a SF6 high voltage CB. The restrike waveform signatures for a medium and high voltage CB identify its possible failure mechanism such as delayed opening, degraded dielectric strength and improper contact travel. The simulated and measured restrike waveform signatures are analysed using Matlab software for automatic detection. Experimental investigation of a 12 kV vacuum CB diagnostic was carried out for the parameter determination and a passive antenna calibration was also successfully developed with applications for field implementation. The degradation features were also evaluated with a predictive interpretation technique from the experiments, and the subsequent simulation indicates that the drop in voltage related to the slow opening velocity mechanism measurement to give a degree of contact degradation. A predictive interpretation technique is a computer modeling for assessing switching device performance, which allows one to vary a single parameter at a time; this is often difficult to do experimentally because of the variable contact opening velocity. The significance of this thesis outcome is that it is a non-intrusive method developed using measurements, ATP and Wavelet Transforms to predict and interpret a breaker restrike risk. The measurements on high voltage circuit-breakers can identify degradation that can interrupt the distribution and transmission of an electricity supply system. It is hoped that the techniques for the monitoring of restrike phenomena developed by this research will form part of a diagnostic process that will be valuable for detecting breaker stresses relating to the interrupter lifetime. Suggestions for future research, including a field implementation proposal to validate the restrike switch model for ATP system studies and the hot dielectric strength curve model for SF6 CBs, are given in Appendix A.

Supply chain management systems benefits : the expectation-confirmation theory perspective

Organizations adopt a Supply Chain Management System (SCMS) expecting benefits to the organization and its functions. However, organizations are facing mounting challenges to realizing benefits through SCMS. Studies suggest a growing dissatisfaction among client organizations due to an increasing gap between expectations and realization of SCMS benefits. Further, reflecting the Enterprise System studies such as Seddon et al. (2010), SCMS benefits are also expected to flow to the organization throughout its lifecycle rather than being realized all at once. This research therefore proposes to derive a lifecycle-wide understanding of SCMS benefits and realization to derive a benefit expectation management framework to attain the full potential of an SCMS. The primary research question of this study is: How can client organizations better manage their benefit expectations of SCM systems? The specific research goals of the current study include: (1) to better understand the misalignment of received and expected benefits of SCM systems; (2) to identify the key factors influencing SCM system expectations and to develop a framework to manage SCMS benefits; (3) to explore how organizational satisfaction is influenced by the lack of SCMS benefit confirmation; and (4) to explore how to improve the realization of SCM system benefits. Expectation-Confirmation Theory (ECT) provides the theoretical underpinning for this study. ECT has been widely used in the consumer behavior literature to study customer satisfaction, post-purchase behavior and service marketing in general. Recently, ECT has been extended into Information Systems (IS) research focusing on individual user satisfaction and IS continuance. However, only a handful of studies have employed ECT to study organizational satisfaction on large-scale IS. The current study will enrich the research stream by extending ECT into organizational-level analysis and verifying the preliminary findings of relevant works by Staples et al. (2002), Nevo and Chan (2007) and Nevo and Wade (2007). Moreover, this study will go further trying to operationalize the constructs of ECT into the context of SCMS. The empirical findings of the study commence with a content analysis, through which 41 vendor reports and academic reports are analyzed yielding sixty expected benefits of SCMS. Then, the expected benefits are compared with the benefits realized at a case organization in the Fast Moving Consumer Goods industry sector that had implemented a SAP Supply Chain Management System seven years earlier. The study develops an SCMS Benefit Expectation Management (SCMS-BEM) Framework. The comparison of benefit expectations and confirmations highlights that, while certain benefits are realized earlier in the lifecycle, other benefits could take almost a decade to realize. Further analysis and discussion on how the developed SCMS-BEM Framework influences ECT when applied in SCMS was also conducted. It is recommended that when establishing their expectations of the SCMS, clients should remember that confirmation of these expectations will have a long lifecycle, as shown in the different time periods in the SCMS-BEM Framework. Moreover, the SCMS-BEM Framework will allow organizations to maintain high levels of satisfaction through careful mitigation and confirming expectations based on the lifecycle phase. In addition, the study reveals that different stakeholder groups have different expectations of the same SCMS. The perspective of multiple stakeholders has significant implications for the application of ECT in the SCMS context. When forming expectations of the SCMS, the collection of organizational benefits of SCMS should represent the perceptions of all stakeholder groups. The same mechanism should be employed in the measurements of received SCMS benefits. Moreover, for SCMS, there exists interdependence of the satisfaction among the various stakeholders. The satisfaction of decision-makers or the authorized staff is not only driven by their own expectation confirmation level, it is also influenced by the confirmation level of other stakeholders‘ expectations in the organization. Satisfaction from any one particular stakeholder group can not reflect the true satisfaction of the client organization. Furthermore, it is inferred from the SCMS-BEM Framework that organizations should place emphasis on the viewpoints of the operational and management staff when evaluating the benefits of SCMS in the short and middle term. At the same time, organizations should be placing more attention on the perspectives of strategic staff when evaluating the performance of the SCMS in the long term.

The Socratic classroom : reflective thinking through collaborative inquiry

This book was written to serve two functions. First it is an exploration of what I have called Socratic pedagogy, a collaborative inquiry-based approach to teaching and learning suitable not only to formal educational settings such as the school classroom but to all educational settings. The term is intended to capture a variety of philosophical approaches to classroom practice that could broadly be described Socratic in form. The term ‘philosophy in schools’ is ambiguous and could refer to teaching university style philosophy to high school students or to the teaching of philosophy and logic or critical reasoning in senior years of high school. It is also used to describe the teaching of philosophy in schools generally. In the early and middle phases of schooling the term philosophy for children is often used. But this too is ambiguous as the name was adopted from Matthew Lipman’s Philosophy for Children curriculum that he and his colleagues at the Institute for the Advancement of Philosophy for Children developed. In Britain the term ‘philosophy with children’ is sometimes employed to mark two methods of teaching that have Socratic roots but have distinct differences, namely Philosophy for Children and Socratic Dialogue developed by Leonard Nelson. The use of the term Socratic pedagogy and its companion term Socratic classroom (to refer to the kind of classroom that employs Socratic teaching) avoids the problem of distinguishing between various approaches to philosophical inquiry in the Socratic tradition but also separates it from the ‘study of philosophy’, such as university style philosophy or other approaches which place little or no emphasis on collaborative inquiry based teaching and learning. The second function builds from the first. It is to develop an effective framework for understanding the relationship between what I call the generative, evaluative and connective aspects of communal dialogue, which I think are necessary to the Socratic notion of inquiry. In doing so it is hoped that this book offers some way to show how philosophy as inquiry can contribute to educational theory and practice, while also demonstrating how it can be an effective way to approach teaching and learning. This has meant striking a balance between speaking to philosophers and to teachers and educators together, with the view that both see the virtues of such a project. In the strictest sense this book is not philosophy of education, insofar as its chief focus is not on the analysis of concepts or formulation of definitions specific to education with the aim of formulating directives that guide educational practice. It relinquishes the role of philosopher as ‘spectator’, to one of philosopher ‘immersed in matter’ – in this case philosophical issues in education, specifically those related to philosophical inquiry, pedagogy and classroom practice. Put another way, it is a book about philosophical education.

Many paths lead to discovery : analogical retrieval of cancer therapies

This paper addresses the issue of analogical inference, and its potential role as the mediator of new therapeutic discoveries, by using disjunction operators based on quantum connectives to combine many potential reasoning pathways into a single search expression. In it, we extend our previous work in which we developed an approach to analogical retrieval using the Predication-based Semantic Indexing (PSI) model, which encodes both concepts and the relationships between them in high-dimensional vector space. As in our previous work, we leverage the ability of PSI to infer predicate pathways connecting two example concepts, in this case comprising of known therapeutic relationships. For example, given that drug x TREATS disease z, we might infer the predicate pathway drug x INTERACTS WITH gene y ASSOCIATED WITH disease z, and use this pathway to search for drugs related to another disease in similar ways. As biological systems tend to be characterized by networks of relationships, we evaluate the ability of quantum-inspired operators to mediate inference and retrieval across multiple relations, by testing the ability of different approaches to recover known therapeutic relationships. In addition, we introduce a novel complex vector based implementation of PSI, based on Plate’s Circular Holographic Reduced Representations, which we utilize for all experiments in addition to the binary vector based approach we have applied in our previous research.

Evaluating stakeholder satisfaction during public participation in major infrastructure and construction projects : a fuzzy approach

Numerous different and sometimes discrepant interests can be affected, both positively and negatively, throughout the course of a major infrastructure and construction (MIC) project. Failing to address and meet the concerns and expectations of the stakeholders involved has resulted in many project failures. One way to address this issue is through a participatory approach to project decision making. Whether the participation mechanism is effective or not depends largely on the client/owner. This paper provides a means of systematically evaluating the effectiveness of the public participation exercise, or even the whole project, through the measurement of stakeholder satisfaction. Since the process of satisfaction measurement is complicated and uncertain, requiring approximate reasoning involving human intuition, a fuzzy approach is adopted. From this, a multi-factor hierarchical fuzzy comprehensive evaluation model is established to facilitate the evaluation of satisfaction in both single stakeholder group and overall MIC project stakeholders.

Exploiting medical hierarchies for concept-based information retrieval

Search technologies are critical to enable clinical sta to rapidly and e ectively access patient information contained in free-text medical records. Medical search is challenging as terms in the query are often general but those in rel- evant documents are very speci c, leading to granularity mismatch. In this paper we propose to tackle granularity mismatch by exploiting subsumption relationships de ned in formal medical domain knowledge resources. In symbolic reasoning, a subsumption (or `is-a') relationship is a parent-child rela- tionship where one concept is a subset of another concept. Subsumed concepts are included in the retrieval function. In addition, we investigate a number of initial methods for combining weights of query concepts and those of subsumed concepts. Subsumption relationships were found to provide strong indication of relevant information; their inclusion in retrieval functions yields performance improvements. This result motivates the development of formal models of rela- tionships between medical concepts for retrieval purposes.

Young children’s metarepresentational competence in data modelling

longitudinal study of data modelling across grades 1-3. The activity engaged children in designing, implementing, and analysing a survey about their new playground. Data modelling involves investigations of meaningful phenomena, deciding what is worthy of attention (identifying complex attributes), and then progressing to organising, structuring, visualising, and representing data. The core components of data modelling addressed here are children’s structuring and representing of data, with a focus on their display of metarepresentational competence (diSessa, 2004). Such competence includes students’ abilities to invent or design a variety of new representations, explain their creations, understand the role they play, and critique and compare the adequacy of representations. Reported here are the ways in which the children structured and represented their data, the metarepresentational competence displayed, and links between their metarepresentational competence and conceptual competence.

Enhancing opportunities to feed forward ; developing problem solving skills using web based scenarios

Universities often struggle to satisfy students’ need for feedback. This is an area where student satisfaction with courses of study can be low. Yet it is clear that one of the properties of good teaching is giving the highest quality feedback on student work. The term ‘feedback’ though is most commonly associated with summative assessment given by a teacher after work is completed. The student can often be a passive participant in the process. This paper looks at the implementation of a web based interactive scenario completed by students prior to summative assessment. It requires students to participate actively to develop and improve their legal problem solving skills. Traditional delivery of legal education focuses on print and an instructor who conveys the meaning of the written word to students. Today, mixed modes of teaching are often preferred and they can provide enhanced opportunities for feeding forward with greater emphasis on what students do. Web based activities allow for flexible delivery; they are accessible off campus, at a time that suits the student and may be completed by students at their own pace. This paper reports on an online interactive activity which provides valuable formative feedback necessary to allow for successful completion of a final problem solving assignment. It focuses on how the online activity feeds forward and contributes to the development of legal problem solving skills. Introduction to Law is a unit designed and introduced for completion by undergraduate students from faculties other than law but is focused most particularly on students enrolled in the Bachelor of Entertainment Industries degree, a joint initiative of the faculties of Creative Industries, Business and Law at the Queensland University of Technology in Australia. The final (and major) assessment for the unit is an assignment requiring students to explain the legal consequences of particular scenarios. A number of cost effective web based interactive scenarios have been developed to support the unit’s classroom activities. The tool commences with instruction on problem solving method. Students then view the stimulus which is a narrative produced in the form of a music video clip. A series of questions are posed which guide students through the process and they can compare their responses with sample answers provided. The activity clarifies the problem solving method and expectations for the summative assessment and allows students to practise the skill. The paper reports on the approach to teaching and learning taken in the unit including the design process and implementation of the activity. It includes an evaluation of the activity with respect to its effectiveness as a tool to feed forward and reflects on the implications for the teaching of law in higher education.

End-of-life care in the intensive care setting : a descriptive exploratory qualitative study of nurses' beliefs and practices

Background: End-of-life care is a significant component of work in intensive care. Limited research has been undertaken on the provision of end-of-life care by nurses in the intensive care setting. The purpose of this study was to explore the end-of-life care beliefs and practices of intensive care nurses. Methods: A descriptive exploratory qualitative research approach was used to invite a convenience sample of five intensive care nurses from one hospital to participate in a semi-structured interview. Interview transcripts were analysed using an inductive coding approach. Findings: Three major categories emerged from analysis of the interviews: beliefs about end-of-life care, end-of-life care in the intensive care context and facilitating end-of-life care. The first two categories incorporated factors contributing to the end-of-life care experiences and practices of intensive care nurses. The third category captured the nurses’ end-of-life care practices. Conclusions: Despite the uncertainty and ambiguity surrounding end-of-life care in this practice context, the intensive care setting presents unique opportunities for nurses to facilitate positive end-of-life experiences and nurses valued their participation in the provision of end-of-life care. Care of the family was at the core of nurses’ end-of-life care work and nurses play a pivotal role in supporting the patient and their family to have positive and meaningful experiences at the end-of-life.Variation in personal beliefs and organisational support may influence nurses’ experiences and the care provided to patients and their families. Strategies to promote an organisational culture supportive of quality end-of-life care practices, and to mentor and support nurses in the provision of this care are needed.

Why renal nurses cope so well with their workplace stressors

Background: Previous studies have found significant stressors experienced by nurses working in haemodialysis units yet renal nurses appear to report less burnout than other nurses. Objectives: This study aims to undertake an inductive process to better understand the stressors and the coping strategies used by renal nurses that may lead to resilience. Method: Sixteen haemodialysis nurses from a metropolitan Australian hospital and two satellite units participated in open-ended interviews. Data were analysed from a grounded theory methodology. Measures of burnout and resilience were also obtained. Results: Two major categories of stressors emerged. First, due to prolonged patient contact, family-like relationships developed that lead to the blurring of boundaries. Second, participants experienced discrimination from both patients and staff. Despite these stressors, the majority of participants reported low burnout and moderately high-to-high levels of resilience. The major coping strategy that appeared to promote resilience was emotional distancing, while emotional detachment appeared to promote burn-out. Conclusion: Assisting nurses to use emotional distancing, rather than emotional detachment strategies to engender a sense of personal achievement may promote resilience.

An integrated educational model for continuing nurse education

Aim This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Background Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. Methods A quasi experimental pre test, post test non–equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. Findings The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. Conclusion The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians.