Sunday, January 26, 2020

Features of Goodpastures Syndrome

Features of Goodpastures Syndrome Introduction Goodpastures syndrome, a rare autoimmune disease is characterized by anti-GBM (anti-glomerular basement membrane) antibodies attacking glomerular and alveolar basement membranes of the kidneys and lungs respectively. It was first reported by Dr. Ernest William Goodpasture in 1919 and first used by Stanton and Tange in 1957 in their case studies involving nine patients with the pulmonary-renal syndrome. [1, 2] Clinical Features   Ã‚   The onset of this disease ranges from the ages of 20-30 and 60-70 especially in young men in their late twenties or in men and women over sixty years of age study. [3] The diagnostic techniques involved in detection of Goodpastures syndrome include i) urine analysis that detects kidney damage by presence of high number of red blood cells or protein in the urine sample ii) blood tests showing the presence of anti-GBM antibodies iii) x-rays that can show anomalies in lung anatomy or iv) biopsies that involve imaging of a kidney tissue sample to demonstrate glomeruli characterised by crescent-shaped structures and lines of antibodies attached to the GBM. [4] While Goodpastures syndrome constitutes the representation of clinical features like rapidly progressive glomerulonephritis (RPGN) and pulmonary hemorrhage from any cause, Goodpasture disease also includes the presence of anti-GBM antibodies in addition to the other characteristics. The term anti-GBM disease constitutes a patient with the typical autoantibodies, irrespective of clinical symptoms and characteristic features. [1,5] The clinical manifestations associated with Goodpastures syndrome include acute renal failure resulting from rapidly progressive glomerulonephritis along with pulmonary hemorrhage that might prove fatal. The symptoms in relation to it consist of bleeding of lungs, kidney failure, hematuria, proteinuria, general malaise, fatigue, and weight loss. [1,6,7,8,9] The exact etiology of this syndrome is not known however there seem to be genetic and environmental risk factors. The factors being i) exposure to organic solvents or hydrocarbons ii) smoking and drugs iii) infection iv) exposure to metal particulate matter v) lymphocyte-depletion therapy. [1,5,10] The characteristic pathology in individuals experiencing the Goodpastures Syndrome can be detected by immunofluorescence staining technique of the IgG on the GBM that shows smooth diffuse linear patterns. [11] Hemodialysis, plasma exchange, cyclophosphamide drugs and immunosuppressive agents like methylprednisolone pulse therapy or oral administration of prednisolone are possible treatments for Goodpastures syndrome. [12,13,14] Basic Cellular and Molecular Mechanisms The localization of immunoglobulin IgG deposits at sites of inflammation within the pulmonary and renal basement membranes shows Goodpastures syndrome (a form of the anti-GBM disease) to be an antibody-mediated autoimmune disease. The pathogenic role of these antibodies has been confirmed by  transplantation of circulating or kidney-eluted anti-GBM antibodies to Rhesus monkey or human kidney allografts that result in the development of the disease.  A type II hypersensitivity reaction occurs when antibodies are targeted against extracellular matrix (ECM) specific antigens. [15]   The hypersensitivity response affects all organs in the body of which collagen is a constituent but the alveolar and glomerular basement membranes are more prone to the effect. This discrepancy is a result of increased accessibility of epitopes (antigen molecules facilitating attachment to a matching antibody) linked to overexpression of ÃŽÂ ±3 collagen chains in the respective basement membranes allowing access and formation of antibodies. [16] While ÃŽÂ ±3NC1 antibodies are the most common in patients with Goodpastures syndrome, ÃŽÂ ±5NC1 antibodies are less prevalent. Sometimes antineutrophil cytoplasmic antibody [ANCA] can also be present. [5,17] The disorder develops antibodies that target ÃŽÂ ±3 chain of basement membrane collagen (type IV collagen) present in alveoli in lungs and in the glomeruli that form the filtering units of the kidneys within the nephrons. These structures contain the basement membrane with collagen as its essential component that differentiates the epithelia from the underlying tissue. The conformational epitopes of the Goodpasture antigen are localized within 2 regions in the carboxyl terminal, noncollagenous (NC1) domain of a type IV collagen chain, ÃŽÂ ±3(IV)NC1. [1, 5, 18]. Upon interaction of the anti-GBM antibodies with the conformational epitope of the GBM glycoproteins, the complement pathway of the immune system gets activated. This results in infiltration by polymorphonuclear leukocytes (PMNs) and monocytes. The severely damaged GBM induces reflux of fibrinogen into the Bowman space, fibrinogen polymerizes to fibrin through the proliferation of procoagulant factors from activated mono cytes, leading to a crescent formation.[19] Goodpastures syndrome is linked with specific HLA types. Both positive (HLA-DR15) and negative (HLA-DR7) associations are defined and being used to develop an understanding of antigen presentation, tolerance and autoimmunity. [20,21,22] Recent Developments Recent developments like the plasmapheresis technique, steroidal drugs, and immunosuppressive therapy have drastically ameliorated the course of the medical condition in comparison to yesteryears, in which Goodpasture syndrome was deemed fatal. [23] Zhao et al., demonstrate the significant role of ÃŽÂ ±5NC1-specific antibodies in pathogenesis of Goodpastures disease and also re-confirm ÃŽÂ ±345 collagen IV molecule as the original GP autoantigen. [17] The invention of a drug, now patented, with its active element containing boron  that constitutes inhibitors of arginase activity has claimed remedial effects in the pathological state of Goodpastures Syndrome. [24] A recently developed, patented prophylaxis for glomerulonephritis resulting from Goodpastures syndrome comprises of administration of a therapeutically effective amount of an IL-6 antibody that binds with or regulates the expression or activity of a mammalian IL-6 polypeptide. [25] Conclusions Goodpastures Syndrome is an autoimmune disease characterized by anti-GBM antibodies attacking glomerular and alveolar basement membranes. The innate immune response comprises of (i) cell death; (ii) polymorphonuclear cell releasing neutrophils, basophils, eosinophils, antigens and monocytes to infiltrate the glomerulus. The adaptive immune response triggers the classical pathway of complement activated by antigen-antibody complex formation, and type II hypersensitivity reaction. Here antigens are targeted against cell- specific and tissue specific antigens (chiefly the connective tissue). Unanswered Questions Currently, there is a lot of research focusing on deciphering the causative agents of the harmful antibodies that lead to the development of Goodpastures syndrome. Evidence from this research can lead to novel drug discovery, eventually leading to a potential definitive cure for Goodpastures syndrome. [17] The exact the genetic determinants that constitute the etiology of Goodpastures syndrome are yet to be found. Bibliography Salama AD, Pusey CD. Goodpasture syndrome and other antiglomerular basement membrane diseases. In: Gilbert SJ, Weiner DE, eds. National Kidney Foundations Primer on Kidney Diseases. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014: chap 21. Benoit, F. L., D. B. Rulon, G. B. Theil, P. D. Doolan, and R. H. Watten. Goodpastures syndrome: a clinicopathologic entity. The American journal of medicine 37, no. 3 (1964): 424-444. Hudson B, Tryggvason K, Sundaramoorthy M, Neilson E. Alport syndrome, goodpasture syndrome, and type IV Collagen. New Engl J Med 2003; 348:2543-56. Fervenza, Fernando C. Goodpasture Syndrome | NIDDK National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/glomerular-diseases/goodpasture-syndrome (accessed March 1, 2017). Phelps RG, Turner AN. Anti-glomerular basement membrane disease and Goodpasture disease. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 24. Lahmer T, Heemann U. Anti-glomerular basement membrane antibody disease: a rare autoimmune disorder affecting the kidney and the lung. Autoimmun Rev 2012;12:169-73. Pedchenko V, Bondar O, Fogo AB, Vanacore R, Voziyan P, Kitching AR, et al. Molecular architecture of the Goodpasture autoantigen in anti-GBM nephritis. N Engl J Med2010;363:343-54. Salant David J. Goodpastures disease new secrets revealed. N Engl J Med 2010; 363:388-91. Dammacco F, Battaglia S, Gesualdo L, Racanelli V. Goodpastures disease: a report of ten cases and a review of the literature. Autoimmun Rev 2013;12:1101-8. Jones, Joanne L., Sara AJ Thompson, Priscilla Loh, Jessica L. Davies, Orla C. Tuohy, Allison J. Curry, Laura Azzopardi et al. Human autoimmunity after lymphocyte depletion is caused by homeostatic T-cell proliferation. Proceedings of the National Academy of Sciences 110, no. 50 (2013): 20200-20205. MD, Edward. Renal Pathology http://library.med.utah.edu/WebPath/RENAHTML/RENAL093.html (accessed March 1, 2017). Greco, Antonio, Maria Ida Rizzo, Armando De Virgilio, Andrea Gallo, Massimo Fusconi, Giulio Pagliuca, Salvatore Martellucci, Rosaria Turchetta, Lucia Longo, and Marco De Vincentiis. Goodpastures syndrome: a clinical update. Autoimmunity reviews 14, no. 3 (2015): 246-253. Bolton, W. Kline. Goodpastures syndrome. Kidney international 50, no. 5 (1996): 1753-1766. Johnson, John P., Walter Whitman, William A. Briggs, and Curtis B. Wilson. Plasmapheresis and immunosuppressive agents in anti-basement25] membrane antibody-induced Goodpastures syndrome. The American journal of medicine 64, no. 2 (1978): 354-359. Rutgers A, Meyers KEC, Canziani G, Kalluri R, Lin J, Madaio MP. High affinity of anti-GBM antibodies from Goodpasture and transplanted Alport patients to 3 (IV) NC1 collagen. Kidney Int. 2000;58:115-122. Kelly, Patrick T., and Edward F. Haponik. Goodpasture syndrome: molecular and clinical advances. Medicine 73, no. 4 (1994): 171-185. Zhao J, Cui Z, Yang R, et al. Anti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severity. Kidney Int 2009; 76:1108. Borza, Dorin-Bogdan, Eric G. Neilson, and Billy G. Hudson. Pathogenesis of Goodpasture syndrome: a molecular perspective. In Seminars in nephrology, vol. 23, no. 6, pp. 522-531. WB Saunders, 2003. Morita, Takashi, Yasunosuke Suzuki, and Jacob Churg. Structure and development of the glomerular crescent. The American journal of pathology 72, no. 3 (1973): 349. Phelps, Richard G., and Andrew J. Rees. The HLA complex in Goodpastures disease: a model for analyzing susceptibility to autoimmunity. Kidney international 56, no. 5 (1999): 1638-1653. Phelps, Richard G., Victoria Jones, A. Neil Turner, and Andrew J. Rees. Properties of HLA class II molecules divergently associated with Goodpastures disease. International immunology 12, no. 8 (2000): 1135-1143. Turner AN, Rees AJ. Anti-glomerular basement membrane disease (Chapter 3.11). In: Cameron SDAM, Grunfeld JP, Kerr DNS, Ritz E, eds Oxford Textbook of Nephrology, 2nd edn. Oxford University Press, Oxford, 1997 Shah MK, Hugghins SY. Characteristics and outcomes of patients with Goodpastures syndrome. South Med J 2002;95:1411-8. Van Zandt, Michael, Adam Golebiowski, Min Koo Ji, Darren Whitehouse, Todd Ryder, and Raymond Paul Beckett. Inhibitors of arginase and their therapeutic applications. U.S. Patent 9,266,908, issued February 23, 2016. Marshall, Diane, and Stevan Shaw. Method for the treatment of glomerulonephritis by administering an IL-6 antibody. U.S. Patent 9,321,837, issued April 26, 2016.

Saturday, January 18, 2020

Impact of Information Technology in Organizations Essay

What Is Information Technology (IT)?Information technology is one of the very advancing and in-demand technologies of this era. Ever since this technology has emerged, it has heavily dominated many organizations and firms providing them with efficient way of work. Before indulging into the depth of this technology with respect to organizations, it is first important to get a brief idea about what information technology really is. Information technology basically involves all the things that are related to the technology and science of computer and telecommunication systems. Information Technology is concerned with developing technology into something more fruitful. Information technology is inclusive of both rational and technological elements. On the other side, technological elements comprise of terms and conditions of information technology that are needed for logical structure of a system (Kalam 1, 2000). In other words, it can be said that information technology includes both computer hardware and software like voice, telecommunication stuff, multimedia and so forth. Therefore, information technology is helpful for inserting, extracting or processing information (Kalam 1, 2000). It must be clear to all that information technology is not just limited to computer oriented areas, but also helpful in departments of telecommunication, micro graphics, various firms and other support services. Internet technology is also termed as â€Å"the information revolution† at many instances and as Information and Communications Technology at other instances. Information technology makes life easier for everyday places especially large organizations and places like libraries and is very helpful in managing all types of information in form of databases. Since information technology relies heavily on computers, many firms and educational institutes call their computer departments as IT departments. Such department is also called Information Services (IS) or Management Information Services (MIS) in several organizations (Jidaw, 2008). Most of the advanced Information Technology Department involves the usage of computers, servers, database management systems, and cryptography. The people needed in such departments are System Administrators, Database Administrators, and Technology Manager and these people are supposed to send all reports to Chief Information Officer (CIO). Since many companies are  really concerned about the security and privacy of the information within them, the scope of job inside Information Technology organization is very high and the data security and server experts get highly paid for their jobs (Schneider, 2008). Impact of Information Technology in the SocietyWith respect to ongoing theories and justifications about the modern changes in the world, it has been justified that this era of humans is in the middle of a third big revolution. Early revolution included innovations and strides in agriculture, mechanization, and industrialization. The third one and the recent one is the Information Revolution. The development in the technology of information and communication has been taking place for nearly hundred years and the growth is still at its pace. It is amazing how easily one piece of information can be transferred from one corner of the world to another in just a blink of an eye. People can exchange all kinds of information to people all over the world or just to a specific group of people. In this ever changing and modernized society, information technology plays a significant part in many aspects. This approach has proposed fresh business offers and advancements in many organizations. Information technology supplies the organizations with firm communication deals that are helpful for the firms to develop the business at a worldwide level very easily. In order to organize a long chain of distributors, dealers, and purchasers, all the organizations have set up global information systems. These global information systems help in keeping a track of placed orders, delivered products, and payments made all over the world. All the credit goes to the advancement in internet technology which has made all these things possible and made them easy to handle. The setup of basic information is made in such a way that at the lowest stage, there are servers comprising of one operating system. Software like database and web serving are usually installed on these servers, making them interconnected with each other and to the users through the help of a network infrastructure. The users who have access to these servers are facilitated with their personal â€Å"hardware, operating systems, and software tools† (Alexandrou). Basic Elements of Information TechnologyBefore jumping in the depth of the  impact of information technology in organizations, it will be handy to learn about the basic elements of information technology so that it will make it easy to comprehend this technology. As it was already mentioned that information technology can be described as such kind of technology which is needed to develop information into something more fruitful. Specifically it can be deduced that employing computer and its software to convert, save, progress, send, and extract information is what information technology is all about. The following technologies are the important technologies generated from information technology:1- Computer Hardware Technologies:Such technologies comprise of personal computers, powerful servers that are maintained by devices that sends, retrieves, and saves information. 2- Telecommunication and Network Technologies:Technologies linked with networking and telecommunication enhance the level of communication between organizations as they comprise of telecommunications media and related software that is both wired and wireless and are helpful for Internet and other networks. 3- Computer Software Technologies:Such technologies comprise of all kinds of software and web browsers useful in educational institutes and business organizations. 4- Data Resource Management Technologies:Such kind of technologies involve all the things needed to maintain a database for a company or institute (Kawatra 25, 2000). Impact of Information Technology on Various InstitutionsWhen the term institution comes, it does not point out to one specific workplace or anything of that sort, instead all the organizations, companies, firms, and schools can be categorized under the word institution. Organizations are divided according to their role and management policies. This portion will now briefly talk about how information technology has affected these institutions in helping them gain success. 1- Governments:Government itself comprises of various branches and  institutions, and each of the institution of government has a particular area to deal with. With the advancements in information technology, all the government institutes have also developed a lot to and have provided the citizens with better services. Not just this, but also, this advancement has heavily improved the security abilities of government by helping them design better and improved weapons and tools for the war and for military and army people (Kawatra 27, 2000). B2 Bomber is one such example of a plane which came into being solely due to the advancement in information technology and modern computer methods. Along with this, government can also keep sensitive information about anything in a safe environment, without the fear of it getting extracted by unauthorized people. 2- Commercial Businesses:Commercial businesses play a vital role in today’s time and therefore, without any doubt, it can be said that the innovations and strides made have affected such businesses too. The extremely vital part played by information technology in such businesses is to supply benefits to the world of commercials. These benefits are achieved by the commercial businesses by the help of the newly progressed software like application software and operating systems (Kumar 104, 2000). Since television is the most entertaining and quick form of showing things all over the world at the same time, commercial businesses have taken the full advantage from this. 3- News & Media Organizations:All the work done by news & media organizations is relied totally on computers and therefore this shows how information technology has put an impact on them. Every task performed by information technology is also needed by news and media organizations, like saving information, sending it out to people, creating information and so forth (Ritendra 42, 2005). Hence, it can be seen how important the information technology is for such organizations. 4- Educational Organizations:Along with providing benefits and advantages to business-oriented organizations, information technology has even influenced the educational organizations. The advancements in information technology has made it very easy for the students as well as the faculty members to pretty much search anything on the Internet, exchange any personal  information via emails and share any knowledgeable things on forums and groups (Meadowcroft, 2000). Impact of Information Technology on Undergraduate EducationEvery industrialized nation has government bodies which try to integrate and coordinate the level of technological progress which aids in the foundation and establishment of educational institutes. Along with having a qualified faculty, it is significant to have information technology as part of the undergraduate education systems. Having information or computer department does not mean that it should only be available to the people of that area; instead students should be involved too by doing presentations, and working on other such things. Faculty members and undergraduate students can use computer facilities to take the full advantage of this technology on their finger tips. This technology has increased the ease of gaining information and decreased the hassle of worrying about the time it would have taken to seek information otherwise (Williams). The following impacts have been put by those tools:1) These tools help students in copying, presenting, researching and understanding the real-life oriented scientific complications which helps in building the examining capability in students. 2) Information technology helps in building the teamwork and learning capabilities among the students and helps them to solve matters and problems by searching and discussing with each other. 3) As information technology is advancing day by day, this is also bringing rapid changes in the formation and distribution of educational tools. 4) The proper and frequent use of information technology can help in providing an efficient educational system. 5) Information technology also helps the students of one part of the world to interact with the students in other parts of the world (Williams, 1996). Impact of Information Systems & Technology on OrganizationsIt will be doubtless to say that nowadays, majority of the organizations, whether  private or government, rely a lot on information systems. Thus, it can be said that information technology has become truly mixed with all sorts of businesses. Organizations, like telecommunications or finance, involve efficient usage of information technology in order for them to exist successfully. Ever since the concept of e-commerce has started, this technology plays a vital and significant role in carrying out any business. Organizations are not only employing information technology to improve old ways of business deals, but are also employing it to discover fresh and innovative chances in order to gain success. Though employing old methods and approaches will not do any harm, but they will not lead to a lot of success in the future and will just maintain a stable outcome for the organizations. For instance, there are several banks and insurance companies that still rely on such systems which were introduced nearly 30 years ago (Bharadwaj 169, 2000). ConclusionIn the end, it can be concluded that the advancements and progresses in information technology in firms and organizations have undoubtedly brought a noticeable revolution. Information technology has led to ideas and notions that not only improve merely one organization, but also increases competition among various organizations to do something better and efficient. Every organization wants to be the best one and therefore, for that purpose it always keeps on looking for advancements and ways to employ them in order to turn itself into a superior and flourishing one. As pressure is building inside organizations and improvements are being made in technologies, all the organizations are making efforts to utilize these technologies and gain success and prosperity from them. There is no doubt that as things are becoming advanced, they are providing easier and quicker way of performing tasks while giving better results every time. Obvious improvements can be seen in all areas of businesses due to the magic spread by the information technology. New approaches and techniques are followed and implemented by all business organizations and training is being given to people of different firms for the sake of making them experts. The story does not end here, there are yet more advancement expected in information technology and as more tools and technologies will be developed, people will be able to succeed more and the competition will increase. Information  technology is a good base for those interested in computers to have their career in this field, as this field will not only give a start to their careers but it also promises success and progresses in the upcoming years. Educational institutes teach information technology as a separate subject in schools, which shows the importance of this technology and the role it plays in everyday life. It can be deduced that information technology is a necessity of daily life and is a food for prosperity. References: 1-Jidaw Systems Limited, 2008, ‘What is Information Technology?’, < http://www.jidaw.com/itsolutions/whatisit.html>2-Laura Schneider, 2008, ‘Information Technology – Definition and History’, Tech Careers Guide, 3-Alexandrou, M. (n.d.), ‘Definition of information technology,’ 4-Goel (Ritendra), 2005, ‘Fundamentals of information technology,’ Lucknow: Paragon. 5-Kawatra, P. S., (2000), ‘Textbook of information sciences’, New Delhi: A.P.H. Pub. 6-Abdul Kalam, A. P. J,2001, February 3-9, ‘Knowledge society,’ Employment News7-Meadowcroft, B, 2001, ‘The impact of information technology on work and society,’ from 8-Kumar, K., Singh, S. P, 2000, ‘From information society to knowledge society,’ Journal of Library and Information Science, 25(2), 104-111. 9-Luther S. Williams, 1996, ‘Information Technology: Its Impact on Undergraduate Education in Science, Mathematics, Engineering, and Technology,’ Report on an NSF Workshop, National Science Foundation. 10-A. Bharadwaj, ‘A resource-based perspective on information technology and firm performance: An empirical investigation’, MIS Quarterly, Vol. 24, No. 1, 2000, 169-196.

Friday, January 10, 2020

My ideal school Essay

Recently, I made a list of what I think my perfect school would look like. As I began developing the list, I was struck by two things: Firstly, how most of it was about making school more student-centered, and secondly, that I didn’t mention technology once. For me, this second trend bears a little more fleshing out. I would never say that there is no place for technology in education, far from it†¦ But I think the place of technology is to support a more student-focused, relevant and engaging methodology. It is the ‘how’, not the ‘what’. For me, technology in the ideal school plays a supporting role – and it is a vital one, since my dream school relies on it to work, but it is still only there as a means to support the growth and flourishing of our students. The specific technologies will change and evolve, but once a school has reliable and fast Internet connectivity, other technologies can grow around it. Just as if our students are given primary status over the syllabus, everything else will fall into place. Finally, some of these ideas you will recognise as eminating from leading education gurus such as Sir Ken Robinson. For this, I make no apologies: I have embraced the learning revolution! With that in mind, here’s what I think the ideal school should be like: (Please feel free to comment and add your own below.) The perfect school: The primary focus is on tinkering, experimenting, problem-solving and making mistakes, rather than getting content into heads. ‘Remembering’ is very much a required skill, but it is closer to the bottom of the pyramid than it is currently in most schools. The whole school environment is challenging, supportive, caring and aimed at personal growth. Students are encouraged to feel as proud of their failures and the lessons learnt from them as they are of their successes. The teachers are passionate about upgrading their skills and embracing the most effective methodologies. The priority in lessons is about engagement and collaboration. There is a focus on helping students to discover their ‘element’, or the thing they feel they can spend their lives  doing. (This is what ‘creativity’ in education really means.) There is no hierarchy of subjects. Art, Drama, Music and the Humanities are treated with the same reverance as Maths, Science and Langua ges. Subject boundaries are also blurred and intermingled. Lessons are customized to the individual, rather than a one-size fits all. Students have a significant amount of input into the design and delivery of lessons. Learning spaces are orientated and arranged around the comfort and learning of the student, not the priorities of the teacher. Enrichment opportunities, running both parallel to the school day, and taking place after school are an essential part of the learning process. I acknowledge that teachers can implement many of these in their own classrooms very quickly, but the most important ones require a systemic shift. I would like to challenge our school leaders to ponder this list and to attempt to put in place the policies and procedures required to make every school the perfect school.

Thursday, January 2, 2020

Reflective Thinking A Component Of Critical Thinking

Reflective thinking: a component of critical thinking Critical thinking is considered as a higher level of reflective thinking that involves us becoming more aware of why we perceive things, the way we feel, act and do† (Phan, 2009). As the demand increases for students to demonstrate course material through hands on application, it is imperative for students to acquire clinical competency and effective critical thinking and decision-making skills. Through the use of HPS, students are offered a sequence and set of instructional practices that create conditions for practice in a mock work world. For example, experiential learning opportunities such as the High Fidelity Simulation (HFS) enhanced lab activity, and increased the student’s ability to synthesize critical content (Alfred Fountain, 2009). These integrated lab activities provide a learning environment where students do self-exploration and share ideas and viewpoints with peers in small groups. Students receive feedback through debriefing about their practice and the experience offers multiple opportunities for corrective practice and critical reflection (Elfrink, et al., 2010). Reflective thinking is a part of the critical thinking process referring specifically to the processes of analyzing, evaluating, and making judgments about what has happened. According to Teekman (2000) reflective thinking is, â€Å"the artistry of combining a professional repertoire with current clinical problems to invent uniqueShow MoreRelatedCritical Thinking And Learning Are Interrelated Lifelong Processes1631 Words   |  7 Pagesâ€Å"Thinking and learning are interrelated lifelong processes† (Institute, 2013). The knowledge and every day experiences gained in the nursing profession, help nurses’ to make thoughtful and appropriate decisions. Nurses are constantly involved in making decisions within their practice. 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