examples of critical thinking during covid 19

• Principal Leadership
• Volume 21 (2020-2021)
• Principal Leadership: October 2020

Critical Thinking During COVID: October 2020

In uncertain times, it’s human to react with stress and fear. As school leaders, you’re tasked with making big decisions and providing reassurance to staff, students, and families. Crises such as the COVID-19 pandemic require us to lead by example through critical thinking. Critical thinking is a research-validated tool in crisis management because it helps us sort through information, gain an accurate view of the situation, and make decisions.

Tapping Into Critical Thinking

Critical thinking requires us to dig deep and focus on facts and credible sources. Applying critical thinking skills helps us wade through uncertainty and reach sound conclusions.

As a reference point, consider the “9 Traits of Critical Thinking™” from Mentoring Minds:

• Adapt: I adjust my actions and strategies to accomplish tasks.
• Examine: I use a variety of methods to explore and to analyze.
• Create: I use my knowledge and imagination to express new and innovative ideas.
• Communicate : I use clear language to express my thoughts and to share information.
• Collaborate: I work with others to achieve better outcomes.
• Inquire: I seek information that excites my curiosity and inspires my learning.
• Link: I apply knowledge to reach new understandings.
• Reflect: I review my thoughts and experiences to guide my actions.
• Strive: I use effort and determination to focus on challenging tasks.

These traits can help individuals of any age navigate unfamiliar circumstances. The pandemic has had an undeniable impact on education, but critical thinking can help us all cope with the changes and challenges presented by COVID-19.

To keep education moving forward during COVID-19 while also supporting your school community, consider the following tips:

• Seek out factual information, not fast information. Make reasoned, informed decisions by understanding facts, evidence-based data, and credible sources. While it is essential to gather and rely on a variety of information and data, critical thinkers know it’s necessary to check the accuracy and bias of what is read and heard. Inquire: Encourage parents, teachers, and students to ask questions. A crisis causes anxiety, stress, and fear if individuals don’t feel permitted to investigate essential questions. Here are a few examples: How will the COVID-19 pandemic impact jobs? What instructional changes might occur? How will grading procedures change? Technology allows us quick access to an abundance of information, some contradictory and misleading. If we forget to pause and carefully review information, it can be dangerous to us and others. Examine: Caution the use of believing everything that is presented in the media. Remind others of the importance of examining information first. Seek out a variety of credible sources. When information is accurate, it can be used to resolve challenges. Misinformation is common, and it’s also harmful. In fact, the U.N. Secretary-General António Guterres recently remarked that the “global ‘misinfo-demic’ is spreading … hatred is going viral, stigmatizing and vilifying people and groups.” While networking platforms such as Facebook work to combat the overabundance of false content, it’s up to us as consumers of media to assess what we read first—and then share it with others. In a crisis, information changes by the minute. A critical thinker knows updates will be forthcoming and how crucial it is to assimilate the latest facts. Because of the vast amount of content available to us, we must continuously remind ourselves to listen to those in the know and to source trusted information—such as the COVID-19 resources NASSP is compiling.
• Practice proactive planning. Be ready to adapt routines as situations change. School leaders have been tasked with hefty responsibilities. As a principal, you’re accountable for the success of your students and staff—a daunting task on the most normal of days. Link: Use your prior knowledge and experiences to problem-solve. As a school leader, you recognize the importance of making connections—if a crisis exists, then effects appear. Discuss potential barriers and challenges with staff members and identify the various ways students and their families may be impacted. We must prepare our school communities to embrace disruption as learning takes on a new image. Educators are not only trying to plan and deliver academic lessons, but they’re also addressing the social aspect of learning in an entirely new format. Collaborate: Offer guidance and support to your colleagues. Set an example by showing how collaboration can help us navigate the new modes of teaching and learning in which we currently find ourselves. Some parents or caregivers might be recently unemployed, others may be struggling to hold onto their jobs, and some may not have the right equipment for remote learning. There are even parents—and teachers—who are trying to manage their schedules while supervising nonschool-aged children. Communicate: Pave the way for two-way communication. Ensure that information sent to students and families is clear and concise. Offer a range of ways for students to interact and ask questions. Provide an avenue for open communication with parents and teachers. As leaders, we must guide our teachers to support parents in establishing new routines while welcoming flexibility in tasks and choice in activities. Remember to integrate time for reflection or downtime within home-based learning. Help parents see the importance of maintaining certain hours for completing tasks or assignments and managing workload.
• Prioritize positive relationship-building. Be confident and recognize the importance of validating the feelings and perspectives of others. Educators are going the distance to keep learning moving forward while maintaining excellence. School leaders realize the importance of retaining the human element in education. Offering reassurance to one another, our students, and their families is vital. Create: Invite faculty to contribute their ideas for the summer and fall semester. Are there instructional practices that should change? Innovative thinking will be a critical piece of successfully returning to school. Never has it been more important to connect with parents and students. We must encourage them and thank them for embracing this new partnership of virtual communication. We must recognize that all situations and classrooms at home are just as diverse as the classrooms in brick-and mortar buildings. Adapt: You have the power to guide others in adapting to new situations. Educators are teaching from their homes; students are learning in their kitchens and living rooms—diverse, at-home situations require flexibility. We can use this as an opportunity to adapt our practices. Whether it’s offering support for parents, hosting “office” hours for students, or providing devices to those in need, change may be required. Let’s work to openly communicate and collaborate, examine the pulse of others, and frequently inquire about their thoughts. We should model talking about today’s issues so we can emulate the importance of analyzing and interpreting information to solve problems—big or small. Strive: Principals recognize the importance of modeling. While planning high-quality online learning isn’t the easiest task, it is possible when you remain focused. When students see their principal and teachers demonstrating “strive,” they can follow suit. Reflect: Take time to reflect on how you can take care of yourself. Crises are draining. We can easily become impatient, weary, and reactive, which makes situations even more problematic. We must pace ourselves, taking moments to pause and consider our own needs as important. Reflecting helps us push through challenges, improve upon past actions, and face our fears. How can we make better choices? How has COVID-19 changed our lives? What support do we need? By voicing our personal experiences, we can dig deeper to reveal strengths and opportunities.

Put Critical Thinking Into Practice

No matter the crisis, the nine traits can assist individuals of any age in making important decisions about their actions or finding an approach for resolution. We all have the capacity to think skillfully. When we incorporate critical thinking into our personal and professional lives, we can better support the growth of ourselves and our school communities. A critical thinker does not give up, but instead seeks ways to improve or resolve problems. Now is the time for principals to recognize the relevancy of thinking beyond the surface.

Sandra Love, EdD, is the director of education insight and research for Mentoring Minds, an organization that provides critical thinking resources to educators. She is a former elementary principal and recipient of the National Distinguished Principal Award.

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Covid-19 and Critical Thinking

Posted on 5/1/2020 4:48:36 PM

Written by  Sharon Schwarze, PhD , from Cabrini's  Department of Philosophy and Liberal Studies

The covid-19 crisis is very upsetting to all of us, you and me.  It has us upset because we do not know how to anticipate the future -- the world's future and our own personal futures.  We can't make plans.  Our expectations are thwarted.  We are very unhappy not knowing what the future will bring and not knowing what consequences our own actions will bring.  We want to have pleasant experiences, not unpleasant ones.  But we do not know what to anticipate.  

This is because our inductive reasoning that helps us to anticipate the future is confounded.  Remember  the principle of induction : that the future will be like the past?  The problem is that we have never had a past like this!  You should also remember that that principle has no non-circular justification.  Just because in past the future was like the past does not  guarantee  that the coming future will also be like the past.  And now it isn't.  We have never had a corona virus like this one, one that makes people so sick.  We do not know what to anticipate and therefore we do not know how to make decisions or to make plans.  It makes us anxious and unhappy.  To put it another way, we have a present that is sufficiently unlike any recent past such that our ordinary expectations for the future have been upset and we are upset.

So how can critical thinking help us in these times?  Certainly, critical thinking cannot make covid-19 and the chaos it is causing go away. What it can do is help us to understand what has happened and suggest ways to cope and improve the current situation.   Inductive reasoning  is at the heart of the problem – and is the tool our leaders and scientists are using to anticipate and improve the future.  They are collecting the  traces , that is the marks they find on the world that indicate something (new) is going on.  These include the deaths and the number of deaths, the pathogens (germs) they find on those bodies, the bodily changes in those who are sick (difficulty breathing, sore throats, fever), and the places the disease strikes.  Then they look for  patterns  among these traces.  They see that people tend to get sick after touching something that the sick person has come in contact with.  They need to know the  patterns  so they can interrupt those patterns and stop the spread of the disease.

They then use  induction , namely the three types of inductive reasoning:  

• They reason by using generalizations .  They see the pattern that older people die from covid-19 more frequently than younger people and draw the  generalization  that covid-19 is more dangerous to older people or to people with underlying conditions.  They generalize that people can catch the disease from people without symptoms, etc. These generalizations are not necessarily universal (they are not about  all , but about  some ).
• They reason using analogy.     They look at past pandemics to see how they spread.  They see that this event has similar properties to other pandemics and reason that it will share other properties as well.  They look at other corona viruses (they cause the common cold) and examine their known behavior.  They reason by analogy that this corona virus will behave somewhat similarly.  Of course, they also have to look at where the similarities stop.  For example, why does this corona virus kill more people than does the common cold?  Microscopic analysis shows some differences.  Those differences will help lead to an antidote or vaccine for covid-19.
• They reason using causal reasoning.    That is, they reason that the virus covid-19  causes  the symptoms that give so much suffering.  There is a  necessary connection  between the virus and the illness.  Whenever A happens, B happens.  Now we know that not everyone who carries the virus gets sick, but we do know that everyone who carries the virus can pass it on to someone else who will most probably get sick.  We do not know exactly why some (lucky) people do not experience symptoms but we do know that the virus is the cause of the disease.  (Just as cigarettes cause cancer but not everyone who smokes gets cancer.)   We also know that good hygiene and disinfecting can  cause  the death of the virus.  That is just as important for us to know.

We also know  using all three of these reasoning processes  that a future vaccine is a must for overcoming this scourge.  We know that most people who are vaccinated against other diseases do not get those disease or get very light cases of them.  That's using generalization and analogy and causal reasoning.   We all look forward to that day!!

Now let's use this example to talk more generally about  correlations .  A correlation is when two events repeatedly happen together, like being exposed to a sick person and later getting sick yourself.  Some correlations happen necessarily because, we assume, there is a causal relation between them.  If the first event happens then the second event  has  to happen.  E.g., if you are exposed to covid-19 you will get sick or you have a very strong immune system that can fight off this invader.  One of those two things has to happen.  There is a  necessary connection  between them.  

Some events happen together by accident.  These are  accidental correlations .  There is an accidental correlation between you're being a Cabrini University student and being healthy (at least I hope so).  It's not that you couldn't get sick, but you just happen to be both a Cabrini student and not sick.  And we hope that there continues to be a fairly high correlation between these two! This distinction is important for understanding causal reasoning.   When researchers look for a vaccine, they want to make sure that the vaccine  causes  the lack of sickness and it is not just an accident that those who received it stayed healthy.

The material in this announcement should help you to understand why inductive reasoning is so important and why critical thinking is so important.  We hope that our scientists have good inductive reasoning.  They are known for it.  Our politicians are not!

You should also keep in mind that inductive reasoning is always about  confirmation, not proof.   We will have to wait for scientists to confirm that a vaccine works.  There is never proof.  We can confirm, over and over again, that hand washing and staying away from sick can keep a person healthy.  But we cannot prove it.  Some people who ignore these prescriptions will not get sick, but they are lucky, not smart.  They are not thinking critically.

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Holistic critical thinking in times of covid-19 pandemic: unveiling fundamental skills to clinical nursing practice

Affiliations.

• 1 Measured Reasons LLC. Hermosa Beach, California, USA.
• 2 Insight Assessment. Hermosa Beach, California, USA.
• 3 Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica. Porto Alegre, Rio Grande do Sul, Brasil.
• 4 Universidade Federal de Santa Catarina (UFSC), Programa de Pós-Graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil.
• PMID: 34706034
• DOI: 10.1590/1983-1447.2021.20210235

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• Matt Morgan: Covid-19...

Covid-19: Complexity thinking for bold decisions and thoughts, and better systems of thought.

Rapid response to:

Matt Morgan: Covid-19 and the need for bold decisions

Read our latest coverage of the coronavirus pandemic.

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Rapid Response:

Dear Editor

Matt Morgan calls for better systems of thought and bold decisions and thoughts for Covid-19, mentioning complicated decision making (1).

Covid-19 produces issues that are simple, complex, complicated and chaotic, often overlapping, intertwined and changing, requiring decision making in that context. A system of thought to understand and use this to make bold and better decisions is available in chaos, complexity and complex systems thinking and science, and are being used for bold decisions for Covid-19, with examples/references below.

The Cynefin diagram, proposed as a framework for decision making (2) best describes the differences, relationship, overlap and change re simple, complex, complicated and chaos (3). Simple is straightforward and anyone can handle, complicated requires detailed knowledge, expertise and experts, complex means many changing interacting interdependent parts with unpredictability and uncertain outcome requiring feedback, adaptation and change in decision making, chaos means most things novel with the need for creativity and making some of it up, while trying to move to the other more comfortable phases.

Medicine is complex, especially in the ICU during Covid, but it can be changed by training to simple, complicated, easy and even dull, as described by Morgan, an ICU physician. Similarly for a practitioner in a busy office or the ER – who generally feel at home when others would not be, or for air traffic controllers and restaurant managers mentioned, at home, when we would not be.

This is a novel system of thought that can be used for Covid-19, and is being used for the simple, complex, complicated and chaos of covid-19. A short BMJ letter does not allow me to elaborate, but you can search, with a few random/selected examples given, including specific real world “coal face” practical uses and bold decisions, not just theoretical and conceptual:

Santa Fe Institute, home of complexity, the science for a complex world: research, teaching and transmission of ideas on all aspects of the pandemic to policymakers, governments, decision makers, etc. New England Complex Systems Institute: stopping the corona virus and endcoronavirus.org - complexity used for research, policy, decision making and practical advice for individuals, groups, governments, etc., Stephen Hawking: says he thinks complexity will be the science for the 21st century. Complexity Institutes, societies, etc at universities, other agencies in UK and globally, addressing Covid-19. “Complexity Explained” webpage with downloadable PDF, as an intro, Complexity Digest, and posts on complexity Covid including on decision making in medicine, health, health systems, business, etc.

Can Google chaos complexity Covid-19 for many more examples, with a few BMJ eletters submitted by this writer, and pre-Covid-19 – a book on medicine from a complexity perspective, and “Tsunami Chaos Global Heart” book made available free online, subtitled “using complexity science to rethink and make a better world” (3).

Chaos and complexity thinking is proposed as a different and possibly better system of thought for bold decisions and thoughts for Covid-19.

1 Morgan M. Covid-19 and the need for bold decisions BMJ 2020; 369:m2320 doi: https://doi.org/10.1136/bmj.m2320 (Published 16 June 2020). 2 Snowden D, Boone M. A Leader’s Framework for Decision Making. Harvard Business Review Nov 2007. https://hbr.org/2007/11/a-leaders-framework-for-decision-making Accessed April 20, 2020. 3 Rambihar VS, Rambihar SP, Rambihar VS Jr. Tsunami Chaos and Global Heart: using complexity science to rethink and make a better world. 2005. Vashna Publications. Toronto, Canada. http://femmefractal.com/FinalwebTsunamiBK12207.pdf (accessed June 20, 2020).

Competing interests: No competing interests

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Original research article, “fake news” or real science critical thinking to assess information on covid-19.

• 1 Department of Applied Didactics, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
• 2 IES Ramón Cabanillas, Xunta de Galicia, Cambados, Spain

Few people question the important role of critical thinking in students becoming active citizens; however, the way science is taught in schools continues to be more oriented toward “what to think” rather than “how to think.” Researchers understand critical thinking as a tool and a higher-order thinking skill necessary for being an active citizen when dealing with socio-scientific information and making decisions that affect human life, which the pandemic of COVID-19 provides many opportunities for. The outbreak of COVID-19 has been accompanied by what the World Health Organization (WHO) has described as a “massive infodemic.” Fake news covering all aspects of the pandemic spread rapidly through social media, creating confusion and disinformation. This paper reports on an empirical study carried out during the lockdown in Spain (March–May 2020) with a group of secondary students ( N = 20) engaged in diverse online activities that required them to practice critical thinking and argumentation for dealing with coronavirus information and disinformation. The main goal is to examine students’ competence at engaging in argumentation as critical assessment in this context. Discourse analysis allows for the exploration of the arguments and criteria applied by students to assess COVID-19 news headlines. The results show that participants were capable of identifying true and false headlines and assessing the credibility of headlines by appealing to different criteria, although most arguments were coded as needing only a basic epistemic level of assessment, and only a few appealed to the criterion of scientific procedure when assessing the headlines.

Introduction: Critical Thinking for Social Responsibility – An Urgent Need in the Covid-19 Pandemic

The COVID-19 pandemic is a global phenomenon that affects almost all spheres of our life, aside from its obvious direct impacts on human health and well-being. As mentioned by the UN Secretary General, in his call for solidarity, “We are facing a global health crisis unlike any in the 75-year history of the United Nations — one that is spreading human suffering, infecting the global economy and upending people’s lives.” (19 March 2020, Guterres, 2020 ). COVID-19 has revealed the vulnerability of global systems’ abilities to protect the environment, health and economy, making it urgent to provide a responsible response that involves collaboration between diverse social actors. For science education the pandemic has raised new and unthinkable challenges ( Dillon and Avraamidou, 2020 ; Jiménez-Aleixandre and Puig, 2021 ), which highlight the importance of critical thinking (CT) development in promoting responsible actions and responses to the coronavirus disease, which is the focus of this paper. Despite the general public’s respect of science and scientific advances, denial movements – such as the ones that reject the use of vaccines and advocate for alternative health therapies – are increasing during this period ( Dillon and Avraamidou, 2020 ). The rapid global spread of the coronavirus disease has been accompanied by what the World Health Organization (WHO) has described as the COVID-19 social media infodemic. The term infodemic refers to an overabundance of information (real or not) associated with a specific topic, whose growth can occur exponentially in a short period of time [ World Health Organization (WHO), 2020 ]. The case of the COVID-19 pandemic shows the crucial importance of socio-scientific instruction toward students’ development of critical thinking (CT) for citizenship.

Critical thinking is embedded within the framework of “21st century skills” and is considered one of the goals of education ( van Gelder, 2005 ). Despite its importance, there is not a clear consensus on how to better promote CT in science instruction, and teachers often find it unclear what CT means and requires from them in their teaching practice ( Vincent-Lacrin et al., 2019 ). CT is understood in this study as a set of skills and dispositions that enable students and people to take critical actions based on reasons and values, but also as independent thinking ( Jiménez-Aleixandre and Puig, 2021 ). It is also considered as a dialogic practice that students can enact and thereby become predisposed to practice ( Kuhn, 2019 ). We consider that CT has two fundamental roles in SSI instruction: one role linked to the promotion of rational arguments, cognitive skills and dispositions; and the other related to the idea of critical action and social activism, which is consistent with the characterization of CT provided by Jiménez-Aleixandre and Puig (2021) . Although research on SSIs has provided us with empirical evidence supporting the benefits of SSI instruction, particularly argumentation and students’ motivation toward learning science, there is still scarce knowledge on how CT is articulated in these contexts. One challenge with promoting CT, especially in SSIs, is linked to new forms of communication that generate a rapid increase of information and easy access to it ( Puig et al., 2020 ).

The study was developed in an unprecedented scenario, during the lockdown in Spain (March–May 2020), which forced the change of face-to-face teaching to virtual teaching, involving students in online activities that embraced the application of scientific notions related to COVID-19 and CT for assessing claims published in news headlines related to it. Previous studies have pointed out the benefits of virtual environments to foster CT among students, particularly asynchronous discussions that minimize social presence and favor all students expressing their own opinion ( Puig et al., 2020 ).

In this research, we aim to explore students’ ability to critically engage in the assessment of the credibility of COVID-19 claims during a moment in which fake news disseminated by social media was shared by the general public and disinformation on the virus was easier to access than real news.

Theoretical Framework

We will first discuss the crucial role of CT to address controversial issues and to fight against the rise of misinformation on COVID-19; and then turn attention to the role of argumentation in students’ development of CT in SSI instruction in epistemic education.

Critical Thinking on Socio-Scientific Instruction to Face the Rise of Disinformation

SSIs are compelling issues for the application of knowledge and processes contributing to the development of CT. They are multifaceted problems, as is the case of COVID-19, that involve informal reasoning and elements of critique where decisions present direct consequences to the well-being of human society and the environment ( Jiménez-Aleixandre and Puig, 2021 ). People need to balance subject matter knowledge, personal values, and societal norms when making decisions on SSIs ( Aikenhead, 1985 ) but they also have to be critical of the discourses that shape their own beliefs and practices to act responsibly ( Bencze et al., 2020 ). According to Duschl (2020) , science education should involve the creation of a dialogic discourse among members of a class that focuses on the teaching and learning of “how did we come to know?” and “why do we accept that knowledge over alternatives?” Studies on SSIs during the last decades have pointed out students’ difficulties in building arguments and making critical choices based on evidence ( Evagorou et al., 2012 ). However, literature also indicates that students find SSIs motivational for learning and increase their community involvement ( Eastwood et al., 2012 ; Evagorou, 2020 ), thus they are appropriate contexts for CT development. While research on content knowledge and different modes of reasoning on SSIs is extensive, the practice of CT is understudied in science instruction. Of particular interest in science education are SSIs that involve health controversies, since they include some of the challenges posed by the post-truth era, as the health crisis produced by coronavirus shows. The COVID-19 pandemic is affecting most countries and territories around the world, which is why it is considered the greatest challenge that humankind has faced since the 2nd World War ( Chakraborty and Maity, 2020 ). Issues like COVID-19 that affect society in multiple ways require literate citizens who are capable of making critical decisions and taking actions based on reasons. As the world responds to the COVID-19 pandemic, we face the challenge of an overabundance of information related to the virus. Some of this information may be false and potentially harmful [ World Health Organization (WHO), 2020 ]. In the context of growing disinformation related to the COVID-19 outbreak, EU institutions have worked to raise awareness of the dangers of disinformation and promoted the use of authoritative sources ( European Council of the European Union, 2020 ). Educators and science educators have been increasingly concerned with what can be done in science instruction to face the spread of misinformation and denial of well-established claims; helping students to identify what is true can be a hard task ( Barzilai and Chinn, 2020 ). As these authors suggest, diverse factors may shape what people perceive as true, such as the socio-cultural context in which people live, their personal experiences and their own judgments, that could be biased. We concur with these authors and Feinstein and Waddington (2020) , who argue that science education should not focus on achieving the knowledge, but rather on gaining appropriate scientific knowledge and skills, which in our view involves CT development. Furthermore, according to Sperber et al. (2010) , there are factors that affect the acceptance or rejection of a piece of information. These factors have to do either with the source of the information – “who to believe” – or with its content – “what to believe.” The pursuit of truth when dealing with SSIs can be facilitated by the social practices used to develop knowledge ( Duschl, 2020 ), such as argumentation understood as the evaluation of claims based on evidence, which is part of CT development.

We consider CT and argumentation as overlapping competencies in their contexts of practice; for instance, when assessing claims on COVID-19, as in this study. According to Sperber et al. (2010) , we now have almost no filters on information, and this requires a much more vigilant, knowledgeable reader. As these authors point out, individuals need to become aware of their own cognitive biases and how to avoid being victims themselves. If we want students to learn how to critically evaluate the information and claims they will encounter in social media outside the classroom, we need to engage them in the practice of argumentation and CT. This raises the question of what type of information is easier or harder for students to assess, especially when they are directly affected by the problem. In this paper we aim to explore this issue by exploring students’ arguments while assessing diverse claims on COVID-19. We think that students’ arguments reflect their ability to apply CT in this context, although this does not mean that CT skills always produce a well-reasoned argument ( Halpern, 1998 ). Students should be encouraged to express their own thoughts in SSI instruction, but also to support their views reasonably ( Puig and Ageitos, 2021 ). Specifically, when they must assess the validity of information that affects not only them as individuals but also the whole society and environment. CT may equip citizens to discard fake news and to use appropriate criteria to evaluate information. This requires the design and implementation of specific CT tasks, as this study presents.

Argumentation to Enhance Critical Thinking Development in Epistemic Education on SSIs

While the concept of CT has a long tradition and educators agree on its importance, there is a lack of agreement on what this notion involves ( Thomas and Lok, 2015 ). CT has been used with a wide range of meanings in theoretical literature ( Facione, 1990 ; Ennis, 2018 ). In 1990, The American Philosophical Association convened an authoritative panel of forty-six noted experts on CT to produce a definitive account of the concept, which was published in the Delphi Report ( Facione, 1990 ). The Delphi definition provides a list of skills and dispositions that can be useful and guide CT instruction. However, as Davies and Barnett (2015) point out, this Delphi definition does not include the phenomenon of action. We concur with these authors that CT education should involve students in “CT for action,” since decision making – a way of deciding on a course of action – is based on judgments derived from argumentation using CT. Drawing from Halpern (1998) , we also think that CT requires awareness of one’s own knowledge. CT requires, for instance, insight into what one knows and the extent and importance of what one does not know in order to assess socio-scientific news and its implications ( Puig and Ageitos, 2021 ).

Critical thinking and argumentation share core elements like rationality and reflection ( Andrews, 2015 ). Some researchers suggest understanding CT as a dialogic practice ( Kuhn, 2019 ) has implications in CT instruction and development. Argumentation on SSIs, particularly on health controversies, is receiving increasing attention in science education in the post-truth era, as the coronavirus pandemic and denial movements related to its origin, prevention, and treatment show. Science education should involve the creation of a dialogic discourse among members of a class that enable them to develop CT. One of the central features in argumentation is the development of epistemic criteria for knowledge evaluation ( Jiménez Aleixandre and Erduran, 2008 ), which is a necessary skill to be a critical thinker. We see the practice of CT as the articulation of cognitive skills through the practice of argumentation ( Giri and Paily, 2020 ).

This article argues that science education needs to explore learning experiences and ways of instruction that support CT by engaging learners in argumentation on SSIs. Despite CT being considered a seminal goal in education and the large body of research on CT supporting this ( Dominguez, 2018 ), debates still persist about the manner in which CT skills can be achieved through education ( Abrami et al., 2008 ). Niu et al. (2013) remark that educators have made a striking effort to foster CT among students, showing that the belief that CT can be taught and learned has spread and gained support. Therefore, CT has slowly made its way into general school education and specific instructional interventions. Problem-based learning is one of the most widely used learning approaches nowadays in CT instruction ( Dominguez, 2018 ) because it is motivating, challenging, and enjoyable ( Pithers and Soden, 2000 ; Niu et al., 2013 ). We see active learning methodologies and real-word problems such as SSIs as appropriate contexts for CT development.

The view that CT can be developed by engagement in argumentation practices plays a central role in this study, as Kuhn (2019) suggested. However, the post-truth condition poses some challenges to the evaluation of sources of information and scientific evidence disseminated by social media. According to Sinatra and Lombardi (2020) , the post-truth context raises the need for critical evaluation of online information about SSIs. Students need to be better prepared to assess science information they can easily find online from a variety of sources. Previous studies described by these authors emphasized the importance of source evaluation instruction to equip students toward this goal ( Bråten et al., 2019 ), however, this is not sufficient. Sinatra and Lombardi (2020) note that students should learn how to evaluate the connections between sources of information and knowledge claims. This requires, from our view, engaging students in CT and epistemic performance. If we want students to learn to think critically about the claims they will encounter on social media, they need to practice argumentation as critical evaluation.

We draw on research on epistemic education ( Chinn et al., 2018 ) which considers that learning science entails students’ participation in the science epistemic goals ( Kelly and Licona, 2018 ); in other words, placing scientific practices at the center of SSI instruction. Our study is framed in a broader research project that aims to embed CT in epistemic design and performance. In Chinn et al. (2018) AIR model, epistemic cognition has three core elements that represent the three letters of the acronym: epistemic Aims, goals related to inquiry; epistemic Ideals, standards and criteria used to evaluate epistemic products, such as explanations or arguments; and Reliable processes for attaining epistemic achievements. Of particular interest for our focus on CT is that the AIR model also proposes that epistemic cognition has a social nature, and it is situated. The purpose of epistemic education ( Barzilai and Chinn, 2017 ) should be to enable students to succeed in epistemic activities ( apt epistemic performance ), such as constructing and evaluating arguments, and to assess through meta-competence when success can be achieved. This paper attends to one aspect of epistemic performance proposed by Barzilai and Chinn (2017) , which is cognitive engagement in epistemic assessment. Epistemic assessment encompasses in our study the evaluation of the content of claims disseminated by media. Aligned with these authors we understand that this process requires cognitive and metacognitive competences. Thus, epistemic assessment needs adequate disciplinary knowledge, but also meta-cognitive competence for recognizing unsupported beliefs.

Goal and Research Questions

This paper examines students’ competence to engage in argumentation and CT in an online task that requires them to critically assess diverse information presented in media headlines on COVID-19. Competence in general can be defined as “a disposition to succeed with a certain aim” ( Sosa, 2015 , p. 43) and epistemic competence, as a special case of competence, is at its core a dispositional ability to discern the true from the false in a certain domain. For the purposes of this paper, the attention is on epistemic competence, being the research questions that drive the analysis of the following:

1. What is the competence of students to assess the credibility of COVID-19 information appearing in news headlines?

2. What is the level of epistemic assessment showed in students’ arguments according to the criteria appealed while assessing COVID-19 news headlines?

Materials and Methods

Context, participants, and design.

A teaching sequence about COVID-19 was designed at the beginning of the lockdown in Spain (Mid-March 2020) in response to the rise of misinformation about coronavirus on the internet and social media. The design process involved collaboration between the first and second author (researchers in science education) and the third author (a biology teacher in secondary education).

The participants are a group of twenty secondary students (14–15 years old), eleven of them girls, from a state public school located in a well-known seaside village in Galicia (Spain). They were mostly from middle-class families and within an average range of ability and academic achievement.

Students were from the same classroom and participated in previous online activities as part of their biology classes, taught by their biology teacher, who collaborated on previous studies on CT and learning science through epistemic practices on health controversies.

The activities were integrated in their biology curriculum and carried out when participants received instruction on the topics of health, infectious diseases, and the immune system.

Google Forms was used for the design and implementation of all activities included in the sequence. The reason to select Google Forms is that it is free and a well-known tool for online surveys. Besides, all students were familiar with its use before the lockdown and the teacher valued its usefulness for engaging them in online debates and in their own evaluation processes. This online resource provides anonymous results and statistics that the teacher could share with the students for debates. It needs to be highlighted that during the lockdown students did not have the same work conditions; particularly, quality and availability of access to the internet differed among them. Thus, all activities were asynchronous. They had 1 week to complete each task and the teacher could be consulted anytime if they had difficulties or any question regarding the activities.

The design was inspired by a previous one carried out by the authors when the first case of Ebola disease was introduced in Spain ( Puig et al., 2016 ), and follows a constructivist and scientific-based approach. The sequence began with an initial task, in which students were required to express their own views and knowledge on COVID-19 and health notions related with it, before then being progressively involved in the application of knowledge through the practice of modeling and argumentation. The third activity engaged them in critical evaluation of COVID-19 information. A more detailed description of the activities carried out in the different steps of the sequence is provided below.

Stage 1: General Knowledge on Health Notions Related to COVID-19

An individual Google Forms survey around some notions and health concepts that appear in social media during the lockdown, such as “pandemic”, “virus,” etc.

Stage 2: Previous Knowledge on Coronavirus Disease

This stage consisted of three parts: (2.1) Individual online survey on infectious diseases; (2.2) Introduction of knowledge about infectious diseases provided in the e-bugs project website 1 and activities; virtual visit to the exhibition “Outbreaks: epidemics in a connected world” available in the Natural History Museum website (blinded for review); (2.3) Building a poster with the chain of infection of the COVID-19 disease and some relevant information to consider in order to stop the spread of the disease.

Stage 3: COVID-19, Sources of Information

This stage consisted first of a virtual forum in which students shared their own habits when consulting scientific information, particularly coronavirus-related, and debated on the main media sources they used to consult for this purpose. Secondly, students had to analyze ten news headlines on COVID-19 disseminated by social media during the outbreaks; six corresponded to fake news and four were true. They were asked to critically assess them and distinguish which they thought were true, providing their arguments. Media sources were not provided until the end of the task, since the act of asking for the source was considered as part of the data analysis (see Table 1 ). The second part of this stage is the focus of our analysis.

Table 1. COVID-19 News Headlines provided to students.

Stage 4: Act and Raise Awareness on COVID-19

The sequence ended with the creation of a short video in which the students had to provide some tips to avoid the transmission of the virus. The information provided in the video must be supported and based on established scientific knowledge.

Data Corpus and Analysis

Data collection includes all individual surveys and activities developed in Google Forms. We analyzed students’ individual responses ( N = 28) presented in Stage 3. The research is designed as a qualitative study that utilizes the methods of discourse analysis in accordance with the data and the purpose of the study. Discourse analysis allows the analysis of the content (implicit or explicit) of written arguments produced by students, and so the examination of the research questions. Our analysis focuses on students’ arguments and criteria used to assess the credibility of COVID-19 headlines (ten headlines in total). It was carried out through an iterative process in which students’ responses were read and revised several times in order to develop an open-coded scheme that captures the arguments provided. To ensure the internal reliability of our codes, each student response was examined by the first and the second author separately and then contrasted and discussed until 100% agreement was achieved. The codes obtained were established according to the following criteria, summarized in Table 2 .

Table 2. Code scheme for research questions 1 and 2.

For Research Question 1, we distributed the arguments in two main categories: (1) Arguments that question the credibility of the information ; (2) Arguments that do not question the credibility of the information.

For Research Question 2, we classify arguments that question the credibility of the headline in accordance with the level of epistemic assessment into three levels (see Table 2 ). The level of epistemic assessment (basic, medium, and high) was established by the authors based on the criteria that students applied and expressed explicitly or implicitly in their arguments. These criteria emerged from the data, thus the categories were not pre-established; they were coded by the authors as the following: content (using the knowledge that each student has about the topic), source (questioning the origin of the information), evidence (appealing to empirical evidence as real live situations that students experienced), authority (justifying according to who supports or is behind the claim) and scientific procedure (drawing on the evolution of scientific knowledge).

Students’ Competence to Critically Assess the Credibility of COVID-19 Claims

In general, most students were able to distinguish fallacious from true headlines, which was an important step to assess their credibility. For those that were false, students were able to question their credibility, providing arguments against them. On the contrary, for true news headlines, as it was expected, most participants developed arguments supporting them. Thus, they did not question their content. In both cases, the arguments elaborated by students appealed to different criteria discussed in the next section of results.

As shown in Table 3 , 147 arguments were elaborated by students to question the false headlines; they created just 22 arguments to assess the true ones. This finding was expected by the authors, as arguments for questioning or criticality appear more frequently when the information presented differs from students’ opinions.

Table 3. Number of students who questioned or not each news headline on COVID-19.

Students showed a higher capacity for questioning those claims they considered false or fake news , which can be related to the need to justify properly why they consider them false and/or what should be said to counter them.

The headlines that were most controversial, meaning they created diverse positions among students, were these three: “The COVID-19 virus can be transmitted in areas with hot and humid climates,” “Skin manifestations (urticaria, chilblains, rashes…) could be among the mild symptoms of coronavirus” and “Antibiotics are effective in preventing and treating coronavirus infection.”

The first two were questioned by 11 students out of 28, despite being real headlines. According to students’ answers, they were not familiar with this information, e.g., “I think the heat is not good for the virus.” On the contrary, 17 students did not question these headlines, arguing for instance as this student did: “because it was shown that both in hot climates and in cold climates it is contagious in the same way.”

A similar situation happened with the third headline, which is false. A proportion of students (9 out of 28) accepted that antibiotics could help to treat COVID-19, showing in their answers some misunderstanding regarding the use of antibiotics and the diseases they could treat. The rest of the participants (19 out of 28) questioned this headline, affirming that “because antibiotics are used to treat bacterial infections and coronavirus is a virus,” among other justifications for why it was false.

Levels of Epistemic Assessment in Students’ Arguments on COVID-19 News Headlines

To analyze the level of epistemic assessment showed in students’ arguments when dealing with each headline, attention was focused on the criteria students applied (see Table 2 ). As Table 4 summarizes, almost all arguments included only one criterion (139 out of 169), and 28 out of 169 did not incorporate any criterion. These types of arguments can be interpreted as low epistemic assessment, or even without epistemic assessment if no criterion is included.

Table 4. Arguments used by students to assess the credibility of each COVID-19 headline.

In the category of Basic Epistemic Assessment , we include all students’ arguments that included one criterion: Content or Empirical Evidence. Students assessed the content of the claim appealing to their own knowledge about that piece of information or to empirical evidence, without posing critical questions for assessing the credibility of the source of information. These two criteria, content and evidence, were included in students’ arguments with a frequency of 86 and 23, respectively, with this category the most common (109 out of 169) when questioning false and true headlines. In the case of true headlines, arguments under this category were identified in relation to headlines 2 and 4, whose credibility were questioned by appealing to the content, such as: “those are not the symptoms (skin manifestations) ” . Examples of arguments assessing the content of false headlines are provided below:

“Because the virus is inside the body, and even if you injected alcohol into the body it would only cause intoxication”

This student rejects headline 5, appealing to the fact that alcohol causes intoxication rather than the elimination of coronavirus.

“I know a person who had coronavirus and they only gave him paracetamol”

In this example, the student rejects headline 6 and appeals to his/her own experience during the pandemic, particularly a close person who had coronavirus, as evidence against the use of antibiotics for coronavirus disease treatment.

The category Medium Epistemic Assessment gathers arguments that make critical questions, particularly those asking for information about the authority or the source of information. For us, these criteria reflect a higher level of epistemic performance since they imply questioning beyond the veracity of the headline itself to its sources and authorship. There are 20 out of 169 arguments coded within this category.

The assessment of true headlines includes arguments that question the authority and source, e.g., “because they said it on the news” (headline 2), “that news does not seem very reliable to me” (headline 4). It is also an ordinary category in questioning false headlines, since students appealed to the source (16), “because in the news they clarified that it was a fake news and because it is not credible either” (headline 10) or the authority (4), “because the professionals said they were more vulnerable (people over 70 years old) but not that it only affected them” (headline 7).

For the highest category, High Epistemic Assessment , we consider those arguments (12 out of 169) in which students appealed to the scientific procedure (11) to justify why the headline is false, which manifests students’ reliance on epistemic processes, e.g., “because treatments that protect against coronavirus are still being investigated” (headline 9). Also, under this category we include arguments that combined more than one criterion, content and scientific procedure “Because antibiotics don’t treat those kinds of infections. In addition, no medication has yet been discovered that can prevent the coronavirus” (headline 6). Students’ arguments included in this category were elaborated to assess false headlines.

Lastly, a special mention is afforded to those arguments that did not include any criteria (28), which are contained in the category Non-Epistemic Assessment. It appears more frequently in students’ answers to headlines 8 and 10, as these examples show: “I don’t think it’s true because it doesn’t make much sense to me” (headline 8) or “I never heard it and I doubt it’s true” (regarding drinking alcohol, headline 10).

The findings of our study indicate that students were able to deal with fake news , identifying it as such. They showed capacity to critically assess the content of these news headlines, considering their inconsistencies in relation to their prior knowledge ( Britt et al., 2019 ). As Evagorou (2020) pointed out, SSIs are appropriate contexts for CT development and to value the relevance of science in our lives.

The examination of RQ1 shows that a proportion of students were able to perceive the lack of evidence behind them or even identified that those statements contradict what science presents. This is a remarkable finding and an important skill to fight against attempts to diminish trust in science produced in the post-truth condition ( Dillon and Avraamidou, 2020 ). CT and argumentation are closely allied ( Andrews, 2015 ) but as the results show, knowledge domain seems to play an important role in assessing SSIs news and their implications. Specific CT requires some of the same skills as generalizable CT, but it is highly contextual and requires particular knowledge ( Jones, 2015 ).

Students’ prior knowledge influenced the critical evaluation of some of the COVID-19 headlines provided in the activity. This is particularly relevant in responses to headline 6 (false) “Antibiotics are effective in preventing and treating coronavirus infection.” A previous study on the interactions between the CT and knowledge domain on vaccination ( Ageitos and Puig, 2021 ) showed that there is a correspondence between them. This points to the importance of health literacy for CT development, although it would not be sufficient to provide students with adequate knowledge only, as judgment skills, in this case regarding the proper use of antibiotics, are also required.

We found that the level of epistemic assessment (RQ2) linked to students’ CT capacity is low. A big majority of arguments were situated in a basic epistemic assessment level, and just a few in a higher epistemic assessment. One reason that might explain these results could be related to the task design and format, in which students worked autonomously in a virtual environment. As CT studies in e-learning environments have reinforced ( Niu et al., 2013 ), cooperative or collaborative learning favors CT skills, particularly when students have to discuss and justify their arguments on real-life problems. The circumstances in which students had to work during the outbreak did not allow them to work together since internet connections were not good for all of them, so synchronous activities were not possible. This aspect is a limitation for this research.

There were differences in the use of criteria, and thus in the level of epistemic assessment, when students dealt with true and false headlines. This could be related to diverse factors, such as the language. The claims are marred by language and they are formulated in a different way. Particularly, it is quite nuanced in true statements while certain and resolute in false headlines. The practice of CT requires an understanding of the language, the content under evaluation and other cognitive skills ( Andrews, 2015 ).

In the case of false headlines, most arguments appealed to their content and less to the criteria of source, authority, and the scientific procedure, whereas in the case of true headlines most of them appealed to the authority and/or source. According to the AIR model ( Chinn and Rinehart, 2016 ), epistemic ideals are the criteria used to evaluate the epistemic products, such as claims. In the case of COVID-19 claims, students need to have an ideal of high source credibility ( Duncan et al., 2021 ). This means that students acknowledge that information should be gathered from reliable news media that themselves obtained information from reliable experts.

Only few students used the criterion of scientific procedure when assessing false headlines, which shows a high level of epistemic assessment. Promoting this type of assessment is important since online discourse in the post-truth era is affected by misinformation and by appeals to emotions and ideology.

Conclusion and Implications

This research has been conducted during a moment in which the lives of people were paralyzed, and citizens were forced to stay at home to stop the spread of the coronavirus disease. During the lockdown and even after, apart from these containment measures, citizens in Spain and in many countries had to deal with a huge amount of information about the coronavirus disease, some of it false. The outbreak of COVID-19 has been accompanied by dissemination of inaccurate information spread at high speed, making it more difficult for the public to identify verified facts and advice from trusted sources ( World Health Organization (WHO), 2020 ). As the world responds to the COVID-19 pandemic, many studies have been carried out to analyze the impact of the pandemic on the life of children from diverse views ( Cachón-Zagalaz et al., 2020 ), but not from the perspective of exploring students’ ability to engage in the epistemic assessment of information and disinformation on COVID-19 under a situation of social isolation. This is an unprecedented context in many aspects, where online learning replaced in-person teaching and science uncertainties were more visible than ever.

Participants engaged in the epistemic assessment of coronavirus headlines and were able to put into practice their CT, arguing why they considered them as true or false by appealing to different criteria. We are aware that our results have limitations. Once such limitation is that students performed the activity independently, without creating a collaborative virtual environment, understood by the authors as one of the e-learning strategies that better promote CT ( Puig et al., 2020 ). Furthermore, despite the fact that teachers were available for students to solve any questions regarding the task, the remote and asynchronous process did not allow them to guide the activity in a way that helped the students to carry out a deeper analysis. CT development and epistemic cognition depends on many factors, and teachers have an important role in achieving these goals ( Greene and Yu, 2016 ; Chinn et al., 2020 ).

The analysis of arguments allows us to identify some factors that are crucial and directly affect the critical evaluation of headlines. Some of the students did not question the use of antibiotics for coronavirus disease. This result highlights the importance of health literacy and its interdependency with CT development, as previous studies on vaccine controversies and CT show ( Puig and Ageitos, 2021 ). Although it is not the focus of this paper; the results point to the importance of making students aware of their knowledge limitations for critical assessment. A key instructional implication from this work is making e-learning activities more cooperative, as we have noted, and epistemically guided. Moreover, CT dimensions could be made explicit in instructional materials and assessments. If we want to prepare students to develop CT in order to face real/false news spread by social media, we need to engage them in deep epistemic assessment, namely in the critical analysis of the content, the source, procedures and evidence behind the claims, apart from other tasks. Promoting students’ awareness and vigilance regarding misinformation and disinformation online may also promote more careful and attentive information use ( Barzilai and Chinn, 2020 ), thus activities oriented toward these goals are necessary.

Our study reinforces the need to design more CT activities that guide students in the critical assessment of diverse aspects behind controversial news as a way to fight against the rise of disinformation and develop good knowledge when dealing with SSIs. Students’ epistemological views can influence their performance on argumentation thus, if uncertainty of knowledge is explicitly address in SSI instruction and epistemic activities, students’ epistemological views may be developed, and such development may in turn influence their argumentation competence and consequently their performance on CT.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

Written informed consent was obtained from the participants’ legal guardian/next of kin to participate in this study in accordance with the National Legislation and the Institutional Requirements.

Author Contributions

BP conducted the conceptual framework and designed the research study. PB-A conducted the data analysis and collaborated in manuscript preparation. JP-M implemented the didactical proposal and collected the data. All authors contributed to the article and approved the submitted version.

This work was supported by the project ESPIGA, funded by the Spanish Ministry of Science, Education and Universities, partly funded by the European Regional Development Fund (ERDF) Grant code: PGC2018-096581-B-C22.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

This study was carried out within the RODA research group during the lockdown in Spain due to COVID-19 pandemic. We gratefully acknowledge all the participants for their implication, despite such difficult circumstances.

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Abrami, P. C., Bernard, R. M., Borokhovski, E., Wade, A., Surkes, M. A., Ramim, R., et al. (2008). Instructional interventions affecting critical thinking skills and dispositions: a stage 1 meta-analysis. Rev. Educ. Res . 78, 1102–1134. doi: 10.3102/0034654308326084

CrossRef Full Text | Google Scholar

Ageitos, N., and Puig, B. (2021). “Critical thinking to decide what to believe and what to do regarding vaccination in schools. a case study with primary pre-service teachers,” in Critical Thinking in Biology and Environmental Education. Facing Challenges in a Post-Truth World , eds B. Puig and M. P. Jiménez-Aleixandre (Berlin: Springer).

Google Scholar

Aikenhead, G. S. (1985). Collective decision making in the social context of science. Sci. Educ . 69, 453–475. doi: 10.1002/sce.3730690403

Andrews, R. (2015). “Critical thinking and/or argumentation in highr education,” in The Palgrave Handbook of Critical Thinking in Higher Education , eds M. Davies, R. Barnett, et al. (New York, NY: Palgrave Macmillan), 93–105.

Barzilai, S., and Chinn, C. A. (2017). On the goals of epistemic education: promoting apt epistemic performance. J. Learn. Sci . 27, 353–389. doi: 10.1080/10508406.2017.1392968

Barzilai, S., and Chinn, C. A. (2020). A review of educational responses to the “post-truth” condition: four lenses on “post-truth” problems. Educ. Psychol. 55, 107–119. doi: 10.1080/00461520.2020.1786388

Bencze, L., Halwany, S., and Zouda, M. (2020). “Critical and active public engagement in addressing socioscientific problems through science teacher education,” in Science Teacher Education for Responsible Citizenship , eds M. Evagorou, J. A. Nielsen, and J. Dillon (Berlin: Springer), 63–83. doi: 10.1007/978-3-030-40229-7_5

Bråten, I., Brante, E. W., and Strømsø, H. I. (2019). Teaching sourcing in upper secondary school: a comprehensive sourcing intervention with follow-up data. Read. Res. Q . 54, 481–505. doi: 10.1002/rrq.253

Britt, M. A., Rouet, J. F., Blaum, D., and Millis, K. K. (2019). A reasoned approach to dealing with fake news. Policy Insights Behav. Brain Sci . 6, 94–101. doi: 10.1177/2372732218814855

Cachón-Zagalaz, J., Sánchez-Zafra, M., Sanabrias-Moreno, D., González-Valero, G., Lara-Sánchez, A. J., and Zagalaz-Sánchez, M. L. (2020). Systematic review of the literature about the effects of the COVID-19 pandemic on the lives of school children. Front. Psychol . 11:569348. doi: 10.3389/fpsyg.2020.569348

PubMed Abstract | CrossRef Full Text | Google Scholar

Chakraborty, I., and Maity, P. (2020). COVID-19 outbreak: migration, effects on society, global environment and prevention. Sci. Total Environ . 728:138882. doi: 10.1016/j.scitotenv.2020.138882

Chinn, C., and Rinehart, R. W. (2016). “Epistemic cognition and philosophy: developing a new framework for epistemic cognition,” in Handbook of Epistemic Cognition , eds J. A. Greene, W. A. Sandoval, and I. Braten (New York, NY: Routledge), 460–478.

Chinn, C. A., Barzilai, S., and Duncan, R. G. (2020). Disagreeing about how to know. the instructional value of explorations into knowing. Educ. Psychol . 55, 167–180. doi: 10.1080/00461520.2020.1786387

Chinn, C. A., Duncan, R. G., and Rinehart, R. (2018). “Epistemic design: design to promote transferable epistemic growth in the PRACCIS project,” in Promoting Spontaneous Use of Learning and Reasoning Strategies. Theory, Research and Practice for Effective Transfer , eds E. Manalo, Y. Uesaka, and C. A. Chinn (Abingdon: Routledge), 243–259.

Davies, M., and Barnett, R. (2015). The Palgrave Handbook of Critical Thinking in Higher Education . London: Palgrave MacMillan. doi: 10.1057/9781137378057

Dillon, J., and Avraamidou, L. (2020). Towards a viable response to COVID-19 from the science education community. J. Activist Sci. Technol. Educ . 11, 1–6. doi: 10.33137/jaste.v11i2.34531

Dominguez, C. (2018). A European Review on Critical Thinking Educational Practices in Higher Education Institutions. Vila Real: UTAD. Available online at: https://www.researchgate.net/publication/322725947_A_European_review_on_Critical_Thinking_educational_practices_in_Higher_Education_Institutions

Duncan, R. G., Caver, V. L., and Chinn, C. A. (2021). “The role of evidence evaluation in critical thinking,” in Critical Thinking in Biology and Environmental Education. Facing Challenges in a Post-Truth World , eds B. Puig and M. P. Jiménez-Aleixandre (Berlin: Springer).

Duschl, R. (2020). Practical reasoning and decision making in science: struggles for truth. Educ. Psychol . 3, 187–192. doi: 10.1080/00461520.2020.1784735

Eastwood, J. L., Sadler, T. D., Zeidler, D. L., Lewis, A., Amiri, L., and Applebaum, S. (2012). Contextualizing nature of science instruction in socioscientific issues. Int. J. Sci. Educ . 34, 2289–2315. doi: 10.1080/09500693.2012.667582

Ennis, R. (2018). Critical thinking across the curriculum. Topoi 37, 165–184. doi: 10.1007/s11245-016-9401-4

European Council of the European Union (2020). Fighting Disinformation . Available online at: https://www.consilium.europa.eu/en/policies/coronavirus/fighting-disinformation/

Evagorou, M. (2020). “Introduction: socio-scientific issues as promoting responsible citizenship and the relevance of science,” in Science Teacher Education for Responsible Citizenship , eds M. Evagorou, J. A. Nielsen, and J. Dillon (Berlin: Springer), 1–11. doi: 10.1007/978-3-030-40229-7_1

Evagorou, M., Jimenez-Aleixandre, M. P., and Osborne, J. (2012). ‘Should we kill the grey squirrels?’ a study exploring students’ justifications and decision-making. Int. J. Sci. Educ . 34, 401–428. doi: 10.1080/09500693.2011.619211

Facione, P. A. (1990). Critical Thinking: a Statement of Expert Consensus for Purposes of Educational Assessment and Instruction. Fullerton, CA: California State University.

Feinstein, W. N., and Waddington, D. I. (2020). Individual truth judgments or purposeful, collective sensemaking? rethinking science education’s response to the post-truth era. Educ. Psychol . 55, 155–166. doi: 10.1080/00461520.2020.1780130

Giri, V., and Paily, M. U. (2020). Effect of scientific argumentation on the development of critical thinking. Sci. Educ . 29, 673–690. doi: 10.1007/s11191-020-00120-y

Greene, J. A., and Yu, S. B. (2016). Educating critical thinkers: the role of epistemic cognition. Policy Insights Behav. Brain Sci . 3, 45–53. doi: 10.1177/2372732215622223

Guterres, A (2020). Secretary-General Remarks on COVID-19: A Call for Solidarity . Available at: https://www.un.org/sites/un2.un.org/files/sg_remarks_on_covid-19_english_19_march_2020.pdf (accessed March 19, 2020).

Halpern, D. F. (1998). Teaching critical thinking for transfer across domains. dispositions, skills, structure training, and metacognitive monitoring. Am. Psychol . 53, 449–455. doi: 10.1037/0003-066x.53.4.449

Jiménez Aleixandre, M. P., and Erduran, S. (2008). “Argumentation in science education: an overview,” in Argumentation in Science Education: Perspectives from Classroom-Based Research , eds S. Erduran and M. P. Jiménez Aleixandre (Dordrecht: Springer), 3–27. doi: 10.1007/978-1-4020-6670-2_1

Jiménez-Aleixandre, M. P., and Puig, B. (2021). “Educating critical citizens to face post-truth: the time is now,” in Critical Thinking in Biology and Environmental Education. Facing Challenges in a Post-Truth World , eds B. Puig and M. P. Jiménez-Aleixandre (Berlin: Springer).

Jones, A. (2015). “A disciplined approach to CT,” in The Palgrave Handbook of Critical Thinking in Higher Education , eds M. Davies, R. Barnett, et al. (New York, NY: Palgrave Macmillan), 93–105.

Kelly, G. J., and Licona, P. (2018). “Epistemic practices and science education,” in History, Philosophy and Science Teaching , ed. M. R. Matthews (Dordrecht: Springer), 139–165. doi: 10.1007/978-3-319-62616-1_5

Kuhn, D. (2019). Critical thinking as discourse. Hum. Dev . 62, 146–164. doi: 10.1159/000500171

Niu, L., Behar-Horenstein, L. S., and Garvan, C. W. (2013). Do instructional interventions influence college students’ critical thinking skills? a meta-analysis. Educ. Res. Rev . 9, 114–128. doi: 10.1016/j.edurev.2012.12.002

Pithers, R. T., and Soden, R. (2000). Critical thinking in education: a review. Educ. Res . 42, 237–249.

Puig, B., and Ageitos, N. (2021). “Critical thinking to decide what to believe and what to do regarding vaccination in schools. a case study with primary pre-service teachers,” in Critical Thinking in Biology and Environmental Education. Facing Challenges in a Post-Truth World , eds B. Puig and M. P. Jiménez-Aleixandre (Berlin: Springer).

Puig, B., Blanco Anaya, P., and Bargiela, I. M. (2020). “A systematic review on e-learning environments for promoting critical thinking in higher education,” in Handbook of Research in Educational Communications and Technology , eds M. J. Bishop, E. Boling, J. Elen, and V. Svihla (Cham: Springer), 345–362. doi: 10.1007/978-3-030-36119-8_15

Puig, B., Blanco Anaya, P., Crujeiras Pérez, B., and Pérez Maceira, J. (2016). Ideas, emociones y argumentos del profesorado en formación acerca del virus del Ébola. Indagatio Didactica 8, 764–776.

Sinatra, G. M., and Lombardi, D. (2020). Evaluating sources of scientific evidence and claims in the post-truth era may require reappraising plausibility judgments. Educ. Psychol . 55, 120–131. doi: 10.1080/00461520.2020.1730181

Sosa, E. (2015). Judgment and Agency. Oxford: Oxford University Press.

Sperber, D., Clement, F., Heintz, C., Mascaro, O., Mercier, H., Origgi, G., et al. (2010). Epistemic vigilance. Mind Lang . 25, 359–393. doi: 10.1111/j.1468-0017.2010.01394.x

Thomas, K., and Lok, B. (2015). “Teaching critical thinking: an operational framework,” in The Palgrave Handbook of Critical Thinking in Higher Education , eds M. Davies, R. Barnett, et al. (New York, NY: Palgrave Macmillan), 93–105. doi: 10.1057/9781137378057_6

van Gelder, T. (2005). Teaching critical thinking. some lessons from cognitive science. Coll. Teach . 53, 41–48. doi: 10.3200/CTCH.53.1.41-48

Vincent-Lacrin, S., González-Sancho, C., Bouckaert, M., de Luca, F., Fernández-Barrera, M., Jacotin, G., et al. (2019). Fostering Students’ Creativity and Critical Thinking: What it Means in School, Educational Research and Innovation. Paris: OED Publishing.

World Health Organization (WHO) (2020). Managing the COVID-19 Infodemic: Promoting Healthy Behaviours and Mitigating the Harm from Misinformation and Disinformation. Available online at: https://www.who.int/news/item/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-from-misinformation-and-disinformation

Keywords : critical thinking, argumentation, socio-scientific issues, COVID-19 disease, fake news, epistemic assessment, secondary education

Citation: Puig B, Blanco-Anaya P and Pérez-Maceira JJ (2021) “Fake News” or Real Science? Critical Thinking to Assess Information on COVID-19. Front. Educ. 6:646909. doi: 10.3389/feduc.2021.646909

Received: 28 December 2020; Accepted: 09 March 2021; Published: 03 May 2021.

Reviewed by:

Copyright © 2021 Puig, Blanco-Anaya and Pérez-Maceira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Blanca Puig, [email protected]

This article is part of the Research Topic

Science Education for Citizenship through Socio-Scientific issues

COVID-19: A Context to Promote Critical Thinking and Argumentation in Secondary and University Students

• First Online: 02 January 2023

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• Blanca Puig 3 &
• Maria Evagorou 4  

Part of the book series: Integrated Science ((IS,volume 12))

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Science education faces urgent challenges related to the increase of “fake news” on socio-scientific issues (SSI) that affect citizens’ lives. This situation affects teaching and learning and critical decisions on health issues. During the COVID-19 pandemic, citizens worldwide were called for actions and decisions to stop the spread of the disease. People were confronted with a rise of disinformation regarding potential ways to prevent and recover from COVID-19. Educators tried to find ways to support their students to understand issues related to COVID-19 and apply their critical thinking to understand SSI. The purpose of this chapter is to describe two case studies of educators as they tried to engage their students in COVID-19 as an SSI during the lockdown.

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Teaching science in the pandemic context. (Made by Santi Jiménez).

Education must enable one to shift and weigh evidence, to discern the true from the false, the real from the unreal, and the facts from the fiction . The function of education , therefore, is to teach one to think intensively and to think critically . Martin Luther King

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Fostering Preservice Science Teachers’ Global Awareness Through a Socioscientific Issues Approach Set in the Context of COVID-19

Pre-Service Teachers’ Analysis of Claims About COVID-19 in an Online Course

Critical STEM Literacy and the COVID-19 Pandemic

https://reliefweb.int/report/world/coronavirus-disease-covid-19-situation-report-153-21-june-2020 .

See ‘Eight ways to spot misinformation: https://media.nature.com/original/magazine-assets/d41586-020-01834-3/d41586-020-01834-3.pdf ’.

https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters?gclid=Cj0KCQjws536BRDTARIsANeUZ5-DZIfUfpXJsV6JPs8oJVVTOSkGsISgcjn1sUVhO9YYaZdItlwwn9AaAm1rEALw_wcB#bleach .

Evagorou M, Dillon J (2020) Introduction: socio-scientific issues as promoting responsible citizenship and innovation. In: Evagorou M, Nielsen D (eds) Science teacher education for responsible citizenship. Springer, pp 1–11

Google Scholar  

Dawson VM, Venville G (2010) Teaching strategies for developing students’ argumentation skills about socio-scientific issues in high school genetics. Res Sci Educ 40(2):133–148

Article   Google Scholar  

Zeidler DL, Berkowitz MW, Bennett K (2014) Thinking (scientifically) responsibly: the cultivation of character in a global science education community. In: Mueller MP et al (eds) Assessing schools for generation R (Responsibility). Springer, Dordrecht, pp 83–99. https://doi.org/10.1007/978-94-007-2748-9_7

Evagorou M, Jimenez-Aleixandre M, Osborne J (2012) ‘should we kill the grey squirrels?’ a study exploring students’ justifications and decision-making. Int J Sci Educ 34(3):401–428

Sadler TD (2011) Socio-scientific issues-based education: what we know about science education in the context of SSI. In: Sadler T (ed) Socio-scientific Issues in the Classroom, vol 39. Springer, Netherlands, pp 355–369

Chapter   Google Scholar  

UNESCO (2018) Journalism, ‘fake news’ and disinformation. Handbook for Journalism Education and Training. United Nations Educational, Scientific and Cultural Organization, France. Available via UNESCO. https://en.unesco.org/sites/default/files/journalism_fake_news_disinformation_print_friendly_0_0.pdf . Accessed June 15, 2020

Bencze L, Halwany S, Zouda M (2020) Critical and Active Public Engagement in Addressing Socio-scientific Problems Through Science Teacher Education. In: Evagorou M, Nielsen JA, Dillon J (eds) Science teacher education for responsible citizenship. Springer, pp 63–83

Puig B, Blanco-Anaya P, Bargiela I, Crujeiras-Pérez B (2019) A systematic review on critical thinking intervention studies in higher education across professional fields. Stud High Educ 44(5):860–869. https://doi.org/10.1080/03075079.2019.1586333

Vincent-Lacrin S, González-Sancho C, Bouckaert M et al (2019) Fostering students’ creativity and critical thinking: what it means in school. Educ Res Innov OED Publishing, Paris. https://doi.org/10.1787/62212c37-en

Boekaerts M (1997) Self-regulated learning: a new concept embraced by researchers, policy makers, educators, teachers, and students. Learn Inst 7:161–186

Perkins DN (1993) Teaching for understanding. Am Educ 17:28–35

Winch C (2006) Education, autonomy and critical thinking. Routledge, London

Kennedy M, Fisher MB, Ennis RH (1991) Critical thinking: literature review and needed research. In: Idol L, Jones BP (eds) Educational values and cognitive instruction: implications for reform. Lawrence Erlbaum, Hillsdale, NJ

Jiménez Aleixandre MP, Puig B (2022) Educating critical citizens to face post-truth: the time is now. In: Puig B, Jiménez-Aleixandre MP (eds) Critical thinking in Biology and Environmental Education. Facing challenges in a post-truth world, Springer, Switzerland, pp 3–19

Jiménez-Aleixandre MP, Puig B (2012) Argumentation, evidence evaluation and critical thinking. In: Tobin K, McRobbie C (eds) Fraser B. Second international handbook of science education Dordrecht, Springer, pp 1001–1015

Fairclough N (1995) Critical discourse analysis. The critical study of language. Longman, Harlow

Anderman EM, Sinatra GM, Gray DL (2012) The challenges of teaching and learning about science in the twenty-first century: exploring the abilities and constraints of adolescent learners. Stud Sci Educ 48(1):89–117. https://doi.org/10.1080/03057267.2012.655038

Giri V, Paily MU (2020) Effect of scientific argumentation on the development of critical thinking. Sci Educ 29:673–690

Sadler TD, Zeidler DL (2004) The significance of content knowledge for informal reasoning regarding socio-scientific issues: applying genetics knowledge to genetic engineering issues. Sci Educ 89(1):71–93

Topcu MS, Sadler TD, Yilmaz Tuzun O (2010) Preservice science teachers’ informal reasoning about socio-scientific issues: the influence of issue context. Int J Sci Educ 32(18):2475–2495. https://doi.org/10.1080/09500690903524779

Angell RB (1964) Reasoning and logic. Appleton-Centure-Crofts, New York

Duschl R (2008) Practical reasoning and decision making in Science: struggles for truth. Educ Psychol 55(3):187–192. https://doi.org/10.1080/00461520.2020.1784735

Lai ER (2011) Critical thinking: a literature review research report. Pearson’s Res Rep 6:40–41. Available via PEARSON. http://images.pearsonassessments.com/images/tmrs/CriticalThinkingReviewFINAL.pdf . Accessed June 18, 2020

Tsui L (2002) Fostering critical thinking through effective pedagogy: evidence from four institutional case studies. J Higher Educ 73(6):740–763

Kuhn D (2019) Critical thinking as discourse. Hum Dev 62(3):146–164

Barnett R (1997) Higher education: a critical business. Open University Press, Milton Keynes

Εnnis RH (1987) A taxonomy of critical thinking abilities and dispositions. In: Baron JB, Sternberg RJ (eds) Teaching thinking skills: theory and practice. New W. H. Freeman, York, pp 9–26

Ennis RΗ (2018) Critical thinking across the curriculum. Topoi 37(1):165–184

Dewey J (1910) How we think. D.C. Heath and Company, Lexington, MA

Chinn CA, Barzilai S, Duncan RG (2020) Disagreeing about how to know: the instructional value of explorations into knowing. Educ Psychol 55(3):167–180. https://doi.org/10.1080/00461520.2020.1786387

National Research Council (2010) Surrounded by science: learning science in informal environments. The National Academies Press, Washington, DC. https://doi.org/10.17226/12614 .

Willingham DT (2008) Critical thinking: why it is so hard to teach? Arts Educ Policy Rev 109(4):21–32. https://doi.org/10.3200/AEPR.109.4.21-32

Sinatra GM, Lombardi D (2020) Evaluating sources of scientific evidence and claims in the post-truth era may require plausibility judgments. Educ Psychol 55(3):120–131. https://doi.org/10.1080/00461520.2020.1730181

Fleming N (2020) Coronavirus misinformation, and how scientists can help to fight it. Nature. Available via NATURE: https://www.nature.com/articles/d41586-020-01834-3

Ministerio de Educación, Cultura y Deporte (MECD) (2015) Real Decreto 1105/2014, de 26 de diciembre, por el que se establece el currículo básico de la Educación Secundaria Obligatoria y del Bachillerato

Ministerio de Sanidad, Consumo y Bienestar Social—Profesionales—Enfermedad por nuevo coronavirus, COVID-19 (2020) Available via Ministerio de Sanidad, Consumo y Bienestar Social. https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/home.htm

Evagorou M, Nisiforou E (2020) Engaging pre-service teachers in an online STEM fair during COVID-19. J Techn Teach Educ 28(2):179–186. Society for Information Technology & Teacher Education, Waynesville, NC USA

Gee JP (2011) An introduction to discourse analyses. In: Theory and method. Routledge, UK

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Acknowledgements

This study was carried out within the RODA research group (code ED431C2021/05). It was supported by the project The Spanish Ministry of Science, Education, and Universities, partly funded by the European Regional Development Fund (ERDF) Grant code: PGC2018-096581-B-C22. We gratefully acknowledge the participants and the illustration provided by the artist Santi Jiménez and Blandine’s draw developed during the lockdown in Spain.

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Puig, B., Evagorou, M. (2023). COVID-19: A Context to Promote Critical Thinking and Argumentation in Secondary and University Students. In: Rezaei, N. (eds) Brain, Decision Making and Mental Health. Integrated Science, vol 12. Springer, Cham. https://doi.org/10.1007/978-3-031-15959-6_12

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Problems in thinking and attention linked to COVID-19 infection

The research found that those with more severe COVID-19 symptoms scored lower on an online series of tests, with performance on reasoning and problem-solving tasks being most affected. Further analysis of the data indicated that those who received mechanical ventilation to help them breathe whilst in hospital had the greatest impairment on cognitive tasks.

Published in the journal EClinicalMedicine , the research was a collaboration between King's College London, Imperial College London and Cambridge University. It was part-funded by the UK Dementia Research Institute Care Research & Technology Centre and the National Institute of Health Research (NIHR) Maudsley Biomedical Research Centre.

Online cognition tests

A series of online tests, developed by first author on the study and Reader in Restorative Neuroscience at Imperial College London Dr Adam Hampshire had been opened up to the general public just before the pandemic for the BBC2 Horizon's Great British Intelligence test. In early 2020 the study team extended the questionnaires to gather information on SARS-CoV-2 infection, the symptoms experienced and the need for hospitalisation.

Out of the 81,337 who provided complete data, 12,689 people suspected they had COVID-19. Participants reported a range of severity of illness, with many experiencing respiratory symptoms whilst still being able to stay at home (3,559 participants). Nearly 200 were hospitalised (192 participants) and about a quarter of these (44 participants) required mechanical ventilation.

The time since illness onset was around 1-6 months, meaning the study could not draw any definitive conclusions about whether these effects on cognition were long-lasting.

Thinking problems and respiratory symptoms

The study found a relationship between deficits in overall cognitive performance and severity of respiratory symptoms experienced. The research also found that not all areas of thinking ability correlated in the same way with COVID-19 illness and that some abilities were spared, which included emotional discrimination (recognition of faces that were expressing the same emotion) and working memory (remembering where a sequence of squares appears on the screen). In comparison 'executive' tasks that required skills in reasoning (e.g. Deciding if relationships between words were similar) and problem solving (working out how many moves it would take to go from one arrangement to another) seemed to show the greatest deficit.

To understand the size of the deficits the authors compared the pattern of scores on the tests to cognitive changes that occur for other reasons. The effects in those hospitalised with mechanical ventilation were similar to the average cognitive decline seen over a period of ten years of ageing and equivalent to a seven-point difference in IQ.

Ruling out other explanations

The researchers carried out a series of checks to ensure these cognitive deficits were associated with COVID-19 and not explicable by other variables. These included separating out those who had a confirmed positive test for SARS-CoV-2 and demonstrating that the cognitive deficits were indeed greater in those with positive tests. Further checks suggested the results were not due to a minority with pre-existing conditions or on-going symptoms of COVID-19. Analysis also indicated that it was unlikely that the results could be explained by the fact that those who contracted more severe COVID-19 disease were less cognitively able before they were ill.

Dr Adam Hampshire, first author on the study, said: "Our study adds to an increasing body of research that is looking at different aspects of how COVID-19 might be impacting the brain and brain function. This research is all converging to indicate that there are some important effects of COVID-19 on the brain that need further investigation. Going forward it would be valuable to bring together brain imaging and cognitive tests with other information on mental health and everyday function, ideally in studies that track peoples' trajectories for months or even years. To really know what the long-term effects are for people will require people to be followed up over time."

New studies, such as COVID-19 Clinical Neuroscience Study (COVID-CNS), led by King's College London and University of Liverpool and the REACT Long COVID study, led by Imperial College London, are now applying these cognitive tools to study the long-term impacts of COVID-19.

"A critical question remains as to why some cognitive functions are more affected than others," said Mitul Mehta, Professor of Neuroimaging from King's College London and senior author on the study. "It is already known that hypoxia and mechanical ventilation are associated with cognitive deficits similar to those observed in this study, and there is now evidence of neurological complications in some patients, as well as psychiatric consequences. As we are coming through the third wave of the pandemic, there are more available options that can reduce the severity of COVID-19 such as vaccination and effective treatments whilst in hospital. The findings from this study suggest that by reducing the severity of illness through these different approaches we may also be able to reduce the severity of cognitive difficulties people may experience."

• COVID and SARS
• Infectious Diseases
• Alzheimer's Research
• Chronic Illness
• Intelligence
• Neuroscience
• Cognitive neuroscience
• Confirmation bias
• Psycholinguistics
• Cognitive science
• Attribution theory
• Cognitive bias
• Collaboration

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Journal Reference :

• Adam Hampshire, William Trender, Samuel R Chamberlain, Amy E. Jolly, Jon E. Grant, Fiona Patrick, Ndaba Mazibuko, Steve CR Williams, Joseph M Barnby, Peter Hellyer, Mitul A Mehta. Cognitive deficits in people who have recovered from COVID-19 . EClinicalMedicine , 2021; 101044 DOI: 10.1016/j.eclinm.2021.101044

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From ‘deadly enemy’ to ‘covidiots’: Words matter when talking about  COVID-19

PhD, Philosophy of Language, Faculty of Applied Science, Emeritus, University of British Columbia

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So much has been said and written about the COVID-19 pandemic. We’ve been flooded with metaphors, idioms, symbols, neologisms, memes and tweets. Some have referred to this deluge of words as an infodemic .

And the words we use matter. To paraphrase the philosopher Ludwig Wittgenstein: the limits of our language are the limits of our world . Words place parameters around our thoughts.

These parameters are the lenses we look through. According to literary theorist Kenneth Burke, “ terministic screens ” are defined as the language through which we perceive our reality. The screen creates meaning for us, shaping our perspective of the world and our actions within it. The language acting as a screen then determines what our mind selects and what it deflects.

This selective action has the capacity to enrage us or engage us. It can unite us or divide us, like it has during COVID-19.

Metaphors shape our understanding

Think about the effect of seeing COVID-19 through the terministic screen of war. Using this military metaphor , U.K. Prime Minister Boris Johnson has described COVID-19 as an “enemy to be beaten.” He asserts that this “enemy can be deadly,” but the “fight must be won.”

Read more: War metaphors used for COVID-19 are compelling but also dangerous

The effect of this military language conflicts with the perpetuated myth that “we are all in this together.” But rather, it invokes aggressive combat against an enemy. It signals an us-versus-them divide, promoting the creation of a villain through scapegoating and racist attitudes . Naming COVID-19 as the “China virus,” “Wuhan virus” or “Kung Flu” places the blame directly on China and increases racism. Attacks against Asian people have dramatically increased globally.

Read more: The Atlanta attacks were not just racist and misogynist, they painfully reflect the society we live in

Conversely, what would be the effect of a replacing the terministic screen of war with a tsunami? A metaphor that encourages “waiting out the storm?” Or working to help a neighbour? What would be the effect if the metaphor of “soldiers” were replaced with “ fire fighters ?” This could increase our perception of working together. Re-framing COVID-19 in this way has the capacity to convince us that we actually are “all in this together.”

An inspiring initiative, #ReframeCovid , is an open collective intended to promote alternative metaphors to describe COVID-19. The profound effect of altering the language is clear – to reduce division and generate unity.

Taking away our critical thinking

In a blog post, linquist Brigitte Nerlich compiled a list of metaphors used during the pandemic .

Although the metaphors of war and battle are foremost, others include bullet trains, an evil trickster, a petri dish, a hockey game, a football match, Whack-a-mole and even a grey rhino. Then there is the omnipresent light at the end of the tunnel .

And while they offer a way to re-frame our reality, helping the unfamiliar become familiar and rationalize our perceptions, there is danger lurking. Metaphors can substitute for critical thinking by offering easy answers to complex issues. Ideas can remain unchallenged if glossed over, falling prey to the trap of metaphors .

But metaphors also have the capacity to augment insight and understanding. They can foster critical thinking. One such example is the dance metaphor . It has been effectively used to describe the longer term effort and evolving global collaboration needed to keep COVID-19 controlled until vaccines are widely distributed.

COVID-19 buzzwords

Besides metaphors, other linguistic structures act as our terministic screens as well. Buzzwords related to the current pandemic have also increased.

We grimace or laugh at covidiot , covideo party and covexit . Then there is Blursday , zoom-bombing and quaran-teams .

According to a British language consultant, the pandemic has fostered more than 1,000 new words .

Why has this happened? According to a socio-linguistic analysis, new words can bond us like “ a lexical social glue .” Language can unite us in a common struggle of expressing our anxiety and facing the chaos. Common linguistic expressions decrease isolation and increase our engagement with others.

In a similar way, memes can reduce the space between us and foster social engagement. Most often sarcastic or ironic, memes about COVID-19 have been plentiful. Like metaphors, these buzzwords, puns and images embody symbols that invoke responses and motivate social action.

More recently, resisters of COVID language have flooded social media sites. Frustrated with the never-ending ordeal, online contributors refuse to name the pandemic. Instead they use absurd “pan-words”; calling it a panini, a pantheon, a pajama or even a pasta dish. These ludicrous words frolic with the terministic screen of “pandemic,” deconstructing the word to expose the bizarre meaningless nature of the virus and the heightened frustration with it.

Read more: How to cope with pandemic fatigue by imagining metaphors

The language used in relation to COVID-19 matters. As the effects of the pandemic intensify, so does the importance of the choice of language. Words, as terministic screens, can enable our perceptions in remarkable ways – they can unite us or divide us, enrage us or engage us, all while moving us to action.

• Coronavirus

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Research Article

Thinking about life in COVID-19: An exploratory study on the influence of temporal framing on streams-of-consciousness

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Department of Communication, University of California, Los Angeles, Los Angeles, California, United States of America

Roles Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, Writing – review & editing

• Constance M. Bainbridge, 

• Published: April 28, 2023
• https://doi.org/10.1371/journal.pone.0285200
• Peer Review
• Reader Comments

The COVID-19 global pandemic led to major upheavals in daily life. As a result, mental health has been negatively impacted for many, including college students who have faced increased stress, depression, anxiety, and social isolation. How we think about the future and adjust to such changes may be partly mediated by how we situate our experiences in relation to the pandemic. To test this idea, we investigate how temporal framing influences the way participants think about COVID life. In an exploratory study, we investigate the influence of thinking of life before versus during the pandemic on subsequent thoughts about post-pandemic life. Participants wrote about their lives in a stream-of-consciousness style paradigm, and the linguistic features of their thoughts are extracted using Linguistic Inquiry and Word Count (LIWC). Initial results suggest principal components of LIWC features can distinguish the two temporal framings just from the content of their post-pandemic-oriented texts alone. We end by discussing theoretical implications for our understanding of personal experience and self-generated narrative. We also discuss other aspects of the present data that may be useful for investigating these thought processes in the future, including document-level features, typing dynamics, and individual difference measures.

Citation: Bainbridge CM, Dale R (2023) Thinking about life in COVID-19: An exploratory study on the influence of temporal framing on streams-of-consciousness. PLoS ONE 18(4): e0285200. https://doi.org/10.1371/journal.pone.0285200

Editor: Michal Ptaszynski, Kitami Institute of Technology, JAPAN

Received: November 4, 2022; Accepted: April 18, 2023; Published: April 28, 2023

Copyright: © 2023 Bainbridge, Dale. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data and analysis script is available on Github: https://github.com/conbainbridge/covid_thoughts DOI: 10.5281/zenodo.7809317 .

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

What is the semantic structure of free-flowing thought? How do meanings come up in our thoughts, and how are they linked over time? Human experience is filled with this structure, while we stand in line for our groceries, wait in line at the bus station or even in a moment of mind wandering while conversing with a friend. In this paper, we explore recent events surrounding COVID as a domain to tap into this semantic structure. We devised a “stream-of-consciousness” task in which participants imagined the future beyond COVID, and quantified how their free-flowing thought varied as a function of how they were prompted before this writing. We find that if participants are prompted with the present COVID situation vs. the pre-COVID times, their structure of thought changes. Our exploratory analyses suggest language from the future-oriented responses reflects its temporal priming, i.e., the pre-pandemic vs. during the pandemic prompt that came before. These results offer hints at the semantic patterns that characterize these self-reflections, and how context is central to the forms they take. We end by arguing that a generalized notion of “self-communication” may organize phenomena such as these in intriguing ways.

When the COVID-19 global pandemic spread rapidly in late 2019 and early 2020, major life impacts reverberated globally. These effects were felt across many aspects of everyday life, from direct health impacts to more indirect effects on the economy and social life. People began referring to life before the pandemic colloquially as the “before times,” and there was a sense of a new normal. These effects were also significant in the lives of younger individuals, such as students, with virtual schooling, diminished social interaction, and limited hands-on learning (e.g., [ 1 ]). Evidence suggests an alarming impact of the pandemic on the mental health of college students, including increased stress moderated by self-regulation efficacy [ 2 ], increased depression and anxiety [ 3 ], and negative changes to student relationships [ 4 ]. The effect of perceived threat of COVID-19 on mental well-being appears to be mediated by future anxiety as well, showing the potential to impact mental health in the long run as decisions about the future may be impacted [ 5 ]. The pandemic thus provides a unique opportunity to study how major events influence perceptions of life and mental health, and their relationship to other dimensions.

To study these perceptions, we investigate how student participants construct a narrative text about their lives. Our approach is inspired by methods used in essay writing and journaling [ 6 ], self-talk [ 7 ], and think aloud [ 8 ]. These domains suggest that when we speak to ourselves, ruminate, or reflect on aspects of our lives, our linguistic styles and strategies may be a signature for underlying mental or emotional states and processes. Intriguingly, such intrapersonal communication has been frequently the topic of discussion, yet remains largely an understudied construct. Self-communication occurs when both sender and receiver of a communicative instance are contained within a single individual, such as in dialogical self-talk [ 7 ], and can include transcending across time and space [ 9 ]. Here we use this process as a source of data about these life perceptions.

While not all aspects of intrapersonal communication may be easily accessible for study, such as the seemingly endless streams-of-consciousness we engage in every day, various methods have been employed to tap into self-talk through writing or speech. Raffaelli et al. [ 8 ] used a think aloud paradigm in which individuals are instructed to speak aloud their thoughts. Negative valence in the words used correlated with a narrowing of conceptual scope, such that thoughts became more semantically similar when they were more negative. Social context may play a role, too. Oliver et al. [ 10 ] used a think aloud task to study mental health outcomes. Changing social context to more supportive environments led to greater use of positive emotion words, fewer negative emotion words, fewer swear words, and fewer first-person references compared to a control condition that lacked emotional recognition or meaningful rationale. Recent work has shown that self-talk also links to mental health outcomes during COVID-19. In a questionnaire study conducted on an Iranian sample, there were significant relationships found between self-talk, death anxiety, obsessive-compulsive disorder, and coping strategies in relation to the pandemic [ 11 ].

As noted above, the onset of COVID for some may present a distinct point in time at which everyday life changed. This temporal effect of COVID may alter the way we contextualize and think about events before, during, and after this distinct transition. Changing the temporal framing of one’s thoughts or self-talk may have an influence on the language that we use. For example, construal-level theory hypothesizes that increased psychological distances are linked to increased abstractness of hypotheticals [ 12 ]. The further away something is in time, space, or relatability (e.g., feeling similar to or different from an individual), the further the perceived psychological distance and the less concrete related thoughts become. Similarly, increasing concreteness, such as through writing about a given event, may decrease psychological distance to that event in time [ 13 ]. High-level construals, or higher abstractions when mentally representing objects or concepts, may better facilitate self-control, such as attenuating the impact of future discounting on economic decision making [ 14 ]. Following the September 11, 2001 attacks on the United States, entries in an online journaling platform used increasingly psychologically distant language in their daily writings, suggesting major events can impact our relationships with time [ 15 ]. However, prior work suggests that writing about emotional experiences such as trauma may provide benefits for both mental and physical health [ 16 ].

Considering these findings, one might expect that writing about “the before times,” pre-pandemic, would influence how one perceives their future, perhaps with increased abstraction leading to greater possibilities and allowing distance from such a troubling and disruptive event. Relatedly, a focus on life during the pandemic may have negative impacts on one’s perceptions of their future after the pandemic, with lower levels of construal leading to ruminative tendencies.

To test this idea, we collect and analyze a text-based “stream-of-consciousness” dataset. Participants carried out this open-ended response task online, typing in their thoughts about COVID-19 life under different temporal conditions. The task was designed to elicit a naturalistic and uninterrupted flow of thought. Participants were first told to consider and write about life either before or during the pandemic. This prompt (before vs. during) served as a frame for a subsequent writing prompt, where participants were instructed to share their thoughts about a post-pandemic life. This future-oriented prompt is the same for all participants and is the focus of our analysis, and participants only differed in which writing prompt preceded this one (before vs. during the pandemic). This open-ended writing task generates a large and rich dataset of text. We thus took a preliminary, exploratory approach to investigate the influence of this temporal framing on their responses. In the Analyses section, we consider prior research that frames some factors guiding our exploratory analysis, and we introduce the ways in which these texts can be measured and analyzed.

Data collection was conducted during two separate college quarters: in the first quarter (fall, 2021), classes were hybrid (both in-person and online), with students returning to campus for the first time since the pandemic began. This research was approved by the UCLA North General Institutional Review Board. 134 undergraduate students (female = 95, male = 38, other = 0) contributed data to this first phase of sampling. The second phase of sampling occurred the following quarter (winter, 2022), which had returned to online-only for the first four weeks due to the rapid spread of a particularly contagious strain of the virus, labeled “omicron.” In this phase, 91 undergraduate students (female = 70, male = 19, other = 2) contributed data. The students completed the study online for course credit in an introductory communication course. The goal of the study was to collect a rich dataset for exploratory analyses, and several aspects of the data were not included for analysis. Because of the pandemic-related constraints participants encountered at the start of the winter quarter, we first use this second phase dataset for our main analyses. We then use the fall dataset for exploratory comparison.

The experiment was built using jsPsych [ 17 ] in conjunction with https://cognition.run to store the data. First, participants encountered a consent page, then click to continue only if they agree to consent to participate in the study. After the initial consent page, participants selected on a slider where in the COVID-19 timeline they considered the current moment to be. For the main portion of the study, participants wrote in a stream-of-consciousness style manner for ten minutes per prompt, responding to three total writing prompts. The first prompt asked participants to write either as if it is before the pandemic, or as if during the pandemic. Following the initial prompt, participants responded to a similar prompt asking to write as though it is after the pandemic. The final prompt included whichever temporal framing was not responded to in the first prompt. This resulted in two possible conditions: before-after-during the pandemic, or during-after-before the pandemic. Our focus here is on how the before vs. during prompt, chosen randomly as the first temporal framing, influences the way participants write about the future, after the pandemic.

During all writing prompts, a countdown timer was visible on the screen during writing, and on multiple pages throughout the study, mental health resources were provided. After completion of the three prompts, participants responded to questions about demographics, COVID-19 experiences, journaling experience, as well as three individual difference measures: a rumination scale [ 18 ], an 18-item adaptation of the need-for-cognition scale [ 19 ], and a social connectedness and belonging scale [ 20 ].

Measures and analyses

In the analyses that follow we focus on document-wide features, taking an exploratory approach. Linguistic Inquiry and Word Count (LIWC) [ 21 ] categorizes the words in a text based on a range of concepts, including emotions, cognitive tension words, causal words. LIWC provides one methodological tool for enabling indirect inferences about mental states. The most recent version of LIWC at the time of analysis features over 100 word categories, capturing a large variable space. This version of LIWC was tested and validated using a “Test Kitchen Corpus” of around 31 million words pooled from a wide range of corpora, including blogs, emails, movie dialogues, transcribed speech, natural conversations, social media posts, and more [ 21 ]. Analysis of language data can be challenging due to the complexities at play. However, LIWC has been successful at predicting a variety of psychological and social measurements from language usage. For example, course performance has been generally predicted based on the written self-introductions of undergraduate students [ 22 ].

Several of the specific LIWC word categories also map neatly onto well-studied and meaningful dimensions of language. LIWC includes several sentiment related categories, including positive and negative emotion and tone, as well as several discrete emotions, such as sadness, anger, and anxiety. Sentiment of language may provide hints at wellbeing. In one pair of studies, improvements in physical health were linked to a greater use of positive emotion words and a moderate number of negative emotion words (neither very high nor very low), as well as increased use in both causal and insight words throughout a writing task [ 23 ]. Pronoun usage may also hint at different psychological processes. Greater use of first person singular pronouns is associated with interpersonal distress [ 24 ], as well as depressive symptoms and negative emotions [ 25 ]. LIWC additionally includes categories relating to time, such as a past or future focus, and health categories, all concepts highly relevant for the topics of interest in this dataset. Content words (e.g., nouns, regular verbs, and various adjectives and adverbs) and function words (e.g., pronouns, prepositions, articles, conjunctions, and so on) are also detectable using LIWC, and may reveal information about one’s social inclination—the use of function words often requires understanding shared knowledge between interlocutors, for example [ 26 ].

For each future-oriented text produced by participants, LIWC generates a set of semantic category measures that reflect the percentage of these categories represented in that text. This can be understood as a multivariate vector of measurements of how positive, negative, etc., a text is based on a calculation of the percentage of words that fall under these categories. To evaluate the influence of temporal framing (i.e., writing about pre-pandemic or during pandemic life in the first prompt) on writing about life after the pandemic, we evaluated the LIWC features present in the post-pandemic documents (the LIWC data for all documents and the analyses script are available at https://github.com/conbainbridge/covid_thoughts ). Because LIWC has over 100 of these categories, we face the challenge of multivariate analysis without simply deploying an analysis pipeline on each of the 100 separate dimensions. To conduct a more global analysis of LIWC features, we used principal components analysis (PCA) to determine components that best predict the temporal framing condition. PCA permits the analysis of many intercorrelated variables, characterizing the structure of both the observations in the dataset and the variables themselves (for a detailed explanation, see [ 27 ]). PCA has been used successfully in prior work to reduce LIWC dimensions [ 22 , 28 , 29 ].

PCA thus extracts a conceptual space across all LIWC dimensions, but at a lower dimensionality. Another way to think of this process is that PCA reveals this lower dimensionality based on how normalized LIWC scores cluster across students’ writing. For example, instead of the three LIWC features “positive tone,” “negative tone,” and “emotion,” the PCA model may infer that these three features load onto just one principal component (PC). This example is intuitive, but finding clusters across texts and many features yields subtler and more complex patterns of correlation. Our main test is whether these lower-dimensional PCs distinguish temporal prompts at all. This analysis is done based solely on the post-pandemic-oriented texts, to see how the framing of a preceding prompt may echo into thoughts about the future. Put simply: It would show that participants primed by the past or present (pre- and during pandemic) alter the way they think (or write about) the future.

The PCA recovers as many PCs as there are variables, ranked by the strongest component to the weakest. In cases where the number of participants is less than the number of variables, the number of PCs is limited to match this sample size. Because the winter dataset’s sample size ( n = 91) is less than the total LIWC variables (117), the PCA yields 91 total PCs. The LIWC features cluster across texts as we found a nonlinear rise in PC strength, expressed through cumulative proportion of variance accounted for ( Fig 1 ). The first 20 PCs account for almost 70% of the cumulative variance in the dataset.

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Of the 91 total PCs, a subset of 20 accounting for approximately 69% of the cumulative variance was taken to determine the most significant PCs.

https://doi.org/10.1371/journal.pone.0285200.g001

As noted above, we tested whether these LIWC PCA components from the future-oriented prompt relate to the temporal frame of the prior prompt (before vs. during the pandemic). With a logistic regression predicting prior condition from these 20 components, we found seven PCs that were significant or approached significance. We chose a liberal initial threshold of p = 0.1 to ensure we captured a wide range of possible semantic structures in the future-oriented writing. In a secondary generalized linear model, six of these remained significant (PCs 1, 4, 5, 10, 11, and 13). We also included the seventh (PC18) in our selected components because it trended towards significance in that follow-up model alone. Note that these results reflect coefficients from a single regression model–not independent tests.

The p -values for each PC in the model, and the top ten most influential LIWC features per PC (i.e., highest absolute values in loading scores, ordered from most to least influential) are in Table 1 . LIWC categories in bold, italic font feature positive loading scores, indicating their tendency to characterize the during -pandemic framing, while negative (normal font) loading scores characterize the pre -pandemic framing. Loading scores are available in the S1 Table . For details on what the different LIWC categories entail, see [ 21 ].

The top ten LIWC features for each PC, ordered from most-to-least influential (i.e., highest absolute loading scores), clustered by the condition they characterize. Features in bold, italic font have positive loading scores and characterize the during-pandemic condition, while the features in normal font have negative loading scores and characterize the pre-pandemic condition. Loading scores for these LIWC features are available in the S1 Table .

https://doi.org/10.1371/journal.pone.0285200.t001

PC5 is the most significant component of the selected components from the generalized linear model. By itself, it is able to predict which temporal framing preceded the post-pandemic prompt, based solely on the linguistic characteristics in that post-pandemic prompt ( p = .011, Fig 2 ). PC5 shows that positive emotion, tone, want, and discrepancy are found more in post-pandemic contemplations when they are preceded by reflections about during the pandemic. Conversely, when prompted with before the pandemic, PC5 shows focus on the past and use of personal pronouns. Interpreting LIWC loadings may be subjectively influenced, and interpretive assessment must be done with caution. In this particular case, PC5 indicates that thoughts about experience during the pandemic prompt positivity (i.e., the presence of the “positive tone” and “positive emotion” LIWC categories) that is desired (“want”, “tone,” “emotion,” and “discrepancy”–which includes words like would, can, and want). On the other hand, the pre-pandemic priming may focus on what was lacking (“lack”) in the past (“past focus”) and may be expressing themselves more spontaneously (“authenticity”).

The temporal framing of during-pandemic represents the reference condition in green, while the pre-pandemic condition is in red. The difference in explanatory power for PC5 between the two conditions is significant at p = .011.

https://doi.org/10.1371/journal.pone.0285200.g002

An interpretation of PC1 could indicate people think more negatively (“negative tone”) and analytically (“analytic”) about health (“health”) as a result of thinking about the experience of the pandemic (e.g., “illness” and “article”, perhaps the result of noting “ the pandemic”). Other PCs may hint at pre-pandemic priming leading to thinking enthusiastically about social life (PC4 –“fulfill,” “prosocial,” “exclamation,” “social behavior”), expressing sadness over remembering one’s lifestyle from the past (PC 10 –“memory,” sad emotion,” “leisure,” “lifestyle,”), or perhaps more episodically inspired thoughts guiding future projections (PC13 –“mental,” “visual,” “perception,” “past focus”). The during pandemic priming may lead to frustration (PC10 –“risk” and “swear”) and one’s needs and their justifications (PC13 –“Cause,” inclusive of words like how, because, and why, and “Need”). Importantly, participants were not prompted to contrast the future and the present/past; the temporal prompt simply alters the semantic patterns in their writing, revealed by the PCs shown in Table 1 .

One way to quantify these overall linguistic trends is to assess them using network analysis [ 30 – 32 ]. This method takes the PCs and visualizes the relationships among the LIWC categories. These more visual, geometric relationships among the dimensions may help to interpret the overall shift taking place in participant writing after the prompts. We built a network model using the “igraph” R package to explore which LIWC features are shared across the selected principal components ( Fig 3 ). The nodes represent the top 50 most influential LIWC features across the selected components (i.e., PCs 1, 4, 5, 10, 11, 13, 18). Edges are formed as the result of shared presence of the linked LIWC features across components, suggesting recurring themes in distinguishing the conditions. The color represents the level of influence that feature has in distinguishing conditions, such that the lighter the purple, the greater the influence across these components. This influence is calculated as the sum of the loading score absolute values for a given LIWC feature across components, and rather than being specific to the condition captures that feature’s overall distinguishing influence.

LIWC features are plotted such that an edge is drawn if the features are shared across principal components 1–50. The redder the node is, the more influential the feature is in the loading scores of the main selected components (PCs 1, 4, 5, 10, 11, 13, 18).

https://doi.org/10.1371/journal.pone.0285200.g003

Therefore, the lighter purple nodes represent features that are more influential across the semantic landscape. The manner in which features cluster may then represent the distinctive set of semantic factors that are combined during our particular task. For example, positive emotion, positive tone, want, tone, emotion, and discrepancy, all features found to characterize the during-pandemic condition in PC5, cluster together even across these components and appear to hint at longing for better times. Other clusters suggest livelihood elements (work, tech, lifestyle, culture), health (health, illness, physical), and sociality (she/he, friend, affiliation). When a feature within a cluster also exhibits a lighter tone, it may be the case that feature is particularly unifying of the cluster’s concepts (e.g., “perception” being linked to “visual” as well as “motion”), although the feature itself may merely have more influence independently. Because semantic graphs of this kind can represent how one “moves” through meaning space (cf. [ 33 ]), a potential future application of this network-based technique is to visualize and characterize the set of potential semantic paths induced by a given prompt or frame of mind [ 34 ]. In our case, thoughts about COVID induce particular sorts of ideas, such as health and social connection. When we prompt participants with a prior temporal frame (i.e., pre-pandemic or during), they appear to take different paths on this network. Such methods may facilitate characterization of the streams-of-consciousness and internal thought processes that open this paper. Importantly though, any such graph structure should be compared to a baseline to ensure that we are not interpreting a chance outcome.

To test whether this network was structured meaningfully relative to a baseline, we extracted some measures and performed a permutation. We analyzed the mean degree (number of adjacent edges), mean betweenness (number of shortest paths going through a vertex or edge), and clustering coefficient (probability that adjacent vertices of a vertex are also connected) of the network. The mean degree is 1.92, mean betweenness 29.02, and transitivity 0.49. We then ran the same network analyses on 10,000 random permutations of the normalized LIWC data to see where the original data falls on this random distribution. This is to confirm whether such semantic structure arises specifically as a result of condition, as opposed to random clustering. The probability of the mean degree in the permutations distribution is .038,.185 for mean betweenness, and.004 for the clustering coefficient. Given both the mean degree and clustering coefficient are outside a 95% confidence interval, this suggests structure meaningfully departs from what would be expected by chance.

We next conducted a PCA on the fall (first phase) dataset. Our initial focus on the winter dataset was because we expect a more intensive response from participants–students who just had another disruption to their class activities during more lock down. To match the winter dataset, we ran a generalized linear model on the first 20 components, which account for 66% of the cumulative variance. Of these 20 components, only PC4 is significant (p = .008). The top ten loading scores for LIWC features characterizing PC4 are word count (-0.205), positive tone (0.182), impersonal pronouns (-0.181), death (-0.179), conversation (-0.17), conflict (-0.169), social references (-0.168), anger (-0.161), social (-0.157), and technology (-0.156), with each associated with the past-primed condition with the exception of positive tone. Because there is only one significant PC, we did not conduct network analysis on this dataset. In general, there are some small effects in the fall dataset but far less pronounced than the structure we find in the winter. We return to this below.

Conclusions and discussion

These exploratory analyses showcase the influence of temporal framing on college students as they envision their post-pandemic lives. Based only on what participants wrote when imagining their post-pandemic lives, LIWC features reduced into principal components can predict which temporal framing participants received. A few significant components hint at different categories of words that aid in making these distinctions. A tentative interpretation suggests that there is an extra focus on health (PC1) and a longing for better times (PC5) when primed by pandemic life, and more socially-oriented thinking (PC4) when primed by pre-pandemic life. In a network analysis, a semantic structure appears to arise, particularly in comparison to a distribution of random permutations of the original LIWC data. Interpretive assessment of the semantic network confirms the results on individual components. This visualization also reinforces the idea that the temporal framing leading into a stream-of-consciousness might shape the conceptual structures that participants work with. These explorations offer an initial foundation for understanding the influence of temporal thinking, and in this particular study on construing imagined futures after a major global crisis. While interpretations of the components are speculative, the LIWC categories may inform deeper studies into the specific ways COVID-19 has shaped the content of students’ imagined futures. Regardless of the meaning behind these semantic spaces, this work highlights that shifts in life triggered by COVID-19 can have an impact on immediate thoughts about the future. With this in mind, interventions may be developed to explore how re-framing thoughts, such as temporally, can encourage shifts where future thoughts may be more hopeful and positive, and less dire or pessimistic.

When conducting PCA on the comparison fall dataset, we find only one component is significant. This could suggest that the winter dataset induced more complex semantics due to the emotional experiences associated with the constricted context, when students returned to remote learning due to the pandemic. Indeed this was our expectation, and motivated our initial focus on that winter data set. However, there are several factors that limit any strong conclusions. First, such environmental contextual influences need to be studied in more depth in future work. These represent just two time points, and a wider sample of data from multiple timepoints may suggest these differences were due to noise. Second, the datasets do have slightly different properties. While the winter dataset had a limited sample size, constraining the total components in the PCA, the fall dataset had a larger sample size, enabling the number of components to match the number of LIWC variables. Because of limited prior work using such methods, we did not have strong priors for an optimal sample size, which may additionally limit power in these analyses. Given our analyses were exploratory in nature, future work will benefit from taking insights gained here to formulate a priori hypotheses and planned analyses.

Priming participants to write in a stream-of-consciousness style seems less common in the literature in favor of journal paradigms, where more editing and refining of language may limit inferences about inner psychological and emotional processes, perhaps especially their dynamics. Nevertheless there are some important limitations to our own design that should be acknowledged. One limitation of the data collection using this paradigm was the online context of the study, which may include extraneous variables that would be valuable to measure and control for in future work. For example, this could include aspects of their state in the moment (e.g., exhaustion, mood), ease of technology use, and the environment when completing the task (such as presence of others in the room). Participants may also have still performed some editing, or struggled to understand or adhere to a free-flowing style of writing. To overcome these issues, it may be useful to integrate content analysis like this with typing dynamics (e.g., [ 35 ]). Indeed, we collected individual keypresses and timings, including the use of the delete key. It may thus be possible to reconstruct some deleted content, and give a full portrait of the stream-of-consciousness exercise. These typing data may also be used to validate and refine this paradigm to study finer-grained psychological events.

Dynamic typing data may also reveal memory search, rumination through recurrent themes or word sequences. These data may also reveal document-wide typing rates that signal cognitive signatures that relate to global features such as overall sentiment and mood. In addition to word categories such as the LIWC dictionaries, other natural language processing techniques and analyses may reveal further insights. LIWC-22 also includes a measure called “narrative arc.” Narrative arc includes proposed stages of composition such as staging, plot progression, and cognitive tension, and appears to follow different patterns depending on text or transcription formats, such as fictional-style writing versus New York Times science articles [ 36 ]. Whether journalistic or stream-of-consciousness writing follows certain narrative arc patterns, or varies depending on the topic, sentiment, or other features, remains an open question. Topic modeling or recurrence analyses can explore how possibilities become constrained (or not) by temporal framing [ 37 , 38 ]. Further explorations into associations across LIWC categories could also contribute to understanding meaningful differences caused by temporal framings.

Individual differences in the experience of COVID-19 life would seem to be a critical ingredient here that we do not yet explore. Future analyses may consider such differences in more detail, such as comparing the framing texts to the post-pandemic texts. If an individual writes particularly optimistically about their life during the pandemic, they may be more likely to then write positively about the future, while greater negativity may similarly bleed into perceptions of the future. A rumination scale [ 18 ], a need-for-cognition scale [ 19 ], and a social connectedness and belonging scale [ 20 ] were included in data collection, though these measures were not factored into the present exploratory analyses. First-person singular pronoun use is increased in the self-focused attention typical of rumination [ 39 ], and thus may have potential for predicting rumination levels based on streams-of-consciousness. The interplay between language and rumination may result in, for example, pervasive use of such pronouns in future-oriented texts regardless of temporal framing. The need-for-cognition scale may also predict how much semantic space one covered in their streams-of-consciousness to begin with, and may inform language-oriented interventions if one temporal framing or the other encouraged greater cognitive exploration. Aside from the social connectedness and belonging measure, we asked questions about actual social experience during COVID-19. Taken together, these measures may explain some of the semantic space that the PCA revealed (e.g., PC4, which included the LIWC categories of “prosocial” and “social behavior” characterizing the pre-pandemic condition).

Given that this dataset was a college sample, factors such as age or other demographics remain open for study as they relate to global crises. For example, experiences of age-related change appear to influence perceptions of the future, and in turn mental health [ 40 ]. Age also appears to be a factor in influencing in-the-moment perceptions of COVID-19, although it may not have had as much influence on perceptions of the future [ 41 ]. While the pandemic marked a sudden major lifestyle shift globally, it will be valuable to evaluate similarities and differences to other health concerns experienced personally, such as chronic health issues, injury, or a terminal illness diagnosis. Whether the global, collective experience of COVID-19, or concern about one’s own experiences drive differences in future projections remains an open question. Understanding the relationships between personal health, global health, and how perceptions of their impact on the future change across the lifespan may clarify how different kinds of interventions may perform better or worse for different health profiles.

This study examines the effects of temporal framing on perception of the future, all within individuals; however, undoubtedly many external factors will also shape how individuals have experienced the COVID-19 pandemic. The media landscape and how the pandemic has been framed to different audiences will certainly have some influence. Indeed, psychological distance has been found to influence the evolution of misinformation regarding COVID-19 when the threats appear more distant [ 42 ]. Future work may examine the effects of the media on self-talk relating to global crises. Additionally, COVID-19 panned out to be a highly politically polarizing event. Political affiliation and intensity of an individual’s antagonistic views will shape how this global event influences thoughts of a post-pandemic life. Social media usage and the makeup of one’s social network both on- and off-line likely moderate perceptions of pandemic life. The language of social media posts across different styles of platforms and through different media (e.g., written such as in a tweet versus video, such as on TikTok) may show differences in socially oriented communication, which may then turn inwards when engaging in self-talk. How inter- and intra-personal communication are linked appears to be a ripe area for research [ 7 , 43 ].

Our findings suggest that streams-of-consciousness could have rich dynamic properties. In broader terms, the contexts of a person’s present thoughts offer a kind of momentum, propelling them into the next stream-of-consciousness. In the language of dynamical systems, there is hysteresis , when “the subject remains longer in the initially perceived interpretation” [ 44 ] (p. 373). This hysteresis property characterizes psychological dwell time in many domains, from motor control to categorization [ 45 ]. Even high levels of cognitive complexity, like streams-of-consciousness, may be given to these properties of complex, dynamic systems. The results here suggest this hysteresis occurs in temporal framings. When participants engage in thought about the past vs. the present, it may set their mind on a given trajectory, giving it some momentum and remaining longer in the initial perceived interpretation. Importantly though, the effects of such framings are confounded with the psychological boundary of a major global event. How context and psychological distance in the temporal domain interact or differently influence hysteresis could be the subject of future work. The global nature of COVID-19 may provide a valuable comparison point to other world events or disasters, such as the findings from Cohn, Mehl, and Pennebaker [ 15 ] of language shifts after the September 11, 2001 attacks on the United States. Future stream-of-consciousness prompts may also explore open-ended thoughts rather than anchoring on a specific event, to further clarify the temporal element alone, instead manipulating how far back or forward in time one is projecting their thoughts.

In the particular study presented here, we took an exploratory step into how streams-of-consciousness may color our views as we look towards the future. Our conscious thoughts, once expressed, are not divorced from measurable effects of thoughts that came before. The words we write and the things we think of before considering the future have a non-trivial influence on the way we frame that future to ourselves, and this can be seen even when considering a global crisis that has shaken our worlds as we knew them.

Supporting information

S1 table. loading scores for the top ten most influential liwc features for each selected component..

The table below features the seven selected components, the ten most influential LIWC features (ordered from most to least influential, based on their absolute values), and their raw loading scores. Positive loading scores best characterize the during-pandemic condition, while negative loading scores best characterize the pre-pandemic condition.

https://doi.org/10.1371/journal.pone.0285200.s001

Acknowledgments

We thank Greg Bryant and Anne Warlaumont for feedback on the project and writing, as well as the participants for contributing their streams-of-consciousness.

• View Article
• Google Scholar
• PubMed/NCBI
• 21. Boyd RL, Ashokkumar A, Seraj S, Pennebaker JW. The development and psychometric properties of LIWC-22. Austin, TX: University of Texas at Austin. 2022.
• 27. Abdi H, Williams LJ. Principal component analysis. Wiley Interdisciplinary Reviews: Computational Statistics. 2010 Jul;2(4):433–59.
• 28. Kramer AD, Rodden K. Word usage and posting behaviors: modeling blogs with unobtrusive data collection methods. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems 2008 Apr 6 (pp. 1125–1128).
• 30. Hills TT, Maouene M, Maouene J, Sheya A, Smith LB. Categorical structure in early semantic networks of nouns. In Proceedings of the Annual Meeting of the Cognitive Science Society 2008 (Vol. 30, No. 30).

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How to Lead With Emotional Intelligence in the Time of COVID-19

Laura K. Murray

As public health faculty at Johns Hopkins, we have been monitoring not only the map and progress on vaccines, but the impact COVID-19 has on the human condition.

This is where I come in as a psychologist.

In my work around the globe, I’ve had the opportunity lately to speak to and observe a wide range of leaders facing a range of challenges: Those running businesses and organizations, who are trying to save jobs and pivot creatively. Leaders in academia, now working through new processes for ensuring student progress and holding graduations. School leaders trying to keep families and kids happy while working with teachers who themselves have children at home. Public health experts making recommendations for people in poverty-stricken areas, where social distancing or hand washing are unattainable luxuries. Leaders in ministries of health in low-income countries, who are struggling to share honest information while staving off fear and violence.

There is no doubt that  leadership will be one of the most heavily tested skills throughout the coronavirus pandemic.

It’s easy to read articles about how leaders “should” or “should not” behave or “be.” In real practice, however, behavioral changes are hard and take practice, little by little.

Emotional intelligence is at the core of being able to make these behavioral shifts and ultimately helping you attain all those adjectives describing stellar leadership. Research shows that EI accounts  for nearly 90% of what sets high performers apart  from others with similar technical skills and knowledge.

Here are some specific suggestions to help leaders achieve (or get closer to) these shifts during the time of COVID-19.

Spend time on your own self-awareness.  At the core of EI, self-awareness is the area that leaders typically least enjoy or spend time on. They may see it as self-focused or a waste of time, but we can effectively work with others only if we get  really good  at knowing ourselves, our thoughts, our emotional reactions, and our tendencies.

As a small step, try spending 60 seconds writing down what you think and feel before you start your day and at the end of the day. Are you fearful, worried, angry? Write down at least two prevailing thoughts running through your mind. You do not have to solve these or work on them for now—just know where you are.

Practice empathy.  A lot is written about empathy, but few know how to break it down into actual steps, practice them, and get skilled at them. Behavioral scientists have studied this and outlined that it includes mental awareness (imagining you are the other person), communication (what you say, how you say it), and a physical aspect (observation of tone, gestures).

Try considering all three of these with each team member. The more attention you focus on who you are speaking to and really listening to them, the more your thoughts will resonate with theirs, making the delivery of empathy easier. If you are set to meet with a team member, take five minutes to write down what you imagine that person is thinking and feeling, and then a sentence that addresses this.

Label the fear.  A proven technique from psychologists and negotiation experts is to label fears in order to defuse them. Labeling the fears of your team members tells them that you are aware. This is particularly critical in times like now. Such statements may include something like, “We understand that you were all hired to do jobs that may not be working the same way right now. You may feel like we are treating you unfairly or are making decisions without each of you and your personal situations in mind.” Cue into your team members’ possible fears; name and label them directly and with empathy. Anger tends to stem from fear, which is best managed by labeling—and empathy.

Be real.  This is common advice, but let’s break down what it means. Share with others your own personal worries, concerns, and common thoughts. Tell the story about how you snapped at your teenager just because he or she is around all the time now. Or perhaps share your concern for an older family member. Now of all times, your team members really need to hear specific ways that you are in this with them.

Take care of yourself.  We have all seen posts or videos of leaders who frankly just look exhausted. Any leader (business, parent, teacher, politician) is still human, and we cannot care for others without being healthy ourselves. That means leaders have to be good at this— really good!  At a basic level, take time each day to do something that brings you happiness or pleasure. What is your  fuel —the thing that refills your own tank? Positive psychology is real science that rewires your brain and leads to greater productivity and stress reduction.

Change your internal thoughts.  Our thoughts, feelings, and behaviors are intricately connected. Changing thoughts to be more helpful will have a huge impact on the intensity of your emotions and shift your behaviors to be much more productive. This sets off a chain of events leading to more positive thoughts and even changes in neurochemistry.

For example, try shifting from:

• Thought : My business is going to go under. I will probably get fired.
• Feeling : Anger (10/10), Frustration (10/10), Fear (9/10)
• Behavior : Yelling at people, taking a long time to make a decision
• Thought : My business and many others are going to struggle a lot.
• Feeling : Anger (7/10), Frustration (8/10), Fear (5/10)
• Behavior : Calling on mentors or board members to discuss creative solutions

You have a critical role in helping others get through these times. At the same time, the challenges they bring will shape you and allow you to grow as a leader. Emotional intelligence will be at the forefront of this growth and worth the investment.

Laura K. Murray, PhD, MA , is a clinical psychologist and a senior scientist in  Mental Health  at the Bloomberg School.

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Critical thinking: how the COVID-19 pandemic is driving progress

The covid-19 pandemic is pushing governments and businesses to their limits, but history shows us that times of crisis often spur innovation.

Author: Charlotte Gifford

Related topics: covid-19 pandemic , innovation , research & development , technology, top 5 ways to manage the board during turbulent times top 5 ways to create a family-friendly work culture top 5 tips for a successful joint venture top 5 ways managers can support ethnic minority workers top 5 ways to encourage gender diversity in the workplace  top 5 ways ceos can create an ethical company culture top 5 tips for going into business with your spouse top 5 ways to promote a healthy workforce top 5 ways to survive a recession top 5 tips for avoiding the ‘conference vortex’ top 5 ways to maximise new parents’ work-life balance with technology top 5 ways to build psychological safety in the workplace top 5 ways to prepare your workforce for the ai revolution top 5 ways to tackle innovation stress in the workplace top 5 tips for recruiting millennials.

Frank Gehry, one of the most prolific architects in the world, claims that his nightmare scenario when building a house would be to have no constraints whatsoever. “It’s better to have some problem to work with,” he explains . “I think we turn those constraints into actions.” It was the strict standards set for the acoustics at the Walt Disney Concert Hall in Los Angeles, for example, that inspired the extravagant interior that makes it one of Gehry’s most well-known works.

We often assume that we are at our most creative when we have an abundance of time and resources at our fingertips, but research suggests that constraints help us unlock our brightest ideas. A 2018 review of 145 academic studies found that resource scarcity produces the most novel solutions to problems, whereas resource abundance encourages people to choose the path of least resistance and propose the easiest available solution rather than testing until they find the best one.

Resource scarcity produces the most novel solutions to problems, whereas resource abundance encourages people to choose the path of least resistance

National and international crises push this theory to the extreme. The COVID-19 pandemic has created an urgent need for more ventilators, hand sanitiser and protective equipment. At the same time, disruption to global supply chains has placed a serious strain on resources, while the confinement of millions of workers to their homes has limited the workforce’s capacity to produce this vital equipment. It’s a challenge that will test the limits of human ingenuity. But from these immense trials, organisations are likely to emerge with novel ways of working and new ideas for the future.

Wartime spirit The Austrian political economist Joseph Schumpeter argued that crises are hotbeds for innovation. This might seem counterintuitive; for example, the financial crisis of 2008 led to reduced investment in research and development. However, times of crisis have also been known to spur huge technological and organisational change.

During the Second World War, businesses were mobilised for the war effort on a scale that had never been seen before. “[The Second World War] is the best example for what we call ‘total war’, that is the total mobilisation of economy and society,” said Tamás Vonyó, an associate professor of economic history at Bocconi University.

“It was mass industrial warfare, a war of attrition on steroids, where military outcomes were determined more in factories than on battlefields… All major powers spent between 30 percent and 70 percent of their GDP on the war. Civilian production in several industries was completely shut down. No manufacturer was building passenger cars or electrical household appliances. They were converted to supply tanks, aircraft engines and radars. For manufacturing firms, military procurement was the only survival strategy.”

Out of this mobilisation emerged technological innovations that were absorbed into commercial sectors once the war had ended. Satellites and commercial aeroplanes owe much to the technological advancements made during the Second World War. In France during the First World War, car manufacturer Renault produced a light tank for the military, which gave it the tools to develop its first tractor. Stainless steel was created while the British Army was looking for corrosion-resistant alloys for guns.

Social distancing measures and disruption to global supply chains have put millions of employees in the manufacturing sector out of work

“Transitions during crises almost always spur innovation, whether it is established makers of goods or suppliers of services changing and adapting, or through creative new start-ups,” said Andrew Simms, Coordinator of the Rapid Transition Alliance. “When transitions are about the public interest, that also means removing the pressures that can lead to competition defeating cooperation.”

Today, manufacturers find themselves in a similar position. “In response to the COVID-19 pandemic, we see brewers producing hand sanitiser, makers of fashion-wear producing protective clothing and Formula 1 engineers making breathing aids,” said Simms. “In all cases, existing skills have been applied to making the products needed.”

For example, the demand for ventilators is so critical that governments have enlisted industrial companies to produce them. The French carmaker Groupe PSA is working in collaboration with Valeo and Schneider Electric to assist Air Liquide Medical Systems in ventilator production. Spanish automaker SEAT is producing simplified ventilators using windscreen wiper motors, gearbox shafts and gearbox housings. In Germany, Volkswagen has floated the idea of using its 125 industrial 3D printers to make critical medical parts.

Just as in wartime, the coronavirus crisis has fuelled companies’ resourcefulness. An Italian 3D printing start-up, Isinnova, has converted a snorkelling mask into a non-invasive ventilator for coronavirus patients. Other innovative devices that have made their way to market include a door-opening device named the Hygienehook, created by London-based designer Steve Brooks to help hospital workers avoid direct contact with door handles. A national effort can accelerate technological development, but we are yet to see whether any of these new inventions could have commercial applications once the crisis has ended.

Stretched thin Many world leaders and economists have drawn comparisons between wartime and the coronavirus pandemic: Mario Draghi, former president of the European Central Bank, urged governments to accept that “a change of mindset is as necessary in this crisis as it would be in times of war”. In March, Italy’s special commissioner for the coronavirus, Domenico Arcuri, told the country to equip itself for a “war economy”.

However, the coronavirus pandemic differs from wartime in at least one crucial respect. “The experience of hibernating economies for months is uncharted territory for government and business alike,” said Vonyó.

“The world wars did nothing of this sort. Quite the contrary: the aim of total war was to exploit all production capacities and mobilise all workers beyond what was considered feasible in peacetime. Short-term survival was everything. Future prospects were unpredictable and therefore secondary. Today, we do the opposite: we shut down all production that is not absolutely essential, using as little capacity and as few workers as possible, so that we can all stay at home. Total war maximised mobilisation; now we minimise mobilisation.”

This is what makes the economic challenge of coronavirus so unique and difficult to overcome. Social distancing measures and disruption to global supply chains have put millions of employees in the manufacturing sector out of work. Moreover, some of the devices these manufacturers are being asked to make – namely ventilators – are complex pieces of equipment that need to meet strict specifications. “Medical device companies usually take a long time to get going,” Peter Ogrodnik, a professor of medical devices design at Keele University, wrote in The Engineer .

Despite the colossal challenges that lie ahead for companies, innovation in the private sphere is likely to bloom

“They need to build their manufacturing knowledge and supply chains to ensure their products are safe and packaged in a sterile way. They need to understand things like biocompatibility (how materials interact with the body) and materials made from animal by-products (in order to minimise the risk of transmissible diseases such as Creutzfeldt-Jakob disease). These companies also need to develop the necessary skills in specific risk management and quality procedures.”

This brings us back to the influence that constraints have on creativity. As mentioned previously, there is evidence that limitations are more conducive to creativity than resource abundance. However, a recent study published in the Journal of Management found that there is an inverted U-shape relationship between constraints and innovation. Too few constraints, and we become complacent. Too many, however, and we become overwhelmed. A perfect balance needs to be struck, it seems, and the constraints imposed by the coronavirus are multifold.

In some respects, the innovation that emerges out of crises is the result of nations and businesses learning where they have blind spots the hard way. The deficiencies exposed in nations’ diagnostics sectors and medical equipment supply chains may push us to rectify these problems once the coronavirus is finally suppressed. Nations are almost certain to invest more in pandemic preparedness, for instance.

Already, we can see that the pandemic has been a catalyst for long-overdue transformation. Greece, which currently sits 25th among the 27 European Union member countries in terms of digital transformation, is rapidly digitalising in the wake of the pandemic. It has launched a web conference system for state officials and brought important documents like residence certificates, family status statements and recognition of university degrees online. Greece’s last-minute digital transformation is a large-scale example of what many companies around the world are currently undergoing.

Organisational change As cities around the world entered lockdown at the start of the year, businesses were forced to rapidly evolve and bring both their services and company infrastructure online. Entire sectors are rethinking their operations, while customer-facing businesses are forced to adapt quickly.

EURACTIV reported that German and Polish farmers are turning to social media and setting up online stores to sell their produce. Meanwhile, Europe’s virtual medicine sector, which has long been held back by strict privacy laws, is relaxing its regulations amid a spike in demand for online appointments. This has created a gap in the market for digital healthcare providers. The Swedish telemedicine company Docly reported a 100 percent increase in demand from one week to the next in the midst of the pandemic.

These changes could have a long-lasting impact on the way companies and industries work. “Crises change firms,” said Klaus Meyer, a professor of international business at Ivey Business School. “They change their processes and people acquire new skills, which in turn enables them to deliver new services – including last-mile logistics. To give an example in my own area, professors get better at online teaching and therefore online learning will play a bigger role in higher education in the future – though I expect mainly in the form of online-offline integration.”

Times of crisis have spurred huge organisational change throughout history

It’s not just businesses that must adapt to the new normal. “The crisis also changes consumers – and hence the products and services they value,” Meyer told European CEO . “For example, consumers may less appreciate cruise-ship holidays or mega entertainment events because of new risk awareness. On the other hand, consumers are learning during the crisis to appreciate services delivered online – such as entertainment or education – and the conveniences of online shopping delivered to their doorstep. Some of this will persist in the long run.”

Times of crisis have spurred huge organisational change throughout history. During the Second World War, Unilever’s multinational corporate structure was broken up, meaning its businesses had to work more independently and hone in on the needs of local markets. In the following decades, Unilever continued to operate as a federation of businesses with high levels of autonomy.

Crises can also lead to deep economic change; Vonyó points out that the war economy had a profound, long-lasting impact on European industry. “The two main areas where European firms and governments faced a steep learning curve,” he told European CEO , “were mass production and planning. American mass-production methods and management practices were widely known and admired by leading European firms. Fordism and Taylorism were not alien, but their practice expanded rapidly in the context of war mobilisation, where suddenly everyone became quite a bit more American: material, capital and scale intensive production methods were adopted to enhance output per worker.”

At the same time, Vonyó argues, the war encouraged western governments to intervene more in their own economies: “With the exception of the Soviet Union, every warring economy remained fundamentally market-based but each developed an increasingly important command-economy element.

There was euphoria all over Europe about economic planning after 1945, not just because of the success of the USSR in defeating Nazi Germany but more so because of each government’s own experience with steering economic activity. US economic historian Barry Eichengreen labelled the prevailing western economic model in the postwar era ‘coordinated capitalism’, which did not restrict the freedom of property and enterprise but intervened in finance, investment, wage settlements and international economic relations.”

The coronavirus pandemic could sow the seeds for a new economic model

The coronavirus pandemic could sow the seeds for a new economic model. In April, US billionaire Leon Cooperman said of the crisis: “Capitalism as we know it will likely be changed forever.” It is impossible to know the extent to which Cooperman is correct, but it’s true that the pandemic has rekindled debates around deglobalisation, bailing out large businesses and the benefits of universal basic income.

The new normal Meyer believes that some firms could change for the better as a result of lockdown. “Some of the new best practices that firms develop during the crisis will eventually be more efficient than established practices,” he told European CEO .

“For example, I would expect many business trips to be replaced by video conferences. Some businesses will discover that staff working from home [and] integrating family and work life will be advantageous for them – though not for all. I would also love to think that society becomes more accepting that people have families – and next time a child joins their dad in a BBC interview, nobody will raise an eyebrow. But perhaps that is too optimistic.”

Despite the colossal challenges that lie ahead for companies, innovation in the private sphere is likely to bloom. Ultimately, this will be the key to defeating the virus. For the first time, Apple and Google have partnered up to develop software that alerts users if they come in contact with someone infected with the virus, while biopharmaceutical leader Takeda is harnessing its industry expertise to develop a plasma-based treatment that could treat coronavirus patients.

Coronavirus will have a profound impact on the way we live and work. Businesses may rethink their value chains, having realised how dependent they are on China. In April 2019, the Business Roundtable redefined the purpose of corporations, stressing the importance of serving all stakeholders, including employees and communities. In the time of coronavirus, this is exactly the model that businesses must adopt to stay afloat. Coronavirus is also forcing us to confront the huge social importance of essential workers, especially compared to their small market value.

Vonyó pointed out that the Second World War inflicted a deeper wound on economies and led to a far greater loss of life than the coronavirus crisis is likely to. “Remember, the war lasted five years and incinerated 60 million souls. In the current pandemic, the worst may be over in a few months, with economies back on track within a few years,” he said. “The economic consequences will not last nearly as long as after 1945.” But, as with war, coronavirus’ impact on business and society will be felt long after the crisis has ended.

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Systems thinking for managing COVID-19 in health care systems: seven key messages.

Phillips JM, Stalter AM. Systems thinking for managing COVID-19 in health care systems: seven key messages. J Contin Educ Nurs. 2020;51(9):402-411.&nbsp; doi:&nbsp;10.3928/00220124-20200812-05.

Focusing on nurses and nurse educators, this article emphasizes systems thinking (a way of viewing, communicating, and understanding relationships that determine the functioning of systems) and the use of the systems awareness model (SAM) for managing the COVID-19 in health systems.

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A mixed-methods systematic review of interventions to address incivility in nursing. July 15, 2020

Nursing student errors and near misses: three years of data. February 22, 2023

Gender bias in risk management reports involving physicians in training - a retrospective qualitative study. November 9, 2022

A concept analysis of systems thinking. January 18, 2017

White paper on recommendation for systems-based practice competency. December 6, 2017

Systems thinking and incivility in nursing practice: an integrative review. February 14, 2018

Burnout and secondary traumatic stress in health-system pharmacists during the COVID-19 pandemic. June 30, 2021

"At home, with care": lessons from New York City home-based primary care practices managing COVID-19. December 16, 2020

Second victim support programs for healthcare organizations. July 29, 2020

Provider-patient communication and hospital ratings: perceived gaps and forward thinking about the effects of COVID-19. December 16, 2020

Toward higher-performance health systems: adults' health care experiences in seven countries, 2007. November 14, 2007

'Doing the best we can': Registered nurses' experiences and perceptions of patient safety in intensive care during COVID-19. September 7, 2022

Clinical alarms: improving efficiency and effectiveness. November 9, 2005

Guidance for health care leaders during the recovery stage of the COVID-19 pandemic: a consensus statement. July 28, 2021

Missed nursing care in the critical care unit, before and during the COVID-19 pandemic: a comparative cross-sectional study. June 22, 2022

Factors associated with missed nursing care and nurse-assessed quality of care during the COVID-19 pandemic. February 23, 2022

Patient voices in hospital safety during the COVID-19 pandemic. November 2, 2022

Missed nursing care during the COVID-19 pandemic: a comparative observational study. July 21, 2021

Planning for a pandemic: mitigating risk to radiation therapy service delivery in the COVID-19 era. July 22, 2020

Effects of extended work shifts and shift work on patient safety, productivity, and employee health. February 10, 2010

Crew resource management: applications in healthcare organizations. September 27, 2006

Neuroscience critical care: the role of the advanced practice nurse in patient safety. November 23, 2005

Measures and measurement of high-performance work systems in health care settings: propositions for improvement. February 9, 2011

The impact of the COVID-19 pandemic on Emergency Department visits and patient safety in the United States. August 26, 2020

Medication reconciliation in the acute care setting: opportunity and challenge for nursing. May 4, 2005

COVID-19 pandemic preparation: using simulation for systems-based learning to prepare the largest healthcare workforce and system in Canada. September 30, 2020

Assisting beginners in root cause analysis operations: analysis and recommendations regarding the spread of COVID-19 in nursing facilities for the elderly. September 30, 2020

Common and consequential fractures that should not be missed in children. November 30, 2022

Bracing for the storm: one health care system's planning for the COVID-19 surge. November 11, 2020

Safety implications of different forms of understaffing among nurses during the COVID-19 pandemic. July 28, 2021

Measurement and monitoring patient safety in prehospital care: a systematic review. February 24, 2021

Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease. July 29, 2020

A checklist to address implicit bias in healthcare settings during the COVID-19 pandemic: The PLACE Strategy. June 8, 2022

Maternal and neonatal health care worker well-being and patient safety climate amid the COVID-19 pandemic. March 31, 2021

Emotional exhaustion among US health care workers before and during the COVID-19 pandemic, 2019-2021. October 5, 2022

Characteristics and unexpected COVID-19 diagnoses in resuscitation room patients during the COVID-19 outbreak - a retrospective case series. September 30, 2020

Intravenous medication safety and smart infusion systems: lessons learned and future opportunities. October 19, 2005

Risk from delayed or missed care and non-COVID-19 outcomes for older patients with chronic conditions during the pandemic. June 8, 2022

An objective framework for evaluating unrecognized bias in medical AI models predicting COVID-19 outcomes. June 1, 2022

National drug shortages worsen during COVID-19 crisis: proposal for a comprehensive model to monitor and address critical drug shortages. November 4, 2020

Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation. October 21, 2020

The source of purchased medications and its impact on medication mistakes and hospitalizations. March 16, 2022

Application of emergency preparedness principles to a pharmacy department’s approach to a “black swan” event: the COVID-19 pandemic. April 21, 2021

Countering cognitive biases in minimising low value care. June 7, 2017

Failure to rescue in neonatal care. September 7, 2011

Understanding patient safety performance and educational needs using the 'Safety-II' approach for complex systems. December 14, 2016

Clinical reasoning in dire times- analysis of cognitive biases in clinical cases during the COVID-19 pandemic. February 23, 2022

Speaking up as an extension of socio-cultural dynamics in hospital settings: a study of staff experiences of speaking up across seven hospitals. February 22, 2023

Alert burden in pediatric hospitals: a cross-sectional analysis of six academic pediatric health systems using novel metrics. November 3, 2021

The calm before the storm: utilizing in situ simulation to evaluate for preparedness of an alternative care hospital during COVID-19 pandemic. June 2, 2021

Choosing wisely in clinical practice: embracing critical thinking, striving for safer care. April 6, 2022

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study. October 21, 2020

Root causes of adverse drug events in hospitals and artificial intelligence capabilities for prevention. May 5, 2021

COVID-19 pandemic: a time for collaboration and a unified global health front. August 12, 2020

Expanding frontiers of risk management: care safety in nursing home during COVID-19 pandemic. September 30, 2020

Nurses' perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services. December 2, 2020

A model for improving health care quality for transgender and gender nonconforming patients. January 23, 2020

Clinical characteristics and short-term outcomes of acute kidney injury missed diagnosis in older patients with severe COVID-19 in intensive care unit. May 19, 2021

Nurse-reported bullying and documented adverse patient events: an exploratory study in a US Hospital. June 24, 2020

Attending to the emotional well-being of the health care workforce in a New York City health system during the COVID-19 pandemic. August 26, 2020

Redeployment of health care workers in the COVID-19 pandemic: a qualitative study of health system leaders' strategies. May 19, 2021

Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review. October 5, 2022

Nursing strategies to safeguard COVID-19 patients from harm in the intensive care unit. December 8, 2021

Streamlining care in crisis: rapid creation and implementation of a digital support tool for COVID-19. October 21, 2020

Identifying barriers to and opportunities for telehealth implementation amidst the COVID-19 pandemic by using a human factors approach: a leap into the future of health care delivery? May 5, 2021

Toward the translation of systems thinking methods in patient safety practice: assessing the validity of Net-HARMS and AcciMap. February 1, 2023

Impact of the initial response to COVID-19 on long-term care for people with intellectual disability: an interrupted time series analysis of incident reports. October 14, 2020

Key considerations in ensuring a safe regional telehealth care model: a systematic review. May 26, 2021

Inpatient telemedicine and new models of care during COVID-19: hospital design strategies to enhance patient and staff safety. September 15, 2021

COVID-19: patient safety and quality improvement skills to deploy during the surge. June 24, 2020

Enhancing departmental preparedness for COVID-19 using rapid-cycle in-situ simulation. September 16, 2020

Burnout and its relationship to self-reported quality of patient care and adverse events during COVID-19: a cross-sectional online survey among nurses. June 9, 2021

Bias at warp speed: how AI may contribute to the disparities gap in the time of COVID-19. September 9, 2020

Video-based communication assessment of physician error disclosure skills by crowdsourced laypeople and patient advocates who experienced medical harm: reliability assessment with generalizability theory. May 18, 2022

Quantifying nursing workflow in medication administration. January 9, 2008

Quest for the ideal: a redesign of the medication use system. January 31, 2007

Beyond communication: the role of standardized protocols in a changing health care environment. January 11, 2012

Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study. November 16, 2022

Managing teamwork in the face of pandemic: evidence-based tips. June 24, 2020

Interdisciplinary Quality Improvement Conference: using a revised morbidity and mortality format to focus on systems-based patient safety issues in a VA hospital: design and outcomes. November 12, 2014

Effects of nursing rounds on patients' call light use, satisfaction, and safety. September 20, 2006

Information concerning ICU patients’ families in the handover—the clinicians’ “game of whispers”: a qualitative study. October 14, 2020

A new argument for no-fault compensation in health care: the introduction of artificial intelligence systems. April 7, 2021

How safe is prehospital care? A systematic review. November 17, 2021

Lessons learned from a systems approach to engaging patients and families in patient safety transformation. February 12, 2020

Racial disparities in diagnostic delay among women with breast cancer. August 18, 2021

What COVID-19 teaches us about implicit bias in pediatric health care. February 24, 2021

Medical bias: from pain pills to COVID-19, racial discrimination in health care festers. June 24, 2020

Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care. March 23, 2022

Delayed access to care and late presentations in children during the COVID-19 pandemic: a snapshot survey of 4075 paediatricians in the UK and Ireland. July 29, 2020

COVID-19 has united patients and providers against institutional betrayal in health care: a battle to be heard, believed, and protected. August 19, 2020

Mental health of staff working in intensive care during COVID-19. February 24, 2021

Factors influencing family member perspectives on safety in the intensive care unit: a systematic review. December 9, 2020

Developing critical thinking skills for delivering optimal care July 28, 2021

Nurse staffing, burnout, and health care-associated infection. August 15, 2012

Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 Pandemic. July 20, 2022

Root cause analysis for hospital-acquired pressure injury. August 14, 2019

Patient safety in the NICU: a comprehensive review. July 6, 2011

Survey of cancer care providers' attitude toward care for older adults with cancer during the COVID-19 pandemic. November 25, 2020

Organisational conditions for safety management practice in homecare and nursing homes, pre-pandemic and in pandemic. March 27, 2024

National survey of patient safety experiences in hospital medicine during the COVID-19 pandemic. January 10, 2024

Voices from frontline nurses on care quality and patient safety during COVID-19: an application of the Donabedian Model. November 1, 2023

The effectiveness of tele-triage during the COVID-19 pandemic: a systematic review and narrative synthesis. February 8, 2023

Speaking up during the COVID-19 pandemic: nurses' experiences of organizational disregard and silence. February 1, 2023

COVID-19 in Nursing Homes: CMS Needs to Continue to Strengthen Oversight of Infection Prevention and Control. October 12, 2022

Clinic design for safety during the pandemic: safety or teamwork, can we only pick one? May 11, 2022

What is needed to sustain improvements in hospital practices post-COVID-19? A qualitative study of interprofessional dissonance in hospital infection prevention and control. May 4, 2022

Patient Safety Primers

Coronavirus Disease 2019 (COVID-19) and Safety of Older Adults Residing in Nursing Homes

Using smart IV infusion pumps outside of patient rooms. February 2, 2022

Quality and safety in hospital pediatrics during COVID-19: a national qualitative study. January 12, 2022

Coronavirus Disease 2019 (COVID-19) and Diagnostic Error

Patient, surgeon, and health care worker safety during the COVID-19 pandemic. November 3, 2021

The less-discussed consequence of healthcare's labor shortage. October 13, 2021

Evidence of respiratory infection transmission within physician offices could inform outpatient infection control. September 1, 2021

Structural racism and the COVID-19 experience in the United States. July 7, 2021

Universal protection: operationalizing infection prevention guidance in the COVID-19 era. May 12, 2021

Has the COVID pandemic strengthened or weakened health care teams? A field guide to healthy workforce best practices. March 31, 2021

Flow accuracy of IV smart pumps outside of patient rooms during COVID-19. February 24, 2021

Implementation of simulation training during the COVID-19 pandemic: a New York hospital experience. February 24, 2021

Patient Safety Recommendations for COVID-19 Epidemic Outbreak: 3.0 January 29, 2021

In the eye of the storm: the role of the pharmacist in medication safety during the COVID-19 pandemic at an urban teaching hospital. December 23, 2020

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Strategic resilience during the COVID-19 crisis

As we approach the one-year mark of the global coronavirus crisis, it is heartening to see that many organizations have stepped up to the challenge, adapting their businesses both to protect their employees and to continue serving their customers and communities. In a recent survey, 80 percent of executives told us they believe their organizations have responded effectively to the pandemic.

Nevertheless, some companies have proven to be more resilient than others, rapidly adapting their strategies to address both the challenges and the opportunities created by the crisis. What did they do that others did not?

To answer the question, we surveyed approximately 300 senior executives in Europe to understand their organizations’ responses in more detail. Three major findings stood out in our analysis of the survey responses. First, roughly half of executives reported that the crisis exposed weaknesses in their companies’ strategic resilience, which we define as the extent to which an organization’s business model and competitive position prove resistant to disruption. Second, business-model innovation was by far the most important strategic lever in addressing the crisis, with three-quarters of respondents reporting such initiatives—including almost 90 percent of those who felt their company’s response to be very effective. Finally, 60 percent of the executives polled said they expect these innovations to persist beyond the crisis, with more projects to come.

The critical importance of business-model innovation highlighted by the survey aligns with our earlier research. In a recent article , we demonstrated how the disruption caused by the COVID-19 pandemic has led to a rapid acceleration of trends that were present before the crisis. The study additionally found a widening gap between the best- and worst-performing companies as organizations with future-ready business models pull away from the pack. As companies start to prepare for a postpandemic world , those that have fallen behind more resilient players will need to take fast, bold action to make up for lost ground.

Testing your strategic resilience

The COVID-19 pandemic has put businesses through rigorous strategic-resilience tests. For many, it was a rude awakening. In our survey, an average of 42 percent of respondents report that the crisis weakened their companies’ competitive position, compared with an average of 28 percent who say their companies increased their competitive edge. We found that these “antifragile” organizations (to use author Nassim Taleb’s term for entities that become stronger when exposed to stressors) relied primarily on proprietary technology or a strong brand to thrive amid widespread economic shocks (Exhibit 1).

Business-model innovation emerged as the key differentiator for those that have gained ground during the pandemic. In fact, the survey respondents who said their companies addressed the crisis very effectively were 1.5 times more likely to report undertaking business-model innovations than those who thought their organizations’ responses were not effective.

Those who adopted new business models have tended to focus on five areas:

• New digital experiences, products, and services in response to changes in customer behaviors and needs. For example, many sports and entertainment venues have moved to fully digital experiences, while a technology provider has launched an on-demand fitness offering to capitalize on the category’s surging popularity.
• New partnerships, both within and outside of the industry. For example, an insurance group has partnered with a connectivity provider to set up a virtual clinic, and pharmaceutical companies have been teaming up directly with healthcare centers to accelerate vaccine development. Meanwhile, sports leagues have banded together with software companies to create virtual-reality experiences for sports enthusiasts.
• Supply-chain and operating-model adjustments to manage risk. Companies are trying to balance the need for just-in-time delivery with protection against delays or shutdowns by securing alternative sources of supply and ensuring that the labor force can continue to operate. Contact centers, for example, have moved to remote operations or split their teams into cohorts that can isolate in case of infection, allowing others to continue working.
• Sales-model changes. Many businesses have had to adapt the way they market and sell their offerings, from logistics companies that have introduced contactless delivery to restaurants shifting to home delivery and pick-up orders. Business-to-business sales have likewise largely moved to remote and digital models .
• Faster product development through more rapid iteration. For example, telecom companies, working with insurers and healthcare providers, quickly responded to the pandemic by creating telemedicine applications to assist in remote COVID-19 testing and diagnosis. Meanwhile, a consumer-packaging player transformed its product development and trial process into an immersive virtual experience.

On average, 42 percent of respondents say the COVID-19 crisis weakened their companies’ competitive position, compared with 28 percent who say their companies increased their competitive edge.

It is noteworthy that most of the innovations highlighted by survey respondents focused on the customer-facing parts of their businesses, such as launching new products and services to meet changing customer demand, adapting the sales and service models, and improving customer experience. By and large, cost and workforce reductions were mentioned only by executives in industries most severely affected by the crisis.

While the urgency of crisis response spurred or accelerated many of these innovations, they are here to stay in most cases. Sixty percent of the respondents expect their business-model changes to persist in the long term—and see more coming. Some retail banks, for example, are considering not reopening the branches they closed during the pandemic, and numerous organizations are planning for a future where employees work at least a few days a week from home. All of these reaffirm a well-tested maxim: in times of great disruption, there is also great opportunity.

Building up your strategic resilience

As the pace of change accelerates, the fastest and boldest movers are likely to pull further away from the pack. To keep pace, your strategic-planning process has to be flexible enough to deal with high uncertainty. Here are four ways you can adapt it to become more strategically resilient:

Set bold aspirations. Economic disruption serves as an opportunity to explore new business avenues. Many executives have realized that if ever there was a time to set bold aspirations and reset long-term strategy, it is now. To illustrate the size of the prize, our analysis of the 2007–2010 downturn  shows those companies that moved early and invested strongly ahead of the recovery increased their earnings before interest, taxes, depreciation, and amortization (EBITDA) by 10 percent on average, while their industry peers lost nearly 15 percent.

The accelerating trends and widening performance gap heighten the urgency to act. Many organizations managed to respond with unprecedented speed to the challenges the pandemic presented, doing in days or weeks what took months in the past. This is the time to reflect on the future role you want your organization to play—in customers’ lives, in your ecosystem, and in society.

• Develop scenarios, not forecasts. Scenarios are back in fashion but are frequently misused. They are not intended to serve as forecasting tools but rather as a means of bounding the uncertainty you confront. The goal is to understand the range of possible eventualities you may face so you can stress-test your portfolio of planned strategic moves against the extremes and ensure that your strategy can succeed in a range of future outcomes. Business leaders should develop scenarios together with finance and strategy functions to ensure they incorporate all relevant perspectives.

Create a hedged portfolio of big moves. According to our research , companies that make big strategic moves—be they portfolio-related, such as M&A, capital spending, or resource reallocation; or be they performance-oriented, such as productivity and differentiation improvements—materially increase their likelihood of outperforming the market. Such moves are especially effective in times of economic upheaval when your competitors are often paralyzed by uncertainty. The organizations we surveyed plan to explore multiple opportunities in the next six months, with the largest focus falling on cost structure and customer-experience improvements and developing new products or business models (Exhibit 2).

But even as you move boldly, it is important to hedge your bets. That could mean only triggering the move once you are confident that a favorable scenario will unfold or combining big new initiatives with no-regret moves that would deliver benefits under all scenarios (digitizing processes, for example, or improving customer experience). Another route is to make small investments that you can later expand, such as taking a minority stake in a company with an option to increase that stake.

• Adapt your strategy dynamically. Dramatic shifts are happening too quickly for companies to continue the traditional annual strategic-planning exercise. In fact, almost half the executives in our survey expect to implement a process that allows for faster iteration on their plans. Some companies have shifted to monthly strategy meetings to review their portfolios of planned strategic moves and update them as new opportunities arise or changes in the external context render some obsolete.

The level of innovation in response to this crisis has been truly impressive at many organizations. But all signs point to more months of uncertainty and change as the pandemic’s impact continues to evolve. To ensure your company is strategically resilient for whatever the future brings, start by establishing dynamic planning processes that will enable you to unlock the big moves required to come out on top while being flexible enough to change direction if needed.

Dago Diedrich is a senior partner in McKinsey’s Düsseldorf office, Nicholas Northcote is a director of strategy and corporate finance in the Brussels office, Tido Röder is an associate partner in the Munich office, and Karolina Sauer-Sidor is a partner in the Vienna office.

The authors wish to thank Alina Blos, Livia Boerner, Franziska Galie, Florian Hillenbrand, Ronja Hoffacker, Johannes Kerst, Philipp Rädle, and Patricia Vicinanza for their contributions to this article.

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Using Rapid Design Thinking to Overcome COVID-19 Challenges in Medical Education

Anupam thakur.

1 A. Thakur is assistant professor, Department of Psychiatry, University of Toronto, and psychiatrist, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

Sophie Soklaridis

2 S. Soklaridis is associate professor, Department of Psychiatry, University of Toronto, and senior scientist in education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

Allison Crawford

3 A. Crawford is associate professor, Department of Psychiatry, University of Toronto, and scientist and associate chief, Virtual Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

Benoit Mulsant

4 B. Mulsant is professor and chair, Department of Psychiatry, University of Toronto, and scientist, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

Sanjeev Sockalingam

5 S. Sockalingam is professor and vice chair, Education, Department of Psychiatry, University of Toronto, and scientist and vice president, Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

The rapid rise of cases of coronavirus disease 2019 (COVID-19) has led to the implementation of public health measures on an unprecedented scale. These measures have significantly affected the training environment and the mental health of health care providers and learners. Design thinking offers creative and innovative solutions to emergent complex problems, including those related to training and patient care that have arisen as a result of the COVID-19 pandemic. Design thinking can accelerate the development and implementation of solution prototypes through a process of inspiration, ideation, and implementation. Digital technology can be leveraged as part of this process to provide care and education in new or enhanced ways. Online knowledge hubs, videoconference-based interactive sessions, virtual simulations, and technology-enhanced coaching for health care providers are potential solutions to address identified issues. Limitations of this model include inherent bias toward utilitarian instead of egalitarian principles and the subsequent threat to diversity, equity, and inclusion in solutions. Although medical educators have embraced digital transformation during the COVID-19 pandemic, there is a need to ensure that these changes are sustained.

The rapid rise of cases of coronavirus disease 2019 (COVID-19) has led to the implementation of public health measures on an unprecedented scale to “flatten the curve” and reduce mortality. 1 These measures (e.g., home quarantine, social isolation, physical distancing, curfews, closures of schools and universities) have significantly affected the training environment and the mental health of learners across the continuum of education. As the demand for some health services increases exponentially and the morbidity of patients with COVID-19 rises, the pandemic is also causing unprecedented psychological distress in health care providers (HCPs) and health professions students, including burnout 2 , 3 and moral injury, the latter of which is exacerbated by shortages in specific health services (e.g., access to ventilators) in the face of growing needs. 4 Now, the lives of frontline HCPs are characterized not only by loss and stress but also by volatility, uncertainty, complexity, and ambiguity. Moreover, stress can lead to learner disengagement and interrupt the consolidation of memory, which can be detrimental to learning.

In parallel, the nature and setting of clinical work have changed for many HCPs and learners. They must adapt to physical distancing and social isolation by rapidly integrating the virtual delivery of health services. Similar to adaptations made during the 2003 severe acute respiratory syndrome (SARS) pandemic, the changes made during COVID-19 are leading HCPs to rethink medical education delivery and its focus. 5 As noted by Torous and colleagues, 6 the COVID-19 pandemic is an opportunity to accelerate the use of digital technology to provide access to quality care for people with complex health needs. The unpredictable scale and timing of the COVID-19 pandemic, paired with evolving digital innovation in medicine, have created a propitious environment for improving both education and patient care.

Medical educators require new models for generating solutions to address the complex training and care needs that have emerged as a result of COVID-19. Design thinking offers creative and innovative solutions to complex problems, 7 including those related to volatility, uncertainty, complexity, and ambiguity. 8 Design thinking principles have been applied in medical education to create educational strategies and programs. 5 , 7 , 9 , 10 With this approach, solutions can be developed or implemented both to sustain existing education and training resources and to enhance existing methods and content to meet the new needs presented by COVID-19. Finally, design thinking can support innovation in response to new competencies and needs that have arisen during the current public health crisis.

In this article, we discuss the role of rapid design thinking during the COVID-19 pandemic to generate innovative solutions to address unique medical education challenges. Using this lens, we share insights into the role digital solutions can play to address these challenges. Finally, we identify potential limitations of rapid design thinking in today’s care and education environments.

Using Rapid Design Thinking to Generate Innovations During COVID-19

Design thinking is a process that involves observation, collaboration, fast learning, the visualization of ideas, rapid prototyping, feedback gathering, and redesign. 11 The stepwise strategies used in design thinking are: (1) empathize: use a needs assessment process to identify the problem and opportunities by observing, engaging, and empathizing with users; (2) define: frame the problem in a user-centered manner; (3) ideate: identify a broad range of ideas and potential solutions; (4) prototype: use an iterative process of testing scaled down versions of solutions with users; and (5) test: implement and refine the chosen solution with user feedback. 12 This last step includes the consideration of such issues as compatibility in a dynamically changing context over time. 7

Similar to plan–do–study–act cycles, design thinking is an iterative process with cycles of improvement. 13 It is perfectly suited to a rapidly changing environment because it gives users the ability to innovate and it acts as a vehicle for organizational change. 14 Design thinking can accelerate the development of prototypes and their implementation in the current COVID-19 environment, where there is rapidly evolving information and quick and wide dissemination is necessary. Apart from accelerated solutions, the goal of design thinking is to develop human-centered solutions and to enhance the user experience; both are critical to improving the uptake of innovations. 5

Design thinking has distinct features compared with other common innovation frameworks, such as agile project management. 15 Design thinking involves deep content analysis, opportunity mapping, and problem framing as well as problem solving. In comparison, agile project management is more implementation focused and generally smaller in scale. Design thinking is an ideal framework for identifying and implementing solutions to COVID-19 challenges that are highly complex, larger in scope, and involving multiple stakeholders.

Given that there are numerous rapid design thinking models, we chose to focus on 3 essential stages and their relevance in medical education during the COVID-19 pandemic (see Figure ​ Figure1 1 and below). 5 The first stage (define) draws inspiration from the problem or opportunity at hand. The second stage (ideate) is ideation, during which innovative educational ideas are generated. Finally, the third stage (test) deals with implementation (i.e., putting innovations into practice). 5

Rapid design thinking approach to overcoming COVID-19 challenges in medical education. Abbreviations: UME, undergraduate medical education; PGME, postgraduate medical education; CPD, continuing professional development.

One core component of rapid design thinking is accelerated prototyping, which can be particularly helpful during times of large-scale disruption. Accelerated prototyping involves implementing, testing, and refining user-driven solutions in an iterative manner. 16 This approach is well suited to the rapidly changing COVID-19 environment and the impact of the pandemic on health professions training and education delivery.

In the following sections, we explore how these 3 stages of rapid design thinking may be used to address the challenges of COVID-19 in medical education.

Inspiration stage

COVID-19 presents a unique tripartite set of challenges for medical education and training. First, information is abundant and in a constant state of flux. 17 Due to the evolving nature of the pandemic, new information is being generated within a short period of time. 18 This information needs to be curated and presented to a diverse range of learners and HCPs to share with patients, their caregivers, and the general public. The process of learning new skills and updating medical knowledge to provide safe and effective care highlights the need for both lifelong learning and narrowing the gap from research to practice.

Second, physical distancing has disrupted training programs, creating uncertainty for learners. COVID-19 mitigation interventions also have interrupted in-person education events, large classroom sessions, and traditional clinical teaching methods. In addition, virtual means of delivering clinical care, such as telemedicine, are increasing the need for proficiency in the use of digital tools. Given social distancing requirements, additional efforts are needed to maintain team connection and integrate services in a constantly changing environment.

Third, COVID-19 has affected HCPs’ ability to teach, mentor, and sustain engagement in academic activities. The possibility of redeployment to meet pandemic care needs has caused anxiety in HCPs, limited their availability for teaching, and negatively affected the learner experience. Emerging reports from teaching hospitals affected by COVID-19 suggest that HCPs, especially those directly involved in assessing and managing COVID-19 patients, are at a high risk of developing psychological distress and other mental health symptoms. 19 – 21 For example, anxiety, depression, insomnia, 20 , 22 and burnout 3 have been reported in these individuals. In addition, quarantining and social isolation have been associated with negative psychological consequences, such as post-traumatic stress symptoms, confusion, and anger. 23 , 24 HCPs also can experience stress-related responses, fear of contagion, and concern for their family’s health. 25 , 26

Although, understandably, the current focus is on controlling and acutely managing the COVID-19 pandemic, supporting HCPs and community members to build resilience and coping strategies is imperative. Online interactive tools, COVID-19 awareness resources, and training using simulations can help HCPs working with COVID-19 learn new medical skills that improve their well-being.

Ideation stage

The pandemic has presented many opportunities to use new digital tools to deliver clinical care, access credible COVID-19 resources and training, and support HCPs’ and learners’ well-being. Design thinking can help HCPs develop a mechanism for rapidly gathering ideas related to these activities. Planning teams with representation from key stakeholder groups should function as “education command centers” that initiate idea generation. Virtual focus groups, team meetings, and online discussion forums also can inform this ideation phase.

Digital solutions have already emerged to bridge the care gaps created by social isolation and travel restrictions during COVID-19. Torous and colleagues 6 observed an increase in video care visits, and they emphasize the need to train HCPs and patients so they can participate fully in this type of virtual care. Building capacity in telemedicine, and virtual care more broadly, requires a range of education interventions to ensure competency, including online education modules; videoconference-based sessions; and longitudinal, technology-enhanced coaching for HCPs. 27

Both HCPs and learners require curated (i.e., reliable) online sources to access updated information and tools to manage both the physical and mental health consequences of COVID-19. Online “knowledge hubs” could distill information for learners and guide them to “just-in-time” resources, while balancing cognitive load. Learners need to develop critical appraisal skills to effectively assess the credibility of the gray literature, online resources, and social media related to COVID-19. For instance, the donning and doffing of personal protective equipment (PPE) is a key procedure related to COVID-19 care; HCPs need to develop virtual simulations delivered via videoconferencing to allow learners to practice these procedures safely (i.e., without the risks of exposure to the virus) without wasting limited PPE supplies. 28

Computer-based simulations can help HCPs and learners practice challenging scenarios in a nonthreatening (“low stake”) environment, for example, making complex decisions about the allocation of resources. HCPs also need to provide training in end-of-life care, as they and learners will be managing patients who may not have access to life-sustaining equipment like ventilators. 29 They urgently need enhanced communication skills to have these difficult discussions with patients and families.

HCPs and learners are already adapting to new ways of working during COVID-19. Similar to innovations in clinical practice, they must learn to attend to their self-care in innovative ways. An integrated pathway, consisting of self-assessment tools and access to mental health resources (ranging from resilience building exercises to formal psychotherapies), is needed to support the psychological well-being of HCPs and learners. Early during the pandemic in China, HCPs with mild distress were interested in online resources, while those with more severe symptoms sought help from mental health professionals. 30 An online platform is ideal to integrate these resources, provide easy access, and create virtual communities of practice and support.

Steps to Consider When Implementing an Educational Innovation During the COVID-19 Pandemic

It is important to reflect on why the organization does the work it does and to align educational innovations with the vision, core values, and organizational strategy.

The degree of success of an innovation depends on the extent to which existing skill sets and resources are harnessed.

Stakeholder engagement (including faculty, learners, and patients) and the co-creation of innovation products are crucial to alignment with purpose and add value.

A design thinking approach to developing and implementing educational innovations should be efficient, impact driven, and build on existing solutions, especially given the rapidly changing landscape of the COVID-19 pandemic.

Priority setting should be driven by goals, value to stakeholders, and the resource capacity of the organization.

Organizing, eliminating waste, pruning, and prioritizing innovations are important steps in implementation. Decision-making tools can be used.

Decisive leadership is necessary to strike a balance by encouraging coproduction, collaboration, and scalability.

Implementation stage

During a crisis like the COVID-19 pandemic, the implementation stage in rapid design thinking is contingent on accelerated prototyping with iterative feedback during testing. 16 The engagement of HCPs and learners during this stage is crucial for prototyping driven by end users. Continuous conversations with these and other stakeholders help to contextualize their needs, elicit preferences, and identify “on-the-fly” education strategies that can be integrated into local settings. Due to physical distancing, soliciting timely feedback during each prototyping cycle can be facilitated by digital technology. List 1 summarizes several factors to consider when implementing an educational innovation during COVID-19.

Sustaining innovations in medical education during a pandemic that could last for months has unique implementation needs. Sustainability efforts should involve existing networks, communities of practice, and various methods for curriculum delivery (e.g., existing online education platforms). Innovations also can leverage existing curricula and competency frameworks (e.g., the Accreditation Council for Graduate Medical Education core competencies, 31 CanMEDS roles 32 ) to quickly build new training opportunities.

In the following sections, we consider the unique factors associated with the rapid implementation of virtual care, knowledge hubs and online training, and self-care and mental health support for HCPs and learners.

Rapid implementation of virtual care.

If properly executed, the scope of the digital revolution ushered in by COVID-19 could transform the educational ecosystem. 33 The rapid explosion of virtual care has created new opportunities for training in telemedicine. In addition, residents and students displaced from traditional care environments may now undergo clinical training in new virtual care rotations and placements.

However, fear of novel digital technology, limited telemedicine capacity, lack of end users’ involvement, lack of awareness of digital tools, and lack of trust in these tools have been shown to impede the implementation of such resources. 34 , 35 Therefore, the rapid scaling of virtual care offerings during COVID-19 should follow a compassionate virtual care model, 36 address medico-legal privacy issues, and meet documentation requirements. Going beyond virtual learning sessions, workplace-based training supported by virtual coaching for learners is needed to continue rapid prototyping within clinical settings.

Rapid implementation of knowledge hubs and online training.

The creation of online knowledge hubs can help HCPs and learners access the most up-to-date information when they need it. In turn, HCPs and learners can provide real-time feedback on their knowledge needs and modify the content to ensure it remains useful and up to date. For example, crowd sourcing can be used to identify new resources and solicit feedback. These processes will facilitate iterative user-driven solutions, a key aspect of rapid design thinking. 16 Establishing clear processes, stable online platforms, and streamlined workflows supported by an information curation and development team is necessary for rapid review, revision, and dissemination of constantly changing information and educational resources to support HCPs and learners. At the same time, newer platforms, mechanisms, and experiences must be established. For example, other key virtual learning opportunities, such as those offered by social media, webinars, and podcasts, can be leveraged.

As the growing number of patients with COVID-19 threatens to overwhelm health care systems, rapid upskilling and redeployment of HCPs and learners are needed. Implementation strategies should quickly identify gaps based on a review of discipline-specific core competencies, online assessments of knowledge, and virtual simulations to assess procedural skills. Simulation is a critical component to skills-based training, specifically when dealing with high-risk or rare situations related to COVID-19. Virtual simulations can build on existing experiences from surgical residency programs, which can be adapted to address training needs during the pandemic. 37

Rapid implementation of self-care and mental health support for HCPs and learners.

There is extensive literature on self-care and mental health support for HCPs and learners. 38 However, the rapid upscaling of programs to support the unique needs of providers during COVID-19 requires adaptation and implementation for this context. This process can start with an environmental scan of existing virtual communities of practice. These networks can provide the necessary infrastructure and bring together HCPs and learners for training and the navigation of online self-help resources. For example, Project Extension for Community Healthcare Outcomes has demonstrated capacity to virtually connect HCPs around the world. This model could be used to support HCPs and learners in addressing their mental health needs during COVID-19. 39 – 42

For direct mental health support, emerging evidence indicates that online self-help interventions using artificial intelligence improve the user experience. 19 In China, online psychological counseling (using WeChat) has been offered 24 hours a day, free of cost, during the COVID-19 pandemic. 43 Counseling by telephone, online psychological support tools, and app-based counseling have also been used and can be expanded to other settings. 19

Iterative data collection from HCPs and learners as they access these educational and support resources is a critical component of the implementation stage, as the content should be congruent with phase-specific needs during the pandemic.

Limitations of a Rapid Design Thinking Model

General limitations.

The deployment of solutions to address the educational challenges of COVID-19 comes with significant risks. First, virtual design thinking solutions may not remedy the risks related to social isolation between learners and their peers and teachers. Second, there is a lack of data on the efficiency and efficacy of these new learning modalities and approaches; therefore, interventions should be firmly anchored in learning theories and examine educational outcomes. Third, many organizations are reducing their educational budgets, which may constrain their ability to respond with new technological and other solutions to meet rapidly changing needs post pandemic. In addition, design thinkers will need to mitigate the financial stress anticipated for organizations during and after COVID-19. Fourth, design thinking innovations could potentially accelerate the need for emerging health professions, such as medical virtualists, 44 HCPs with expertise in artificial intelligence, 45 and the use of predictive analytics. Therefore, competency in these areas may be needed sooner than anticipated.

Bias and threats to equity, diversity, and inclusion

Another potential limitation of rapid design thinking is inherent in its very methodology. In times of rapid change and scarce resources, utilitarian principles are usually favored as a way to maximize the overall health and well-being of a society. 46 Less popular are the egalitarian principles that purport that all individuals are equal and that inequalities between groups should be addressed. 29 If rapid design thinking is used to inspire, ideate, and implement innovative educational strategies, then a concomitant effort is needed to ensure these processes address inequity.

All individuals, whether they believe themselves to be prejudiced or not, hold mental schemas that classify people into categories based on gender, race, ethnicity, age, sexual orientation, and religion, to name a few; this categorization often leads to bias and stereotyping. 47 Although the design thinking process was conceived to include feedback from multiple stakeholders, it must include strategies to identify inherent biases. Strategies can be implemented at each stage of the process to address equity, diversity, and inclusion. For example, designers can challenge their assumptions and become aware of their biases by taking the implicit bias test. 48 Creating opportunities for the design team to become aware of their implicit biases forces them to shift how they identify problems and understand proposed solutions.

Testing proposed innovations during each of the 3 design thinking stages against the common goals and values of the team to ensure alignment with diverse perspectives should not be a symbolic effort. Including screening questions can prompt designers to ensure they are addressing inequity. For example, access to care is key to addressing inequity, and research shows that access to broadband Internet and smartphones depends on the racial, ethnic, and socioeconomic status of individuals. 49 Designers would need to respond to these issues during the rapid design thinking process.

Increasing the diversity of the design team alone will not reduce bias and discrimination. 50 The process itself must include ways to address the issues of power and privilege within a team. For example, if the organizational leadership decides that a utilitarian approach is needed during a pandemic to maximize communal well-being, then all decisions, regardless of the diversity of the team, will be affected by this ideology. However, research shows that ideological influences can be challenged when groups share common goals and values. 51

Like in all aspects of society, the COVID-19 pandemic has triggered considerable change in medical education. Rapid design thinking can be used to develop and implement solutions to overcome COVID-19-related barriers in medical education. It can help educators transform the COVID-19 crisis into an opportunity for positive and sustained change. We must ensure that the digital transformation gained during the COVID-19 pandemic continues, instead of reverting back to the pre-COVID status quo.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.