Next, two variations of the “International Institute for Competency Development’s 21st Century Skills Framework” are presented. We then present the process of official assessment and certification known as “labelization”, suggesting it as a solution both for establishing a publicly trusted assessment of the 4Cs and for promoting their cultural valorization. In a section on each C, we provide an overview of assessment at the level of individual performance, before focusing on the less common assessment of systemic support for the development of the 4Cs that can be measured at the institutional level (i.e., in schools, universities, professional training programs, etc.). It focuses in particular on key soft skill competencies known as the “4Cs”: creativity, critical thinking, collaboration, and communication. This article addresses educational challenges posed by the future of work, examining “21st century skills”, their conception, assessment, and valorization. Operative vaginal delivery might be a risky procedure and should be performed only when clinically indicated and after adequate critical analysis. Therefore, clinicians tend to intervene performing vacuum delivery without adopting critical analysis and without adequately considering the clinical situation. Among these, 66 women (26.1%) had an operative vaginal delivery which was then considered to be inappropriate, while in 114 cases (45.1%) CTG traces resulted to be unreadable.ĭecision making process, which leads clinicians to go for operative vaginal delivery, is often influenced by shortness of time and complexity of the situation. Cardiotocography, classified as ACOG category 2 or 3 was the indication for vacuum assisted delivery in 253 patients (54.29%). Overall, 466 women undergoing operative vaginal deliveries were included. A board consisting of five among authors evaluated appropriateness of the procedure. Indications to operative vaginal delivery were grouped as alterations of fetal cardiotocography (CTG) patterns, delay/arrest of second stage of labour or elective shortening of second stage of labour. All term pregnant women, either nulliparous and multiparous, with singleton pregnancy and a cephalic fetus, with spontaneous or induced labour, requiring vacuum-assisted delivery were enrolled. This is a prospective, longitudinal, multicenter, observational study and it was conducted in three Italian Obstetric Units (Pisa, Massa Carrara and Prato). Since operative vaginal delivery may be risky for women and might cause neonatal complications, the aim of this study is to assess appropriateness of the procedure. As a result, our narrative review aims to present some insights on this contentious topic based on both medical and psychological literature. Recognizing and accepting the role of biases is only the first and unavoidable step toward any effective intervention proposal. Furthermore, advances in information technology have given us powerful tools for addressing and preventing errors in health care. There are several approaches to bias mitigation, some of which may be impractical. Because suboptimal diagnostic reasoning processes can have dramatic consequences, the clinical setting is an ideal setting for developing targeted interventions to reduce the rates and magnitude of biases. Unfortunately, heuristics frequently misguide us, and we fall victim to biases and systematic distortions of our perceptions and judgments. Indeed, cognitive shortcuts lead us to solutions that are sufficiently satisfying to allow us to make quick decisions. Our cognitive sources' limitations, as well as the need for speed, can frequently impair the quality and accuracy of our reasoning processes. Every day, we must make decisions that range from simple and risk-free to difficult and risky.
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