Acute Illness Presentation – Testicular Torsion

Week 3: Acute Illness Presentation – Testicular Torsion

By: Travis Ang, Soseh Babayan, & Bernadette Ashley Villena

FNP 594

Overview of the Health Issue

Testicular torsion:

Twisting of the testicles around the spermatic cord

Impaired blood supply

Permanent ischemia or damage to the testicular tissue

Urological emergency → timely intervention is essential as ischemia depends on the time frame of the torsion and the extent of twisting

(Laher et al., 2020)


Can occur at any age, yet most common in:


Adolescence → 12-18 years old

Peak → 13-14 years old

Incidence in males under 25 years old

1 in 4000

(Laher et al., 2020)

Risk Factors


Teenage males

Under 25 years old

Family history

Increased risk if relative had prior history

Sports injury or trauma

High-impact sports

Torsion can happen at any instant, even when asleep

(American Academy of Pediatrics, 2023)

Signs and Symptoms

Pain, pain, pain! (unbearable pain in the scrotum with a sudden start)

Scrotum swelling with no particular reason like trauma

Nausea and vomiting

Uneven testicles, one high riding testicle


Scrotal erythema

(Mayo Foundation for Medical Education and Research, 2022)


Anatomy and Physiology

Testes-male sex organs responsible for the creation of sperm and testosterone secretion

Scrotum-sac that holds the epididymis, testes, distal parts of the spermatic cord

A sudden twist of the testes around the spermatic cord due to the testes not being attached well

The testes are being “put in the a choke hold” cutting all blood supply to the testicles causing the spontaneous pain, swelling and the unbalance

(Urology Care Foundation, 2022)

Diagnostic Tests

Power doppler ultrasound- most sensitive at detecting flow in and out of the testicle

Color doppler ultrasound- can show the speed and direction of blood flow with colors

Urinalysis-can detect WBC to determine if cause was from infection

(Advanced Radiology Consultant, 2021)

Treatment Methodologies

Surgery is required to correct testicular torsion

The sooner the testicle is untwisted, the greater the chance it can be saved.

After 6 hours from the start of pain, the chances of needing testicular removal are greatly increased.

In some cases, manual detorsion can be attempted

Surgery is done under general anesthesia, surgeon will make a small incision in the scrotum, untwist the spermatic cord, and stitch one or both testicles inside the scrotum.

Testicular Torsion in newborns and infants

Very rare, but can occur

(Schick & Sternard, 2022)

Differential Diagnosis

Epididmyitis (N45.1)-Erythema, Swelling and pain

Orchitis (N45)-Swelling in one or both testicles, pain, fever

Testis tumor (C62.90)-Pain, discomfort, swelling

Symptomatic hydrocele (N43)-Swollen testicle or testicular discomfort

Scrotal hematoma (S30.22XA)-swelling, pain, and bruising of the scrotum

(Schick & Sternard, 2022)

Needs of the Patient &/or Family

Post-Operative Education:

Pain medicine, rest and ice therapy will relieve pain and swelling after surgery

Rest at home for several days

Wear a scrotal support for a week after surgery

Avoid strenuous activities for 1 to 2 weeks,

Resume sexual activity after 4 to 6 weeks.

Educate boys that they can still live a normal life following testicular torsion surgery. The loss of one testicle won’t keep a man from having a normal sexual relations and is still likely to father children when the time is right.

Don’t miss follow-up appointments with your urologist after surgery.

(Mount Sinai, 2021)


Advanced Radiology Consultants. (2021). Color and power doppler ultrasound. Retrieved March 14, 2023, from,the%20direction%20of%20blood%20flow.

American Academy of Pediatrics. (2023). Testicle pain & testicular torsion.

Mayo Foundation for Medical Education and Research. (2022, February 24). Testicular torsion. Mayo Clinic. Retrieved March 14, 2023, from

Mayo Clinic. (2022). Testicular Torsion. Retrieved from,usually%20done%20under%20general%20anesthesia.

Mount Sinai. (2022). Testicular Torsion. Retrieved from,about%204%20to%206%20weeks.

Laher, A., Ragavan, S., Mehta, P., & Adam, A. (2020). Testicular torsion in the emergency room: A review of detection and management strategies. Open Access Emergency Medicine, 12, 237-246.

Schick, A. M., & Sternard, T. B. (2022). Testicular Torsion. Retrieved from,other%20etiology%2C%20and%20scrotal%20hematoma.

Urology Care Foundation. (2022). Testicular Torsion: Symptoms, Diagnosis & Treatment. Retrieved March 14, 2023, from

Thank you for viewing 🙂

-Travis, Soseh, & Bernadette

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Theories used in the study are Expectancy-Value Theory

Please provide at least 150-word response to each student response below. Be sure to research/cite/reference sources in each discussion.

1st Post:

The dissertation I used has the same topic I would like to use “A Case Study on Full-Time Faculty Perceptions of Classroom Assessment” (Pottinger, 2021).  

The literature review consisted of the following topics: “Introduction and Background, Gaps in the Literature, Theoretical Frameworks, Assessment, Method, Instrumentation, and Summary” (Pottinger, 2021, p. ix). The introduction included the purpose of the study which was to determine faculty perceptions of assessment, building on current assessment models, and the development of best practice assessment in online courses (Pottinger, 2021). The background information included the difference between formative and summative assessment (Pottinger, 2021). The researcher also indicated the desire to learn faculty perceptions of knowledge and use of formative assessment (Pottinger, 2021). Finally, the background included the correlation between formative assessment and teaching/learning (Pottinger, 2021). I consider the detailed introduction and background strong strengths of this literature review (Roberts & Hyatt, 2019). I agree with Pottinger (2021) that it is important to set up the literature review by restating the purpose and providing a strong background on assessment. I also hope to add information linking assessment to program/institutional accreditation and, therefore, the importance in conjunction with institutional effectiveness and the university’s strategic plan. Gaps in the literature revealed a lack of perceptions from faculty particularly those teaching the course (Pottinger, 2021). I’m not sure if I will include the specific assessment models since they may not be relevant to the population I select, whereas Pottinger’s sample used the Classroom Assessment Techniques model of assessment—CATs (Pottinger, 2021). 

Theories used in the study are Expectancy-Value Theory, Theory of Multiple Intelligences, Transformational Reflection Theory, and Transactional Distance theory (Pottinger, 2021). Another strength of the dissertation was the pyramid of hierarchy used to visually depict the amount of use of the theories and the importance of the theories in terms of assessment, teaching, and learning (Pottinger, 2021). 

The only weakness I can identify is the lack of information on the evolution of faculty roles and the possible reason why faculty may not be driving assessment in their respective institutions (Middaugh, 2010). 

2nd Post:

The dissertation selected is from Warner (2019) on the corporate learner and asynchronous online learning. The literature review section for this dissertation is presented via the textbook checklist:

1. Yes, the review is comprehensive.

2. Yes, there is one primary and six secondary variables that are addressed.

3. Yes, the doctoral student has a balanced review of the citations combining key points with critical analysis.

4. Yes, Chapter 1 had key definitions, historical foundations, and research questions which segued logically into Chapter 2 literature review.

5. Yes, the review expanded on the variables, audience, and concepts.

6. Yes, between the first two chapters there is a good coverage of historical and current methodologies and theories.

7. Yes, the review used credible sources that were properly cited.

8. No, each section of the review built on the previous without presenting opposing views.

9. Yes, summaries and subsections are well structured.

10.  Yes, primary sources are well represented.

11.  No, minimal to no quotations are used. Paraphrasing and critical analysis used.

12.  No, primary sources that complement each other are presented separately.

13.  Yes, it is well written and is not just a catalog of sources.

The University that the doctoral student was in uses a similar format as Aspen University or the textbook (Roberts & Hyatt, 2018).

 3rd Post:

When writing the literature review, the dissertation student develops the review in a manner writing what journalists/authors have disclosed concerning a chosen topic. The dissertation student writes what is known about the topic in a manner to intrigue the reader. One of the goals requires writing carefully revealing points such as a bridge of the introduction chapter to the literature review. When reviewing a literature review, the dissertation student takes the opportunity to assess for common writing problems. 

For an example, the author of a massive topic and literature review will lose the reader/audience if the reading becomes easily disorganized. Zacharzuk-Marciano, 2017 provided mass information in the literature. The use of an employ table could have organized the mass literature. The use of subheadings could have supported the organization of information in the literature review for the reader. Zacharzuk-Marciano, 2017 provided headings with seldom use of subheadings. Overall, the literature provided a thorough synopsis of the problem with key focus points. With the literature review being massive, the author should be careful not to string together the works cited and control the amount of literature reviewed by avoiding including enormous pieces of literature read. 

4th Post:

For many writers, the literature review procedure might be a difficult undertaking. It necessitates extensive investigation, planning, and critical thought. Unfortunately, many writers struggle with common writing problems that can make the process even more difficult.  One of the most common writing problems in the literature review process is the lack of a clear focus. Writers often struggle to narrow down their topic and develop a clear thesis statement. Without a clear focus, the literature review can become unfocused and disorganized. Writers should take the time to brainstorm and develop a clear focus for their literature review before beginning the research process. 

Another common writing problem is the lack of organization. Writers often struggle to organize their research and ideas into a cohesive structure. Without a clear organizational structure, the literature review can become confusing and difficult to follow. Writers should take the time to create an outline and organize their research into a logical structure.  A third common writing problem is the lack of critical thinking. Writers often struggle to analyze and evaluate the research they have gathered. Without critical thinking, the literature review can become a summary of the research rather than an analysis of the research. Writers should take the time to think critically about the research and draw meaningful conclusions. 

Finally, writers often struggle with the lack of adequate citations. Without proper citations, the literature review can become plagiarized, and the writer can be accused of academic dishonesty. All sources utilized in the literature review should be correctly cited, therefore writers should take their time. In general, many writers find the process of conducting a literature review to be challenging. However, by taking the time to address these common writing problems, writers can ensure that their literature review is well-written and effective.

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For a healthcare organization to be politically viable it must have influential stakeholders.

State : Texas

 For a healthcare organization to be politically viable they must have influential stakeholders. In that, the stakeholders must understand limitations and be able to adopt accordingly. In a minimum of 250 words, discuss the following:

  • Highlight and present one key player/stakeholder (i.e., federal, state, or local) in political health policy in your state.
  • Choose two state/local/federal healthcare organizations. Then, compare and contrast their political viability in terms of one/more of their health polic(ies).
  • Apply the “method for analyzing political feasibility” as defined in Chapter 10 of your textbook to define your key player’s viability.

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Assessing value in health care is based on the outcome


Assessing value in health care is based on the outcome. The policy that is implemented to analyze value must be one that is specific to the healthcare organization, and must address the value issues (i.e., past, current, and forecasted). It is important to note that ethics and values are both inclusive and exclusive of each other in terms of policy; from both the stance of “professional decision-making” and “policy analysis.” In a minimum of 250 words, discuss the following:

  • Review the “General Requirements for Informed Consent” in Chapter 12 of your text.
  • Create an Informed Consent (for a hypothetical human subject research) using items 1 – 8 under Section A.

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Nursing Theory

A nursing theory is defined as a collection of rigorous and creative ideas that postulate a tentative and purposeful view of phenomenon. Nurses often can develop knowledge through systematic inquiry that is relevant and essential in the improvement patients’ care. A theory is a coherent collection of general opinions that are used for the purposes of explanation. Nursing theories are pivotal since they lead to the formation of knowledge in the profession of nursing (NSW Health, 2011). Before the evolution of nursing theory, professionals made limited attempts to contribute towards knowledge formation. Therefore, it is essential for a nurse to make use of any nursing theory of choice to inform the direction of practice towards the achievement of specific professional goals. In my practice, I use Patricia Brenner’s novice to expert theory to guide my most important decisions.

According to Benner (1984), expert nurses can only develop and nurture their current nursing practices through a sufficient educational background coupled with the right combination of experience. According to her, an individual is able to “know how” without necessarily “knowing that.” In other words, she believes that one can obtain knowledge and skills without necessarily turning to theory for assistance. The development of knowledge in the practice of nursing extends to gaining practical knowledge through performing research. Therefore, the theory is conceptualized on the basis that experience is the basis for one to become an expert nurse. Besides, she proposes several levels of nursing experience beginning with novice then to advance beginner, competent, proficient and ending up with the expert. A novice is a beginner without any practical experience while and an advanced beginner can demonstrate some level of skills. The expert is one who no longer relies on guidelines or principles and rules during practice.

In my own practice, I have always strived to ensure that I offer the best quality care to the deserving patients. Therefore, as Patricia postulates, the practice ought to have a firm foundation of knowledge and skills to enable myself, and any other nurse achieves this goal. She reiterates on research, which is an essential part of the practice. Research is the only means by which one can develop from being a novice to an expert (Fitzpatrick & Gripshover, 2016). The reason is that, through research, one is capable of unraveling vast information on a particular topic.  As a consequence, these can then be applied in the practical areas of the profession. Information is vital in attempts to offer quality health care just as skills and knowledge are.

Through attending this course, I managed to develop leadership skills that are essential in my professional practice. Furthermore, I also learnt the benefits of adopting research in the practice of nursing towards building knowledge. The skill has assisted me in making good use of my nursing theory, which also emphasizes the use of research for knowledge creation. The knowledge is then critical towards becoming an expert. Noteworthy, those were the goals and objectives that I had in mind when making a choice to take this course. However, the seven domains of practice were not on my mind at that time. Finally, I was able to timeline of practicum activities that were set at the beginning of the course. As a consequence, this, too has assisted me towards my drive of developing myself into an expert nurse.


Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice.       Menlo Park: Addison-Wesley, pp. 13-34.

Fitzpatrick, S. & Gripshover, J. (2016). Expert nurse to novice nurse practitioner: The journey     and how to improve the process. The Journal of Nurse Practitioners, 12, (10), 419-421.

NSW Health. (2011). Benner’s stages of clinical competence. NaMO – WOW Project tool.           Retrieved from   expert-benner.pdf

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Deconstruction Theory

Deconstruction Theory

Deconstruction is a philosophical word that has been in use since the 1960s. Jacques Derrida initially used it as he sought to understand conceptual distinctions in western philosophy by closing examination of language and philosophical logic. It is an approach historically used when people want to establish the relationship between text and their meaning. Derrida read as many texts as he could in his effort to discover how this different text affects the intended meaning of the same text. The sole aim of deconstruction is to help people understand how different text and languages used in a text are irreducibly complex and unstable.

The assumption that language cannot render truths about the world in an objective manner is based in the fact that deconstructionism considers that connotation is revealed through exploratory organizational codes in the manuscript and that there is not ‘one’ precise meaning in a poem. Instead poems can be tacit from a different perspective. This is to mean that with different perception and understand of words; it is difficult to understand the world decisively.

The second assumption of deconstruction that states language is a thought prison is based on the fact that language tends to affect the way people see the world. There is a difference in how people will understand the same term. Some words tend to alter and change the perception of things people know little (Powell, 2006). Some languages tend to have many words that are supposed to describe one thing, to this end, there is a limitation on how one is by their own languages since it is hard to express what they see and feel. The effect then is peoples understanding and action will be dictated by how they will understand some issues and perceive the world.

The reasoning for the third assumption language is an arena of power is based on the fact that words tend to derive meaning from other words and these meaning will work differently. A language is a powerful tool that for different people who will choose to use the language the best way they deem fit: Language present people with the power to understand and take actions.

Critics of Deconstructive who have used it in a critical manner believe that text tends to deconstruct themselves, and it is not the critics who deconstruct the text to show people the extent to which the text is a challenge to itself hence dismantling itself. It can then be deduced through the deconstruction, that textual meaning is not infinite; there is much importance in close reading, the meaning of the text in a various way (Powell, 2006).  It also indicated that the text didn’t have a unified, logical whole meaning. According to Jacques, deconstruction, the textual part of the story tends to have more than one meaning hence giving different storylines and endings.

The Reasoning behind the Three Primary Assumptions of Deconstructionism

Truth has been defined as something that corresponds to its objects and one that is able to describe or place the actual status of issues (Still, 2012). According to this explanation, truth tends to correspond with the reality; in another word, truth does not contradict the reality of affairs. According to Christianity, the truth is narrow by nature as it tends to go against the opposite. Contrary to the relativist who believes that it is hard to know the reality, that is exaggerated and inconsistent, Christian believes that there is truth in the word of God, the truth that cannot be changed but stands firm to the test of time. Christian believes that it is essential for people to understand the reality in order to be in a position of questions the nature of one’s reality. God is the truth, is intricate and appreciates the personality of His creation. He is the representation of truth articulated through the Holy Book, and whatever he says about His conception is accurate and commanding. God has made man in His image with the aptitude to comprehend truth and know the truth. The correspondence philosophy is reinforced in the Old and New Testament.

Christians believe that God is the source of truth. He is moral and personal. According to the Bible, 2 Timothy 3:16 states, “All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness.” In this statement from a verse in the Bible indicates that the Bible serves as the guideline to the Christians and leads them to the truth, which is the expectation of God. And that God is the one who embodies truth and will ensure people understand the truth heavenly language that God Himself invented and has been part of his kingdom. The heavenly language has since been used to help people understand God and his true nature purposely to increase people’s Faith on him. Through the word, Christians have received truth and believed that their faith is based on the truth they get from the Bible. This truth is on God. In order to fully understand this truth, they regularly attend their various religious gathering to be taught the word of God.


Powell, J. E. (2006). Jacques Derrida: A biography. London: Continuum.

Still, J. (2012). Derrida and hospitality: Theory and practice. New York: Edinburgh University Press.

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Einstein’s Theory of Light (relativity)

Einstein’s Theory of Light (relativity)

For many decades Isaac Newton’s theory on the law of motion remained unquestioned. This was not until the 20th century when Albert Einstein published the theories of relativity. The theory proofs that Isaac Newton theory of the law of motion as approximate and not sufficient to explain all parameter of light, speed and energy.  Albert Einstein published two relative theories: special relativity theory and general relativity theory (Einstein, 2013). The former was developed in 1905 while general relativity theory was developed in 1916. The development of the two theories was based on several empirical studies and theoretical research that was done by Albert Einstein and his colleagues. The special theory became important in the fields of nuclear physics, atomic physics, and quantum mechanics in 1920s after many years of denial in the field of physic due to complications of its mathematics (Einstein, 2013).  General relativity theory forms a basis of modern scientific inventions such as GIS. The theory was not easily accepted due to its complexity. In its initial time, the theory was seen as a minor development of Newton’s theory of gravitational pull. A small number of individuals only understood the mathematics of the theory and very few experiments could be done to prove the theory because it required astronomical scale experiment. The theory became relevant in the 1960s after the discovery of astronomical phenomena like quasars in 1963, microwave background radiation in 1965, pulsars in 1967 and black hole candidates in 1981 (Einstein, 2013). The experiments that accompanied these phenomena confirmed the theory and asserted it to be true.  The two relative theories of Albert Einstein determine the law of physic, and they are very significant to theorist in modern physics.

Special theory is composed in Einstein paper of electrodynamics of the moving bodies of 1905. The special relativity theory bases its arguments on space-time. The theory is the development of Newton’s theory of absolute space-time. Einstein’s paper had a new definition of space and time. Einstein came up with two important principles which are the principle of relativity and constancy of light.  Special relativity theory had two postulates which are the principle of relativity which states that so long as the two moving bodies are moving in the same direction at a constant speed without acceleration, the law of physic is the same to every individual  (Einstein, 2013). To explain this principle he used an example of an observer resting in a train with another train opposite to one of the observer. He further explained that the observer might fail to tell if the next train is moving or they are moving if the speeds of the two trains are constant. To acknowledge this principle, Einstein states that it is impossible to tell if the motion is perfectly uniform for the two moving bodies. The second postulate in special relativity theory is constancy of light. According to Einstein (2013), the speed of light is constant in all aspects no matter is the observer, or the source of light is moving.   With this two postulates, Einstein developed consequences of special relativity theory to show that space and time are usually intertwined the way classical scientist had not discovered. One of the consequences is that the faster the body goes, the heavier it becomes, and more resistance is created to stop that body to move faster. In this way, he proved no object that has a mass that can be able to have the speed of light. The other consequences is that matter and energy are intertwined using the well-known formulae of E=mc2 (E means energy, m mass and c speed of light) (Einstein, 2013). The speed of light is a very large number that means even a very tiny particle can emit a massive amount of energy; a good example is the atomic and hydrogen bomb (Einstein, 2013).

General relativity was developed between 1907 and 1915 by Albert Einstein to elaborate more on gravitational force.  The theory was developed on two equivalent principles which are accelerated motion and resting on gravitational field. The outcome for this he stated that free fall is inertial movement. To explain this, he stated that the object released freely in the air falls because that is how that object moves since no force has been applied to them or instead it is because of the force of gravity as proposed by a classical scientist on the law of motion and force of gravity.  He proposed that the gravity is curved. The more massive an object is, the more it curves the space around it (Einstein, 2013). To elaborate this, he used an example of the sun in the solar system as the more curved object that is why planets move on the warped paths around it. The consequence of this theory is that the clock is faster when is away from the gravitational field a good example is that clock appears to trickles faster on a mountain than in a deep valley. The light bends due to the gravitational force (Einstein, 2013).

Albert Einstein published the two theories of relativity in the 20th century. The two theories are special relativity theory and general relativity theory. The special relativity theory was first to be developed and talks about space and time. This theory has two ideologies which are the standard of relativity and standard of light constancy. The general relativity theory was developed later, and it explains more on gravitational force the way classical mechanic fails to elaborate.


Einstein, A. (2013). Relativity. Routledge.

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Criminological Theory

The importance of theory: This paper will be a reflective paper where you critically analyze the roots of theory and develop a hypothesis as to why theory is important in studying the criminal justice system. This paper will be 4-6 pages in length.  Your paper must include (1) the name and theorist of your chosen topic, (2) a brief description of the important aspects of the theory, (3) how the theory can be useful for practical application, (4) why you think the theory is useful and needed in criminal justice study.

Annotated Bibliography Template

The concept of critical thinking has become a boon to society. The apparent inability of students to constructively engage in thought processes that are not preconceived or concretely provided to them has hampered academia from advancing past institutions of memorization. Taking the Vygotskian theory of how cognitive thought processes are developed in childhood and demonstrating that in adolescence or young adulthood is a challenge that researchers have studied. The three following journals have incorporated the concept of critical thinking. The two supplemental articles were obtained by searching for peer-reviewed articles using the terms Vygotsky and critical thinking.

Wertsch, J. V. (2008). From social interaction to higher psychological processes: A clarification and application of Vygotsky’s theory. Human Development, 51(1), 66–79.

The Wertsch article provided two key elements concerning Vygotsky’s speech, language, and thought stance. First, a clarification was necessary due to an inaccurate translation from Russian to English. Without proper understanding due to conceptual inaccuracies, the theorist has been misunderstood and thus not lauded for the use and distinction between speech and language. It further explained from an empirical study how the relationship develops between adults and children and how children can better develop their ability to discern what needs to be done by less adult verbiage and more of their critical thinking skills.

The paper concluded that there are four transitions or means by which adults provide direction to children, and children interpret and carry out those orders. Of the identified transitions from adult instruction and child interpretation, the ability of children to carry out direction comes from their preconceived definition of how that translates to a behavior. Within the complex strategies that develop within children and what they deem appropriate responses, some are correct, while others are not.

The article provided a clear view of Vygotsky’s intended use of the development of mental functioning from childhood to adulthood, particularly in interaction between parent and child. The idea that children can develop their problem-solving method without an adult’s aid is derived. Exploration of how this develops when children are observed completing tasks without adults offering hints or directives or how children misinterpret directives further indicates how critical thinking skills are formed.

Wass, R., Harland, T., & Mercer, A. (2011). Scaffolding critical thinking in the zone of proximal development. Higher Education Research & Development, 30(3), 317-328. doi:10.1080/07294360.2010.289237

Wass, Harland, and Mercer’s peer-reviewed article provided empirical research data through observation of zoology undergraduate students regarding developing critical thinking skills. The progression from providing academic materials for coursework through information needed to ascertain conceptual aspects allowed the evidence of the zone of proximal development in the students. Vygotsky’s developmental theory becomes apparent through the social aspect of group interaction and the ability to discern complex concepts.

It was apparent from the findings that as time progressed, so did the ability to discern and apply information. Students learned to open up more to teachers and peers. With that experience, they could better discern information and support other students. As the information became more complex, so did their ability to offer up more intricate methods of discovering newer information. Students would be more apt to develop better critical thinking skills if they are left to seek it independently instead of merely being provided to them.

Vygotsky theorized that people develop skills somewhere between the information being offered and the final ability to distinguish new concepts on their own. Through Wass, Harland, and Mercer’s experiment, discovery of how to function as an academic was obtained after a short time of information provided through course material and superficial interaction. The zone of proximal development was established not far into their first-year experience allowing the students to function on a higher plain.

Lyutykh, E. (2009). Practicing critical thinking in an educational psychology classroom: Reflections from a cultural-historical perspective. Educational Studies: Journal of The American Educational Studies Association, 45(4), 377-391.

Lyutykh focused on her psychology students and their inability to inquire critically. Emphasis was also placed on how culture plays a role in developing one’s ability to complete tasks in a simple or complex manner. Intertwined with student observations is the author’s history and upbringing in the Soviet Union. The rigid structure placed on society in that setting was analyzed through the lens of social construct and how it influenced individual thought.

Assessing a student’s inability to engage critically predisposes the individual to merely regurgitating what others have taught them prior. The author actively engages her students to avoid what makes them comfortable and challenges them to disregard preconceived notions. The realization that although what is believed by each student is difficult for them to release, a constant challenge must be made to encourage their push further from what is known.

Critical thinking and inquiry are concepts that cannot develop within a vacuum. Vygotsky theorized that guidance from others who are more knowledgeable is a start, but it is left to individuals to assimilate from all sources as much as possible. Pinar et al. stated that there is a plethora of material out there to reference through a worldview that provides a great wealth of information for the “extraordinarily complicated conversation” that learning is supposed to be (as cited in Lyutykh, 2009, p. 389).

Whereas critical thinking skills develop in childhood, they can be honed over a lifetime. While education plays an extremely vital role in practicing those skills, individuals have a personal responsibility to exercise their critical thinking ability. Assessments can be developed indicating how far an individual’s ability to think abstractly has been established and exercises created to help those who lack advancement.


Lyutykh, E. (2009). Practicing critical thinking in an educational psychology classroom: Reflections from a cultural-historical perspective. Educational Studies: Journal of The American Educational Studies Association, 45(4), 377-391.

Wass, R., Harland, T., & Mercer, A. (2011). Scaffolding critical thinking in the zone of proximal development. Higher Education Research & Development, 30(3), 317-328. doi:10.1080/07294360.2010.289237

Wertsch, J. V. (2008). From social interaction to higher psychological processes: A clarification and application of Vygotsky’s theory. Human Development, 51(1), 66–79.

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Anthony Giddens and Erik Olin Wright’s Theory on Middle Class

Answer the following question. Make sure your answer to the question you chose is set out in terms of the concepts developed in this course. You should include in your answer at least a total of two or three quotations from Wright and Giddens that you explain in detail.

Anthony Giddens and Erik Olin Wright’s Theory on Middle Class

First spell out Wright’s analysis of the middle class or what he refers to as the two contradictory class locations of the managers/supervisors and the semi-autonomous professional as located between the dominant capitalism class (bourgeoisie) and the subordinate class (proletariat). (Note, there is no need to discuss what Wright refers to as small employers, as they are not part of the middle class.)
Second, also present Giddens’ understanding of the middle class as based upon its market capacity (possession of high educational qualifications) in relation to the upper class (ownership of the means of production) and working class (possession of manual labor-power.)

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Critique The Theory Of Self-Efficacy Using The Internal And External Criticism Evaluation Process

Title off Discussion of week 2 : ” Making judgement as to whether a theory could be adapted for research is significant.  Describe the internal and external criticism that is used to evaluate middle-range theories. “

Critique, The Theory Of Self-Efficacy, Using The Internal And External Criticism Evaluation Process

 Evaluating middle-range theories is essential to advancing the nursing field of study. It helps ensure that the appropriate concepts are used in research tasks, leading to accurate and useful data gathering and interpretation. This is done by examining the theory’s internal consistency, coherence, and empirical accuracy, as well as its external validity and comparability to other theories and empirical data. Further, it is essential to evaluate the theory’s parsimony.

Internal criticism is essential to evaluating a theory’s logical consistency, coherence, and empirical accuracy. This type of criticism involves examining the internal structure of a theory to determine its logic, consistency, and coherence. Examining the theory’s assumptions, ideas, and hypotheses is part of this process. Examining the conceptual definitions and connections between ideas in a theory is an important part of internal critique. This ensures that any inconsistencies or gray areas inside the idea are identified and addressed (Khoshnood, Rayyani & Tirgari, 2020). A logical contradiction may exist, for instance, if a theory defines a notion in one manner and then utilizes it differently. It can also be challenging to grasp a theory and apply it to empirical evidence if its notions are not well-defined or are too ambiguous.

            External criticism is essential to evaluating a theory’s external validity or how well it applies to other settings or populations. This critique looks at how well a theory generalizes by contrasting it with other ideas and evidence. Evaluation of a theory’s external validity involves testing its assumptions, ideas, and hypotheses in various contexts and with other populations. A key aspect of external criticism is the evaluation of a theory’s assumptions (Smith, 2019). A theory’s assumptions are the basic ideas or beliefs upon which it rests. A theory’s external validity can be compromised, for instance, if it presupposes that all members of a given population act in the same manner. Any further challenge in evaluating the generalizability of a theory arises if its underlying assumptions are either poorly defined or too nebulous.


Nursing theory is always developing, and as a result, evaluation of intermediate ideas is essential. One approach to nursing theory that seeks to bridge the gap between research and practice is “middle-range nursing.” Compared to other types of theories, such as the grand theories of nursing, middle-range theories are simple to put into practice because they are more detailed, have a clearer focus, and have a narrower scope. Both external and internal critique examines the efficacy of midrange ideas.

Reference :

 Khoshnood, Z., Rayyani, M., & Tirgari, B. (2020). Theory analysis for Pender’s health     promotion model (HPM) by Barnum’s criteria: a critical perspective. International    journal of adolescent medicine and health32(4).

Smith, M. C. (2019). Nursing theories and nursing practice. FA Davis.

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