Background: Medical education requires innovative approaches to enhance critical thinking, decision-making, and ethical reasoning. The "hot seat" method simulates real-time clinical and ethical scenarios, promoting rapid analysis. This study aims to review its applications, benefits, limitations, and challenges to improve educational quality and clinical skill development.
Materials and Methods: This narrative review conducted a comprehensive literature search using English and Persian terms such as hot seat, medical education, critical thinking, clinical decision-making, ethical reasoning, simulation-based learning, interactive teaching, problem-solving, and student engagement. Searches across Scopus, ERIC, Web of Science, PubMed, SID, CIVILICA, and Google Scholar up to April 2025 were screened by two independent reviewers. Extracted data were qualitatively analyzed to identify key themes.
Results: The evidence review shows that the "hot seat" method has significant potential to enhance medical students’ critical thinking, clinical decision-making, and ethical reasoning. Its advantages include increased confidence in decision-making, enhanced active participation, improved communication skills, and bridging theory with clinical practice. However, challenges such as anxiety induction, unequal student participation, high resource requirements, and possible negative experiences exist. Implementation obstacles include insufficient faculty training, institutional limitations, and variability in facilitation quality. This method is applied across pathology, dental, allied health, and general medical education. To optimize its use, gradual introduction, creation of safe learning environments, encouragement of peer support, integration of technology, continuous feedback collection, and comprehensive facilitator training are recommended.
Conclusion: The "hot seat" method enhances critical thinking, decision-making, and ethical reasoning by engaging students in realistic scenarios. It promotes active learning and bridges theory with practice but faces challenges such as student anxiety, resource demands, and faculty training. Gradual implementation and supportive strategies can optimize its effectiveness.