Digital learning designs in occupational therapy education: a scoping review

BACKGROUND

Digital learning is a rapidly advancing method for teaching and learning in professional health education. Although various digital learning designs have been tried in OT education, studies on digital learning designs are still limited.

METHODS

We conducted a scoping study that aimed to identify the digital learning designs used in occupational therapy (OT) education and review the effectiveness, learner perceptions, clinical skills integrated, and technology-based learning strategies used to facilitate learning. Four databases were searched using subheadings and terms relating to digital learning, occupational therapy, and education. The included studies were mapped according to the types of digital learning design, subjects, key clinical skills, and outcomes.

RESULTS

Twenty-two studies were included in this review, most of which were qualitative, observational, or mixed studies of the two designs. The digital learning designs identified in OT education were flipped, blended, hybrid, and distance learning, including e-learning and massive open online courses (MOOC). Among the components of clinical skills, professional reasoning and procedural knowledge were the most integrated into digital learning, and covered various OT subjects. Digital learning designs were reported to be equivalent to or more effective than the traditional face-to-face (F2F) class in learning outcomes of knowledge and skill acquisition, enhancing learning participation, reflection, and collaboration between learners. Various technologies have been used to promote synchronous or asynchronous active learning, providing learning strategies such as thinking, reflection, discussion, peer learning-group activity, and gamifying online learning.

CONCLUSIONS

In OT digital learning, appropriate learning subjects, the arrangement of clinical skill components that can be well integrated into digital learning, and the selection of appropriate technologies for effective learning are important. The results should be confirmed within an experimental study design.

Virtual reality in midwifery education: A mixed methods study to assess learning and understanding

BACKGROUND

Virtual reality learning environments (VRLEs) are a potentially valuable learning tool that have recently increased in popularity due to widespread availability and decreased cost. VRLEs can provide an immersive learning environment that increases the understanding of three-dimensional relationships between anatomical structures. However, there is a paucity of evidence in the literature supporting its use within Midwifery education.

OBJECTIVES

To explore the effectiveness of a VRLE as an educational tool in midwifery education.

SETTING

A large University in Ireland, with institutional ethical approval.

PARTICIPANTS

Undergraduate and graduate degree midwifery students.

DESIGN

A descriptive qualitative and quantitative study was carried out. Data collection was carried out between September 2020 and March 2021.

METHODS

Participants underwent a VRLE lesson based on the topic of fetal lie, position, and presentation in pregnancy. A multiple-choice questionnaire was used to quantitatively evaluate knowledge before and immediately after the intervention, and knowledge retention after one week. Qualitative data was collected using open-ended questions in the questionnaire. The primary outcome was a difference in pre- and post-intervention knowledge scores. Data was analysed using repeated measures one-way ANOVA. Qualitative data was analysed using thematic analysis and simple content analysis. All students participated in the quantitative and qualitative components of the study. Secondary outcomes included participant satisfaction and self-confidence in learning which were analysed using thematic analysis. The side effect profile of the virtual reality device was also explored using open-ended questions in the questionnaire.

RESULTS

Forty-one midwifery students participated in the study, with a 100 % participation and response rate. Repeated measures one-way ANOVA revealed no statistically significant differences in knowledge scores pre- and post-intervention. Participants rated high satisfaction and self-confidence scores with regard to the VRLE as a learning modality. Side effects most commonly experienced by participants included dizziness (49 %), disorientation (30 %) and symptoms similar to motion sickness (32 %). The following themes were identified: "Learning in 3D", "The Power of Visual Learning", "The value of Educational Technology", "Learning can be fun and enjoyable".

CONCLUSIONS

This study showed that the VRLE had no impact on knowledge gain, though high levels of satisfaction and self-confidence indicate a positive response to the VRLE. VRLEs are a potentially valuable learning tool to help enhance the student learning experience, promoting increased engagement, satisfaction, and self-confidence with the learning material.

Online Courses Provide Robust Learning Gains and Improve Learner Confidence in the Foundational Biomedical Sciences

The early stages of medical school involve education in a number of foundational biomedical sciences including genetics, immunology, and physiology. However, students entering medical school may have widely varying levels of background in these areas due to differences in the availability and quality of prior education on these topics. Even students who have recently taken formal courses in these subjects may not feel confident in their level of preparation, leading to anxiety for early-stage medical students. These differences can make it difficult for instructors to create meaningful learning experiences that are appropriate for all students. Additionally, actual or perceived differences in preparation may lead fewer students from diverse backgrounds to apply to medical school. Therefore, creating an efficient and scalable way to increase students' knowledge and confidence in these topics addresses an important need for many medical schools. We recorded pre- and post-course quiz scores for 9790 individuals who completed HMX online courses, developed in accordance with evidence-based learning practices and covering the fundamentals of biochemistry, genetics, immunology, pharmacology, and physiology. Each question was accompanied by a Likert scale question to assess the learner's confidence in their answer. Learners' median post-course quiz performance and self-assessed confidence significantly increased relative to pre-course quiz performance for each course. Improvements were consistent across US-based medical schools, non-US medical schools, and course runs open to the public. This indicates that online courses created using evidence-based learning practices can lead to significant increases in knowledge and confidence for many learners, helping prepare them for further medical education.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01660-4.

An orange will do: Suspending learner disbelief in simulations

INTRODUCTION

Increasingly, educators are implementing simulation to supplement teaching. Where simulation is not already integral, difficulties have arisen with the utilization of simulation due to limited resources, training requirements, and educator uncertainty.

PERSPECTIVE

A learner's ability to suspend disbelief in a simulation can impact the effectiveness of learning. In other words, they become so immersed in the simulation that they ignore obvious limitations and choose to believe the activity is realistic. When designing simulations, educators need to consider intended learning outcomes (ILOs), realism, and briefings/debriefings to help learners suspend disbelief. Realism encompasses physical realism (fidelity), conceptual realism, and emotional/experiential realism. The ILOs should drive the simulation design and type of realism required. These should be presented to learners in a briefing, explaining where and why they may need to suspend disbelief; this should be reiterated during a debriefing to centre a learner's focus on whether the ILOs were met. Without this, learners may not "buy into" the simulation and instead can get lost in detail not relevant to their learning.

IMPLICATIONS

The use of cutting-edge equipment does not, on its own, ensure that learners get the most realistic learning experience. The goal of simulations should be to utilize resources in the most advantageous manner for attainment of ILOs. In a time when institutions may be pressured for time, staff, and resources, educators should remember that it is possible to facilitate effective learning in low-resource ways.

Framework for developing an exposure science curriculum as part of the European Exposure Science Strategy 2020-2030

BACKGROUND

Evaluating and managing exposures to chemical, physical and biological stressors, which frequently interplay with psychological stressors as well as social and behavioural aspects, is crucial for protecting human and environmental health and transitioning towards a sustainable future. Advances in our understanding of exposure rely on input from well-trained exposure scientists. However, no education programmes in Europe are currently explicitly dedicated to cover the broader range of exposure science approaches, applications, stressors and receptors.

OBJECTIVE

To address this challenge, a curriculum is needed that yields credible, well-defined career pathways in exposure science.

METHODS

Needs and conditions for advancing exposure science education in Europe were identified. As a starting point for a way forward, harmonised learning outcomes for exposure science were defined at each level of the European Qualifications Framework. The course programme coordinators were recruited for three varying courses, with respect to the course level and the proportion of the curriculum dedicated to exposure science. These courses were assessed via our systematic course review procedure. Finally, strategic objectives and actions are proposed to build exposure science education programmes.

RESULTS

The ISES Europe 'Education, Training and Communication' expert working group developed a framework for creating a viable exposure science curriculum. Harmonised learning outcomes were structured under eight learning levels, categorised by knowledge, skills and competence. Illustrative case studies demonstrated how education providers integrated these learning outcomes for their educational context and aligned the overall exposure science curriculum.

CONCLUSIONS

The international recognition and adoption of exposure science education will enable advances in addressing global exposure science challenges for various stressors, from behavioural aspects from individual to population scale, and effective communication between exposure scientists and relevant stakeholders and policy makers, as part of the European Exposure Science Strategy 2020-2030.

Integration of Arts and Humanities in Medical Education: a Narrative Review

This narrative review aims to identify and review the extant literature describing methods and outcomes of embedding the arts and humanities (AH) into medical school curricula. The Association of American Medical Colleges changed the Medical College Admission Test (MCAT) in 2015 to place new emphasis on the role of liberal arts in the process of developing well-rounded physicians. Consequently, medical schools have been implementing more connections to creative writing, literature, theater, movies, music, and the visual arts into their curricula. To review the current literature, we focused on methods medical educators used to embed content related to AH into their curricula to shape and drive associated learning outcomes. We conducted searches in PubMed, CINAHL, PsycINFO, and ERIC for peer-reviewed articles from 2011 to 2020. The authors selected three dyads in medical humanities and reviewed articles independently followed by discussion to identify thematic links to major findings. Out of 261 articles, a total of 177 full-text articles were reviewed with 34 selected for final inclusion. Our review included articles describing curriculum development and delivery in publications from Australia, Canada, India, New Zealand, and the USA. This review showed medical educators are implementing didactic and experiential instructional approaches to embedding the arts, humanities, and social sciences into the medical school classroom. Medical educators' attempts to embed AH into medical school curricula show promising results. Unfortunately, small sample sizes, short-term interventions, and an over-reliance of subjective assessment measures limit our knowledge of the true impact of these interventions. More rigorous assessments of required and longitudinal coursework are necessary to know the true impact of participation in AH coursework for medical students.

How learner engagement impacts non-formal online learning outcomes through value co-creation: an empirical analysis

From the perspective of service science and its core concept of value co-creation, promoting learner engagement is critical for learning outcomes in a non-formal online learning environment. To promote online learning performance, we study how multidimensional learner engagement affects both instrumental and experiential learning outcomes. By incorporating the service-dominant logic perspective into the research model, we designed an online survey to investigate the impact of platform value co-creation on learners' engagement outcomes. By employing a partial least squares-structural equation modeling (PLS-SEM), the results show that behavioral engagement, cognitive engagement, and emotional engagement have a significant impact on learning outcomes through the mediating effect of platform value, a second-order hierarchical latent variable. This study has multiple theoretical contributions and practical implications. First, we found new evidence that pursuing good learning outcomes in a non-formal online learning setting is not just a technological architecture or pedagogic guidelines, but also a "win-win" value co-creation process. Second, our results confirm the posited direct and indirect effects, thus evidencing functional value, emotional value, social value, and personalized value as components of the platform value construct, and it as a driver and mediator for better online learning outcomes. Third, our results underscore the importance of platform value in studying the impact of learner engagement on learning outcomes and provide a sharper theoretical lens to evaluate online learning platform value from the perspective of online learners.

A systematic literature review of requirements engineering education

Requirements engineering (RE) has established itself as a core software engineering discipline. It is well acknowledged that good RE leads to higher quality software and considerably reduces the risk of failure or budget-overspending of software development projects. It is of vital importance to train future software engineers in RE and educate future requirements engineers to adequately manage requirements in various projects. To this date, there exists no central concept of what RE education shall comprise. To lay a foundation, we report on a systematic literature review of the field and provide a systematic map describing the current state of RE education. Doing so allows us to describe how the educational landscape has changed over the last decade. Results show that only a few established author collaborations exist and that RE education research is predominantly published in venues other than the top RE research venues (i.e., in venues other than the RE conference and journal). Key trends in RE instruction of the past decade include involvement of real or realistic stakeholders, teaching predominantly elicitation as an RE activity, and increasing student factors such as motivation or communication skills. Finally, we discuss open opportunities in RE education, such as training for security requirements and supply chain risk management, as well as developing a pedagogical foundation grounded in evidence of effective instructional approaches.

Team-based learning versus interactive lecture in achieving learning outcomes and improving clinical reasoning skills: a randomized crossover study

BACKGROUND

This study aimed to investigate the impact of interactive lecture (IL) and team-based learning (TBL) on improving clinical reasoning skills (CRSs) and achieving learning outcomes (LO). Students' feedback was obtained about the strategies.

METHODS

This study was carried out at the Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia. Two modules, endocrinology, and emergency were selected. Students of each batch in both modules were divided into two arms. With a randomized crossover design, IL & TBL were used for two separate topics in each module. After each topic, a quiz in the form of well-structured MCQs was taken. A questionnaire was designed to obtain students' feedback. SPSS version 23 was used to analyse results. The difference between the mean values was calculated by Student's t-test. Feedback data is presented as frequency. P-value ≤ 0.05 was considered statistically significant.

RESULTS

Learning outcomes were achieved by all groups in two modules, with both instructional strategies, IL and TBL. Students attempted >70% correct answers. However, in the emergency module, the groups with TBL as the instructional strategy performed better in quiz1 and quiz 2 (p = 0.026 and p = 0.016, respectively). Similarly, in the endocrinology module (3^rd year), although the groups with TBL as the instructional strategy performed better in both quizzes, it was significant in quiz1 (p = 0.02). The difficulty indices of the clinical reasoning questions (CRQ) were used as the parameters for comparison. In the emergency module, group1, in quiz1, with TBL as an instructional strategy performed better in the CRQ (p = 0.017), while in quiz2, group2 with TBL as the instructional strategy performed better (p < 0.001). Group1 of the third-year students (endocrinology module) performed better in the CRQ in quiz 1 with TBL as an instructional strategy than group 2 with IL (p = 0.04). Mostly, students in both modules preferred TBL over IL, and especially they liked team application. Students perceived that TBL was a better strategy to learn CRS.

CONCLUSIONS

Students achieved LOs and CRS better with TBL as an instructional strategy. They preferred TBL over IL. It is suggested to include TBL, or increase its percentage, in the curriculum.

An Online Management System for Streamlining and Enhancing the Quality of Learning Outcomes Assessment

Learning outcomes assessment is an effective academic quality assurance tool that enables educators to review and enhance the alignment between planned, delivered, and experienced curricula. Accurately assessing what students know and are able to do after completing a learning module is the first step to decide on the strategies to implement and the proper actions to take in order to ensure the continuous improvement of the student learning experience. Nonetheless, learning outcomes assessment processes in higher education are still facing major challenges that affect their proper and effective implementation. Hence, faculty do not usually experience noticeable improvement in the students' performance over several assessment cycles, which causes their frustration and reluctance to continue participating in the assessment process. This paper discusses the main issues that affect the implementation of the assessment process and prevent the closure of the assessment loop. It also introduces a unified assessment process and an online management system that have been developed recently to address the discussed issues. The online management system streamlines the assessment process, while providing administrators and quality assurance officers with valuable infographics and reports to effectively oversee the implementation of the assessment process. The system has been deployed at the United Arab Emirates University since fall 2018, and has been successfully used by faculty to assess the learning outcomes for more than 1000 courses each semester. Moreover, collected statistics showed that the online features provided by the system allowed faculty to continue their assessment tasks seamlessly during the COVID-19 pandemic.

Teaching design thinking as a tool to address complex public health challenges in public health students: a case study

BACKGROUND

Developing a public health workforce that can understand problems from a population perspective is essential in the design of impactful user-centred responses to current population health challenges. Design Thinking, a user-driven process for problem-defining and solution-finding, not only has utility in the field of public health but stands as a potential mechanism for developing critical skills -such as empathy, creativity and innovation- amongst future professionals. Though the literature reflects the use of DT across many health sciences disciplines, less research has been published on how students apply learned concepts using real-world challenges of their choice and what difficulties they face during the process.

METHODS

This case study evaluates achieved learning outcomes after the introduction of a design thinking block into post-graduate public health curriculum at the University College Dublin. Two independent assessors evaluated student learning outcomes and observed difficulties during the process by assessing group presentations to identify and understand any learning difficulties using an ad-hoc designed tool. The tool consisted of twelve items scored using a 5-point Likert scale. Student feedback, in the form of an online survey, was also analysed to determine their level of enjoyment, perceived learning outcomes and opinions on the course content.

RESULTS

The assessors evaluated thirteen DT group presentations and reports from 50 students. The groups chose a range of topics from socialization of college students during Covid-19 to mental health challenges in a low-income country. Independent assessment of assignments revealed that the highest scores were reached by groups who explored a challenge relevant to their own lives (more than 80% of total possible points versus 60% class average). The groups that explored challenges more distant to themselves struggled with problem finding with a mean score of 2.05 (SD ± 1.2) out of 5 in that domain. The greatest difficulties were observed in problem finding and ideation. Though most students found the design thinking block enjoyable and relevant to their education, they recommended that the DT block be a stand-alone module. Students recognized that groups who chose a familiar topic experienced fewer difficulties throughout the process.

CONCLUSION

The study showed that DT learning outcomes were best achieved when students focused on challenges, they had either personally experienced or were familiar with. These findings provide insight for future iterations of DT workshops and support the teaching of user-centred approaches to future public health practitioners.

Assessment of the impact of co-curricular activities on achievement of Doctor of Pharmacy program outcomes

INTRODUCTION

Co-curricular activities are recognized as an increasingly important aspect of pharmacy education. However, the impact of these activities on student learning is not well understood compared to that of curricular learning. The purpose of this study was to assess student-perceived progress in achieving program outcomes through voluntary co-curricular activities compared with learning of the same outcomes through mandatory curricular activities.

METHODS

The study was performed over six semesters between fall 2017 and spring 2020 at the University of Southern California School of Pharmacy. Separate surveys were sent to all first- through third-year doctor of pharmacy students each semester to assess the impact of curricular and co-curricular activities on improvement in six program outcomes. Graduating student survey data were also mapped to learning outcomes to assess improvement of these outcomes upon graduation.

RESULTS

Three main results emerged from these data. First, there was greater variation in the impact of co-curricular activities on different learning outcomes compared to the effect of curricular activities on the same outcomes. Second, co-curricular activities had a greater impact on "soft skills," including leadership and professionalism, compared to concrete knowledge in areas such as therapeutic mechanisms. Finally, the impact of co-curricular activities on most learning outcomes diminished with progression through the curriculum while the impact of curricular activities remained relatively constant.

CONCLUSIONS

Student-perceived improvement in learning of program outcomes differs when based on co-curricular compared to curricular activities. These results show how these activities can complement each other in achievement of program outcomes.

A novel algorithm-driven hybrid simulation learning method to improve acquisition of endotracheal intubation skills: a randomized controlled study

Background

Simulation-based training is a clinical skill learning method that can replicate real-life situations in an interactive manner. In our study, we compared a novel hybrid learning method with conventional simulation learning in the teaching of endotracheal intubation.

Methods

One hundred medical students and residents were randomly divided into two groups and were taught endotracheal intubation. The first group of subjects (control group) studied in the conventional way via lectures and classic simulation-based training sessions. The second group (experimental group) used the hybrid learning method where the teaching process consisted of distance learning and small group peer-to-peer simulation training sessions with remote supervision by the instructors. After the teaching process, endotracheal intubation (ETI) procedures were performed on real patients under the supervision of an anesthesiologist in an operating theater. Each step of the procedure was evaluated by a standardized assessment form (checklist) for both groups.

Results

Thirty-four subjects constituted the control group and 43 were in the experimental group. The hybrid group (88%) showed significantly better ETI performance in the operating theater compared with the control group (52%). Further, all hybrid group subjects (100%) followed the correct sequence of actions, while in the control group only 32% followed proper sequencing.

Conclusions

We conclude that our novel algorithm-driven hybrid simulation learning method improves acquisition of endotracheal intubation with a high degree of acceptability and satisfaction by the learners’ as compared with classic simulation-based training.

What do I take home after the simulation? The importance of emergent learning outcomes in clinical simulation

BACKGROUND

Clinical simulation learning includes a debriefing after the simulated experience. Debriefing consists of several stages. In this work we focus on the last stage (summary or transfer phase), in which the participants present the most relevant of what they learned during the session.

OBJECTIVES

To analyze the perception of 4th year Nursing Degree students on the most significant aspects they learned during the simulation sessions.

METHOD

A qualitative, cross-sectional and descriptive study was conducted, with students in their last year of the Nursing Degree at the Catholic University of Murcia. The opinions of 67 students from 5 groups, on the debriefing phase, were analyzed, by comparing them with the objectives that were initially proposed during the design of the scenarios used in the simulations.

RESULTS

A total of 78 clinical scenarios were analyzed, with 292 pre-established learning objectives, on a total sample of 67 students. The participants provided a total of 464 learning outcomes that were significant for them, of which 101 coincided with those that were initially planned (21.8%), while the rest, 363 (78.2%), were considered emergent (not planned a priori). For the most part, the learning outcomes described by the students were technical knowledge and/or skills (70.5%), as compared to non-technical knowledge and/or skills (29.5%).

CONCLUSION

For the most part, the learning outcomes considered by the students to be significant did not correspond with the objectives set a priori in the design of the scenarios. Most were emergent elements, especially those that referred to the technical knowledge and skills. The emergent knowledge must be considered crucial by the educators for the teaching and training of students.

Medical Students' Opinions of Anatomy Teaching Resources and Their Role in Achieving Learning Outcomes

Several teaching resources are used to enhance the learning of anatomy. The purpose of this study was to examine the preference of medical students on the use of various resources to learn anatomy and their link to 12 learning outcomes. A selected response item questionnaire was administered that asked students to rank six laboratory teaching resources from most to least preferred, and rate how useful these six resources were towards achieving 12 learning outcomes. These learning outcomes covered many of the learning domains such as demonstrating an understanding of anatomy, visualizing structures, appreciating clinical correlations, and understanding anatomical variations. Medical students ranked cadaveric prosections paired with an active learning clinical tutorial as the highest rank and most useful resource for learning anatomy, followed by dissection videos, electronic resources, and printed material, followed by plastinated specimens and plastic models. Overall, cadaveric prosections were also rated as the most helpful teaching resource in achieving various learning outcomes. In conclusion, anatomy teachers should provide prosections coupled with clinical tutorials as well as electronic resources as students prefer these and think they help them learn anatomy. Future studies will investigate the impact of using these resources on students' performance.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01436-2.

Effects of simulation technology-based learning on nursing students' learning outcomes: A systematic review and meta-analysis of experimental studies

BACKGROUND

Gaps between theory and clinical practice represent challenges for nursing students during their learning processes. Providing simulation technology-based learning for nursing students is essential for modern nurse education, but evidence of efficacy remains scarce.

OBJECTIVES

To determine the effects of simulation technology-based learning for nursing students.

DESIGN

A systematic review and meta-analysis.

METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Five databases (CINAHL, Embase, MEDLINE, PubMed, and Web of Science) were electronically searched through May 30, 2021. Eligibility criteria included nursing students, simulated technology-based learning as the primary intervention, and randomised controlled trials or quasi-experimental studies published in English. The methodological quality of included studies was evaluated by the Cochrane risk-of-bias tool. Comprehensive Meta-Analysis Version 3.0 was used to conduct a meta-analysis using the random-effects model. Begg's and Egger's tests were performed to assess publication bias, and sensitivity analysis performed using a remove one study method.

RESULTS

A total of 17 studies were included in this study. Simulated technology-based learning significantly increased nursing student knowledge acquisition (standard mean difference [SMD]: 0.72, 95% confidence interval [CI]: 0.25-1.18, p < 0.001), enhanced student's confidence (SMD: 0.50, 95% CI: 0.02-0.99, p = 0.043), and increased student's satisfaction in learning (SMD: 0.81, 95% CI: 0.61-1.00, p < 0.001). Subgroup analyses showed that receiving simulation by manikins simulator had a greater effect on knowledge acquisition (SMD: 1.01, 95% CI: 0.27-1.74, p = 0.007).

CONCLUSIONS

Simulation technology use may meet the expectations of undergraduate nursing students and prepare them for clinical practice, representing an opportunity to fill gaps between theory and clinical practice while simultaneously developing new teaching scenarios.

Comparison of blended versus traditional classrooms among undergraduate nursing students: A quasi-experimental study

BACKGROUND

Blended learning is a relatively new educational approach that has been introduced into higher education in Palestine. While it has many advantages, there is no empirical evidence, nor any case studies from Palestine to support the use of blended learning over traditional classroom.

OBJECTIVES

To compare students' learning outcomes, learning perceptions of their educational environment, and satisfaction of blended learning versus traditional classroom.

DESIGN

A quasi-experimental study.

SETTING

A public university in Palestine.

PARTICIPANTS

102 Bachelor of Science in nursing students enrolled on the maternal health course.

METHODS

Students freely chose to register for the blended teaching section (49 students) or traditional classroom (53 students), then the teaching method for each section was assigned. Student demographics, course component grades, perceptions of the educational environment, measured by the Arabic version of Dundee Ready Education Environment Measurement (DREEM) inventory, and degree of satisfaction were collected in this study. Descriptive statistics and the Independent Sample t-test were used to analyze the data.

RESULTS

The sample included 49 students in the blended teaching section and 53 students in the traditional section. Overall DREEM scores, Student Perceptions of Learning, and Student Perceptions of Teachers were significantly higher for students taught with the blended method compared to traditional classroom settings. The total DREEM scores were between 101 and 151 for both sections, indicating that all students, regardless of teaching method, had more positive than negative perceptions of their educational environment. Moreover, there was no significant difference in scores and total course GPA (Grade Point Average), both with and without assignment grades, or between blended and traditional learning in first, second and final exams. However, students taught with the blended format scored significantly higher in assignments than students taught the traditional classroom.

CONCLUSIONS

Blended learning can be a useful educational approach in nursing education and Palestinian universities may consider using it for nursing courses.

The effects of mindfulness on health profession students' simulation training outcomes: An integrative review

Health profession students (HPSs) continuously experience psychological issues which can exacerbate cognitive errors and harm emotional well-being. The Healthcare simulation environment is stressful and overwhelming in nature and may impair learning outcomes. Therefore, integrating psychological interventions into simulation-based learning (SBL) instructional design may alleviate students' psychological distress and improve their learning outcomes.

OBJECTIVES

to examine the effects of mindfulness on health professions students' SBL outcomes.

DESIGN

a literature review, based on Whittemore and Knafl's (2005) updated methodology was used in this study.

DATA SOURCES

We investigated PubMed, ERIC, ScienceDirect, and Google Scholar to find papers addressing the effects of mindfulness on health professions students' SBL outcomes. We targeted Results: This integrative review suggests that although mindfulness improves SBL outcomes, HPSs still struggle to transfer mindfulness benefits to real clinical practice.

CONCLUSION

research on mindfulness in healthcare SBL is in its infancy, thus, further research is needed to prove mindfulness effects on HPSs' SBL outcomes.

Comparing evaluation responses of an interprofessional education initiative with students in undergraduate nursing and medical programmes

BACKGROUND

Interprofessional education initiatives can be used as effective means to influence students' perceptions of their own and others' roles and interactions as health professionals. There is a need to better understand how interprofessional education learning outcomes are appreciated by students.

AIM

The aims of this study were to describe and compare evaluation feedback from students in undergraduate nursing and medicine programmes about the learning outcomes of an interprofessional education initiative.

METHODS

A mixed methods pre-post-study design was used to collect data using evaluation questions about the initiative and two interprofessional learning outcomes: communication and teamwork. Ratings were analysed with a two-way repeated measures analysis of variance or a t-test. Written responses were analysed using a general inductive approach.

RESULTS

Data from 30 nursing students and 12 medical students were analysed. A noteworthy finding was a significantly higher average rating for nursing students than medicine students before and after the session for the statement about valuing interprofessional learning. Three themes represented comments from both groups: positive experiences, relevance to practice, and learning design issues.

DISCUSSION

Findings were interpreted to indicate that students from both programmes valued the learning outcomes session and was greater at the end of the session. Notably, the perceived value of interprofessional learning was higher for nursing students than medical students before and after the session. This finding may be related to the familiarity nursing students may have with the teaching methods used in the initiative. Further exploration of this finding is needed so educators can better understand how they can provide optimal learning experiences for all students who participate in interprofessional education.

CONCLUSION

Nursing and medicine students appear to value the interprofessional learning outcomes in an undergraduate health professional initiative. However, differences between these two groups of students are an area for further exploration.

Association between maternal hypertensive disorders, fetal growth and childhood learning outcomes

OBJECTIVE

Both small for gestational age (SGA) birthweight and pregnancies complicated by maternal hypertension (HTN) are independently associated with poorer childhood learning outcomes, however the relative contribution of each remains unknown.

STUDY DESIGN

A retrospective cohort was created in which 2014-2017 third grade Rhode Island Department of Education data were linked to Rhode Island Department of Health birth certificate data. The study population was composed of non-anomalous, singleton births between 22- and 42-weeks' gestation. Reading and math proficiency were compared among four groups: 1) appropriate for gestational age (AGA) and no maternal HTN (referent), 2) AGA with HTN, 3) SGA without HTN and 4) SGA with HTN.

MAIN OUTCOME MEASURES

Bivariable and multivariable log-binomial regression were used to examine the association between subject proficiency and pregnancy complication, adjusting for potential confounders.

RESULTS

Of the 23,097 who met inclusion criteria, 1004 (4%) were AGA with HTN, 1575 (7%) were SGA without HTN and 176 (1%) were SGA with HTN. Overall, when adjusted for maternal age, gestational age, sex and socioeconomic factors, only children born SGA without HTN had reduced reading proficiency (relative risk (RR) 0.86 95% confidence interval (CI) 0.78, 0.92) and math proficiency (RR 0.88 95% CI 0.82, 0.94) compared to children born AGA without HTN.

CONCLUSION

In a diverse, statewide cohort, only SGA without HTN was associated with lower reading and math proficiency compared to uncomplicated pregnancies. This suggests that only decreased fetal growth from causes other than HTN is associated with risk of poorer school-age outcomes, and has implications for early resource allocation.

An eye tracking study: positive emotional interface design facilitates learning outcomes in multimedia learning?

Unlike the other studies on emotional design in multimedia learning, the present study differentiated the two confounding variables of visual interface design and structured content to manipulate the instructional material. Specifically, we investigated how the visual aesthetics of positive emotional interface design influenced learners' cognitive processes, emotional valences, learning outcomes, and subjective experience. Eighty-one college students took part in the experimental study. They were divided into the three experimental groups: a holistic layout of positive emotional design group (HPED), a local layout of positive emotional design group (LPED), and a neutral emotional design group (ND). By using a mixed approach of questionnaires and eye tracking, we further explored the differences among the three groups in cognitive processing, learning outcomes, and subjective experience. Results indicated that the LPED group invested higher cognitive effort, put more attentional focus in the relevant knowledge content module, and achieved better learning performance (i.e., retention and transfer tests) in contrast to the HPED group and the ND group. However, no significant difference in dynamic changes of emotional state among the three groups was detected. The analytical results can provide researchers and practitioners with valuable insights into the positive emotional design of multimedia learning, which allows for the facilitation of mental engagement, learning outcomes and subjective perception.

Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education?

The COVID-19 pandemic has disrupted many societal institutions, including health care and education. Although the pandemic's impact was initially assumed to be temporary, there is growing conviction that medical education might change more permanently. The International Competency-based Medical Education (ICBME) collaborators, scholars devoted to improving physician training, deliberated how the pandemic raises questions about medical competence. We formulated 12 broad-reaching issues for discussion, grouped into micro-, meso-, and macro-level questions. At the individual micro level, we ask questions about adaptability, coping with uncertainty, and the value and limitations of clinical courage. At the institutional meso level, we question whether curricula could include more than core entrustable professional activities (EPAs) and focus on individualized, dynamic, and adaptable portfolios of EPAs that, at any moment, reflect current competence and preparedness for disasters. At the regulatory and societal macro level, should conditions for licensing be reconsidered? Should rules of liability be adapted to match the need for rapid redeployment? We do not propose a blueprint for the future of medical training but rather aim to provoke discussions needed to build a workforce that is competent to cope with future health care crises.

Looking beyond changes in averages in evaluating foundational learning: Some inequality measures

This paper uses measurements of learning inequality to explore whether learning interventions that are aimed at improving means also reduce inequality, and if so, under what conditions. There is abundant evidence that learning levels are generally low in low- and middle-income countries (LMIC), but there is less knowledge about how learning achievement is distributed within these contexts, and especially about how these distributions change as mean levels increase. We use child-level data on foundational literacy outcomes to quantitatively explore whether and how learning inequality using metrics borrowed from the economics and inequality literature can help us understand the impact of learning interventions. The paper deepens recent work in several ways. First, it extends the analysis to six LMIC, displaying which measures are computable and coherent across contexts and baseline levels. This extension can add valuable information to program evaluation, without being redundant with other metrics. Second, we show the large extent to which the disaggregation of inequality of foundational skills between- and within-schools and grades varies by context and language. Third, we present initial empirical evidence that, at least in the contexts of analysis of foundational interventions, improving average performance can reduce inequality as well, across all levels of socioeconomic status (SES). The data show that at baseline, the groups with the highest internal inequality tend to be the groups with lowest SES and lowest reading scores, as inequality among the poor themselves is higher than among their wealthier counterparts. Regardless of which SES groups benefit more in terms of a change in mean levels of reading, there is still a considerable reduction in inequality by baseline achievement as means increase. These results have policy implications in terms of targeting of interventions: much can be achieved in terms of simultaneously improving averages and increasing equality. This seems particularly true when the initial learning levels are as low as they currently are the developing world.

Measuring the impact of productive failure on nursing students' learning in healthcare simulation: A quasi-experimental study

BACKGROUND

Previous research suggests that making errors in a non-threatening simulated environment can facilitate learning. Productive failure, which combines problem-solving tasks followed by instruction, enables students to learn from making mistakes. This teaching approach has demonstrated improved learning outcomes such as explanatory knowledge and transfer of knowledge compared to a direct instruction approach where students receive instruction prior to problem-solving tasks. However, no previous studies have examined the impact of productive failure on nursing students' learning in manikin-based simulation.

OBJECTIVE

To measure the impact of productive failure on nursing students' declarative knowledge, explanatory knowledge, and transfer of knowledge compared to a direct instruction approach in a paediatric closed head injury simulation.

METHODS

Second year undergraduate nursing students (n = 349) from one Australian university were invited to participate in the study. Consenting participants (n = 344) were randomised into two groups: productive failure and direct instruction. The intervention consisted of two paediatric closed head injury simulations separated by a simulation debrief. Knowledge tests were administered before and immediately after the simulation.

RESULTS

Data from 331 participants were analysed. The productive failure group outperformed the direct instruction group in the post-test (p < 0.001). Learning gains for participants in the productive failure group were significantly higher than the direct instruction group for both explanatory knowledge (p < 0.001) and the ability to apply learning to solve novel clinical problems (p < 0.001). The difference in the median scores for declarative knowledge was not significant (p = 0.096).

CONCLUSION

This study demonstrated that a productive failure simulation that leads learners to make mistakes before receiving instruction can facilitate deeper levels of explanatory knowledge and enable the transfer of learning to new clinical situations. These results suggest the need for further exploration of pedagogies that foster learning from errors in simulation-based learning.

The influence of the multimedia and modality principles on the learning outcomes, satisfaction, and mental effort of college students with and without dyslexia

The purpose of this study was to examine the application of the multimedia and modality principles on cued-recall, recognition, and mental effort of college students with and without dyslexia. The study used a Multimedia (Image Present vs. Image Absent) × Modality (Narration vs. Onscreen Text) × Dyslexia (Dyslexia vs. Non-Dyslexia) 3-way factorial design with each independent variable serving as a between-subject condition. A total of N = 148 participants (73 with dyslexia and 75 without dyslexia) were recruited from five different institutions of higher education in the Southeastern United States and systematically assigned to one of four multimedia learning conditions. After assessing our data for statistical assumptions, we employed factorial Analysis of Variance (ANOVA) models on each dependent measure. Our findings show a reverse modality effect for students with dyslexia who performed better than their peers without dyslexia in Onscreen Text conditions. Although performance was better across groups and conditions when images were present, there were no significant interactions related to the multimedia condition. Similarly, there were no significant interactions related to mental effort even though learners with dyslexia exhibited high instructional efficiency in the Onscreen Text-Image Present condition while learners without dyslexia exhibited low task involvement in the Onscreen Text-Image Absent condition. Our results provide theoretical implications and important avenues for future research and practice as related to how multimedia learning influences students with dyslexia. We also suggest studies that could inform the eventual design of adaptive and personalized multimedia learning solutions for learners with dyslexia.