A Paradox of School Social Organization: Positive School Climate, Friendship Network Density, and Adolescent Violence

Schools are often encouraged to foster a positive climate to reduce adolescent violence, but evidence on the effectiveness of this approach varies significantly. This study investigates the roots of this variation by testing alternative hypotheses about how positive school-level climate and school-level student friendship network density interact to shape adolescent violence perpetration. Research on informal social control and network closure suggests that the violence-reducing association of positive school climate will be enhanced among schools where students are more densely tied through their friendships. Research on youth conflict and subversion of control suggests the opposite. These hypotheses are tested with data from Waves I-II of the National Longitudinal Study of Adolescent to Adult Health (n = 11,771; 49% Female; Age mean = 15.04, SD = 1.60). Consistent with the conflict/subversion hypothesis, analyses indicate that the inverse association between positive school climate and adolescent violence is only evident among schools with a very low density of friendship ties. Strikingly, however, there is evidence that a more positive school climate is associated with increases in violence among youth attending schools with a high density of friendship ties. These findings suggest that efforts to reduce violence by fostering cohesion among youth in their schools and other social contexts can be undermined by youth network processes.

Effectiveness of Pictorial Education Handout on Tracheostomy Care Self-efficacy in Patients With Head and Neck Cancer and Family Caregivers: A Pilot Quasi-Experimental Study

BACKGROUND

Learning and performing tracheostomy care are challenging for laypersons. Effective pictorial patient education handouts are needed for nonprofessional individuals to learn health management skills.

OBJECTIVES

The study aims to (1) evaluate the preliminary efficacy of the pictorial education handout on patients' and family members' self-efficacy in tracheostomy care and (2) identify demographic, psychological, and education-related factors associated with lower self-efficacy on tracheostomy care.

INTERVENTIONS/METHODS

This was a preliminary pilot study with a pretest-posttest design. We recruited a total of 39 participants, including 22 patients with head and neck cancer-related tracheostomy and 17 family caregivers in 2021. All participants received A3-size (297 × 420 mm) pictorial patient education handouts on how to suction and how to clean their tracheostomy at home.

RESULTS

Pictorial education handouts showed a medium to large effect size on self-efficacy in the patient (Cohen D = 0.46) and caregiver participants (Cohen D = 0.78). Participants with higher anxiety were associated with a greater gain in self-efficacy with the pictorial patient education handouts ( r = 0.35, P = .027).

CONCLUSIONS

Pictorial patient education handouts were effective tools for improving patients' and family caregivers' confidence in tracheostomy care, and it is particularly helpful for individuals with high anxiety with tracheostomy.

IMPLICATION FOR PRACTICE

Clinical nurses should use the pictorial education handouts not only to assist patients and family members on learning and practicing tracheostomy care but also to relieve anxiety associated with tracheostomy care at home.

Inclusive Mentorship for the Next Generation of Veterinary Professionals

Veterinary medicine is one of the least diverse professions in terms of race and ethnicity. Inclusive mentorship has the potential to increase representation and retention of BIPOC (black, indigenous, people of color) individuals and individuals with other marginalized identities in the field. Inclusive mentorship benefits not only the mentors and mentees but also the veterinary profession and the communities we serve. It is critical to incorporate inclusion principles throughout the mentoring relationship, starting with creating an inclusive environment and considering inclusion in program design and mentor training. Inclusion is an ongoing process that requires dedication and maintenance.

The Student Voice: Perceptions of Durable Learning

BACKGROUND

Durable learning is the teaching/learning methods that result in retained knowledge that can be transferred to practice. There is limited research on durable learning in nursing education (NE).

PURPOSE

The purpose of this study was to understand the perceptions of how learners acquire and retain knowledge.

METHODS

Nursing students and recent graduates were recruited from 2 large universities. Focus groups (n = 7) were audio-recorded, and transcripts were analyzed.

RESULTS

Thematic analysis of learners' perceptions revealed (1) effective learner-initiated techniques, (2) effective instructor-initiated techniques, (3) learner-initiated techniques that were not effective, and (4) instructor-initiated techniques in the classroom, clinical practice, and simulation that were not effective.

CONCLUSION

Additional research is needed to understand faculty perspectives on durable learning techniques and their effectiveness. Findings from student, graduate, and faculty perspectives will guide the development of a validated, reliable tool to evaluate durable learning in NE.

The effects of gaze-display feedback on medical students' self-monitoring and learning in radiology

Self-monitoring is essential for effectively regulating learning, but difficult in visual diagnostic tasks such as radiograph interpretation. Eye-tracking technology can visualize viewing behavior in gaze displays, thereby providing information about visual search and decision-making. We hypothesized that individually adaptive gaze-display feedback improves posttest performance and self-monitoring of medical students who learn to detect nodules in radiographs. We investigated the effects of: (1) Search displays, showing which part of the image was searched by the participant; and (2) Decision displays, showing which parts of the image received prolonged attention in 78 medical students. After a pretest and instruction, participants practiced identifying nodules in 16 cases under search-display, decision-display, or no feedback conditions (n = 26 per condition). A 10-case posttest, without feedback, was administered to assess learning outcomes. After each case, participants provided self-monitoring and confidence judgments. Afterward, participants reported on self-efficacy, perceived competence, feedback use, and perceived usefulness of the feedback. Bayesian analyses showed no benefits of gaze displays for post-test performance, monitoring accuracy (absolute difference between participants' estimated and their actual test performance), completeness of viewing behavior, self-efficacy, and perceived competence. Participants receiving search-displays reported greater feedback utilization than participants receiving decision-displays, and also found the feedback more useful when the gaze data displayed was precise and accurate. As the completeness of search was not related to posttest performance, search displays might not have been sufficiently informative to improve self-monitoring. Information from decision displays was rarely used to inform self-monitoring. Further research should address if and when gaze displays can support learning.

Collaborative augmented reality in higher education: A systematic review of effectiveness, outcomes, and challenges

This article reports a systematic literature review that examined past research exploring the effectiveness of collaborative Augmented Reality (AR) enabled instruction, in higher education contexts. To be included, an article should consist of an experimental study investigating the use of collaborative AR for learning in higher education settings. An initial search was conducted on five databases that resulted in a total of 2537 articles, of which 20 were finalized for this review. The main findings suggest that AR-enabled collaborative learning benefits students' overall learning outcomes and provides a positive collaboration experience in higher education settings. Further research is needed to determine the interaction elements, collaboration mechanisms, and information representation through AR that would potentially enhance student learning outcomes. This article concludes by discussing the implications of these findings, identifying challenges and strategies for developing effective collaborative AR-enabled learning content.

A Team-Based American Board of Surgery In-Training Examination (ABSITE) Competition Improves Exam Performance

OBJECTIVE

The American Board of Surgery In-Training Examination (ABSITE) is an important factor in general surgery resident career development. The use of practice question banks for ABSITE preparation improves exam scores and completing more practice questions results in higher scores. The objective of this study is to describe the design of a novel, team-based ABSITE competition implemented into our residency program and analyze its effect on exam performance.

DESIGN

For the 2023 to 2024 academic year (AY), residents were randomly sorted into teams. The number of TrueLearn (TL) practice questions completed by each team during the 6-month period preceding the 2024 ABSITE was monitored at regular intervals. Paired sample t-test was used to compare total questions completed and ABSITE percent scores from the prior AY. Simple linear regression was performed to determine if total completed questions predicted ABSITE percent scores, and if the change in total completed questions predicted a change in ABSITE percent scores for unique residents.

SETTING

University-affiliated general surgery residency program.

PARTICIPANTS

34 clinical and research general surgery residents.

RESULTS

Mean total TL questions completed per resident increased by 175.2, with a difference trending toward statistical significance (1037.9 ± 583.6 vs 1213.1 ± 596.0, p = 0.08). Mean ABSITE percent scores significantly increased by 4.6% (68.2 ± 8.7 vs 72.8 ± 5.7, p < 0.001). Total completed questions positively correlated with ABSITE percent scores (R2 = 0.21, F (1,66) = 17.04, p < 0.001). Among individual residents, completing more questions than the prior AY predicted improvement in ABSITE percent scores (R2 =.18, F (1,32) = 7.02, p = 0.01). Our model predicts that by completing 300 additional practice questions (e.g. 10 more questions/day for 1 month) a resident's ABSITE percent score will increase by 4.8 percentage points.

CONCLUSION

Implementation of a team-based ABSITE competition is a straightforward and effective intervention that increases general surgery resident question bank utilization and significantly improves ABSITE percent scores.

Between- and within-person effects of affective experiences on coping in CBT: Direct effects and interplay with therapeutic alliance and resource activation

OBJECTIVE

The role of affective experiences (AE) in cognitive-behavioral therapy (CBT) has rarely been investigated. We examined between- and within-person effects of AE on coping in CBT for family caregivers and interactions with therapeutic alliance and resource activation.

METHODS

67 family caregivers rated AE, therapeutic alliance, resource activation, and coping after each of 12 sessions of telephone-based CBT. We examined direct session-to-session effects of AE on coping in structural equation modeling and interactions of AE with therapeutic alliance and resource activation in multilevel models.

RESULTS

AE did not directly predict coping. Instead, within-person effects of AE interacted with simultaneous within-person emotional bond. Given strong emotional bond, AE positively predicted coping, whereas given weak emotional bond, AE negatively predicted coping. Further, cross-level interactions of between-person AE and within-person agreement on collaboration and resource activation indicated that these positively predicted coping only in dyads with high between-person AE.

CONCLUSION

AE may enhance coping when complemented with strong emotional bond. Further, within-person effects of agreement on collaboration and resource activation seem to rely on a certain degree of between-person AE. Results are discussed in relation to current findings on emotional processing in CBT.

You Get What You Reward: A Qualitative Study Exploring Medical Student Engagement in 2 Different Assessment Systems

PURPOSE

Educational impact is dependent on student engagement. Assessment design can provide a scaffold for student engagement to determine the focus of student efforts. Little is known about how medical students engage with assessment. Therefore, we asked the following research question: How do medical students engage with the process of assessment and their assessment data in 2 clinical assessment systems?

METHOD

This multi-institutional, cross-sectional constructivist grounded theory study of fourth-year undergraduate medical students at the University of Washington and Cleveland Clinic Lerner College of Medicine assessed 2 different assessment systems: traditional tiered grading, in which clerkship grades were summative, and programmatic assessment, in which students received low-stake, narrative feedback across clerkships with progress based on aggregated performance data in student portfolios. All fourth-year students were invited to participate in one-on-one semistructured interviews guided by student engagement theory between September 2022 and January 2023. Verbatim transcripts underwent iterative, qualitative analysis.

RESULTS

Twenty-two medical students were interviewed, 13 from a traditional grading assessment system and 9 from a programmatic assessment system. Three major ways in which assessment systems affected how students engaged with their assessments were categorized into the affective, cognitive, and behavioral domains of engagement: as a sociocultural statement of value, as the cognitive load associated with the assessment system and practices themselves, and as the locus of power and control in learning and authentic practice.

CONCLUSIONS

Medical students' beliefs about assessment goals, cognitive burden of assessment, and relationships with others significantly affected their engagement with their assessments. In assessment systems that reward grading and an archetypal way of being, students report engaging by prioritizing image over learning. In programmatic assessment systems, students describe more fully and authentically engaging in their assessment for and as learning. Systems of assessment communicate what is rewarded, and you get what you reward.

The interplay between ego-resiliency, math anxiety and working memory in math achievement

Previous research has suggested that math anxiety may contribute to poor math performance by interfering with working memory. However, only a limited number of studies investigated the mediating role of working memory in the math anxiety-math performance link in school-aged children. Unlike math anxiety, ego-resiliency is a personality resource that promotes the management of challenges and has been positively associated with math performance and negatively with anxiety. Nevertheless, there is still limited understanding regarding the specific role of ego-resiliency in math learning and how it relates to math anxiety. This study aimed to investigate conjunctly the interplay between primary school children's ego-resiliency, math anxiety, working memory, and performance on two different math tasks (i.e., arithmetic task and word problem-solving task), after controlling for general anxiety and age. The study involved 185 Italian children from grades 3 to 5. Serial multi-mediational analyses revealed that: (1) ego-resiliency has a positive indirect effect on math achievement through two paths - math anxiety, and math anxiety and working memory; (2) the study replicated previous findings showing that working memory partially mediated the relationship between math anxiety and math performance; (3) similar patterns of results were found for both math skills. The study identifies ego-resiliency as a possible protective factor in the development of math anxiety and suggests that ego-resiliency could be worth considering when designing interventions aimed at reducing negative emotions towards mathematics.

Examining the relative impact of adverse and positive childhood experiences on adolescent mental health: A strengths-based perspective

BACKGROUND

It is well-documented that Adverse Childhood Experiences (ACEs) have a negative impact on mental health outcomes across the lifespan, while Positive Childhood Experiences (PCEs) act as a protective factor. Less is known about the relative impact of ACEs and PCEs on mental health outcome for adolescents.

OBJECTIVE

The present study sought to identify the relative impact of ACEs and PCEs on mental health outcomes for youth.

PARTICIPANTS AND SETTING

Data were drawn from a state-wide, cross-sectional health survey of 12-17 year-olds (n = 1169) conducted on a continuous basis throughout 2021, following the height of the COVID-19 pandemic.

METHODS

Adolescents completed ACEs and PCEs screeners and the Kessler 6-item Psychological Distress Scale to assess current mental health symptoms. A multiple regression analysis controlling for age, gender, and poverty level, was conducted to examine the relative impacts of ACEs and PCEs on mental health outcomes.

RESULTS

Male gender, younger age, lower family poverty level (e.g., more financial hardship), absence of ACEs, and experiencing more PCEs were significantly associated with better mental health outcomes for adolescents [F(5, 1163) = 104.48, p < .001]. Notably, ACEs were found to account for only 9 % of variance in mental health outcomes (ΔR2 = 0.09), while PCEs accounted for 18 % of variance (ΔR2 = 0.18).

CONCLUSIONS

PCEs explained approximately double the variance in mental health outcomes for adolescents compared to ACEs. Results indicate promoting youths' exposure to PCEs in childhood and adolescence may offer a meaningful pathway for supporting adaptive mental health outcomes.

Effects of perceptual redundancy, conceptual redundancy and self-relatedness on categorical responses

A redundancy gain occurs when perceptually identical stimuli are presented together, resulting in quicker categorization of these paired stimuli than lone stimuli. Similar effects have been reported for paired stimuli within the same conceptual category, particularly if the category is self-related. We recruited 528 individuals across three related studies to investigate whether, during perceptual and conceptual redundancy, such self-bias effects on foreground stimuli are modulated by natural versus urban backgrounds. Here, we highlight our observations pertaining to perceptual and conceptual redundancy effects of the foreground stimuli. In our first experiment, response options were randomised per trial. Results showed reaction time gains for perceptually identical stimuli, but this advantage was not modulated by self/other categorization. However, slower reaction times were observed for conceptually-related stimulus pairs and were influenced by self/other categorization. The second experiment replicated the methods of earlier studies of redundancy and observed comparable results to Experiment 1: a perceptual redundancy gain unmodulated by self/other categorization, yet for conceptual redundancy, no gain/cost but effects of self/other categorization. In the third experiment, self/other categories were substituted with arbitrary A/B categories: Once more, there was a perceptual redundancy gain and no conceptual redundancy gain. Notably, A/B categorisation produced effects equivalent to self/other categorisation. Overall, these findings challenge previous research on the facilitated early processing of conceptually-related stimuli and suggest that self-relatedness may not exert a unique effect on stimulus processing beyond attentional and response preferences during categorization. Our study motivates further research to understand conceptual categorization and redundancy gain effects.

How Do Personal Attributes Shape AI Dependency in Chinese Higher Education Context? Insights from Needs Frustration Perspective

OBJECTIVE

The adoption of Generative AI in education presents both opportunities and challenges, particularly regarding its potential to foster student dependency. However, the psychological drivers of this dependency remain unclear. This study addresses this gap by applying the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and Basic Psychological Needs (BPN) theory to explore how specific personality traits-neuroticism, self-critical perfectionism, and impulsivity-contribute to AI dependency through needs frustration, negative academic emotions, and reinforced performance beliefs.

METHOD

Data were collected from 958 university students (Mage = 21.67) across various disciplines. Structural equation modeling (SEM) was used to analyze the relationships among the variables.

RESULTS

Neuroticism, self-critical perfectionism, and impulsivity were found to be significantly associated with increase needs frustration and negative academic emotions, which in turn reinforced students' positive beliefs about performance of AI tools, deepening their dependency. The study also uncovered complex serial mediation effects, highlighting intricate psychological pathways that drive maladaptive AI use.

CONCLUSIONS

This research provides a critical insight into the interplay between personality traits and technology use, shedding light on the nuanced ways in which individual differences influence dependency on generative AI. The findings offer practical strategies for educators to promote balanced AI use and support student well-being in educational settings.

Radiographical diagnostic competences of dental students using various feedback methods and integrating an artificial intelligence application-A randomized clinical trial

INTRODUCTION

Radiographic diagnostic competences are a primary focus of dental education. This study assessed two feedback methods to enhance learning outcomes and explored the feasibility of artificial intelligence (AI) to support education.

MATERIALS AND METHODS

Fourth-year dental students had access to 16 virtual radiological example cases for 8 weeks. They were randomly assigned to either elaborated feedback (eF) or knowledge of results feedback (KOR) based on expert consensus. Students´ diagnostic competences were tested on bitewing/periapical radiographs for detection of caries, apical periodontitis, accuracy for all radiological findings and image quality. We additionally assessed the accuracy of an AI system (dentalXrai Pro 3.0), where applicable. Data were analysed descriptively and using ROC analysis (accuracy, sensitivity, specificity, AUC). Groups were compared with Welch's t-test.

RESULTS

Among 55 students, the eF group by large performed significantly better than the KOR group in detecting enamel caries (accuracy 0.840 ± 0.041, p = .196; sensitivity 0.638 ± 0.204, p = .037; specificity 0.859 ± 0.050, p = .410; ROC AUC 0.748 ± 0.094, p = .020), apical periodontitis (accuracy 0.813 ± 0.095, p = .011; sensitivity 0.476 ± 0.230, p = .003; specificity 0.914 ± 0.108, p = .292; ROC AUC 0.695 ± 0.123, p = .001) and in assessing the image quality of periapical images (p = .031). No significant differences were observed for the other outcomes. The AI showed almost perfect diagnostic performance (enamel caries: accuracy 0.964, sensitivity 0.857, specificity 0.074; dentin caries: accuracy 0.988, sensitivity 0.941, specificity 1.0; overall: accuracy 0.976, sensitivity 0.958, specificity 0.983).

CONCLUSION

Elaborated feedback can improve student's radiographic diagnostic competences, particularly in detecting enamel caries and apical periodontitis. Using an AI may constitute an alternative to expert labelling of radiographs.

Developmental relations of achievement goals and affect in physical education

OBJECTIVE

This study aimed to examine the developmental relationships between achievement goals and affect in school physical education.

METHOD

The study sample comprised 1063 (girls 546) Finnish Grade 6 students (M = 12.27 years ± 0.33 at the beginning of the study). The participants in the study were asked to provide annual assessments about their perceptions of achievement goals, enjoyment, and anxiety. The assessments were conducted four times over three consecutive years.

RESULTS

The results indicated that mastery-approach goals were positively associated with enjoyment (between-level), whereas both mastery-avoidance and performance-avoidance goals were positively associated with anxiety (between-level). Additionally, the associations between repeated measures (within-level) of mastery-approach goals and enjoyment were similar each year, whereas mastery- and performance-approach/avoidance goals were consistently associated with anxiety within the same year. Girls reported lower performance-approach goals and enjoyment but higher mastery-avoidance goals and anxiety than boys.

CONCLUSION

The findings suggest that mastery approach goals exhibit a positive correlation with favorable affective reactions, while performance-avoidance goals demonstrate a connection with maladaptive responses. Physical education teachers should endeavor to establish mastery-oriented goals for their students from the outset of the educational process.

Presentation matters: Surface text features and text quality in written narratives of Dutch high school students with and without dyslexia

Presentation features such as spelling, punctuation and handwriting can influence the evaluation of general text quality. High school students with dyslexia might therefore be at a disadvantage, as at least their spelling performance is typically poor(er). Furthermore, these students might show less sophisticated linguistic features of texts, such as word length and sentence complexity, that might also be related to text quality. We compared narratives written by Dutch high school students (mean age 13.7 years) with (n = 28) and without (n = 29) dyslexia. Students with dyslexia's texts contained more spelling errors and poorer handwriting quality, but not more punctuation errors. Teacher-rated general text quality was lower for the texts of students with dyslexia in uncorrected versions. When spelling and punctuation errors were corrected, no teacher-rated text quality differences emerged. No differences in linguistic text features were found. Furthermore, spelling, punctuation and, to a lesser extent, number of words per sentence clause were related to ratings of text quality across participants. These results confirm the influence of presentation features on text quality rating. They encourage teachers to be aware of this effect and emphasize the importance of spelling and writing support and interventions for students with dyslexia throughout education.

The development of self-initiated visuo-spatial working memory

Studies on the development of visuo-spatial working memory (VSWM) have focused almost exclusively on memory tasks in which children had no control over the content of the representations they memorized. In contrast, in everyday life children often select the items that they encode in memory. In the current study, we used two modified span tasks to explore the development of this aspect of memory, termed self-initiated (SI) VSWM, in children aged 7 to 10 years. In Experiment 1 participants memorized sequences of spatial locations, whereas in Experiment 2 participants memorized sequences of pictures of real-world objects and the spatial locations of the targets were irrelevant for task performance. In both experiments, participants either selected the targets they memorized themselves or memorized randomly selected targets that were provided to them. Previous studies in adults have shown that efficient processing in the SI condition in both tasks entails the construction of spatially structured representations. The results of the two experiments revealed that children constructed spatially structured representations with short paths between successive locations in the spatial sequences, fewer path crossings, and more linear shapes compared with the provided representations. Self-initiation benefited overall performance, especially in Experiment 1 where the memory task was more demanding. This study shows that 7- to 10-year-old children have access to the metacognitive knowledge on the spatial structure of VSWM and strategically impose structure during encoding to benefit memory performance. More generally, SI VSWM highlights an important aspect of behavior, demonstrating how children shape their environment to facilitate functioning.

Using Popular Media to Change Attitudes and Bolster Knowledge About Autism Spectrum Disorder

This research investigated the impact popular novels have on knowledge about and attitudes towards Autism Spectrum Disorder (ASD), compared to that of traditional college textbooks. Study 1 found that participants in the novel condition chose fewer correct and fewer incorrect responses to questions about ASD. Participants did not differ in their desired social distance from individuals with ASD. Study 2 found that participants in the novel and textbook conditions both showed the same amount of learning, with higher scores on the post-test assessment of knowledge than the pre-test. Participants in the novel condition showed significant improvement in their attitudes towards individuals with ASD after reading, while those in the textbook condition showed more negative attitudes after reading the textbook chapter. These findings add to our understanding of the potential of popular fiction to impact consumers' knowledge about ASD while improving our attitudes towards individuals with ASD. These findings also raise concerns about traditional educational material used to teach about ASD.

Auxiliary diagnostic method of Parkinson's disease based on eye movement analysis in a virtual reality environment

Eye movement dysfunction is one of the non-motor symptoms of Parkinson's disease (PD). An accurate analysis method for eye movement is an effective way to gain a deeper understanding of the nervous system function of PD patients. However, currently, there are only a few assistive methods available to help physicians conveniently and consistently assess patients suspected of having PD. To solve this problem, we proposed a novel visual behavioral analysis method using eye tracking to evaluate eye movement dysfunction in PD patients automatically. This method first provided a physician task simulation to induce PD-related eye movements in Virtual Reality (VR). Subsequently, we extracted eye movement features from recorded eye videos and applied a machine learning algorithm to establish a PD diagnostic model. Then, we collected eye movement data from 66 participants (including 22 healthy controls and 44 PD patients) in a VR environment for training and testing during visual tasks. Finally, on this relatively small dataset, the results reveal that the Support Vector Machine (SVM) algorithm has better classification potential.

School Refusal Behaviors: The Roles of Adolescent and Parental Factors

School refusal behaviors in adolescents have deleterious immediate and long-term consequences and are associated with mental ill-health such as anxiety and depression. Understanding factors that place youth at higher risk of school refusal behavior may assist in developing effective management approaches. We investigated parental and adolescent factors that may be associated with school refusal behaviors by specifically focusing on the role of parental and adolescent emotion dysregulation, their anxiety and depression, and parental rearing style. First, we hypothesized that adolescents with school refusal behaviors, as well as their parents, will report higher levels of emotion dysregulation, anxiety, and depression compared to their counterparts without school refusal behaviors. Furthermore, we hypothesized that multivariate models testing the role of parental and child factors concurrently will show that parental (emotion dysregulation, anxiety and depression, and rearing styles) and adolescent (emotion dysregulation, anxiety, and depression) factors are associated with school refusal behaviors. One hundred and six adolescents aged 12 to 18 years and their parents completed an online questionnaire measuring both parental and adolescent emotion dysregulation, anxiety, depression, parental rearing styles, and adolescents' school refusal behaviors. Adolescents with school refusal behaviors reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Multivariate analyses showed that parental emotion dysregulation and adolescent age were associated with school refusal behaviors independently. Future management for school refusal behaviors should consider age-tailored approaches by incorporating training for parental emotion regulation skills.

Mathematics anxiety and math achievement in primary school children: Testing different theoretical accounts

Some students suffer from math anxiety and experience negative emotions in mathematics education. Children's math anxiety is negatively related to their math achievement, suggesting that math anxiety puts their math learning at risk. Several theoretical accounts have been proposed that help to explain this association between math anxiety and achievement. In the current study, we aimed to test predictions of two prominent theories, namely the disruption account and the reduced competency account, using a comprehensive and unifying approach. A sample of 6- to 8-year-olds (N = 163) answered a math anxiety questionnaire, solved a spatial task (mental rotation), and solved several arithmetic problems. After each arithmetic problem, they were asked how they solved the problem. Strategies were then classified into counting and higher-level mental strategies (including decomposition and retrieval), with higher-level strategies loading strongly on working memory resources. Analyses revealed a negative, albeit small, association between children's math anxiety and accuracy in solving arithmetic problems. In line with the disruption account, children's frequency of using higher-level mental strategies mediated this relation between math anxiety and arithmetic performance. Moreover, our results support the reduced competency account given that arithmetic performance was related to math anxiety, whereas mental rotation was only indirectly related to math anxiety. Overall, our findings corroborate both accounts, lending further support to the notion that these accounts might not be mutually exclusive. Our findings imply that interventions might be most effective when focusing on emotion regulation strategies and improving mathematical and spatial performance.

Age-related changes in how 5- to 8-year-old children use and execute finger-based strategies in arithmetic

To determine how young children use and execute finger-based strategies, 5- to 8-year-olds were asked to solve simple addition problems under a choice condition (i.e., they could choose finger-based or non-finger strategies on each problem) and under two no-choice conditions (one in which they needed to use finger-based strategies on all problems and one in which they could not use finger-based strategies). Results showed that children (a) used both finger-based and non-finger strategies to solve simple addition problems in all age groups, (b) used fingers less and less often as they grew older, especially while solving smaller problems, (c) calibrated their use of finger-based strategies to both problem features and strategy performance, and (d) improved efficiency of both finger-based and non-finger strategy execution. Moreover, (e) strategy performance was the best predictor of strategy selection in all age groups, and (f) when they had the possibility to use fingers, children of all age groups obtained better performance relative to when they could not use fingers, especially on larger problems.

Effects of a staff physical activity professional development intervention on preschoolers' mental health and self-regulation: The active learning Norwegian Preschool(er)s (ACTNOW) cluster randomised controlled trial

BACKGROUND AND AIM

Physical activity may have positive effects on preschoolers' mental health and self-regulation. The preschool setting provides children with opportunities to meet physical activity guidelines and could improve with staff training in delivering physical activity. This study examined the effect of physical activity professional development for preschool staff on preschoolers' proxy-measured mental health and self-regulation.

METHODS

In total, 1265 children from 46 preschools were cluster randomised to either the intervention or the control group. The intervention was nested within two levels implemented concurrently: the preschool level, formed as a professional development where preschools conducted development work, and the child level, with whom the staff implemented physical activity with four core components. Data were analysed using an ANCOVA model through structural equation modelling with latent outcome factors of: emotional problems, peer problems, hyperactivity, and prosocial behaviour from the Strength and Difficulties Questionnaire; and cognitive, emotional, and behavioural self-regulation from the Child Self-regulation and Behaviour Questionnaire.

RESULTS

No effects of the intervention (standardised effect sizes -0.195-0.145, p-values 0.118-0.893) were observed. Secondary analysis showed that children with initially high prosocial behaviour and behavioural self-regulation positively benefited from the intervention (p = 0.035 and p = 0.047, respectively).

CONCLUSION

The ACTNOW intervention had no effects on preschoolers' mental health or self-regulation after 18 months, besides effects for children with initially the highest prosocial behaviour and behavioural self-regulation. Although the professional development was more extensive than previous studies it may have been insufficient to change the preschools physical activity practices.

CLINICAL TRIAL REGISTRATION

www.

CLINICALTRIALS

gov identifier NCT04048967.

Is it possible to promote executive functions in university students? Evidence of effectiveness of the πFEx-Academics

Executive functions (EF) impact the success of university students. These skills appear to have a predictive role in academic performance. The aim of this study was to investigate the effectiveness of an intervention program in EF aimed at university students, the πFex-Academics, seeking to verify whether there are gains in EF, a reduction in inattention and hyperactivity indicators and a transfer to reading comprehension. Participants were two professors and their respective classes, totaling 129 students. The classes were divided into: experimental group (EG) (n = 66) and control group (CG) (n = 63). All students underwent a pre- and post-intervention assessment. The program implementation process was mediated by the EG professor. Although no direct gains were identified in the indices of EF difficulties, greater gains in the EG were verified in the hyperactivity/impulsivity and reading comprehension indices, when compared to the CG. These findings are promising, demonstrating the first evidence of the effectiveness of the πFex-Academics. The incorporation of interventions into the university context can provide various benefits for students, with improved behavior and written language processing, necessary for the best possible academic success. Activities of EF mediation for higher education learning can be incorporated into extension courses or the curriculum of university courses.

Perceived Peer Integration, Parental Control, and Autonomy Support: Differential Effects on Test Anxiety during the Transition to Secondary School for Girls and Boys

Although previous research has investigated the impact of parents and peers on test anxiety in secondary or tertiary education, little is known about younger students, especially during the transition to secondary school. Additionally, it is unclear whether these social factors affect girls' and boys' test anxiety differently. Therefore, the current study examined the role of perceived peer integration into the new class context, perceived parental control, and autonomy support on girls' and boys' test anxiety (worry and emotionality) during the transition to secondary school. Data from 1770 students (Mage = 10.47, SD = 0.56; 51% females) were analyzed before (4th grade) and after the transition (5th grade) using a multigroup (girls vs. boys) structural equation model. Both facets of test anxiety decreased from 4th to 5th grade. Perceived peer integration into the new class was only relevant for girls' test anxiety, while parental control predicted post-transition test anxiety for boys. The results suggest that the perceived social environment is an important factor in helping students cope with the demands of the transition to secondary school.

Substance use among trans and gender diverse young people in Australia: Patterns, correlates and motivations

INTRODUCTION

There is a dire paucity of research into the burden, correlates and motives of substance use among trans young people in Australia.

METHOD

Using data from a national survey of Australian trans young people (N = 859, Mage = 19.4), we estimated prevalence of past 6-month substance use (tobacco, alcohol, cannabis, other drugs) and lifetime substance use disorder diagnoses. Covariate-adjusted multivariate logistic regression models tested associations between substance use types with 18 interpersonal factors. Open-ended responses regarding substance use motives (n = 489) were qualitatively analysed using thematic analysis with an interpretative phenomenological approach.

RESULTS

Prevalence of lifetime substance use disorder diagnosis was 13.5% (95% confidence interval [CI] 11.1, 16.1). Alcohol use was most reported (72.4%; 95% CI 68.9, 75.6) followed by tobacco (31.1%; 95% CI 27.7, 34.6) and cannabis (30.6%; 95% CI 27.2, 34.2). Trans women reported highest rates of alcohol and cannabis use; use of other drugs was highest among trans men. Highest risk of substance use was observed among trans youth who experienced discrimination, intimate partner abuse, peer rejection and lack of family support (adjusted odds ratios ranging 1.5 to 3.0). Four multi-levelled themes of substance use motives were identified: circumstantial use, somatic use, feeling better about oneself and one's life, and harm reduction.

DISCUSSION AND CONCLUSIONS

While substance use among trans young is largely circumstantial, hedonistic and altruistic, facilitating self-exploration, friendship and community connectedness, substance use among trans young people is highly prevalent and may be used to cope with sleep difficulties, depression/anxiety and cisnormativity, including delays and waitlists for accessing gender-affirming care.

Overcoming socioeconomic adversity: Academic resilience in mathematics achievement among children and adolescents in Ireland

Although socioeconomic disadvantage is linked with academic underachievement, many children from low-income backgrounds perform well in school. Which modifiable factors predict this academic resilience? We examine between- and within-person predictors of one important academic metric - mathematics performance - across adolescence in 1715 (796 male, 919 female) youth living in poverty in Ireland, using data from three waves (9, 13, and 17/18 years) of the Growing Up in Ireland study. Using linear mixed models, math performance was worse when adolescents had more socioemotional and behavioural difficulties, more child-parent relationship conflict, parents had lower expectations of the adolescent's educational achievement, and when primary caregivers had less education. Adolescents who had better intellectual self-concept and attended a non-disadvantaged school had greater math performance. This research adds to the growing body of work suggesting academic resilience is dynamic and multisystemic; it provides potential targets at multiple levels to promote such resilience.

Insufficient evidence for interactive or animated graphics for communicating probability

OBJECTIVES

We sought to analyze interactive visualizations and animations of health probability data (such as chances of disease or side effects) that have been studied in head-to-head comparisons with either static graphics or numerical communications.

MATERIALS AND METHODS

Secondary analysis of a large systematic review on ways to communicate numbers in health.

RESULTS

We group the research to show that 4 types of animated or interactive visualizations have been studied by multiple researchers: those that simulate experience of probabilistic events; those that demonstrate the randomness of those events; those that reduce information overload by directing attention sequentially to different items of information; and those that promote elaborative thinking. Overall, these 4 types of visualizations do not show strong evidence of improving comprehension, risk perception, or health behaviors over static graphics.

DISCUSSION

Evidence is not yet strong that interactivity or animation is more effective than static graphics for communicating probabilities in health. We discuss 2 possibilities: that the most effective visualizations haven't been studied, and that the visualizations aren't effective.

CONCLUSION

Future studies should rigorously compare participant performance with novel interactive or animated visualizations against their performance with static visualizations. Such evidence would help determine whether health communicators should emphasize novel interactive visualizations or rely on older forms of visual communication, which may be accessible to broader audiences, including those with limited digital access.

Is zero more than nothing? Relations between concepts of zero and integer understanding

The concept of zero is challenging for many children. This study investigated conceptions of zero in fifth- through seventh-grade children (N = 72) in the United States and examined how children's conceptions of zero related to other aspects of their integer knowledge. At the outset of the study, many participants held a null conception of zero (i.e., zero as "nothing"), and some participants held a conception of zero as the symmetry point between the positive and negative integers. Participants in higher grades were more likely to hold a symmetry conception. We hypothesized that participants' conceptions of zero would be related to other aspects of their integer knowledge. Relative to participants who held a null conception of zero, participants who held a symmetry conception demonstrated greater knowledge of the additive inverse principle (for every number x, there exists an inverse, -x, such that the two numbers sum to zero) and greater integer arithmetic skill. Conceptions of zero were not related to integer magnitude understanding. We also examined whether a brief lesson focusing on zero as the symmetry point would lead to shifts in participants' conceptions of zero and gains in understanding of the additive inverse principle. Participants were randomly assigned to receive a lesson about zero as null or zero as the symmetry point between positive and negative integers. Relative to the lesson about zero as null, the lesson about zero as the symmetry point did not lead to substantial changes in conceptions of zero or additive inverse knowledge.

Promoting Adolescents' Heritage Cultural Identity Development: Exploring the Role of Autonomy and Relatedness Satisfaction in School-Based Interventions

Given the significance of heritage cultural identity for optimal adolescent development, it is imperative to investigate factors influencing the efficacy of interventions aimed at promoting heritage cultural identity. Using latent profile cluster analysis and multinomial logistic regressions, this longitudinal study examined how autonomy and relatedness need satisfaction at school (1) related to heritage cultural identity development trajectories, and (2) moderated effects of a school-based intervention. The study included N = 198 adolescents (Mage = 12.86 years, SDage = 0.75, 52% female, 41% immigrant descent, 49% intervention group) in Germany. Teacher-student relationships played an important role in facilitating intervention effects on identity development trajectories, emphasizing the importance of the relational context when implementing school-based interventions to promote heritage cultural identity development.

Sex/gender differences in general cognitive abilities: an investigation using the Leiter-3

Research has shown that differences between males and females are not in general intelligence, but only in some specific factors and tasks. We used the Italian standardization of the Leiter-3, which is a completely nonverbal cognitive battery, to investigate the nature of sex/gender (we used sex/gender to reflect the awareness that the effects of biological 'sex' and socially constructed 'gender' cannot be easily separated and that most individuals' identities are informed by both sex and gender) differences. In doing so we used a multigroup confirmatory factor analysis approach. Results confirmed that males and females perform similarly in general intelligence, but present with some specificities. Males perform better on some, but not all, tasks requiring the spatial manipulation of the stimuli, but females consistently outperform males in tasks such as the nonverbal Stroop, requiring inhibition and attention control to a larger extent. The clinical and practical implications of our findings are considerable. The identification of specific cognitive strengths and weaknesses in males and females underscores the importance of tailored approaches in clinical assessments and interventions.

Unravelling self-regulation in early childhood: protocol for the longitudinal SPROUTS study

BACKGROUND

Enough is known about self-regulation to establish it as a priority target for education and intervention efforts beginning in early childhood, yet not enough to meaningfully and reliably alter developmental trajectories. Rather than resigning our aspirations, we need more nuanced and integrative understanding of self-regulation abilities and change.

METHODS

Launching in 2024, SPROUTS is a 3-year longitudinal study of early self-regulation, beginning in the pre-school period (3-5 years old at Wave 1) with retrospective data back to birth and annual data collection across the transition to school period (ages 5-7 years at Wave 3). Data will be collected on children's self-regulation, related abilities, outcomes, as well as prior and current contexts. One nested study within each Wave-that contributes complementary insights via supplementary and in-depth methods and data-will enable further exploration of contemporary issues related to self-regulation.

DISCUSSION

Insights generated can potentiate more effective intervention and education efforts by: improving intervention cost-benefit ratios; identifying likely mechanisms of change; easing burdens of unhealthy and antisocial behaviours associated with low self-regulation; and, most importantly, contributing to giving children the best early start to life. These benefits are timely in the context of intense policy and educational interest in fostering children's self-regulation.

TRIAL REGISTRATION

Open Science Framework: osf.io/maqdg. Date of registration: 26 Sep 2024.

A four-factor model of executive function: Predicting physical and academic outcomes from cognitive assessments in adolescents

Impulsivity and cognitive function are essential for understanding behavioral regulation, particularly in relation to health-risk behaviors like substance use, physical activity, and academic performance. This study examined the factor structure underlying executive function in adolescents using the UPPS-P Impulsive Behavior Scale and NIH Toolbox Cognition Battery. We explored how parental monitoring moderates, and peer network health and perceived stress mediate, relationships between cognitive function and outcomes such as BMI, physical activity, and academic performance. Exploratory factor analysis (EFA) on 2228 observations identified a four-factor model (BIC = -97.92, RMSEA = 0.040, TLI = 0.936), validated by confirmatory factor analysis (CFA) (CFI = 0.961, RMSEA = 0.055). Structural equation modeling (SEM) on 5902 observations showed that parental monitoring moderated Factor 1 (adaptive impulsivity) in relation to physical activity and academic performance, while peer network health mediated Factor 2 (emotional impulsivity) effects on BMI and physical activity. This model underscores the influence of peer relationships, parental involvement, and stress on cognitive, health, and academic outcomes, suggesting that interventions enhancing peer support, reducing stress, and promoting healthy behaviors may improve adolescent well-being.

Working memory training in students with dyslexia: Additional effects to reading and spelling remediation not likely

BACKGROUND

Poor decoding and spelling (literacy) skills have been associated with weak working memory.

AIMS

The aim of this study was to elucidate the contribution of working memory to literacy progress in students with dyslexia. It has been suggested that working memory can be enhanced by training, which in turn may have a positive effect on reading and spelling abilities (e.g., Peijnenborg et al., 2023).

METHODS AND PROCEDURES

Participants consisted of a specific group of children with dyslexia and weak working memory skills (n = 62). The effect of Cogmed training on decoding and spelling progress during remediation was investigated using a randomized controlled trial with three research groups (experimental: Cogmed training; active control: fixed computerized training; passive control group).

OUTCOMES AND RESULTS

Findings revealed that the Cogmed training enhanced working memory to a rather small extent and that no effects of the Cogmed training on literacy progress occurred over and above the reading and spelling remediation program.

CONCLUSIONS AND IMPLICATIONS

Most likely, Cogmed training does not contribute to literacy development in children with dyslexia. The null results are important information for teachers of this specific group of students, albeit inevitably small samples in intervention studies applied to niche populations increase the risk of type-II errors. Therefore, replication studies are needed.

Do concept maps prompt long-term memory in CLIL schoolchildren?

To address the learning disadvantages that students might face in a foreign language (L2) environment, this research explores the impact of concept mapping on enhancing long-term memory retention among Content and Language Integrated Learning (CLIL) pupils. The research design is quasi-experimental and involves sixty Spanish primary education students non-randomly assigned from a Spanish-English semi-public bilingual school. The main hypothesis investigated is that concept maps serve as effective teaching instruments for enhancing long-term memory. During training, new information was systematically integrated with students' prior knowledge to aid long-lasting retention of instructional content. The study examines the use of concept maps in a CLIL classroom as a complement to traditional teaching strategies and instructional design, focusing on improving the recall of previously learned information. Findings show that concept maps are reliable tools for assisting CLIL students whose mother tongue (L1) is not English, significantly reducing forgetfulness because of the precision of the transmitted information. The study shows the potential of concept mapping to improve learning outcomes in L2 settings by providing visual, accurate, and structured learning aids.

Optimizing cognitive load and learning adaptability with adaptive microlearning for in-service personnel

Adaptive microlearning has emerged as a crucial approach for enhancing the working skills of in-service personnel. This study introduces the design and development of an innovative adaptive microlearning (AML) system and investigates its effectiveness compared to a conventional microlearning (CML) system. The main distinguishing feature of an AML system from a CML system is its adaptive features that tailor the learning experience to individual needs, including personalized content delivery, real-time feedback, and adaptive learning paths. A quasi-experimental study involving 111 in-service personnel (NAML = 56, NCML = 55) was conducted. ANCOVA results confirmed that the AML system significantly reduced unnecessary cognitive load due to inappropriate instructional design (mean difference of -20.02, p < 0.05) and significantly improved learning adaptability (mean difference of 40.72, p < 0.05). These findings highlight the potential of adaptive microlearning systems to overcome barriers to effective learning, thereby supporting lifelong learning and professional development in various working contexts.

The role of variable retrieval in effective learning

Current research on memory indicates that learning is most effective when it involves spaced retrieval practice of study materials. Here, we investigated whether the benefits of both retrieval practice and spacing can be further boosted when variability is introduced across practice sessions. Across six experiments, participants learned translations of foreign vocabulary, with foreign words embedded in contextual sentences hinting at the meaning of these words. These sentences were then either kept constant or varied from one learning cycle to another. Whenever repeated practice took the form of retrieval from long-term memory with contextual sentences serving as cues (with or without feedback after retrieval attempts), variable sentences led to better learning of the meanings of the embedded foreign words than constant sentences. The benefits of variable retrieval were observed both immediately after study and after a 24-h delay, and they were larger when retrieval practice was spaced rather than massed. However, these benefits were not appreciated by the learners who judged learning to be more effective with constant rather than variable cues. This metacognitive illusion, misaligning the effectiveness of learning and its appraisal by learners, was confirmed in the seventh experiment which focused on learning lecture content. Thus, while spaced retrieval practice employing variable cues clearly produces robust benefits for memory performance, such benefits may be severely underappreciated by the learners.

Structural model of intelligence beliefs, motivational beliefs, academic self-handicapping and academic adjustment in Chinese undergraduate students

BACKGROUND

Academic adjustment is crucial for students' success and well-being, yet the factors influencing this process must be more adequately understood. Although prior research has explored the impact of Intelligence and motivational beliefs on academic outcomes, there is a need to clarify how these beliefs interact to influence academic adjustment. Specifically, the existing literature needs a comprehensive model that integrates intelligence beliefs, motivational beliefs, and academic self-efficacy and examines their combined effect on academic adjustment.

OBJECTIVES

This research aims to develop and analyze a model that explains the relationships among intelligence beliefs (fixed and growth mindsets), motivational beliefs (including self-efficacy and intrinsic value) and test anxiety in predicting academic adjustment. This study also seeks to investigate the mediating role of academic self-efficacy in these associations, providing a deeper understanding of the underlying mechanisms that contribute to students' academic adaptation.

METHOD

The research employed a correlational methodology, targeting male and female undergraduate students at Inner Mongolia Medical University during the 2021 academic year. The statistical population comprised students from various departments, and a convenience sampling approach was utilized. Data collection involved 384 participants who completed questionnaires, including the Academic Adjustment Questionnaire, Intelligence Beliefs Questionnaire, Motivational Beliefs Questionnaire, and Academic Self-Efficacy Questionnaire.

RESULTS

The findings revealed a favourable fit between the proposed model and the collected data. Furthermore, through a comprehensive direct and indirect effects analysis, it was evident that academic self-efficacy mediated the relationships among intelligence beliefs (both inherent and incremental), self-efficacy, intrinsic value, test anxiety, and academic adjustment. These results contribute to a nuanced understanding of the factors influencing academic adjustment among undergraduate students. CONCLUSIONS AND IMPLICATIONS: In conclusion, this research underscores the pivotal role of academic self-efficacy as a mediator in the nexus between intelligence beliefs (both inherent and incremental) and academic adjustment. The study advocates for heightened attention to these constructs in educational planning. It emphasizes the need for educational interventions that foster positive Intelligence and motivational beliefs and mitigate test anxiety to enhance academic self-efficacy and promote successful academic adjustment. The implications of these findings extend to educators, counsellors, and policymakers involved in shaping the educational experiences of undergraduate students.

The Symptom Structure and Causal Relationships of Comorbid Anxiety and Depression Among Chinese Primary and Middle School Teachers: A Network Analysis

Background

In China, as educational reforms progress, the characteristics of teachers' work have undergone significant changes, resulting in extremely high levels of stress that can trigger anxiety and depression. Anxiety and depression often co-occur, with two mainstream theories explaining this co-existence: the tripartite model and the diathesis-stress model. However, systematic research focusing on this population is relatively scarce, and the applicability of these models has not been thoroughly tested. This study aims to use network analysis methods to examine the interactions between symptoms and analyze the co-existence of anxiety and depression, thereby expanding the research on teachers.

Methods

Data were provided by the Science Database of People Mental Health, which includes 1670 teachers with a mean age of 30.01. The Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to estimate the network structures of anxiety and depression, respectively. Shared symptoms between depression and anxiety were identified using network analysis and clique percolation methods. Bayesian Networks was used to estimate causal relationships between symptoms. Data were analyzed using R packages. Network structure was constructed with the qgraph package, node centrality and bridge symptoms were evaluated using the networktools package, and network stability was measured via the bootnet package. The Clique Percolation method was implemented with the CliqurPercolation package, and Bayesian network modeling was performed via the Bnlearn package.

Results

Dizziness and Easy Fatigability & Weakness were central symptoms in the network. Bridging strength results showed that, the important bridging symptoms included Tachycardia, Depressed Affect, Fatigue, Crying Spell, Easy Fatigability & Weakness, Nightmares, Face Flushing, and Sweating were the strong bridging symptoms. Additionally, Sleep Disturbance played a key mediating role. Depressed Affect and Dissatisfaction were activation symptoms for anxiety-depression co-existence.

Conclusion

Using network analysis, this study elucidated core, bridging, and shared symptoms, as well as potential causal pathways between anxiety and depression. Specifically, somatic symptoms are crucial in maintaining and developing the anxiety-depression network among teachers. Sleep disturbance serves as the sole gateway for mild symptoms to develop into other communities. The Bayesian network identified two key activating symptoms within the teacher anxiety-depression network, validating the applicability of the tripartite model among teachers.

Using Animation to Address Disparities in Kidney Transplantation

This essay reviews an arts-based project based in Buffalo, New York, seeking to educate patients with kidney failure and their social network about the transplantation process. Through a multi-phase arts-based research project, informed by a community-based steering committee and key stakeholders, 33 educational animated videos were developed and tested for efficacy in samples of diverse patients at a regional transplant center. Animation was chosen for its potential to better explain health concepts more sensibly to patients and support knowledge dissemination to their social network, who may donate a kidney or support a recipient or donor. The videos are 2D, short in duration, and designed for easy viewing on small devices using characters, scenes, narration, and movement. Aesthetic choices reinforce learning: characters have confident posture, memorable features (e.g. hair style, clothing color) with minimal detail, and model diverse races, ethnicities, gender, and body types. Scenes feature light backgrounds, illuminate main images, and are as large as possible for small screens. Narration is slow, calm, and uses strategic pauses to introduce concepts. Movement is selective to reinforce the message (signaling). The animation was guided by self-efficacy theory and the cognitive theory of multimedia learning. Findings to date indicate promising results with respect to patient knowledge and the feasibility of using animation to address disparities in kidney transplantation. Figures illustrate the evolution of the project and provide examples of the art used to capture a given aspect of the transplantation process.

The relationship between executive functions and mathematics achievements in early-grade elementary students

Mathematics, along with reading and writing, is a core academic subject in the school curriculum. The development of mathematical skills is influenced by various cognitive factors, with executive functions (EF) playing a central role. EF, which encompasses working memory, inhibitory control, and cognitive flexibility, is critical for supporting complex cognitive processes required for problem-solving and mathematical reasoning. Research consistently shows that children with stronger EF tend to achieve better academic outcomes, including in mathematics. The goal of the present study was to examine the relationships between the global EF and its three core components - working memory, inhibitory control, and cognitive flexibility - and their impact on mathematics achievement. The sample for this study consisted of 180 children, aged 8-11 years (mean age: 9.6, SD: 1.0 year; 83 girls, 97 boys). EF was assessed using the Yellow-Red test, while mathematics achievement was evaluated based on teachers' evaluations of the child's mathematics performance. The results indicated a statistically significant effect of global EF and its three components on mathematics achievement. Given the potential malleability of EFs, we conclude with recommendations for strategies to enhance EF development at an early school age.

Effect of Virtual-Reality-Based Training on Emotions of Medical Students Undertaking Radiation Emergency Medicine: An Educational Experimental Study

OBJECTIVE

Integration of head-mounted virtual reality (VR) devices has been revolutionary in health professions education. In disaster preparedness training, VR simulation-based learning exposes health care professionals to the unique challenges of diverse scenarios, enhancing their adaptability. The aim of the study was to evaluate the effectiveness of a head-mounted VR tool for teaching basic radiation emergency medicine skills to medical students.

METHODS

The participants were 64 medical students (5th-year) who underwent a 3-hour training session in radiation emergency medicine that was conducted via head-mounted VR devices. Students scored their perceived emotion, performance, and self-efficacy at various time points in a self-reported online questionnaire.

RESULTS

Comparison of survey responses before and after the session showed significant differences in terms of neutral emotion (P = 0.011), negative activating emotions (P < 0.001), and negative deactivating emotions (P = 0.004). The post-hoc test revealed statistically significant differences in negative activating emotions between before and during (P < 0.05), and between before and after (P < 0.05) the VR simulation. In addition, negative deactivation and neutral emotions changed significantly after the simulation.

CONCLUSIONS

The use of head-mounted VR devices was effective in modulating medical students' emotions and contributed to improving their perceived performance in radiation emergency medicine.

Digital Location Tracking of Children and Adolescents: A Theoretical Framework and Review

Many parents in the U.S. have begun using GPS-based digital location tracking (DLT) technologies (smartphones, tags, wearables) to track the whereabouts of children and adolescents. This paper lays the foundation for an emerging science of DLT by performing the first theoretical analysis and review of empirical literature on DLT. First, we develop a framework to clarify how DLT should be conceptualized and measured, how it compares to historical strategies for monitoring youths' location, and the mechanisms by which it might affect youth adjustment. Second, we review what is known about DLT today, finding that (1) DLT use is now common from childhood to emerging adulthood, with 33-69% of U.S. families using it; (2) there are sociodemographic differences in DLT use; (3) DLT use has significant cross-sectional associations with other parenting behaviors, with family functioning, and with youth adjustment; and (4) there is much speculation, but minimal data, about the new ethical and developmental issues that might arise from DLT use (e.g., privacy invasions). Third, we critique the existing evidence base to outline priorities for future research, emphasizing the need for longitudinal data, better measurement, and moving beyond convenience samples. We conclude that DLT is a new, common, and vastly understudied parenting behavior of clinical and developmental relevance.

Gaze and hand behaviors during haptic abilities testing-An update to multimedia learning theory

The Cognitive Theory of Multimedia Learning (CTML) suggests humans learn through visual and auditory sensory channels. Haptics represent a third channel within CTML and a missing component for experiential learning. The objective was to measure visual and haptic behaviors during spatial tasks. The haptic abilities test (HAT) quantifies results in several realms, accuracy, time, and strategy. The HAT was completed under three sensory conditions using sight (S), haptics (H), and sight with haptics (SH). Subjects (n = 22, 13 females (F), 20-28 years) completed the MRT (10.6 ± 5.0, mean ± SD) and were classified as high or low spatial abilities scores with respect to mean MRT: high spatial abilities (HSA) (n = 12, 6F, MRT = 13.7 ± 3.0), and low spatial ability (LSA) groups (n = 10, 7F, MRT = 5.6 ± 2.0). Video recordings gaze and hand behaviors were compared between HSA and LSA groups across HAT conditions. The HSA group spent less time fixating on mirrored objects, an erroneous answer option, of HAT compared to the LSA group (11.0 ± 4.7 vs. 17.8 ± 7.3 s, p = 0.020) in S conditions. In haptic conditions, HSA utilized a hand-object interaction strategy characterized as palpation, significantly less than the LSA group (23.2 ± 16.0 vs. 43.1 ± 21.5 percent, p = 0.022). Before this study, it was unclear whether haptic sensory inputs appended to the mental schema models of the CTML. These data suggest that if spatial abilities are challenged, LSA persons both benefit and utilize strategies beyond the classic CTML framework by using their hands as a third input channel. This data suggest haptic behaviors offer a third type of sensory memory resulting in improved cognitive performance.

Exploration of Student Experiences and Perceptions of Self and Peer: Implications for Tailoring Supports

INTRODUCTION

Doctor of Physical Therapy (DPT) students have reported learning new behaviors, enhanced self-awareness, and personal and professional growth during their first year of DPT school. The purpose of this study was to explore in greater depth, through semistructured interviews, the student perceptions of self-identity and social identity.

SUBJECTS

Seventeen early second-year DPT students from 3 universities.

METHODS

This investigation is an extension of a larger multisite study. Qualitative interviews were employed to enable the use of a constructivist lens to explore the importance of personal context in participants' experiences during the first year of DPT school.

RESULTS

Students across programs shared similar characteristics and experiences. Three themes emerged: DPT students share common perceptions of themselves and classmates; sociocultural experiences shaped their actions and perceptions of self; and students recognized the need to change to be successful. The voices of the older second-career students and racially minoritized students were uniquely different from other participants.

DISCUSSION AND CONCLUSION

Doctor of Physical Therapy student experiences are similar across programs except for older students and racially minoritized students. Early professional identity formation was noted as well. A richer understanding of the personal characteristics, influential sociocultural factors, and student perceptions of self and classmates could enable educators to customize supports and educational strategies to help students understand the role their past and present experiences play in shaping their professional identities.

Serratus Anterior Plane Block Remote Learning Curriculum

Introduction

Regional anesthesia aids in management of acute pain in the emergency department, but many emergency physicians remain inadequately trained. Further complicating medical education, our academic center continues to use remote learning as the primary setting for residency didactics. This project aims to create a remote conference session on ultrasound-guided serratus anterior plane blocks (USG-SAPB).

Methods

We used the ADDIE (analyze, design, develop, implement, evaluate) model for curricular design, with emergency medicine residents as our intended learners. For the analyze element, we examined clinical need and resident program evaluation feedback. For design, we utilized best practices for remote learning, principles of mental rehearsal, and multimodal instructional theory. For develop, we completed recruitment of faculty leads, materials, and beta testing of each component. We implemented our 50-minute session on the videoconferencing platform Zoom. For evaluate, we created a program evaluation survey based on Kirkpatrick's evaluation model.

Results

Seventeen learners completed the evaluation. For Kirkpatrick level 1, 94% reported being very or extremely satisfied. For Kirkpatrick level 2, 91% ranked their presession confidence level in performing USG-SAPB as not at all or slightly confident, compared to the postsession, where 88% ranked themselves as moderately, very, or extremely confident. For Kirkpatrick level 3, 94% reported that they would incorporate at least a moderate amount of content into clinical practice.

Discussion

This remote learning session on USG-SAPB demonstrated high levels of learner satisfaction, improvement in learner confidence, and potential to impact learners' clinical practice. Future studies can elucidate patient outcomes related to educational sessions.

Learning how to explore spiritual aspects in encounters with patients with chronic pain: a pre-test post-test trial on the effectiveness of a web-based learning intervention

BACKGROUND

Integrating spiritual aspects into treatment plans can release essential resources for coping with chronic pain. However, some spiritual aspects may also induce distress and hinder the coping process. There is a lack of evidence regarding how to perform the clinical tasks of exploring spiritual aspects and of instruments assessing related competencies. Therefore, we developed a web-based learning module to provide education on the subject alongside corresponding assessment instruments. The module presents the InSpiRe (Integration of Spirituality and/or Religion in patient encounters) protocol. The instruments encompass cognitive, affective, and behavioral dimensions.

METHODS

This paper aims to determine (i) the learning effects associated with completing the web-based spiritual-care learning module and (ii) the reliability and validity of the instruments employed. To address these aims, we conducted a pre-test/post-test trial with N = 32 randomly selected fourth-year medical students. During the pre-test, we assessed the students' knowledge, attitudes, and self-efficacy regarding exploring spiritual aspects. For this purpose, we developed a short-answer knowledge test, an attitude questionnaire, and a self-efficacy scale. Additionally, the students explored spiritual aspects with a simulated patient portraying a person with chronic pain. Three trained raters evaluated the students' performances using a self-developed scale. In the intervention phase, the students completed the 45-minute learning module on a personal computer. The module presented InSpiRe-related content as text and step-by-step video demonstrations, including hints that denote critical actions. The subsequent post-test was identical to the pre-test.

RESULTS

The internal consistency was suitable for all respective instruments, and there was an indication of solid validity of the performance test. After completing the spiritual care learning module, the students showed statistically significant increases in knowledge scores and significant positive shifts in their attitudes and levels of self-efficacy regarding exploring spiritual aspects. They also attained significantly higher performance scores in the same regard.

CONCLUSIONS

Completing the spiritual-care module is associated with meaningful learning effects on cognitive, affective, and behavioral dimensions related to exploring spiritual aspects, as demonstrated in the post-test conducted shortly after the intervention. Due to good reliability and validity scores, the self-developed instruments can be applied appropriately.

Evaluating the Value of Eye-Tracking Augmented Debriefing in Medical Simulation-A Pilot Randomized Controlled Trial

INTRODUCTION

Debriefing after simulation facilitates reflective thinking and learning. Eye-tracking augmented debriefing (ETAD) may provide advantages over traditional debriefing (TD) by leveraging video replay with first-person perspective. This multisite randomized controlled trial compared the impact of ETAD with TD (without eye-tracking and without video) after simulation on 4 outcomes: (1) resident metacognitive awareness (the primary outcome), (2) cognitive load (CL) of residents and debriefers, (3) alignment of resident self-assessment and debriefer assessment scores, and (4) resident and debriefer perceptions of the debriefing experience.

METHOD

Fifty-four emergency medicine residents from 2 institutions were randomized to the experimental (ETAD) or the control (TD) arm. Residents completed 2 simulation stations followed by debriefing. Before station 1 and after station 2, residents completed a Metacognition Awareness Inventory (MAI). After each station, debriefers and residents rated their CL and completed an assessment of performance. After the stations, residents were interviewed and debriefers participated in a focus group.

RESULTS

There were no statistically significant differences in mean MAI change, resident CL, or assessment alignment between residents and debriefers. Debriefer CL was lower in the experimental arm. Interviews identified 4 themes: (1) reflections related to debriefing approach, (2) eye-tracking as a metacognitive sensitizer, (3) translation of metacognition to practice, and (4) ETAD as a strategy to manage CL. Residents reported that eye tracking improved the specificity of feedback. Debriefers relied less on notes, leveraged video timestamps, appreciated the structure of the eye-tracking video, and found the video useful when debriefing poor performers.

CONCLUSIONS

There were no significant quantitative differences in MAI or resident CL scores; qualitative findings suggest that residents appreciated the benefits of the eye-tracking video review. Debriefers expended less CL and reported less perceived mental effort with the new technology. Future research should leverage longitudinal experimental designs to further understand the impact of eye-tracking facilitated debriefing.

Playful activities mitigate relations between parental mental health difficulties and child verbal outcomes

This study examined the role of parental involvement in the home learning environment in the association between parental mental health and child cognitive performance. In a sample of 174 three- to five-year-old children (52% female, 97% White, 7% Hispanic, 2019-2022), playful activities moderated the relation between parental general depression and child verbal reasoning and acquired verbal knowledge. However, there was no evidence that parental involvement moderated the association between parental mental health and child spatial reasoning. These results improve our understanding of the pathways by which parental mental health, even in a non-clinical community sample, relate to child outcomes and raise the possibility of leveraging playful activities as one mechanism to alleviate the potential role of parental mental health difficulties.

Reliability, reproducibility, and feasibility of youth activity profile (YAP) questionnaire in Chilean children and adolescents

This study aimed to evaluate the reliability, reproducibility, and feasibility of the Youth Activity Profile Questionnaire (YAP-SL) in the Chilean version (YAP-C) in a sample of children and adolescents. This cross-sectional study included 160 youth, 59 children (5-11 years old), and 101 adolescents (12-17 years old) from the city of Viña del Mar (Chile). The YAP-SL is a 15-item self-report instrument which was administered twice at an interval of 7 days apart. This questionnaire was designed to capture physical activity (PA) and sedentary behaviour in youths in the last week, categorizing them into three domains: PA at school, PA out-of-school, and sedentary habits. Cronbach's α coefficients were calculated to evaluate the internal consistency (reliability), and the reproducibility was determined by test-retest and Kendall's tau b coefficients. Concerning the total YAP-C score, results indicated moderate-to-high reliability in the total sample (0.71), boys (0.76) and girls (0.66), as well as for children (0.73) and adolescents (0.70). The results also revealed variations in reliability and reproducibility across the three domains. In conclusion, the YAP-SL questionnaire presents moderate-to-high reliability in Chilean children and adolescents. However, the reliability and consistency of the YAP varied across the domains.