The Effectiveness of Blended Learning in Health Professions: Systematic Review and Meta-Analysis

Dental education during the pandemic: Cross-sectional evaluation of four different teaching concepts

Objectives

To evaluate the advantages of student satisfaction with and functionality of three digital teaching concepts during the SARS‐CoV‐2 pandemic compared to a conventional lecture setup.

Methods

This cross‐sectional study was a survey‐based e‐learning research among dental students in the clinical study phase of a department of prosthetic dentistry at a German university hospital. A total of 44 questions were answered in four main sections: 1. general technical components; 2. acceptance; 3. evaluation and functionality; and 4. overall evaluation and grades of the various digital concepts. The use of Zoom conference, livestream, and prerecorded PowerPoint was compared to the conventional lecture setup (control group/CG). Data were analyzed using the Kolmogorov‐Smirnov test, followed by an exploratory data analysis and Cronbach's alpha test (α = 0.05).

Results

Students were very satisfied with the provision, quality, and benefit of the digital concepts. The asynchronous concept was significantly more satisfying than the synchronous concepts in many aspects but was less successful in interactions. In the overall evaluation and grading, the asynchronous concept was rated significantly better than the other synchronous concepts (p ≤ 0.007), followed by Zoom conference, conventional lecture (CG), and livestream, while Zoom conference and the conventional lecture showed no significant difference (p = 0.784).

Conclusions

Students significantly preferred the asynchronous concept to the synchronous concepts. The results suggested that asynchronous concepts are an effective and functional form of distance education during a pandemic. In general, digital teaching concepts are currently widely accepted for maintaining university education.

Converting to a Synchronous Virtual Nursing Research Conference Amidst a Pandemic: A Case Study

University of California San Diego Health was set to launch its 13th annual Nursing and Inquiry Innovation Conference event in June 2020. However, the Coronavirus Disease 2019 (COVID-19) pandemic placed a barrier to large gatherings throughout the world. Because the World Health Organization designated 2020 as the Year of the Nurse and Midwife, the University committed to continuing the large-scale conference, converting to a virtual event. This article reviews the methodologies behind the delivery of the virtual event and implications for user engagement and learning on the blended electronic platform.

Exploring the components of student support system in blended learning for Iranian Universities of Medical Sciences: A thematic analysis

BACKGROUND

Support services are a very important element for all educational institutions. The aims of this study were to explore the components of the student support system in blended learning for universities of medical sciences in Iran.

MATERIALS AND METHODS

The present study was performed qualitative with exploratory approach. The tool used to collect data was a semi-structured interview, after conducting interviews with 17 e-learning experts and specialists of universities of medical sciences, we reached information saturation. The study was conducted at Aja University of Medical Sciences in Tehran in 2020. Data analysis was performed as Thematic Content Analysis by Attride-Stirling method.

RESULTS

From the content analysis of the interviews, 6 main themes and 19 sub-themes were obtained. Main themes included "Scientific- cognitive Support", "Systematic Support", "Human Resource Support", "Emotional Support", "Technical Support" and "Financial- economic Support".

CONCLUSION

Based on the results of this study, 6 basic components and its subcomponents of the student support system were obtained. It is suggested that the educational officials of medical universities with blended learning use the results of this study in setting up their student support system for academic success in e-learning and medical students.

Current Use, Perceived Barriers, and Learning Preference of Point of Care Ultrasound (POCUS) in the Emergency Medicine in Qatar - A Mixed Design

Introduction

Point of care ultrasound (POCUS) has been a part of emergency medicine (EM) training for almost two decades. EM training program has a very broad and rigorous POCUS curricula which, in several cases, does not translate to routine application in clinical settings. This study therefore sought to compare the indications, utilization, barriers, and preferred POCUS educational method in a large Middle Eastern academic EM.

Methodology

A validated questionnaire was emailed to 50 EM faculties between April and May 2019. Volunteer faculty members partook in a semi-structured interview to better understand the indications, current use, barriers, and preferred learning method. Responses were anonymous, and data were analyzed with descriptive statistics.

Results

This was a mixed design study. 30/50 (60%) of faculty responded to the survey, with a mean age of 39.2 years and a mean number of years in practice, 13.1. 55% (n=28) completed POCUS training in less than five years, while 45% completed more than five years ago and 5% never completed it. Forty percent of EM physicians were trained in Africa, while 55% were qualified in Asia and 5% completed their training in Europe. The indications and frequently performed procedures were consistent with the previous research. The common barrier reported was lack of time, lack of credentialing, lack of quality assurance, and national guidelines. The majority of the faculty preferred a blended learning approach for POCUS.

Conclusion

POCUS perceived barriers to its full use include time constraints, lack of national guidelines, and credentialing (awarding POCUS qualifications) of the faculty. Blended learning appears to be the preferred approach towards acquiring the knowledge and skills of POCUS.

Blended teaching versus traditional teaching for undergraduate physiotherapy students at the University of the Witwatersrand

Background

Shifting from face-to-face teaching to incorporating technology may prepare students better for future work as health professionals. Evidence of blended teaching’s effect on the academic performance of undergraduate physiotherapy students’ performance is scarce.

Objective

The purpose of our study was to determine students’ theoretical and clinical performance in a blended teaching module compared to their own performance in two knowledge areas taught face to face, and student perceptions of blended teaching in the third-year physiotherapy curriculum.

Methods

The cross-sectional study design included 47 third-year physiotherapy students. The orthopaedic module was delivered using a blended teaching approach in two consecutive semesters, whilst two other physiotherapy knowledge areas, neuromusculoskeletal and cardiopulmonary, in the same semesters were delivered face to face. Theoretical and clinical performances of students were compared for significance and effect. Students were assessed on their theoretical and clinical knowledge in all areas using the same assessment methods. The students (n = 43) also completed a survey on their blended teaching experience.

Results

Significantly higher theoretical marks for orthopaedics were calculated compared to neuromusculoskeletal and cardiopulmonary for both semesters with a large positive effect (average Cohen d = 4.44) for blended teaching on theoretical examination performance; no statistically significant difference for clinical performances. Students felt engaged in the blended teaching process, and 72% preferred blended teaching over face-to-face teaching or online delivery.

Conclusion

Blended teaching improved the theoretical marks, demonstrating that knowledge acquisition was improved, but not clinical performance.

Clinical implications

The study contributes to the knowledge base of blended learning in Health Science Education in South Africa. The authors identified a gap where future studies should investigate the effect of blended learning on clinical performance outcomes as a continuation from this one.

Determining the effects of blended learning using the community of inquiry on nursing students' learning gains in sudden patient deterioration module

Aims

To determine the effectiveness of blended learning using the community of inquiry framework on nursing students' learning gains in a sudden patient deterioration module.

Design

A quasi‐experimental trial.

Methods

233 Chinese nursing students in their fourth semester of a sudden patient deterioration learning module were assigned to control (N = 113) and experimental group (N = 120). Students in experimental group engaged in community of inquiry‐based blended learning in sudden patient deterioration module, including computer‐aided self‐instruction, team‐based topic discussion and simulation training. Control group learned similar contents through face‐to‐face teaching comprising of a presentation with lecture, tutorial and simulation training. Student assessment of learning gains, knowledge and practical ability was quantified after the interventions.

Results

Compared with control group, students in experimental group had improved student assessment of learning gains (p = .001, Cohen d = 0.69) and practical ability (p < .001, Cohen d = 0.48). Although no significant difference in overall knowledge score, experimental group students did better performance in application and analysis (p = .001, Cohen d = 0.45).

Triage Training in Iran from 2010 to 2020: A Systematic Review on Educational Intervention Studies

BACKGROUND

Accurate decision-making in triage requires continuous education, so triage nurses should receive annual refresher courses. Identifying the most effective method can make the provision of practical education to triage staff in hospitals possible. This review was conducted with the aim to determine the effectiveness of triage education methods in Iran.

MATERIALS AND METHODS

In this systematic review on educational intervention studies, international and Iranian medical sciences databases were searched using a defined search strategy compatible with each database. PubMed, Scopus, Web of Science, Google Scholar, SID, Islamic Science Center (ISC), and IranDoc databases were searched for literature published from January 2010 to January 2020. The MeSH terms of "health care staff," "triage," "education," and "Iran" in English and Persian were combined to develop a search strategy. Initially, 768 article titles were retrieved. Finally, 16 articles were selected for the review.

RESULTS

All conducted studies were quasi-experimental. Half of the studies had used a face-to-face approach for education (workshop, lecture, and simulation), and four studies had used lectures and pamphlets. All studies (except 1) reported that their educational intervention significantly improved nursing knowledge on triage.

CONCLUSIONS

Almost all studies had reported the effectiveness of an educational intervention in improving nurses' triage knowledge. However, it seems that the non-face-to-face method is superior to the face-to-face method because of its learner-centeredness and cost-effectiveness. Moreover, providing educational content using a blended learning approach (simulation and games) can enhance the effectiveness of triage education.

Different pedagogies for acquisition of knowledge and skill: a systematic review and network meta-analysis

BACKGROUND

This network meta-analysis aimed to assess the efficacy of different educational methods for healthcare professionals.

METHODS

A systematic literature search was conducted to identify relevant randomised controlled trials. The standardised mean difference (SMD) with 95% CI was estimated using network meta-analysis for knowledge acquisition and skill performance, and ranked the effects of different educational methods using the surface under the cumulative ranking area (SCURA) technique.

RESULTS

Fifty-five randomised controlled trials including of 4292 participants were identified. Compared with no intervention, the results demonstrated all education methods achieved significant improvements in knowledge acquisition (SMD 1.73-2.66). Only education methods involving high fidelity virtual patient simulation reported significantly better skill performance (SMD 1.25-1.81). High fidelity virtual patient simulation plus self-directed learning was the most effective educational method both in terms of knowledge acquisition (SMD 2.66, 95% CI 1.4 to 4.12, SCURA 0.78) and skill performance (SMD 1.81, 95% CI 0.42 to 3.2, SCURA 0.89).

CONCLUSIONS

Our study demonstrates all educational methods have positive effects on knowledge acquisition, but education methods involving high fidelity virtual patient simulation are better at improving skill performance than other methods.

Developing a blended learning postgraduate teaching programme in anaesthesia: pandemic and beyond

One of the many challenges facing doctors in training during the COVID-19 pandemic was a significant reduction in postgraduate medical education in the form of formal teaching. Consequently, we sought to provide a blended and asynchronous teaching programme that would be delivered to anaesthetic trainees preparing for their postgraduate examinations. Six sessions of 90-minute duration were delivered during the months July, August and September 2020. Each of the six sessions was delivered live using a variety of online educational tools in addition to traditional didactic-style teaching by the presenters. Participants submitted requests for topics to be covered by the presenters in the final of the six sessions. The sessions were recorded and later uploaded onto an online educational learning platform for viewing at the participants' discretion. The live nature of the sessions ensured participant interaction and a sense of community that trainees had come to expect from previous face-to-face teaching sessions prior to the COVID-19 pandemic.Evaluation was via qualitative and quantitative means using preset questions using the Likert scale and a free-text comments box. The results demonstrated positive feedback across all sessions with particular relevance to the interactive element of the course, the content and delivery.This article describes the requirement for a method of continuing postgraduate medical education in an era where traditional face-to-face teaching is not possible and how the introduction of various innovative educational applications and resources can be used to further postgraduate medical education in the future.

The content of the nurses in the lead programme for empowering community nurse leadership in implementing evidence

PURPOSE

This study aims to provide a detailed description of the nurses in the lead (NitL) programme for empowering community nurse leadership in implementing evidence.

DESIGN/METHODOLOGY/APPROACH

The NitL programme is described using the template for intervention description and replication-checklist.

FINDINGS

The NitL programme consists of two components. The first component is a systematic approach with implementation steps and tools to empower community nurses in implementing evidence targeted at encouraging functional activities of older adults offered via a Web-based eLearning programme. The second component is training to empower community nurses in enabling team members to change their practice, which focussed on motivational interviewing, influencing behaviour, dealing with resistance to change and coaching delivered as a combination of group training in practice and background theory via a web-based eLearning programme.

RESEARCH LIMITATIONS/IMPLICATIONS

Further research is needed to evaluate the feasibility and effects of the NitL programme.

PRACTICAL IMPLICATIONS

The NitL programme has been developed in cooperation with community nurses to meet their needs in practice and has the potential to develop leadership for the core tasks of community nurses.

ORIGINALITY/VALUE

The NitL programme has been developed to empower the leadership of community nurses in implementing evidence targeted at encouraging functional activities of older adults. The leadership role of community nurses is key for delivering high-quality care and implementing evidence within the community care setting for encouraging functional activities of older adults to preserve their independence.

A Dietary Assessment Training Course Path: The Italian IV SCAI Study on Children Food Consumption

The eating patterns in a population can be estimated through dietary surveys in which open-ended assessment methods, such as diaries and interviews, or semi-quantitative food frequency questionnaires are administered. A harmonized dietary survey methodology, together with a standardized operational procedure, in conducting the study is crucial to ensure the comparability of the results and the accuracy of information, thus reducing uncertainty and increasing the reliability of the results. Dietary patterns (i) include several target variables (foods, energy and nutrients, other food components), (ii) require several explanatory variables (age, gender, anthropometric measurements, socio-cultural and economic characteristics, lifestyle, preferences, attitudes, beliefs, organization of food-related activities, etc.), and (iii) have impacts in several domains: imbalance diets; acute and chronic exposures affect health, specifically non-communicable diseases; and then sanitary expenditure. On the other hand, food demand has impacts on the food system: production, distribution, and food services system; food wastes and other wastes generated by food-related activities of the households (e.g., packaging disposal) have consequences on the “health of the planet” which in turn can have effects on human health. Harmonization and standardization of measurement methods and procedures in such a complex context require an ad hoc structured information system made by databases (food nomenclatures, portion sizes, food atlas, recipes) and methodological tools (quantification methods, food coding systems, assessment of nutritional status, data processing to extrapolate what we consider validated dietary data). Establishing a community of professionals specialized in dietary data management could lead to build a surveillance system for monitoring eating habits in the short term, thus reducing costs, and to arrange a training re-training system. Creating and maintaining the dietary data managers community is challenging but possible. In this context, the cooperation between the CREA Research Centre for Food and Nutrition and the Italian National Health Institute (ISS) promoted and supported by the Italian Ministry of Health may represent a model of best practice that can ensure a continuous training for the professional community carrying out a nutritional study.

Massive Open Online Courses-based blended versus face-to-face classroom teaching methods for fundamental nursing course

An increasing number of studies focus on the effectiveness of Massive Open Online Courses (MOOC)-based blended learning, whereas none have yet studied using it for teaching fundamental nursing skills at an undergraduate level.To evaluate the effectiveness of MOOC-based blended learning versus face-to-face classroom teaching techniques within the fundamental nursing course at the Faculty of Nursing, University of Xiang Nan, China.This cluster randomized controlled trial enrolled 181 students and assigned them into either an MOOC-based blended or a face-to-face classroom teaching group, both involving the Fundamental Nursing course for undergraduate nursing students. The analyzed outcomes included test scores, critical thinking ability, and feedback received from the students on the Fundamental Nursing course.MOOC-based blended techniques versus face-to-face classroom teaching methods demonstrated higher daily performance (P = .014), operational performance (P = .001), theoretical achievements (P < .001), and final grades (P < .001) in Fundamental Nursing.Moreover, the mean change in the participants' critical thinking ability items between groups were, mostly, statistically significant. The items focusing on the feedback from the students demonstrated significant differences between the groups in terms of their satisfaction with the teaching they received (P < .001) and the overall learning effects (P = .030).This study confirmed that receiving MOOC-based blended learning was superior when compared against face-to-face classroom teaching techniques for learning within the Fundamental Nursing course.

Effectiveness of face-to-face, blended and e-learning in teaching the application of local anaesthesia: a randomised study

BACKGROUND

Local anaesthesia plays a key role in many aspects of a dentist's work. The required skills to perform anaesthesia successfully are acquired at university. To take advantage of the possibilities for new teaching formats, a blended learning concept for the local anaesthesia course was developed. The aim of the study was to compare the effectiveness of face-to-face, blended and e-learning in teaching in local anaesthesia by assessing students' knowledge gain, performance of practical skills and satisfaction with the course.

METHODS

All participants (n = 37) were randomly allocated into three groups. After acquiring the theoretical background in the blended learning, e-learning or lecture groups, a test to assess knowledge gain was performed. The performance of the practical skills was assessed in a small-group seminar. Student attitudes were evaluated with a questionnaire.

RESULTS

The blended group showed significantly better results (mean = 17, SD =1.5) in theoretical knowledge gain than the other two groups (e-learning group: mean = 14.7, SD = 2.2; lecture group: mean = 14.8, SD =2.3). When comparing the results of the clinical skills assessment, there was no significant difference among all three groups (p > 0.017). The participants confirmed a high overall satisfaction with the course, in particular with the blended learning approach.

CONCLUSION

This study indicates that blended learning improves the learning outcome for theoretical knowledge in teaching local anaesthesia more than either face-to-face learning or e-learning alone. Furthermore, the blended learning approach is highly appreciated by the students. For acquiring practical skills, this study shows that blended learning is as effective as other teaching methods.

Privacy Concerns Over the Use of Webcams in Online Medical Education During the COVID-19 Pandemic

The emergence of the coronavirus diseases 2019 (COVID-19) pandemic has transformed traditional classroom education to online learning worldwide. Challenges to this sudden transformation include protecting student privacy while using online medical education services. Consequently, dealing with challenges to online medical education became a heated debate at Alfaisal University. This study aimed to determine the challenges of using webcams during online classes and the ensuing implications for medical education during the COVID-19 pandemic. A cross-sectional study was conducted during the 2020-2021 academic year. The study investigators developed and validated a self-administered online questionnaire that targeted preclinical and clinical medical students at Alfaisal University, which is a private not-for-profit academic institution that was founded in 2008. Alfaisal University consists of five colleges: Medicine, Business, Engineering, Pharmacy, and Science. A total of 319 medical students completed the study questionnaire, with a response rate of 25%. The median age of the study sample was 21 years, with 63.3% females; 78.1% were in preclinical (first to third) years and 21.9% were in clinical (fourth to fifth) years. Of the respondents, 76.5% reported not using webcams when communicating via social media and 64.3% preferred blended learning, i.e., a combination of face-to-face and online learning. An overwhelming majority (91.5%) of study respondents were against using webcams in online classes for reasons including privacy (88.4%) and anxiety (64.4%). Privacy was the main concern of study respondents. Information about online privacy, including information being collected and how it will be used, should be provided to the students. Effective strategies to improve online learning experiences and protect the privacy of students should be explored.

A hemodialysis curriculum for nephrology fellows using a blended learning approach: best of both worlds?

A comprehensive, hands-on hemodialysis curriculum during nephrology training is necessary for effective learning and optimal patient care. Traditional instructive approaches are unable to fully meet the needs of the digitally inclined learner and are limited by time constraints and increasing clinical workload. Internet based learning (E-learning) is becoming increasingly popular in medical education and nephrology and gaining even greater relevance in the COVID era. However, it presents technical challenges and may create an environment of social isolation. A ‘blended learning approach’ combines E-learning with traditional methods of teaching and offers advantages over either approach alone. We have designed and implemented a formalized hemodialysis curriculum at our institution that is based on blended learning, utilizing faculty-created E-learning tools combined with traditional pedagogical methods (bed-side and classroom). The web-based tools discuss hemodialysis adequacy, principles of urea transport, hemodialysis access examination and access complications. These tools are open access and structured around the science of cognitive learning using animation, interactivity, self-assessment and immediate feedback features. They have been viewed by a wide audience of nephrologists, dialysis nurses as well as medicine house-staff and have received strong validation in a post-test survey. The online tools have supported a ‘flipped classroom’ instructive model and our blended curriculum has been successfully used for nephrology fellow training at our institution. Incorporating faculty designed/approved E-learning tools to create a ‘blended’ nephrology curriculum for trainees at various levels of medical education, can help streamline active and time-efficient learning, with the goal of improving learner engagement, knowledge acquisition and academic curiosity in the field.

Implementation of an interprofessional collaboration in practice program: a feasibility study using social network analysis

BACKGROUND

Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people.

METHOD

A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis.

RESULTS

The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program.

CONCLUSIONS

This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.

Impact of COVID-19 on digital medical education: compatibility of digital teaching and examinations with integrity and ethical principles

The COVID-19 (coronavirus disease 2019) pandemic in 2020 has had a lasting impact on all areas of personal life. However, the political, economic, legal and healthcare system, as well as the education system have also experienced the effects. Universities had to face new challenges and requirements in teaching and examinations as quickly as possible in order to be able to guarantee high-quality education for their students.

This study aims to examine how the German-speaking medical faculties of the Umbrella Consortium of Assessment Network (UCAN) have dealt with the challenges but also the opportunities that the outbreak of the COVID-19 pandemic created in medical education and whether digitalisation has been driven forward as a result. In an initial online-survey we focused our questions on the current teaching situation with regard to digitised teaching content, the support or establishment of adequate framework conditions by the medical faculties and IT facilities and also the execution of examinations during the summer semester 2020.

Between August and September 2020, a total of 88 examiners, educators, dean of study and/or technical admins from 32 partner faculties took part in the survey. Students were not included in our survey. Most respondents stated that a switch to a digital semester had worked, the use of e-learning increased compared to previous semesters and that most courses could be converted, with the exception of practical courses, which were largely cancelled. The respondents also indicated that most examinations could still be taken, with the exception of practical examination formats, like Objective Structured Clinical Examinations (OSCEs). However, in the case of face-to-face examinations, strict distance and hygiene conditions had to be obeyed or there had to be a switch to distance-online examinations, which raised many open issues such as equal opportunities of students (technical equipment, internet access, premises) and attempts at deception (third-party help with the exam, mutual exchange between students, web search).

In conclusion, we identified several issues regarding the rapid transition to a digital semester due to COVID-19 which were categorised into the following topics: Face-to-face teaching could not take place, (2) know-how of educators, (3) integrity aspects, (4) technical aspects, (5) additional personnel required, (6) additional time and effort required for implementation of digital teaching. Our study shows that a switch to digital teaching and distance online examinations is feasible, but many problems were encountered concerning academic integrity and basic ethical principles still need to be solved. In order to investigate whether above mentioned issued could be solved one year after the transition to a digital semester, we conducted a second survey in which the 32 initially surveyed institutions were questioned again.

Significant differences in written assessments as a result of a blended learning approach used in a clinical examination course in internal medicine: a randomized controlled pilot study

Background: Taking a medical history and performing a physical examination represent basic medical skills. However, numerous national and international studies show that medical students and physicians-to-be demonstrate substantial deficiencies in the proper examination of individual organ systems. Aim: The objective of this study was to conduct a randomized controlled pilot study to see if, in the context of a bedside clinical examination course in internal medicine, an additional app-based blended-learning strategy resulted in (a) higher satisfaction, better self-assessments by students when rating their history-taking skills (b1) and their ability to perform physical examinations (b2), as well as (c) higher multiple-choice test scores at the end of the course, when compared to a traditional teaching strategy. Methods: Within the scope of a bedside course teaching the techniques of clinical examination, 26 students out of a total of 335 students enrolled in the 2012 summer semester and 2012/2013 winter semester were randomly assigned to two groups of the same size. Thirteen students were in an intervention group (IG) with pre- and post-material for studying via an app-based blended-learning tool, and another 13 students were in a control group (CG) with the usual pre- and post-material (handouts). The IG was given an app specifically created for the history-taking and physical exam course, an application program for smartphones enabling them to view course material directly on the smartphone. The CG received the same information in the form of paper-based notes. Prior to course begin, all of the students filled out a questionnaire on sociodemographic data and took a multiple-choice pretest with questions on anamnesis and physical examination. After completing the course, the students again took a multiple-choice test with questions on anamnesis and physical examination. Results: When compared to the CG, the IG showed significantly more improvement on the multiple-choice tests after taking the clinical examination course (p=0.022). This improvement on the MC tests in the IG significantly correlated with the amount of time spent using the app (Spearman's rho=0.741, p=0.004). Conclusion: When compared to conventional teaching, an app-based blended-learning approach leads to improvement in test scores, possibly as a result of more intensive preparation for and review of the clinical examination course material.

Teaching alcohol and smoking counselling in times of COVID-19 to 6th-semester medical students: experiences with a digital-only and a blended learning teaching approach using role-play and feedback

Objectives: Digital teaching formats have seen increased use, and not just since the beginning of the pandemic. They can also be used to teach cognitive, practical and communicative learning objectives effectively. We describe the implementation of an online-only course on alcohol/smoking counselling in the COVID-19 summer semester (SS) 2020 and an inverted classroom (IC) concept in the winter semester (WS) 2020/21 at the University Hospital of Würzburg. Methodology: The interdisciplinary subject of "prevention" teaches students about high-risk alcohol consumption/smoking and how to conduct a brief verbal intervention. All 143 (SS) and 131 (WS) 6^th-semester medical students completed a 90-minute course: module 1 included a Prezi^® presentation on alcohol/smoking basics. Module 2 introduced a counselling concept (alcohol or smoking) online or classroom-based (WS only), depending on the participants' choice. In the online practical component, each student created a counselling video and reflections at home, and later received written feedback from lecturers/tutors. Supervised role-playing was used in the classroom-based format in the WS. There were 2 exam questions on module 1 at the end of each semester. Results: The students surveyed (11%) were satisfied with module 1. Practical exercises and feedback received praise in the evaluation of the classroom-based format (response: 97%). It was not possible for all students to perform counselling due to time constraints. A majority of participants filmed live role-playing in the online practical component. The exam questions were answered correctly by 31% (SS) and 36% (WS) respectively. Conclusions: Counselling can also be taught digitally: creating one's own videos with delayed written feedback is an innovative form of teaching. We are now aiming for a mix of both aspects as an IC with 90 minutes of classroom-based practical exercises.

Rapid Intensive Care Unit Onboarding in Response to a Pandemic

BACKGROUND

In the wake of the coronavirus disease 2019 (COVID-19) pandemic, hospital resources have been stretched to their limits. We introduced an innovative course to rapidly on-board a group of non-intensive care unit (ICU) nurse practitioners as they begin to practice working in a critical care setting.

OBJECTIVE

To assess whether a brief educational course could improve non-ICU practitioners' knowledge and comfort in practicing in an intensive care setting.

METHODS

We implemented a multi-strategy blended 12-week curriculum composed of bedside teaching, asynchronous online learning and simulation. The course content was a product of data collected from a targeted needs assessment. The cognitive learning objectives were taught through the online modules. Four simulation sessions were used to teach procedural skills. Bedside teaching simultaneously occurred from critical care faculty during daily rounds. We assessed learning through a pre and post knowledge multiple choice question (MCQ) test. Faculty assessed learners by direct observation and review of clinical documentation. We evaluated learner reaction and comfort in critical practice by comparing pre and post surveys.

RESULTS

All 7 NPs were satisfied with the course and found the format to work well with their clinical schedules. The course also improved their self-reported comfort in managing critically ill patients in a medical ICU. There was an increase in the mean group score from the pre-to the post-course MCQ (60% vs 73%).

CONCLUSIONS

The COVID-19 Critical Care Course (CCCC) for NPs was implemented in our ICU to better prepare for an anticipated second surge. It focused on delivering practical knowledge and skills as learners cared for critically ill COVID-19 patients. In a short period of time, it engaged participants in active learning and allowed them to feel more confident in applying their education.

Communication about breast cancer genetic counseling with patients with limited health literacy or a migrant background: evaluation of a training program for healthcare professionals

Access to breast cancer genetic counseling is suboptimal for patients with limited health literacy or a migrant background due to ineffective communication and lack of healthcare professionals' recommendation. This study examines the effect of a blended training program (Erfo4all) for healthcare professionals on their awareness, knowledge, and self-efficacy towards communication about genetic counseling with patients with limited health literacy or a migrant background. In total, 59 breast surgeons and specialized nurses from 16 Dutch hospitals completed an online module and group training. Knowledge, self-assessed awareness, and self-efficacy were assessed before the training and 33 participants also completed a posttest questionnaire 6 months after the training program. We also assessed the perceived applicability and relevance of the training program from healthcare professionals' perspectives. We found a significant increase in self-assessed awareness of the prevalence and impact of limited health literacy and in healthcare professionals' self-efficacy to recognize limited health literacy and to communicate effectively with patients with limited health literacy or a migrant background. We did not find an increase in knowledge score. Almost all healthcare professionals reported that they use the techniques learned in the training, such as the teach-back method and plain language, and felt more confident discussing breast cancer genetic counseling. Our results suggest that a blended training program for healthcare professionals has potential to improve their ability to communicate effectively about breast cancer genetic counseling with patients with limited health literacy or a migrant background and offers a promising way to increase the referral rate for these groups of patients.

Blended learning versus face-to-face learning in an undergraduate nursing health assessment course: A quasi-experimental study

BACKGROUND

Blended learning, which integrates face-to-face and online instruction, is increasingly being adopted. A gap remains in the literature related to blended learning, self-efficacy, knowledge and perceptions in undergraduate nursing.

OBJECTIVES

To investigate outcomes of self-efficacy, knowledge and perceptions related to the implementation of a newly blended course.

DESIGN

This was a quasi-experimental pre-post test design.

SETTING

This study was conducted at an undergraduate university in Alberta, Canada.

PARTICIPANTS

A total of 217 second-year undergraduate nursing students participated and 187 participants completed all study components.

METHODS

A convenience sampling method was used. Data were collected at the start and end of the semesters. Data were analyzed using descriptive and inferential statistics using R(3.4.3) and R-Studio(1.1.423).

RESULTS

There were no significant differences in self-efficacy scores between groups or in the pre-post surveys (p > 0.100) over time. There was no significant difference in knowledge between the blended online and face-to-face groups (p > 0.100). For students in the blended course, perceptions of the online learning environment were positive.

CONCLUSION

Blended learning has the potential to foster innovative and flexible learning opportunities. This study supports continued use and evaluation of blended learning as a pedagogical approach.

Educational theory and its application to advanced life support courses: a narrative review

The knowledge, skills and attitudes taught on Advanced Life Support (ALS) courses are an important learning requirement for healthcare professionals who are involved with the care of acutely unwell patients. It is essential that the course design and delivery is appropriately planned to ensure that it optimises the learning opportunities for all learners. This paper offers a narrative review of how the application of educational theory has positively influenced the evolution of ALS courses since their inception in the late twentieth century. By embracing and understanding the relevant educational theories, the ALS course design has transformed from a predominantly lecture-based and behaviourist approach, to a more participative and social constructivist approach to learning. In addition, the advent of smarter technology and the challenges posed by the COVID-19 pandemic have facilitated a more connectivist approach to learning. It can therefore be demonstrated that the ALS course is influenced by a combination of theoretical approaches and provides a diverse framework of teaching and learning strategies that cater for many individual learning styles. Any further evolution and development of the course should be based upon contemporary educational theory to ensure that it remains fit for purpose.

How medical education survives and evolves during COVID-19: Our experience and future direction

Background

Due to the outbreak of coronavirus disease 2019 (COVID-19), school openings were postponed worldwide as a way to stop its spread. Most classes are moving online, and this includes medical school classes. The authors present their experience of running such online classes with offline clinical clerkship under pandemic conditions, and also present data on student satisfaction, academic performance, and preference.

Methods

The medical school changed every first-year to fourth-year course to an online format except the clinical clerkship, clinical skills training, and basic laboratory classes such as anatomy lab sessions. Online courses were pre-recorded video lectures or live-streamed using video communication software. At the end of each course, students and professors were asked to report their satisfaction with the online course and comment on it. The authors also compared students’ academic performance before and after the introduction of online courses.

Results

A total of 69.7% (318/456) of students and 35.2% (44/125) of professors answered the questionnaire. Students were generally satisfied with the online course and 62.2% of them preferred the online course to the offline course. The majority (84.3%) of the students wanted to maintain the online course after the end of COVID-19. In contrast, just 13.6% of professors preferred online lectures and half (52.3%) wanted to go back to the offline course. With the introduction of online classes, students' academic achievement did not change significantly in four subjects, but decreased in two subjects.

Conclusions

The inevitable transformation of medical education caused by COVID-19 is still ongoing. As the safety of students and the training of competent physicians are the responsibilities of medical schools, further research into how future physicians will be educated is needed.

Production and digital discussion of video presentations by students - a project report

In the summer semester 2020, the module "People in different stages of life" in the Bachelor program "Interprofessional Health Care, B.Sc." had to be adapted to online teaching. The module exam, originally planned as an oral presentation, was presented by the students in interprofessional tandems as a video presentation using case studies. Based on cognitive and social constructivism, all students reflected on these video presentations using the "Think-Pair-Share" method. Similar to regular inverted classroom methods, knowledge transfer through the video presentations was asynchronous and cognitively constructive; accompanying discussion questions of the respective speakers were answered in writing by the fellow students (Think). The students met independently online in small groups on a regular basis to discuss the respective presentations and questions based on personal and professional experiences (Pair; socially constructed). In open online debriefings with the lecturers, the speakers and all interested students, relevant aspects were taken up and discussed again (Share). First experiences showed that the students enjoyed the production of the video presentations and that many of them voluntarily participated in the discussion rounds, in which aspects of health care beyond the presentations were discussed. Considering the experiences made, continuing online teaching in this format may be worthwhile for both lecturers and students.

The use of the community of inquiry survey in blended learning pedagogy for a clinical skill-based module

AIM AND OBJECTIVES

The primary aim of this study was to examine the effectiveness of the blended learning pedagogy in a clinical skill-based module using the Community of Inquiry (CoI) framework. The secondary objectives were to assess the effectiveness of blended learning in improving the nursing knowledge, and students' satisfaction with this approach.

BACKGROUND

Blended learning is increasingly adopted in education as more online resources are made available for tutors to use for the benefit of their students. That implied a reduction in the face-to-face contact time in replacement for online teaching, which therefore warrants a need to examine the effectiveness of blended learning approach. The application of CoI framework could evaluate the blended learning approach to assist teaching faculty with evidence-based practices on online teaching.

DESIGN

This study used the quasi-experimental, pretest-posttest design, and results were presented according to the Transparent Reporting of Evaluations with Nonrandomised Designs (TREND) guidelines.

METHODS

This study was conducted in a university and recruited 219 Year 1 nursing students who completed a clinical-based module.

RESULTS

The results of the CoI survey found that teaching presence scored the highest mean, followed by cognitive and social presence. The design of the blended learning was effective in enhancing students' knowledge but they only expressed a moderate level of satisfaction.

CONCLUSIONS

Blended learning is a feasible pedagogical strategy for a clinical skill-based module. However, further investigation is required to explore the factors and strategies which could improve students' satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Blended learning has become one of the contemporary trends in education. Refining teaching strategies may meet the learning needs of today's generation and improve students' learning outcomes.

The feasibility and effectiveness of a blended-learning course for detecting and avoiding bias in medical data: a pilot study

BACKGROUND

Conflicts of interest (COIs), including those arising from interactions with pharmaceutical companies, may lead to bias in medical data. Although medical students are now requesting more education on COIs and bias, they are still not adequately taught during medical school, and few published courses on this topic exist. The objective of our study was therefore to evaluate the feasibility and effectiveness of a blended-learning course for detecting and avoiding bias in medical data, with a special focus on COIs.

METHODS

We developed a blended learning course on bias detection, COIs, and risk communication. It was piloted in the Fall Semester of 2019/2020 using a pre/post-test design. The primary outcome was a gain in bias detection skills, tested by a novel key feature test. Secondary outcomes were (i) skepticism (tested using an attitude questionnaire), (ii) the intention to manage COIs in a professional way so as to avoid bias (tested using a situational judgment test) and (iii) the course evaluation by the students.

RESULTS

Seventeen students participated in the study. The key feature test showed a significant improvement in bias detection skills at post-testing, with a difference in means of 3.1 points (95%-CI: 1.7-4.4, p-value: < 0.001; highest possible score: 16 points). The mean score after the course was 6.21 (SD: 2.62). The attitude questionnaire and situational judgment test also showed an improvement in skepticism and intentions to manage COIs, respectively. Students evaluated the course as having been worthwhile (Median: 5, IQR: 0.75, Likert-Scale 1-6, 6 = fully applicable).

CONCLUSIONS

The blended learning format of the course was feasible and effective. The results suggest a relevant learning gain; however, the low mean score on the key feature test after the course reflects the difficulty of the subject matter. Although a single course has the potential to induce significant short-term improvements in bias detection skills, the complexity of this important subject necessitates its longitudinal integration into medical curricula. This concept should include specific courses such as that presented here as well as an integration of the topic into clinical courses to improve context-related understanding of COIs and medical data bias.

Methodology of Specialist Physicians Training: From Traditional to e-Learning

Different studies show that mixed methodology can be effective in medical training. However, there are no conclusive studies in specialist training on advanced life support (ALS). The main objective of this research is to determine if, with mixed didactic methodology, which includes e-learning, similar results are produced to face-to-face training. The method used was quasi-experimental with a focus on efficiency and evaluation at seven months, in which 114 specialist doctors participated and where the analysis of the sociodemographic and pre-test variables points to the homogeneity of the groups. The intervention consisted of e-learning training plus face-to-face workshops versus standard. The results were the performance in knowledge and technical skills in cardiac arrest scenarios, the perceived quality, and the perception of the training. There were no significant differences in immediate or deferred performance. In the degree of satisfaction, a significant difference was obtained in favour of the face-to-face group. The perception in the training itself presented similar results. The main limitations consisted of sample volume, dropping out of the deferred tests, and not evaluating the transfer or the impact. Finally, mixed methodology including e-learning in ALS courses reduced the duration of the face-to-face sessions and allowed a similar performance.

Factors affecting the acceptance of blended learning in medical education: application of UTAUT2 model

BACKGROUND

Blended learning is a new approach to improving the quality of medical education. Acceptance of blended learning plays an important role in its effective implementation. Therefore, the purpose of this study was to investigate and determine the factors that might affect students' intention to use blended learning.

METHODS

In this cross-sectional, correlational study, the sample consisted of 225 Iranian medical sciences students. The theoretical framework for designing the conceptual model was the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). Venkatesh et al. (2012) proposed UTAUT2 as a framework to explain a person's behavior while using technology. Data were analyzed using SPSS-18 and AMOS-23 software. Structural equation modeling technique was used to test the hypotheses.

RESULTS

The validity and reliability of the model constructs were acceptable. Performance Expectance (PE), Effort Expectance (EE), Social Influence (SI), Facilitating Conditions (FC), Hedonic Motivation (HM), Price Value (PV) and Habit (HT) had a significant effect on the students' behavioral intention to use blended learning. Additionally, behavioral intention to use blended learning had a significant effect on the students' actual use of blended learning (β = 0.645, P ≤ 0.01).

CONCLUSION

The study revealed that the proposed framework based on the UTAUT2 had good potential to identify the factors influencing the students' behavioral intention to use blended learning. Universities can use the results of this study to design and implement successful blended learning courses in medical education.

A multidisciplinary approach to online support for device research translation: regulatory change and clinical engagement

OBJECTIVES

To promote medical device EU regulatory understanding in the biomedical research community and encourage greater levels of clinical engagement to further medical device research innovation, translation and effective clinical trials.

METHODS

An interdisciplinary, iterative, needs-based design approach was used to develop medical device regulatory training, information and clinical expertise resources.

RESULTS

A multimedia based self-paced e-Learning course focusing on the 'Fundamentals of Medical Device Design and Regulation' was produced in tandem with an interactive online web portal: Medtech Translate.

CONCLUSIONS

Health research translation relies on both clinical input and regulation to drive progress and to ensure quality and safety standards from concept development to clinical investigation. A lack of regulatory awareness and access to clinical expertise has the potential to significantly impact on health research translation and ambition for market. Our interdisciplinary academic-regulator-clinical-industry led approach meets the need for a coordinated stakeholder response to support innovation and promote growth in the medical technology sector.

[Hospital paramedic. An interprofessional blended learning concept to qualify paramedics and medical personnel for deployment in intensive care units and emergency departments during the COVID-19 pandemic]

Hintergrund

Die COVID-19-Pandemie machte eine zeitkritische Erweiterung der personellen Intensiv- und Notaufnahmekapazitäten notwendig.

Ziel der Arbeit

Diese Arbeit schildert erste Ergebnisse eines Blended-Learning-Konzepts zur Qualifikation von Rettungsdienst- und medizinischem Personal in intensivmedizinischen Maßnahmen zur Zeit der COVID-19-Pandemie.

Material und Methoden

Interprofessionell erfolgte die Entwicklung und Umsetzung eines 2‑stufigen Blended-Learning-Konzepts (Stufe 1: E‑Learning mit Onlinetutorials, Stufe 2: Praxiseinsatz) in 3 Modulen (Intensivstation, Notaufnahme, innerklinische Notfallmedizin) zur Weiterqualifikation in intensivmedizinischen und -pflegerischen Maßnahmen. Erfasst wurden Einsatzort, durchgeführte Maßnahmen, subjektive Kenntnisstandbewertung der definierten Maßnahmen vor und nach Abschluss der Weiterqualifikation anhand einer 4‑stufigen Likert-Skala, Bewertung der Einsetzbarkeit im Rahmen der COVID-19-Pandemie sowohl durch die Teilnehmenden als auch Praxisanleitenden bzw. supervidierenden Ärzte.

Ergebnisse

Nach 6 Wochen hatten 63 % der 92 angemeldeten Teilnehmenden den Onlinekurs und 29 % zusätzlich ihren Praxiseinsatz (Intensivstation bzw. Notaufnahme) abgeschlossen. Auf Intensivstationen assistierten sie u. a. bei der Vorbereitung von Katheteranlagen, Medikamenten, pflegerischen Tätigkeiten, in Notaufnahmen bei der Triage und der Erstversorgung. Nach Abschluss fühlten sich die Kliniksanitäter signifikant sicherer bei einem Krankenhauseinsatz, der Assistenz der ZVK-Anlage sowie der Tracheostomapflege (p < 0,05). Alle Teilnehmenden willigten ein, im Rahmen der COVID-19-Pandemie zu unterstützen. Die Praxisanleitungen bewerteten die Teilnehmenden in 94 % als einsetzbar.

Diskussion

Blended-Learning-Konzepte können zeitkritisch medizinisch vorgebildetes Personal für den Einsatz in kritischen Krankenhausbereichen qualifizieren, Pflegekräfte entlasten und für eine personelle Erweiterung der Intensivkapazitäten freisetzen. Die aktuellen Empfehlungen und zukünftigen Pandemiepläne sollten diesbezüglich erweitert werden.

Assessing the effectiveness of Chagas disease education for healthcare providers in the United States

BACKGROUND

Chagas disease is a zoonotic infection caused by the parasite Trypanosoma cruzi, which affects an estimated 8-11 million people globally. Chagas disease is almost always associated with poverty in rural areas and disproportionately impacts immigrants from Latin America living in the United States. Approximately 20-30% of people who are infected with Chagas disease will develop a chronic form of the infection that can be fatal if left untreated. Chagas disease is vastly underestimated in the United States, often goes undiagnosed and is not well understood by most U.S. healthcare providers. One of the most important ways at reducing barriers to improving diagnostics of Chagas disease in the U.S. is giving healthcare providers the most up-to-date information and access to leading experts.

METHODS

An online webinar was conducted for healthcare providers, veterinarians and public health professionals using Chagas disease expert panelists. Pre and post tests were administered to participants (n = 57) to determine the efficacy in raising awareness and to determine key focus areas for improving knowledge. A Wilcoxon rank-sum was used for non-parametric variables equivalent and for questions that assessed knowledge the McNemar's Chi-Square test was used.

RESULTS

There were statistically significant learning increases in multiple categories including transmission (p = <.001), clinical presentation (p = 0.016), diagnostics (p = <.001), and treatment (p = <.001).

CONCLUSION

Providing easily accessible learning opportunities using validated testing and evaluations should be further developed for rural healthcare providers in the U.S. as well as healthcare providers serving under represented populations such as immigrants. There is a clear lack of knowledge and awareness surrounding Chagas disease in the United States and just by raising awareness and providing education on the topic, lives will be saved.

The Impact of a Virtual Radiology Medical Student Rotation: Maintaining Engagement During COVID-19 Mitigation

Introduction

The purpose of this study is to introduce a virtual radiology rotation curriculum that is being used to safely maintain medical student and intern education and engagement with the Department of Radiology at Walter Reed National Military Medical Center during coronavirus disease 2019 (COVID-19) mitigation.

Materials and Methods

The curriculum is designed as a 4-week block with each week representing one of the four highest yield radiology subspecialties for medical students; neuroradiology, thoracic radiology, body radiology, and musculoskeletal radiology. A subspecialist radiologist from each section was identified as a primary mentor and tasked with designing a daily schedule for medical students and interns. The first 2 months of virtual rotators were surveyed to assess the effectiveness of the course.

Results

Thirty-five of 41 rotators responded to the survey, a response rate of 85%. Thirty-one of 35 (89%) of the rotators gave this virtual elective rotation a positive rating, with 16 trainees scoring the course as 4 out of 5 and 15 trainees selecting 5 out of 5. Four respondents selected 3 out of 5. Five out of 5 respondents who had experienced an in-person radiology elective rotation before this virtual rotation rated the virtual elective as more educational than the in-person rotation. We found the 4-week subspecialist mentor-based structure to be highly versatile, allowing us to simultaneously accommodate multiple groups of full or partial block rotators throughout COVID-19 mitigation.

Conclusion

A virtual rotation curriculum is a viable method of maintaining medical student and intern education and engagement with the department of radiology during COVID-19 mitigation.

Impact of COVID-19 on academic activities and way forward in Indian Optometry

PURPOSE

Academia is experiencing massive reforms globally amid lockdown in COVID-19 outbreak. This study is aimed to apprehend the enabling and impeding factors of these reforms, with a focus on optometry education. It brings together how the Indian optometry educational system has responded to COVID-19 disruptions with findings of the 2020 survey, in light of similar survey done in 2018.

METHODOLOGY

A cross-sectional survey was designed to find changes in optometry training and adaptations of Indian optometry educators amid COVID 19 lockdown. In the last week of April 2020, on the observation that the majority of optometry institutions have switched their teaching-learning activities on e-learning mode, an online survey was conducted using a validated questionnaire containing a mix of open and close-ended questions.

RESULTS

Seventy-three out of 78 optometry educators (93.58%) have switched to e-learning mode in a very short time span with good confidence. Most teaching-learning and assessment activities are carried out using multi-device supporting video conferencing tools, dedicated educational portals and social media apps.

CONCLUSION

The COVID-19 pandemic is proving to be a constructive disruptor, giving an opportunity for restructuring the present conventional, classroom based educational system. The quick transitions to online mode assisted in keeping continuity of optometry education programs, effectively fitting in the purpose of completion of the current academic year. The rapid transition to online education has not only benefited optometry students but also has created a momentum of continued education for practicing optometrist in the country.

MammographyOnline: An evaluation of an online mammography education program for radiographers

INTRODUCTION

In Australia, the gold standard for post graduate education in mammography is the Certificate of Clinical Proficiency in Mammography (CCPM) awarded by the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT). The award has two components -academic and clinical. This paper reports on the experiences of the first online offering of the academic component, MammographyOnline (MO), by BreastScreen Victoria, Australia. Online learning is well established in health professional education at all levels of learning, however evaluation is essential to ensure its effectiveness and inform future development.

METHODS

Consenting course participants completed module evaluations, and pre and post program evaluations. Course planners (n = 5) attended a 1-h focus group about the development process. Placement supervisors (n = 3) took part in a 30 min semi-structured telephone interview, identifying views of graduate performance. Survey data and rating scales were analysed descriptively. Qualitative data from surveys and interviews underwent content analysis.

RESULTS

Course participants found the content of MO to be beneficial but highlighted technical issues and suggested improvements for more interactive methods of delivery. Enablers to the program's development identified by course planners, included having experienced and knowledgeable staff on-board, appropriate project management processes, and management support. Challenges expressed by course planners included staffing for the duration of the project and the burden of time and finances, though all perceived they had produced a high quality, relevant and comprehensive online programme. Supervisors recognised that MO fulfilled the requirements of the academic component of the CCPM but did not supersede the need for the clinical component.

CONCLUSIONS

Despite numerous challenges associated with its development, the overwhelming view of learners, developers and supervisors was that MO is a high quality academic program of learning, that provides the theory to support and prepare radiographers for their future clinical practice. Some refinement of content, assessment tasks and technical features are required.

Utility of Real-Time Online Teaching During COVID Era Among Surgery Postgraduates

A cross-sectional study was conducted to assess the utility of online teaching for general surgery postgraduate residents at the end of 1 month of online teaching during the COVID-19 lockdown. A questionnaire related to different aspects of online teaching was developed on a 5-point Likert scale from “strongly agree” to “strongly disagree”. Following a pilot study, the questionnaire was shared among surgery residents, and response collection was done. The residents who did not attend at least 90% of scheduled classes were excluded. A total of 55 resident doctors without prior experience of online teaching program were enrolled in the study. All the participants responded to all questions and submitted their responses within stipulated time. On the basis of validity testing, questions 1 and 2 were found invalid and hence deleted. The median value for the total cohort was 4 indicating that majority of residents gave affirmative response. On segregating the result with the year of residency program, similar results were found in the 1st year and 2nd year group; however, the 3rd year group showed a median of 3, thus eliciting that only 50% of 3rd year residents liked online teaching. From the present study, it can be concluded that the online teaching is a feasible alternative to the physical class among surgical postgraduates. The questionnaire utilized in the present study can be used for assessing similar online teaching protocols.

Virtual laboratory lessons in enzymology

The recent COVID-19 pandemic has led to widespread lock-down strategies that force universities to perform all educational activities remotely. In this context, laboratory lessons pose a significant challenge. Here, I present an on-line tool that simulates the kinetics of chemical reactions. Enzymatic mechanisms can be easily modeled and followed through time. In addition, professors can customize the interface to hide the reaction mechanism. This setting will force students to design virtual experiments to uncover the mechanism and obtain the relevant enzymatic parameters. While some of the skills developed in a practical lesson cannot be simulated, this tool can be used to teach students important concepts about data acquisition and processing.

Effectiveness of blending E-learning with field trip on Chinese herbal medicine education: quasi-experimental study

Background

Chinese Medicine education is part of professional medical training in Hong Kong. An important element of this is herbal medicine, which requires both theoretical and practical knowledge. A field trip programme was adopted to provide students with direct experience of medicinal plants studied in lectures. However, problems with the current programme were identified in learning outcome assessment and long-term knowledge management. To improve the teaching quality, a Moodle e-learning module was designed for augmentation. This study aimed to quantitatively evaluate the effectiveness of the Moodle module in supplementing the current field trip programme.

Methods

Prospective quasi-experiment. Participants were 49 year-2 students in the Bachelor of Chinese Medicine programme. A Moodle module including five online activities regarding two groups of herbal plants was integrated before and after the field trip. Fill-in-the-blank questions were used to assess the learning outcome. Also, a questionnaire was developed to collect student feedback as the secondary outcome.

Results

For herbal plants in Group A, the assessment score was higher in Moodle group (29.65 ± 5.0) than for the control group (21.65 ± 6.5) (P <  0.01). For herbal plants in Group B, the assessment score was higher for the Moodle group (28.68 ± 4.7) than for the control group (24.26 ± 7.7) (P <  0.01). The questionnaire results showed that students were satisfied with the Moodle platform.

Conclusions

A specially designed Moodle module may be effective in augmenting the field trip for Chinese herbal medicine education.

Blended Learning Compared to Traditional Learning in Medical Education: Systematic Review and Meta-Analysis

Background

Blended learning, which combines face-to-face learning and e-learning, has grown rapidly to be commonly used in education. Nevertheless, the effectiveness of this learning approach has not been completely quantitatively synthesized and evaluated using knowledge outcomes in health education.

Objective

The aim of this study was to assess the effectiveness of blended learning compared to that of traditional learning in health education.

Methods

We performed a systematic review of blended learning in health education in MEDLINE from January 1990 to July 2019. We independently selected studies, extracted data, assessed risk of bias, and compared overall blended learning versus traditional learning, offline blended learning versus traditional learning, online blended learning versus traditional learning, digital blended learning versus traditional learning, computer-aided instruction blended learning versus traditional learning, and virtual patient blended learning versus traditional learning. All pooled analyses were based on random-effect models, and the I² statistic was used to quantify heterogeneity across studies.

Results

A total of 56 studies (N=9943 participants) assessing several types of learning support in blended learning met our inclusion criteria; 3 studies investigated offline support, 7 studies investigated digital support, 34 studies investigated online support, 8 studies investigated computer-assisted instruction support, and 5 studies used virtual patient support for blended learning. The pooled analysis comparing all blended learning to traditional learning showed significantly better knowledge outcomes for blended learning (standardized mean difference 1.07, 95% CI 0.85 to 1.28, I²=94.3%). Similar results were observed for online (standardized mean difference 0.73, 95% CI 0.60 to 0.86, I²=94.9%), computer-assisted instruction (standardized mean difference 1.13, 95% CI 0.47 to 1.79, I²=78.0%), and virtual patient (standardized mean difference 0.62, 95% CI 0.18 to 1.06, I²=78.4%) learning support, but results for offline learning support (standardized mean difference 0.08, 95% CI –0.63 to 0.79, I²=87.9%) and digital learning support (standardized mean difference 0.04, 95% CI –0.45 to 0.52, I²=93.4%) were not significant.

Conclusions

From this review, blended learning demonstrated consistently better effects on knowledge outcomes when compared with traditional learning in health education. Further studies are needed to confirm these results and to explore the utility of different design variants of blended learning.

Doctor of Physical Therapy Education in a Hybrid Learning Environment: Reimagining the Possibilities and Navigating a "New Normal"

Professional physical therapist education has experienced a transformation over the last few decades, moving to a doctoring profession with more autonomy and a broader scope of practice. These changes have occurred in parallel with systemic and structural changes in health care and higher education, both of which have experienced challenges with improving access and controlling costs, and have become a centerpiece of legislative and political discourse. At the same time, advances in technology have introduced new possibilities in education, with the emergence of online, blended, and "flipped" learning models that supplement or replace face-to-face instruction with distance learning. Hybrid education is a type of blended learning, utilizing both face-to-face and online instructional strategies. In a hybrid learning environment, online content may be delivered synchronously or asynchronously, replacing traditional face-to-face instructional time and reducing "seat time" for students. Recent attention has been brought to online and hybrid/blended learning in physical therapist education in the wake of the COVID-19 pandemic, as programs have been required to abruptly move from face-to-face to remote instruction. Hybrid and other forms of blended learning strategies have been described at the physical therapist education course level. However, there is no literature describing hybrid learning implementation at the physical therapist education program "levels," and there has been limited discussion on best practices for delivering hybrid, blended, and online instruction in physical therapist education. This perspective provides an overview of hybrid education, describes theoretical frameworks that guide implementation of a hybrid education curriculum, and discusses future directions for hybrid physical therapist education and educational research.

Predictors of health professionals' satisfaction with continuing education: A cross-sectional study

OBJECTIVES

to verify which organizational, methodological, and resource-related characteristics of Continuing Health Education (CHE) help to best predict the professionals´ satisfaction.

METHOD

a cross-sectional study with multivariate logistic regressions to predict a high mean satisfaction with different dimensions of educational actions used: Overall satisfaction, Utility, Methodology, Organization and resources, and Teaching Capacity. 25,281 satisfaction questionnaires have been analysed completed by health professionals attending 1,228 training activities in Andalusia (Spain), during the period from March 2012 to April 2015.

RESULTS

the characteristics that best predict a high overall satisfaction are the following: clinical session type as opposed to the workshop (Odds Ratio [OR]=2.07, p<0.001); face-to-face attendance modality (OR=3.88, p<0.001) or semi-personal-attendance (OR=2.83, p<0.001), as opposed to e-learning; and 1-2 days in duration (OR=2.38, p<0.001) as opposed to those of between 3 and 14 days. A lower number of hours (OR=0.99, p<0.001) and a lower number of professionals (OR=0.98, p<0.05) also increase the probability. Having the educational actions accredited increases the probabilities in the following dimensions: Utility (OR=1.33, p<0.05), Methodology (OR=1.5, p<0.01) and Teaching capacity (OR=1.5, p<0.01).

CONCLUSION

the study provides relevant information on aspects that improve professional satisfaction, such as that e-learning activities should improve their content, teaching methods, and styles, or that face-to-face clinical sessions are the type of CHE with the greatest satisfaction.

Safety Voice for Ergonomics (SAVE): Evaluation of a masonry apprenticeship training program

BACKGROUND

Masons have a high rate of musculoskeletal disorders among construction workers and greater than all other industries. Viable solutions to musculoskeletal hazards have been identified by industry stakeholders, yet masons receive minimal ergonomics training. Apprentices, as the next generation of masons, need training and strategies to identify and speak up about ergonomic and safety issues on job sites. To fill this gap, our team developed the Safety Voice for Ergonomics (SAVE) training program.

METHODS

The interactive, 7-unit SAVE program was developed specifically for masonry brick and block apprentices. This innovative training contains detailed ergonomics lessons focusing on risk factors and solutions specific to this masonry craft. It also contains lessons that provide communication and problem solving strategies. Evaluation of SAVE employed a randomized control trial designed to assess the effectiveness of SAVE for apprentices over a six-month period.

RESULTS

Our findings demonstrated that compared to controls, SAVE trained apprentices used their safety voice more (P = .049) and had greater safety participation (P = .028). They adopted more ergonomic practices such as adjusting scaffolding (P = .016) and using better body postures (P = 042). Apprentices liked SAVE and indicated that it prompted them to change workplace safety behaviors.

CONCLUSIONS

SAVE is an effective program, providing needed ergonomic and safety communication training for workers as they begin their trade. The broad adoption of SAVE training by the masonry industry has the potential to empower apprentices, elevate the trade's safety culture, and ultimately reduce musculoskeletal disorders.

Effectiveness of an Evidence-Based Practice Educational Intervention among School Nurses

The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school nurses in Taiwan to determine whether and how effectively it improved their knowledge levels, attitudes, skills, and self-efficacy. A pretest-posttest research design was employed. Participants were recruited via convenience sampling from among 193 primary schools throughout Tao-Yuan and New Taipei City in Taiwan. The EBP program implemented both mobile learning technology and the flipped classroom format. The learning outcomes were evaluated before, immediately after, and at a 3-month follow-up. In this regard, the data were collected using the School Nurse Evidence-Based Practice Questionnaire. The results showed that the participant scores for the items of knowledge and self-efficacy significantly increased over the study period. Somewhat differently, scores for the skill items significantly increased from the pre-test to the immediate post-test, but significantly decreased from the immediate post-test to the final follow-up. Overall, however, the EBP program led to marked improvements in knowledge, skills, and self-efficacy. These findings can help guide the development of a creative evidence-based school nursing curriculum.

A Blended Learning System to Improve Motivation, Mood State, and Satisfaction in Undergraduate Students: Randomized Controlled Trial

Background

Smartphone-based learning, or mobile learning (m-learning), has become a popular learning-and-teaching strategy in educational environments. Blended learning combines strategies such as m-learning with conventional learning to offer continuous training, anytime and anywhere, via innovative learning activities.

Objective

The main aim of this work was to examine the short-term (ie, 2-week) effects of a blended learning method using traditional materials plus a mobile app—the iPOT mobile learning app—on knowledge, motivation, mood state, and satisfaction among undergraduate students enrolled in a health science first-degree program.

Methods

The study was designed as a two-armed, prospective, single-blind, randomized controlled trial. Subjects who met the inclusion criteria were randomly assigned to either the intervention group (ie, blended learning involving traditional lectures plus m-learning via the use of the iPOT app) or the control group (ie, traditional on-site learning). For both groups, the educational program involved 13 lessons on basic health science. The iPOT app is a hybrid, multiplatform (ie, iOS and Android) smartphone app with an interactive teacher-student interface. Outcomes were measured via multiple-choice questions (ie, knowledge), the Instructional Materials Motivation Survey (ie, motivation), the Profile of Mood States scale (ie, mood state), and Likert-type questionnaires (ie, satisfaction and linguistic competence).

Results

A total of 99 students were enrolled, with 49 (49%) in the intervention group and 50 (51%) in the control group. No difference was seen between the two groups in terms of theoretical knowledge gain (P=.92). However, the intervention group subjects returned significantly higher scores than the control group subjects for all postintervention assessed items via the motivation questionnaire (all P<.001). Analysis of covariance (ANCOVA) revealed a significant difference in the confusion and bewilderment component in favor of the intervention group (P=.01), but only a trend toward significance in anger and hostility as well as total score. The intervention group subjects were more satisfied than the members of the control group with respect to five out of the six items evaluated: general satisfaction (P<.001), clarity of the instructions (P<.01), clarity with the use of the learning method (P<.001), enough time to complete the proposed exercises (P<.01), and improvement in the capacity to learn content (P<.001). Finally, the intervention group subjects who were frequent users of the app showed stronger motivation, as well as increased perception of greater gains in their English-language competence, than did infrequent users.

Conclusions

The blended learning method led to significant improvements in motivation, mood state, and satisfaction compared to traditional teaching, and elicited statements of subjective improvement in terms of competence in English.

Trial Registration

ClinicalTrials.gov NCT03335397; https://clinicaltrials.gov/ct2/show/NCT03335397

Daily medical education for confined students during coronavirus disease 2019 pandemic: A simple videoconference solution

The outbreak of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 infection has recently spread globally and is now a pandemic. As a result, university hospitals have had to take unprecedented measures of containment, including asking nonessential staff to stay at home. Medical students practicing in the surgical departments find themselves idle, as nonurgent surgical activity has been canceled, until further notice. Likewise, universities are closed and medical training for students is likely to suffer if teachers do not implement urgent measures to provide continuing education. Thus, we sought to set up a daily medical education procedure for surgical students confined to their homes. We report a simple and free teaching method intended to compensate for the disappearance of daily lessons performed in the surgery department using the Google Hangouts application. This video conference method can be applied to clinical as well as anatomy lessons.