A Meta-synthesis on Technology-Based Learning Among Healthcare Students in Southeast Asia

How Are Alternative Clinical Placements Performed Compared to Traditional Clinical Placements During the COVID-19 Pandemic? Sought Through a Systematic Review and Meta-Analysis

Clinical placement is the essential method of learning in health professions education, but it has been the most disrupted by the COVID-19 pandemic. Institutions of higher education resorted to alternative learning such as telehealth, simulations, and blended-learning for clinical placement to ensure that educational activities continue without delay. However, this raises questions about student competency and necessitates making up for missed in-person hours. A thorough investigation of the effectiveness of alternative clinical placement learning is required. A systematic searching was conducted on ten electronic databases, and the quality of the included articles was assessed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis was conducted by pooling studies with examination mark outcomes. Twenty-four articles were included in the systematic review and nine were included in the meta-analysis. The average MERSQI score for included studies is 11.15. Outcomes on student performance favor alternative placement, whereas perceived-based outcomes have mixed results and are slightly prone to traditional clinical placement. Meta-analysis indicates that alternative learning is either more effective than traditional clinical placement or at least on par with it. There is a discrepancy between perceived outcome and performance assessment regarding the utility of alternative learning to conventional clinical placement. Nonetheless, objective measurement outcomes and the meta-analysis support alternative learning as a reliable learning strategy for clinical education. Alternative learning for clinical placement experience can be improved further by adding more synchronous sessions, and implementing various learning methods, learning activities based on strong instructional design, and at least a short real-setting attachment.

A Meta-Synthesis on Sexuality in Persons with Dementia Mapped Using the Model of Human Occupation

Dementia affects the individual's functional ability including sexual activity. Limited understanding is available to support sexual health practices. This meta-synthesis review aimed to identify the gaps in the study of sexuality in dementia using the Model of Human Occupation (MOHO). Electronic searches utilizing six databases for existing articles involving persons living with dementia, care partners, and healthcare workers. The result showed that available studies primarily explored sexuality from the viewpoint of spouses of persons living with dementia. The volition domain of MOHO was the most explored provides a deeper understanding of volition on intrinsic perspective on sexuality in people with dementia. The environment domain was the least explored, highlighting healthcare professionals' need for social support and training. The topic of sexuality remains sensitive, limiting the availability of evidence-based interventions in this area.

Medical education during the coronavirus disease 2019 pandemic: an umbrella review

Background

The coronavirus disease 2019 (COVID-19) pandemic affected many aspects of lifestyle and medical education during the recent years. We aimed to determine the impacts of COVID-19 pandemic on medical education to provide an overview of systematic reviews on it.

Methods

We searched PubMed, Scopus, Web of Science, Cochrane library, Google Scholar, and medRxiv, with the following keywords: "SARS-CoV-2," "COVID-19," "Medical Education," "E-learning," "Distance Education," "Online Learning," "Virtual Education," "systematic review," and "meta-analysis," up to 15 April 2023. Studies were included if they were systematic reviews assessing the impacts of the COVID-19 pandemic on medical sciences students. We used A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) checklist for quality assessment.

Results

A total of 28 systematic reviews were included. The eligible reviews included between five and 64 primary studies, ranging from 897 to 139,381 participants. Technology-enhanced learning and simulation-based learning were the most frequently used strategies. Virtual teaching has several drawbacks like technical difficulties, confidentiality problems, lower student involvement, connection problems, and digital fatigue. The overall satisfaction rate for online learning was above 50%. Also, favorable opinions about perception, acceptability, motivation, and engagement were reported. The quality of 27 studies were critically low and one was low.

Conclusion

There were reduced clinical exposure and satisfaction for medical students during the pandemic. Further high-quality systematic reviews are required.

Factors affecting medical students' satisfaction with online learning: a regression analysis of a survey

BACKGROUND

Medical education requires the implementation of different teaching methods and strategies for future doctors to achieve broad learning objectives. This wide range of methods and strategies includes the use of Information Technologies. For a long time, there was a call for a change in medical education for blending new teaching approaches to lessen medical students' class time. The COVID-19 pandemic then sped up the transition to the new way of medical education and classroom lectures were quickly moved to a virtual environment. We expect that these changes will continue, and online learning will be one of the main teaching strategies in medical education. Therefore, educational experiences during the COVID-19 pandemic will improve our understanding of online learning and will help to develop blended medical school curricula in the future. For this reason, we aimed to determine students' overall satisfaction with their online learning experience and to define the main factors affecting students' satisfaction with their online learning program at Cerrahpaşa Medical Faculty.

METHODS

A cross-sectional survey study was conducted to determine medical students' overall satisfaction with online learning methods and to identify factors associated with positive and negative satisfaction levels. A questionnaire, consisting of 24 questions to collect demographic characteristics, factors associated with online education experience and overall satisfaction levels was developed and distributed to 1600 medical students. Multivariable linear regression analysis was used to determine the factors associated with positive and negative satisfaction levels.

RESULTS

Regression analysis showed that being familiar with online teaching techniques (β = 0.19, 95% CI [0.07, 0.30], faculty members' higher online teaching skill levels (β = 0.42, 95% CI [0.32, 0.51], interactive online teaching approaches (β = 0.54, 95% CI [0.41, 0.67], having a personal workspace (β = 0.43, 95% CI [0.19, 0.67], and a self-reported longer attention span (β = 0.75, 95% CI [0.57, 0.92] were associated with higher overall satisfaction with online learning. The occurrence of technical problems (β = -0.19, 95% CI [-0.26, -0.12] was associated with lower overall satisfaction.

CONCLUSIONS

Higher online teaching skills of faculty members, use of interactive approaches, students' familiarity with online teaching techniques, provision of a personal workspace, and self-reported longer attention spans positively contributed to higher levels of student satisfaction with online learning. Considering the increasing significance of online educational methods, our study identified key components that affect students' level of satisfaction. This information might contribute to the development of online educational programs in the future.

Teaching Philosophy in a Teaching Portfolio: Domain Knowledge and Guidance

Background

Teaching philosophy defines the beliefs and ideas that guide practices in teaching and learning. Writing teaching philosophy statements for promotion or employment is daunting for inexperienced new faculty members.

Aim

This article aims to discuss the principles of relevant educational domains that academics need to know to be well informed when writing their teaching philosophy. It also provides a new perspective on how to write the personal statements.

Methods

Journal articles published in English language between 2018 and 2023 (as well as important older ones) in electronic databases (Google Scholar, MEDLINE, PubMed, and SCOPUS) were searched, sifted, reviewed and used for this narrative literature review. Additionally, the websites of educational organisations such as higher education institutions were selected using convenience sampling method and searched to ascertain practices.

Results

Educators need to link teaching philosophy statements to the literature about teaching. However, there is a scarcity of literature that provides a comprehensive overview of the required domain knowledge. These domains are Supervision, Curriculum development, Assessment, Mentorship, Pedagogy, and Scholarship of teaching and learning (S-CAMPS domains).

Conclusion

Using various teaching practices and models to achieve the best quality learning and valued transformation is crucial in achieving a comprehensive Scholarship of Teaching and Learning. Therefore, developing a personal philosophy provides the opportunity for reflection on utilizing the theory-practice-philosophy perspective best to serve the students, academic institution, and society.

Implementation of a Web-Based Educational Intervention for Promoting Flipped Classroom Pedagogy: A Mixed-Methods Study

Introduction

Flipped classroom pedagogy (FCP) is recognised as an effective and efficient teaching-learning method. However, nursing students and teachers may be hesitant to adopt FCP due to technophobia and time constraints linked to academic and clinical responsibilities. This necessitates the provision of promotional training for adopting FCP. However, there is a dearth of research regarding how the practice of FCP could be promoted and in demonstrating its efficacy in developing countries. Thus, this study aimed to examine the educational impact of a web-based education intervention, branded as the Flipped Classroom Navigator (FCN), for promoting FCP in nursing education in Sri Lanka.

Methods

This mixed-methods study employed pre- and post-training knowledge tests, the Instructional Materials Motivation Survey (IMMS), the Perceived Transfer of Learning Questionnaire survey, and collected students' and teachers' open-ended responses to evaluate the impact of the FCN. Fifty-five undergraduate nursing students and 15 university teachers participated in the study from two state universities in Sri Lanka. Repeated-measures ANOVA, t-tests, Levene's test of homogeneity, Cohen's d, and an inductive thematic approach were employed in the data analysis.

Results

Post-training knowledge test scores were significantly higher than the pre-training knowledge test scores indicating improved understanding of FCP. Participants were also highly motivated to learn in the FCN instructional materials. Participants exhibited positive attitudes towards FCN training with transfer of learning to their teaching-learning practice. The inductive thematic analysis identified the following themes: user experiences, FCN learning content, behaviour changes, and suggested improvements.

Conclusion

Overall, the FCN enhanced both students' and teachers' knowledge and understanding of FCP in undergraduate nursing education.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01706-7.

Chatbot-based serious games: A useful tool for training medical students? A randomized controlled trial

OBJECTIVES

Chatbots, conversational agents that walk medical students (MS) though a clinical case, are serious games that seem to be appreciated by MS. Their impact on MS's performance in exams however was not yet evaluated. Chatprogress is a chatbot-based game developed at Paris Descartes University. It contains 8 pulmonology cases with step-by-step answers delivered with pedagogical comments. The CHATPROGRESS study aimed to evaluate the impact of Chatprogress on students' success rate in their end-term exams.

METHODS

We conducted a post-test randomized controlled trial held on all fourth-year MS at Paris Descartes University. All MS were asked to follow the University's regular lectures, and half of them were randomly given access to Chatprogress. At the end of the term, medical students were evaluated on pulmonology, cardiology and critical care medicine.

MAIN OUTCOMES MEASURES

The primary aim was to evaluate an increase in scores in the pulmonology sub-test for students who had access to Chatprogress, compared to those who didn't. Secondary aims were to evaluate an increase in scores in the overall test (Pulmonology, Cardiology and Critical care medicine test (PCC)) and to evaluate the correlation between access to Chatprogress and overall test score. Finally, students' satisfaction was assessed using a survey.

RESULTS

From 10/2018 to 06/2019, 171 students had access to Chatprogress (the Gamers) and among them, 104 ended up using it (the Users). Gamers and Users were compared to 255 Controls with no access to Chatprogress. Differences in scores on the pulmonology sub-test over the academic year were significantly higher among Gamers and Users vs Controls (mean score: 12.7/20 vs 12.0/20, p = 0.0104 and mean score: 12.7/20 vs 12.0/20, p = 0.0365 respectively). This significant difference was present as well in the overall PCC test scores: (mean score: 12.5/20 vs 12.1/20, p = 0.0285 and 12.6/20 vs 12.1/20, p = 0.0355 respectively). Although no significant correlation was found between the pulmonology sub-test's scores and MS's assiduity parameters (number of finished games among the 8 proposed to Users and number of times a User finished a game), there was a trend to a better correlation when users were evaluated on a subject covered by Chatprogress. MS were also found to be fans of this teaching tool, asking for more pedagogical comments even when they got the questions right.

CONCLUSION

This randomised controlled trial is the first to demonstrate a significant improvement in students' results (in both the pulmonology subtest and the overall PCC exam) when they had access to Chatbots, and even more so when they actually used it.

Navigating nursing curriculum change during COVID-19 pandemic: A systematic review and meta-synthesis

AIM

To consolidate the evidence around the experiences of nursing undergraduates and faculty members navigating through remote and online education during the COVID-19 pandemic.

BACKGROUND

The Coronavirus disease 2019 caused by the SARS-CoV-2 Virus (COVID-19) has placed massive pressure on healthcare, economic and education systems globally. Restrictive social distancing policies and public health measures necessitated educational institutions to switch from face-to-face to remote and online education to sustain the learning process. These changes have created an uncertain path and undue stress for healthcare learners and faculty, especially for professional roles that traditionally require more hands-on and access to clinical practice particularly pre-licensure nursing students. As such, there is an urgent need to consolidate evidence on the experiences of nursing undergraduates and faculty members as they navigate the rapid transition from face-to-face to remote and online education to ensure continuity of learning in achieving optimal learning outcomes and to support them during current and future public health crises.

DESIGN

A systematic review and meta-synthesis of the qualitative literature was undertaken using Sandelowski and Barroso's approach.

METHODS

Six electronic databases, CINAHL, Embase, ERIC, PsycINFO, PubMed and Scopus, were searched systematically using the eligibility criteria from December 2019 to September 2022. The Critical Appraisal Skills Program checklist for qualitative studies was used to conduct the critical appraisal of the selected articles.

RESULTS

Forty-seven studies were included in this review, which encapsulates the experiences of 3052 undergraduates and 241 faculty members. An overarching meta-theme 'Remote and online education: a rollercoaster ride', emerged along with three main meta-themes: (1) Transition to remote and online education: A turbulent road, (2) Acceptance of the untravelled road, (3) Hopes and recommendations for the road ahead.

CONCLUSION

To improve nursing undergraduates' and faculty member's navigation of remote and online education, more institutions should move towards establishing hybrid education as the new 'normal' and exercise prudence in the organisation and delivery of curriculum, teaching, well-being and clinical attachment contingencies of their healthcare courses.

An innovation on clinical placement for occupational therapy mental health during the COVID-19: A mixed-methods feasibility study

The COVID-19 pandemic altered the health profession's education. Educational activities were shifted to online, and clinical placements were compromised in certain countries. A mixed-methods study included 17 undergraduates undergoing a mental health placement. The first 3 weeks of clinical placement applied online case-based learning in written and in video format. The last 2 weeks involved hybrid remote and physical onsite clinical placement. SPICES model utilizing various active learning activities, case studies and client attendance, facilitator engagement, discussion and feedback were implemented. A self-administered System Usability Scale (SUS), e-learning preference level, focus group discussion, and reflective writing was conducted at the end of each week and the students' final marks were compared with the past cohort who attended conventional physical clinical placement. Two-way mixed ANOVA indicates no significant interaction was found on the SUS (p = 0.062, ηp2 = 0.062) and preference scores (p = 0.285, ηp2 = 0.079) according to week and practical site. There was no significant difference in the final mark among the online and onsite placement of the current cohort (p = 0.350, d = 0.47). The current cohort reported better marks than the previous cohort who attended conventional placement (p = 0.006, d = 0.99). Qualitative findings show positive responses where online activities have minimal restriction on the learning process. This innovative approach is acceptable for substituting conventional clinical learning during this restricted situation.

Restructuring education activities for full online learning: findings from a qualitative study with Malaysian nursing students during Covid-19 pandemic

The COVID-19 pandemic and Movement Control Order have restricted learning activities from traditional face-to-face classrooms attendance shifted to full online learning in the student's environment. The present study is aimed to explore pertaining issues on full online learning among nursing students and offer a contingency solution. Nursing students from one Malaysian public institution were recruited. The sessions were conducted online via teleconference and were recorded. The data were analysed using thematic analysis with the assistance of QDA Miner Lite software. Twenty-one students participated, resulting in four focus group discussions and three in-depth interviews. Three themes with a total of ten sub-themes were generated: (i) Full online learning has ramifications on life (it is about life; blurred division on education life and personal life; non-conducive environment for learning; health and well-being; human is an adaptable being while the transition takes time), (ii) full online learning is a medium of teaching and learning delivery but with several concerns (the boon and bane of fully online learning; challenges associated with full online learning; coping strategy in handling full online learning), and (iii) Foundation in teaching and learning is the key (role of the educator; teaching and learning approaches; motivation and regulation). A model of practice for full online learning was developed, consisting of some modifications to create a conducive and healthy learning environment. This study embarks on a more structured and standard online learning practice for making the Internet of Things and Industrial Revolution 4.0 concept a contemporary and mainstream education practice.

The English as a Foreign Language Learners’ Psychological and Emotional Perceptions on Technology Integration in Language Classrooms

Recently, the use of new educational technologies in language teaching development is expanding rapidly. Educational technologies attach new features to the learning environments. The integration of educational technologies in language teaching has been received special attention among language researchers. In so doing, the present study investigated language learners’ perceptions of the integration of innovative educational technologies in their language classrooms. The sample comprised 301 English as a foreign language (EFL) students with different academic qualifications from Shaanxi Province (299) and other provinces (Fujian province = 1, Sichuan province = 1) in China. To gather the necessary data, the researcher conducted a technology integration questionnaire and a focus group interview. The results of obtained data demonstrated that the language learners had positive attitudes toward using technology in their classrooms. However, the findings of the interviews indicated that learners had some problems such as lack of technology literacy and inadequate assess to facilities in participating in technology-based classroom activities.