Blended learning in medical physiology improves nursing students' study efficiency

Blended learning: Assessing nursing students' perspectives

BACKGROUND

 Blended learning combines face-to-face and online learning and has recently gained popularity, accelerated by the coronavirus disease 2019 (COVID-19) pandemic, often without active evaluation.

OBJECTIVES

 This study aimed to assess university nursing students' perceptions of a blended learning approach during the COVID-19 pandemic.

METHOD

 The population was 150 third-year nursing students from a university in the Western Cape, South Africa, using all-inclusive sampling. A one-group, pre-and post-evaluation study was conducted using a self-administered questionnaire (Student Perceptions of Blended Learning scale). Differences were assessed using Chi-squared and Mann-Whitney U tests with a significance level of p  0.05.

RESULTS

 Before implementing blended learning, 128 students (85.3%) completed the questionnaire, while 95 (63.3%) did so after. Demographics and access showed no significant differences between the groups. Post-implementation showed a 10.1% increase in preference for blended learning (χ2 = 2.832, p = 0.092). Ease of use was rated significantly higher before implementation (3.07 ± 0.49), with no significant change post-implementation (2.99 ± 0.58). The blended learning process received lower ratings compared to content, with no significant differences before or after implementation for either (process: 2.55 ± 0.58 vs 2.54 ± 0.63; content: 2.75 ± 0.52 vs 2.79 ± 0.52).

CONCLUSION

 Nursing students had a positive perception of blended learning, though the online learning component posed challenges with time and module comprehension.Contribution: The findings can help higher education institutions evaluate existing online management systems and guide nurse educators in meeting students' needs when developing module resources.

Students' Satisfaction Regarding the Application of Crossword Puzzles During the Online Teaching Practice of Medical Physiology: A Promising Experience During the COVID-19 Pandemic

Introduction

The coronavirus has hit the world and has led to substantial changes in all aspects of life. One of the important affected aspects is the teaching and learning process. Most of the learning authorities including King Abdulaziz University, Rabigh branch, have shifted to distant and online learning to avoid social contact and spreading the viral infection. Creating an interesting and interactive environment via online learning became necessary to attract the students' attention and sharing in the online sessions was, therefore, crucial.

Methods

Crossword puzzles were created using an online tool. A questionnaire that assesses the satisfaction of the students regarding the application of the online puzzle was built and medical education experts did the content validity. Lectures were given online via the blackboard ultra-collaborate system followed by a brief session for solving the crossword puzzle. Students were given five minutes to think and prepare their answers and then they solved the puzzle via the chat window and the teacher corrected them. The questionnaire was sent to students in a Google form. Statistical analysis was followed using SPSS software.

Results

No major gender differences in students' satisfaction levels. 75.7% strongly agreed that games are an interesting and enthusiastic method in physiology education. 78.4% strongly agreed that games are an effective tool of communication between the teacher and students. 70.3% strongly agreed: crossword puzzle is an interesting interactive online educational tool. 64.9% strongly agreed that puzzles helped them to memorize the definitions and terminologies in physiology. 78.4% strongly agreed that crossword puzzles are a good addition to the educational practice of physiology.

Conclusion

The crossword puzzle is considered a good tool for promoting an interesting, interactive online educational practice. The presence of no major gender difference in the students' satisfaction regarding this tool casts light on the importance of interactive, enjoyable, and creative teaching practice particularly during the stigmata of epidemics.

Chinese anatomy educators' perceptions of blended learning in anatomy education: A national survey in the post-COVID-19 era

Blended learning, which combines face-to-face lectures with online learning, has emerged as a suitable teaching approach during the COVID-19 pandemic. This study used a national survey of anatomy educators in Mainland China to evaluate the changes in the implementation of blended learning in anatomical pedagogy. A total of 297 responses were collected from medical schools across all provinces. Respondents included 167 males and 130 females, with an average age of 44.94 (±8.28) and average of 17.72 (±9.62) years of professional experience. The survey showed adoption of online teaching and assessment by Chinese anatomy educators increased by 32.7% and 46.8%, respectively, compared to pre-pandemic levels. Perceptions of blended learning outcomes varied, with 32.3% and 37% educators considering it superior and inferior to traditional teaching, respectively. Faculty training programs related to blended learning increased significantly, fostering a collaborative learning environment; however, challenges remained in achieving satisfactory online assessment outcomes. Anatomy educators' attitudes reflected a strong preference for classroom learning (4.941 ± 0.856) and recognition of the importance of relevant technology (4.483 ± 0.954), whereas online learning received lower acceptance (4.078 ± 0.734). Female anatomy teachers demonstrated effective time management in online teaching. Meanwhile, educators with over 15 years of experience encountered difficulties with relevant technology, consistent with negative attitudes toward blended learning. Overall, this survey highlights the persistent challenges in implementing blended learning in anatomy education and provides insights for enhancing the pedagogical model in the post-COVID-19 era.

Learning Outcomes of Nursing Students' Experience With Cadaveric Dissection: A Scoping Review

Introduction

Cadaver dissection in anatomy, a cornerstone of medical school education, has been replaced by digital technologies. This study aimed to determine the learning outcomes nursing students could achieve through cadaveric dissection practice (CDP).

Methods

This scoping review was carried out using the checklist outlined in the Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews through August 2023. Articles from PubMed, ERIC, and CINAL were included. This scoping review included studies that focused on the learning effects of nursing students' experiences with cadaver dissection, written in English, and covered all study types.

Results

The cadaveric dissection exercise resulted in a strong interest in the human body and a thorough understanding of anatomy and physiology. It also allows for creating an image of care for the patient before death, the meaning of existence after death, acceptance that death is not frightening, and an understanding of the afterlife. Furthermore, the cadaveric dissection exercise has been reported to improve confidence in patient care, lead to a better understanding of what other professions practice, and involve the development of professional identity.

Conclusions

Studies on the learning effects of CDP have differed in subject matter and educational methodologies. In the future, while determining how the experience of CDP is related to nursing practice of nursing students and graduates, we must explore effective CDP and develop educational methodologies that can achieve similar learning effects.

Challenges of fully online learning for dermatology education: a retrospective study

Background

Blended learning has proven to be an effective teaching strategy. During the COVID-19 pandemic in 2019, educational institutions worldwide switched to online learning. However, there is limited research on the effectiveness of blended learning and fully online learning. This study aims to evaluate and compare whether pure online learning is as effective as traditional blended learning by taking the example of dermatology education.

Methods

The researchers compared traditional blended learning and fully online learning by evaluating the achievement scores of undergraduate students in a dermatology course in the academic years 2019 and 2020, respectively, at the Shandong First Medical University, China. In 2019, students undertook small private online courses (SPOCs) combined with face-to-face teacher-led learning. In 2020, live teacher-led learning replaced face-to-face teacher-led learning. The researchers also conducted a questionnaire survey in 2020.

Results

The scores of students in 2019 were significantly higher than in 2020 (p = 0.002). There was no significant difference in the distribution of achievement variance in the scores between the two academic years. In the questionnaire survey, the majority of the students rated highly the fully online education mode and responded that pure online learning enhanced their self-study ability.

Conclusion

The present study shows that fully online learning currently does not perform as well as traditional blended learning in terms of examination scores due to some limitations. However, pure online education has several advantages over traditional blended education. Online courses should be improved to ignite students' interest and increase their learning efficiency.

Integration of anatomy and physiology into nursing practice as perceived by undergraduate students and registered nurses: a scoping review

OBJECTIVE

The current study aimed to determine perceptions of registered and student nurses regarding the integration of anatomy and physiology into nursing practice.

METHODS

This scoping review was conducted following the checklist provided in the Reporting Items for Systematic reviews and Meta-Analysis extension for scoping reviews. Articles published in PubMed, ERIC, and CINAL from January 1, 2002 to September 30, 2022 were included.

RESULTS

A literature review of 20 articles that matched the indicative criteria revealed that both undergraduate student and registered nurses recognized knowledge of anatomy and physiology as important to nursing practice. Student nurses recognized that such knowledge is related to understanding patient pathophysiology, patient observation, treatment selection, and patient safety and forms the basis for nursing practice. Registered nurses who were confident in their knowledge of anatomy and physiology also reported that they were able to explain the rationale for their nursing practice. They also reported that this knowledge is necessary for communication with multiple professions, which promotes patient/family trust in nurses and is the basis for building trusting relationships with patients and their families.

CONCLUSIONS

Although undergraduate student and registered nurses recognized the importance of learning anatomy and physiology, the integration of anatomy and physiology into nursing practice was not the same for all student and registered nurses. This suggests the need to investigate the overall perceptions of nurses regarding the integration of anatomy and physiology into nursing practice and for faculty to discuss how to facilitate critical thinking among students.

Behavior analysis and formative assessments in online oral medicine education during the COVID-19 pandemic

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, traditional teaching methods were disrupted and online teaching became a new topic in education reform and informatization. In this context, it is important to investigate the necessity and effectiveness of online teaching methods for medical students. This study explored stomatology education in China to evaluate the development and challenges facing the field using massive open online courses (MOOCs) for oral medicine education during the pandemic.

AIM

To investigate the current situation and challenges facing stomatology education in China, and to assess the necessity and effectiveness of online teaching methods among medical students.

METHODS

Online courses were developed and offered on personal computers and mobile terminals. Behavioral analysis and formative assessments were conducted to evaluate the learning status of students.

RESULTS

The results showed that most learners had already completed MOOCs and achieved better results. Course behavior analysis and student surveys indicated that students enjoyed the learning experience. However, the development of oral MOOCs during the COVID-19 pandemic faced significant challenges.

CONCLUSION

This study provides insights into the potential of using MOOCs to support online professional learning and future teaching innovation, but emphasizes the need for careful design and positive feedback to ensure their success.

Effect of a blended learning design in an undergraduate nursing electrocardiogram course: A quasi-experimental study

AIM

The study aimed to explore learning achievement and students' satisfaction with a blended learning (BL) electrocardiogram (ECG) education programme in undergraduate nursing education.

DESIGN

This was a quasi-experimental post-test design.

METHODS

The study was conducted during semester one of the academic year 2020/2021. Participants were divided into two groups: the BL group and face-to-face (FTF) group. The BL group received the newly designed BL programme. The FTF group received the traditional learning methods. Post-test measures of the study variables such as knowledge, study time and satisfaction were conducted. Chi-square (χ² ) test was used to evaluate categorical variables. The Mann-Whitney test was used to analyse continuous variables.

RESULTS

Participants in BL group had significantly higher scores in ECG interpretation and total score. No significant differences in foundational knowledge between the two groups were found. Study time was significantly longer in the BL group. Regarding satisfaction, significant differences were found in structure rationality and promotion of self-learning.

Testing the effectiveness of motivation-based teaching in Nursing English course: A quasi-experimental study

BACKGROUND

Motivation is a crucial factor in determining the student-learning process. Integrating the Attention, Relevance, Confidence, and Satisfaction (ARCS) motivation model into the Nursing English course has the potential to motivate nursing students and improve their learning outcomes.

OBJECTIVES

To apply motivational tactics to the Nursing English course and explore the effects on the learning motivation, engagement, and performance of vocational college nursing students.

DESIGN

A quasi-experimental study.

SETTING

The study was conducted at a vocational college in XXXX.

PARTICIPANTS

A total of 229 sophomore nursing students (experimental group = 114; comparison group = 115) participated.

METHODS

Motivation-based teaching was applied to the experimental group, while traditional lecture-based teaching was used with the comparison group. The Course Interest Survey (CIS) was used to measure student learning motivation; the Utrecht Work Engagement Scale-Student (UWES-S) was used to assess student learning engagement (both pre- and posttest). Midterm and final examination scores were used to compare the learning performance between both groups.

RESULTS

There were no significant differences between both groups at the pretest in the CIS, UWES-S, and midterm examination scores. Significant group ∗ time interactions were found for CIS, UWES-S, and examination scores. The simple effect analysis showed that the experimental group's CIS, UWES-S, and examination scores were significantly higher than the comparison group at the posttest. Furthermore, the motivation-based teaching led to significant improvements in the CIS scores (from 3.12 [0.43] to 3.66 [0.34], p < 0.001), UWES-S scores (from 3.72 [0.53] to 4.05 [0.69], p < 0.001) and the CIS and UWES-S sub-scale scores of the experimental group. No changes were observed in the comparison group. The experimental group showed more remarkable improvement than the comparison group in examination scores.

CONCLUSIONS

Motivation-based teaching effectively improved learning motivation, learning engagement, and learning performance of students in the Nursing English course.

An international exploration of blended learning use in pre-registration nursing and midwifery education

AIM

To explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy.

BACKGROUND

The global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere.

DESIGN

Cross-sectional, sequential, mixed methods study PARTICIPANTS/SETTINGS: Nursing/nurse education leaders from across International Council of Nurses regions METHODS: Exploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants' knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes.

RESULTS

Participants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation.

CONCLUSIONS

Blended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact.

TWEETABLE ABSTRACT

Blended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.

A blended learning exercise physiology theory module that supports student autonomy and improves academic performance

A limited number of studies have explored the impact of blended exercise physiology theory curricula on student learning and experience. This study aimed to investigate the impact of an exercise physiology blended learning theory module on student performance, engagement, and perceptions. The module, which comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), was implemented in a third-year subject taken by students in nonspecialist undergraduate science, technology, engineering, and mathematics (STEM) degrees. Students chose which elements to engage with to support their learning. Exam performance was assessed by comparing exam marks from fully face-to-face delivery to the blended delivery with an independent t test. Student perceptions were determined via an end-of-module questionnaire comprised of Likert-scale questions and open-ended questions. Descriptive statistical analysis was conducted on the Likert-scale responses, and qualitative content analysis was conducted on the open-ended responses. Student engagement with online resources was determined through analysis of access statistics from the learning management system. Student exam marks in the blended learning student group were significantly higher (P < 0.0001) than in the face-to-face group, even though the questions were of a higher Bloom's level in the blended learning group. Students preferred blended delivery over fully face-to-face delivery. Most students accessed the student guide, lecturer-recorded videos, and quizzes, with supplementary videos, workshops, and discussion forums accessed by fewer students. In conclusion, a blended exercise physiology theory module improved student exam performance and was positively perceived by students, and engagement with the elements of the module was varied.NEW & NOTEWORTHY Few studies have explored the impact of blended delivery of exercise physiology theory curricula on student learning and experience. This study investigated the impact of a novel blended model on student learning and experience. The module comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), where students were able to choose which elements to engage with to support their learning.

An eLearning module is comparable to face-to-face teaching in a nursing human pathophysiology subject

BACKGROUND

Human pathophysiology is important in undergraduate nursing education to help students develop clinical reasoning skills. Traditionally pathophysiology education in undergraduate nursing is taught face-to-face. However, eLearning in nursing curricula may provide flexible delivery options.

OBJECTIVE

With increased inclusion of technology enhanced learning in nursing curricula, a hematology eLearning module was evaluated in a pathophysiology subject to determine whether it was comparable to face-to-face learning.

DESIGN

Single-blind randomized pre-test/post-test controlled trial.

SETTING

School of Health and Behavioural Sciences, University of the Sunshine Coast.

PARTICIPANTS

A total of 271 second-year undergraduate students enrolled in Human Pathophysiology were included in the study. Students were from three bachelor programs: Nursing Science; Paramedic Science; and Clinical Exercise Physiology. Students were randomly allocated to either the experimental group (n = 85) or the control group (n = 186).

METHODS

A hematology eLearning module was designed to be self-directed and learner-centered, guided by constructivist learning theories for delivery in the human pathophysiology subject. The experimental "eLearning" group completed the module independently, and the control "face-to-face" group completed equivalent paper-based activities facilitated by a tutor. All students completed a pre-test assessment and two post-test assessments two weeks after the intervention and at the end of the subject.

RESULTS

There was no significant difference in assessment scores between the experimental and control groups, or between nursing and other programs.

CONCLUSION

eLearning was comparable to face-to-face teaching in this study. We recommend further research to strengthen the links between pathophysiology theory to clinical reasoning skills using eLearning.

A Survey of College Students on the Preference for Online Teaching Videos of Variable Durations in Online Flipped Classroom

In the spring semester of 2020, online flipped classroom was used to replace offline face-to-face teaching of the physiology course at Xiangya School of Medicine. In order to analyze the preferences and utilization of different teaching resources by students, registered questionnaire was applied to investigate the preference divergence of the students on the duration of different teaching videos used in the online flipped classroom model. One hundred forty-seven students of clinical medicine in grade 2018 of Xiangya School of Medicine were selected as the research objects. Three formal surveys were conducted in total. The results showed that there were significant divergences in preference of students for different durations in the first two surveys. 56.43 and 50.00% of the students preferred 15 min mini-video, whereas 43.57 and 50.00% preferred 45 min complete video. Meanwhile, students showed a significant preference for mini-video in active learning before class, with 65.00 and 59.29% watched only mini-video, 17.14 and 25.71% watched only complete videos, and 17.86 and 15.00% watched both mini and complete videos. Although most students preferred to watch mini-video in active learning before class, there was a significant proportion of students who watched complete video before class. The results suggested that the individualization of student in the online flipped classroom is prominent. Multiple logistic regression analysis showed that the selection of videos with different durations at different time points (before, in and after class) was significantly associated with the characteristics of the videos themselves. Therefore, the construction of online teaching resources and the application of teaching methods should consider the requirements of different student groups and provide a variety of online curriculum resources.

Explaining medical students' learning outcomes in blended course designs: combining self-reported and observational learning experiences

Blended course designs have been increasingly adopted in medical education. However, research on the relations between the key aspects of students' learning experience and their learning outcomes often only measures students' self-reported experience, neglecting what they actually do in learning. This study combined both self-reported and observational measures of students' learning experiences and examined the relations between the two sets of measures and their contributions to learning outcomes. Australian medical students were asked to report their approaches to, and perceptions of, learning. The frequency and duration of their interactions with both online formative and summative tasks were observed and recorded. Correlation analyses showed that the learning outcome was positively related to deep approaches to using online technologies and duration of interactions with online summative tasks. The hierarchical multiple regression analysis found that the self-reported approaches and duration of interactions jointly explained the learning outcomes, accounting for 6% of the variance. The study demonstrated the complementary nature of using both self-reported and observational measures of students' learning experiences to explain the learning outcomes in blended course designs.

Blended learning model via small private online course improves active learning and academic performance of embryology

While blended learning has been growing in popularity in recent years, the effectiveness of this procedure remains controversial. In this report, we assess the effectiveness of blended learning of embryology within international medical students. The participants were international medical students taking embryology in the Bachelor of Medicine and Bachelor of Surgery program. The blended learning group (BLG) consisted of students (n = 43) in the 2018-2019 academic year, taught with blended learning model via a customized small private online course (SPOC). The control traditional teaching group (TTG) consisted students (n = 48) in the 2017-2018 academic year, taught with traditional teaching model. Academic performance, including mean scores and passing ratios on the final exam of two groups were compared and analyzed with a t-test. In addition, a questionnaire directed toward evaluating student's perceptions with the blended learning was administered to students in BLG. The majority of students in BLG actively participated in online self-study activities and discussion in face-to-face class sessions. The mean score and passing ratio were significantly greater than those of students in TTG (p < 0.01). Results from the questionnaire revealed that the majority of BLG students felt that this method was beneficial for their learning of human embryology. The blended learning model, that integrates SPOC with face-to-face class lectures proved a more effective means for the teaching of embryology than the traditional lecture-based teaching model. This blended learning method may serve as a feasible model that can be readily applied for use in other medical courses.

An Adaptive Blended Learning Model for the Implementation of an Integrated Medical Neuroscience Course During the Covid-19 Pandemic

The implementation of an integrated medical neuroscience course by technologically pivoting an in-person neuroscience course to online using an adaptive blended method may provide a unique approach for teaching a medical neuroscience course during the Covid-19 pandemic. An adaptive blended learning method was developed in response to the requirements necessitated by the Covid-19 pandemic. This model combined pedagogical needs with digital technology using online learning activities to implement student learning in a medical neuroscience course for year one medical students. This approach provided medical students with an individually customized learning opportunity in medical neuroscience. The students had the complete choice to engage the learning system synchronously or asynchronously and learn neuroscience materials at different locations and times in response to the demands required to deal with the pandemic. Students' performance in summative and formative examinations of the adaptive blended learning activities were compared with the previous performance obtained the previous year when the contents of the medical neuroscience course were implemented using the conventional "face-to-face" learning approach. While the cohort of our students in 2019 and 2020 changed, the contents, sessions, volume of material, and assessment were constant. This enabled us to compare the results of the 2019 and 2020 classes. Overall, students' performance was not significantly different between the adaptive blended learning and the in-person approach. More students scored between 70% and 79% during the adaptive blended learning compared with in-class teaching, while more students scored between 80% and 89% during the in-person learning than during the adaptive blended learning. Finally, the percentage of students that scored >90% was not significantly different for both Years 2019 and 2020. The adaptive blended learning approach was effective in enhancing academic performance for high-performing medical students. It also permitted the early identification of underachieving students, thereby serving as an early warning sign to permit timely intervention.

Improvement in Student Performance and Perceptions through a Flipped Anatomy Classroom: Shifting from Passive Traditional to Active Blended Learning

One of the major challenges facing anatomy educators is delivering the anatomy materials in fewer hours with a reduction of anatomy courses in the integrated curricula. The flipped classroom modality may be an innovative solution. However, its effectiveness remains under debate due to a lack of outcome-based research and the mixed results of students' performance. The present study aimed to determine the outcome of the flipped classroom based upon the level of student cognition. The study investigated performance on 17 multiple-choice anatomy questions as a part of the final examination of the musculoskeletal system module. The results were compared between the first-year female students of Qassim Medical College, specifically the flipped classroom group (46 students) of the academic year (2018-2019) and the traditional group (49 students) of the academic year (2017-2018). The mean differences in the students' grades on the anatomy questions at the level of knowledge, application, and analysis using Cohen's d test were 0.43, 1.41, and 1.01, respectively. These results suggest the positive impact of flipping the students' classrooms on improving their levels of thinking according to Bloom's taxonomy. Perception surveys also revealed students' enthusiasm for the pre-class activities, leading to a better performance in the class with more engagement with their peers and teachers. The present study suggested that the flipped classroom modality can be performed to compensate for the reduction of anatomy educational hours. However, further studies are recommended to investigate the best practices of the flipped classroom that fit with the students' needs and workloads.

Effect of blended learning with BOPPPS model on Chinese student outcomes and perceptions in an introduction course of health services management

Although the teaching methods of the blended learning and BOPPPS (bridge-in, objective, preassessment, participatory learning, postassessment, and summary) model are proven to be successful and highly effective at improving the academic knowledge of the students, respectively, it is unclear whether blended learning combined with the BOPPPS model (BL-BOPPPS) could work well in an introduction course of health services management (HSM) for the health management students in China. The study investigated the perceptions and effects of implementing the BL-BOPPPS model on student learning outcomes in an introduction course of HSM. The intervention group consisted of 55 students introduced to the BL-BOPPPS model, while the control group consisted of 54 students who received a conventional lecture. After the end of course, the effectiveness of teaching was self-assessed with questionnaires by all students, and examination scores for the two groups were compared. The students' satisfaction levels of BL-BOPPPS teaching strategy were up to 81.8% in the intervention group. Compared with the control group, the intervention group showed significant elevation of perception scores of skills (P = 0.001), initiative (P = 0.002), self-control (P = 0.008), self-efficacy (P = 0.001), motivation (P = 0.004), and the academic performance (P = 0.001). The BL-BOPPPS model could stimulate the enthusiasm and interest of health students; boost students' skills, initiative, and motivation in learning; and improve the self-directed learning ability, academic performance, and teaching quality. The findings provide a basis of evidence for the promotion of the BL-BOPPPS model in various disciplines in Chinese colleges and universities.

Outside the Box: An Experienced Registered Nurse Orientation Redesign

Nurse educators play an important role in implementing changes within hospital orientation, supporting a learner-focused orientation. Utilizing different learning styles and delivery methods, an orientation can promote an environment where registered nurses are active participants and guide the learning. This article discusses the process of incorporating multiple learning styles and modalities into an experienced registered nurse orientation program, creating a learner-centered environment promoting engagement, increased satisfaction, and retention of experienced staff.

A blended learning teaching strategy strengthens the nursing students' performance and self-reported learning outcome achievement in an anatomy, physiology and biochemistry course - A quasi-experimental study

In nursing, bioscience is regarded as one of the cornerstones of nursing practice. However, bioscience disciplines as anatomy, physiology and biochemistry are considered challenging for students and the failure rate is high. In this study we explore a blended learning teaching strategy in an anatomy, physiology and biochemistry course for first year Bachelor nursing students. In the blended learning teaching strategy, short narrated online digital resources of bioscientific terms and concepts were integrated into the teaching design along with digital metacognitive evaluations of learning outcomes. Results show that compared to students receiving traditional face-to-face teaching, the students with a blended learning approach performed better on their national exam with a small to medium effect size (Cohen's d=0.23). Student course evaluations supported the blended learning delivery with small to medium effect sizes. The students reported that the digital resources supported their learning outcome achievement, that they better understood the teacher's expectations and that they were more satisfied with their virtual learning environment. This study adds to the growing literature of blended learning effectiveness in higher education, and suggests the use of digital resources as an enrichment of teaching and enhancement of students' study experience.

What knowledge is available on massive open online courses in nursing and academic healthcare sciences education? A rapid review

BACKGROUND

With the recent challenges due to the Coronavirus 2019 outbreak, distance learning has been largely introduced in healthcare sciences curricula, and universities have been called upon to share learning opportunities with each other to ensure continuity of education and delivery of new graduates to the health system. However, decisions about its introduction should be supported by up-to-date evidence capable of providing an overview of available knowledge.

OBJECTIVES

To map the (a) state of research on massive open online courses in undergraduate and postgraduate health sciences education, (b) evaluation methods and tools used to measure learning outcomes, and (c) factors increasing their effectiveness as documented to date.

DESIGN

A rapid review following the preferred reporting items for systematic reviews and meta-analysis guidelines.

METHODS

PubMed, the Cumulative Index to Nursing and Allied Health Literature, Cochrane, Scopus, PsycInfo and Medline (via Ovid) were searched. Primary studies reporting one or more massive open online course (1) devoted to undergraduate and/or postgraduate students in nursing and healthcare sciences (2), written in English (3) with abstract available (4) and published up to February 18th, 2020 were all included. After having assessed the need for a review and the topic itself (a), the literature search was performed (b), studies were screened and selected (c), data was extracted (d), and the findings were summarised (e).

RESULTS

Thirty-six studies emerged with mainly an explorative/descriptive or case study design. The courses have been developed mainly by universities alone or in collaboration with institutions mainly in US, Sweden and the UK. Their delivery has been performed at multi-national levels, mainly in English, and with a number of participants ranging from 45 to >23,000. The duration spanned from two weeks to six months on clinical topics (e.g., emergency medicine) to methods (e.g., statistics). The target audience has been mainly mixed, including students, healthcare professionals, and lay citizens. Evaluation methods and tools have been described in 28 studies, and multiple-choice questions were most frequently adopted. Factors affecting the effectiveness of massive open online courses have been identified analysing the courses themselves and the participants.

CONCLUSION

Massive open online courses have recently started to be studied in healthcare sciences: these can be useful to educate students, mainly as elective courses, and to educate a massive audience, thus embodying the third mission of the university. The complexity of factors increasing effectiveness suggests the need for a multidisciplinary approach both in their design and implementation.

Implementation of Blended Learning Approach for Improving Anatomy Lectures of Phase I MBBS Students - Learner Satisfaction Survey

PURPOSE

The application of blended learning approach improves student engagement, active learning and achievement of higher order analytical thinking. Despite that there is still no clear proof that use of computer assisted learning is better than traditional teaching in human anatomy. In this study, a model of collaborative learning strategy is applied, using both online and face-to-face instruction delivery, for the Phase I medical students. The study aimed to innovate a model of blended learning in delivery of gross anatomy lectures and determine the effectiveness of this strategy in comparison to traditional classroom teaching by student's perception analysis.

METHODS

Students were provided with PowerPoint lectures, clinical video of patient cases, and lecture summary handouts before the interactive face-to-face lecture session. Learner satisfaction survey was done to validate the student's perception.

RESULTS

The students' participation in the survey was 90.4%, with the mean of students' responses on the survey scale was 4.10 ± 0.94 (standard deviation). Highest agreement was 83.1% on the effectiveness of online resources. Students gave minimum agreement of 54.9% about the time allotted for the online materials. Thematic analysis of the perception of student feedback provided with many positive outcomes for this approach.

CONCLUSION

We propose that blended learning is a process that helps in enhancing student involvement and participation, motivation for self-directed learning and promotes deeper learning of educational outcomes.

Characteristics of Adaptation in Undergraduate University Students Suddenly Exposed to Fully Online Education During the COVID-19 Pandemic

This study aimed to clarify the adaptation features of University students exposed to fully online education during the novel coronavirus disease 2019 (COVID-19) pandemic and to identify accompanying mental health problems and predictors of school adaptation. The pandemic has forced many universities to transition rapidly to delivering online education. However, little is known about the impact of this drastic change on students' school adaptation. This cross-sectional study used an online questionnaire, including assessments of impressions of online education, study engagement, mental health, and lifestyle habits. In total, 1,259 students were assessed. The characteristics of school adaptation were analyzed by a two-step cluster analysis. The proportion of mental health problems was compared among different groups based on a cluster analysis. A logistic regression analysis was used to identify predictors of cluster membership. P-values < 0.05 were considered statistically significant. The two-step cluster analysis determined three clusters: school adaptation group, school maladaptation group, and school over-adaptation group. The last group significantly exhibited the most mental health problems. Membership of this group was significantly associated with being female (OR = 1.42; 95% CI 1.06-1.91), being older (OR = 1.21; 95% CI 1.01-1.44), those who considered online education to be less beneficial (OR = 2.17; 95% CI 1.64-2.88), shorter sleep time on weekdays (OR = 0.826; 95% CI 0.683-.998), longer sleep time on holidays (OR = 1.21; 95% CI 1.03-1.43), and worse restorative sleep (OR = 2.27; 95% CI 1.81-2.86). The results suggest that academic staff should understand distinctive features of school adaptation owing to the rapid transition of the educational system and should develop support systems to improve students' mental health. They should consider ways to incorporate online classes with their lectures to improve students' perceived benefits of online education. Additionally, educational guidance on lifestyle, such as sleep hygiene, may be necessary.

Blended learning in basic medical laboratory courses improves medical students' abilities in self-learning, understanding, and problem solving

Blended learning, is a teaching approach that integrates online self-learning and classroom teaching. When designed well, blended learning courses in medicine can facilitate students to improve themselves in self-learning, understanding, and problem solving, ultimately enhancing their learning efficiency. However, blended teaching methods are usually used in only a single course, so it is unclear whether these methods can work well in a variety of basic medical courses. The goal of this study is to explore students' perceptions of whether blended laboratory courses are helpful for them in overcoming the difficulties they experience. Blended laboratory courses were taken by medical students at Guilin Medical University. Approximately 71.1% of the students agreed that online lecture courses improved their understanding of threshold concepts and the underlying theories. The majority of the students (63.01%) held the opinion that the blended laboratory courses were more effective than other types of courses in achieving the knowledge goals. The majority of the teachers believed that students' interest in experimentation operations, hands-on abilities, confidence, and other factors were greatly improved compared with those of students taught using the traditional teaching model (face to face). In addition, the average scores for the quizzes of laboratory courses were significantly improved in the blended learning method compared with the traditional learning method. Blended laboratory courses are successful and welcomed by both students and teachers in undergraduate laboratory courses.

Blended learning in undergraduate nursing education - A scoping review

OBJECTIVES

To provide a comprehensive scoping review of the existing literature regarding the use of blended learning in undergraduate nursing education. To align the varied educational terms and definitions with the broad definition of blended learning.

DESIGN

Scoping review following established methodology.

DATA SOURCES

In consultation with library services, the academic literature was searched. Electronic databases searched included ERIC (OVID), Medline (OVID), PubMed, Nursing and Allied Health, and CINAHL Plus.

REVIEW METHODS

A total of 189 potentially relevant nursing research articles published between the years of 2009 and 2019. Three reviewers independently reviewed the articles, leaving 37 relevant primary articles in the nursing field to be included in the scoping review.

RESULTS

Nursing content delivered using blended learning approaches were organized into 8 themes. Themes include Professional Nursing Skills; Mental Health Nursing; Bioscience; Pharmacology, Specialty Populations; Nursing Assessment; Acute Care Nursing; and the Art of Nursing. A variety of blended learning approaches are being utilized in Undergraduate nursing education, the majority of which are happening in the classroom.

CONCLUSION

This scoping review presents explicit the degrees to which blended learning is referred to in the nursing education literature and expanded the definition of blended learning to encompass the terminology associated with distributed, decentralized, hybrid, and flexible learning. There is a wide, varied, and expanding number of blended learning approaches currently being utilized in nursing education to teach a wide range of nursing content and skills. An expanded scoping review focused on blended learning in psychiatric nursing, licenced practical nursing, nurse practitioners, and all graduate level nursing education programs is recommended as is additional research into the use of blended learning in the lab or clinical setting.

The Effect of Blended Learning on Nursing Students’ Knowledge

Introduction: Blended learning is assumed to improve the students’ understanding of learning at nursing school especially in the current industrial revolution 4.0 era.  The combination of classroom and online activities is expected to provide better study outcomes.  This research aimed to compare the knowledge scores of the nursing students in blended learning concerning a research and statistics course at a private faculty of nursing.Methods: The knowledge scores resulted from the student’s score in their mid and final examinations (0-100). A total of 474 respondents who were third year students involved in the study.  This study applied a pre-experimental design. Due to the data having a significant non-normal value (p value < 0.001), this study further compared the mean-rank of the students’ score using a Wilcoxon test analysis.Results: The results of this study revealed that there was a significant difference (p value < 0.0001) between the students’ score in the mid (Median 72.5; SD 9.82) and final exam examinations (Median 86.66; SD 4.75). This means that the students had a better score in their final exam.Conclusion: Applying a blended learning method was a positive experience for the nursing students in terms of knowledge. It is needed to explore the students’ understanding and interest in their learning process using blended learning.

Massive open online courses (MOOCs) for continuing medical education - why and how?

Continuing medical education (CME) is meant to not only improve clinicians' knowledge and skills but also lead to better patient care processes and outcomes. The delivery of CME should be able to encourage the health providers to accept new evidence-based practices, and discard or discontinue less effective care. However, continuing use of expensive yet least effective and inappropriate tools and techniques predominates for CME delivery. Hence, the evidence shows a disconnect between evidence-based recommendations and real-world practice - borne out by less than optimal patient outcomes or treatment targets not being met especially in low- to middle-income countries. There is an ethical and professional obligation on CME-providers and decision-makers to safeguard that CME interventions are appraised not only for their quality and effectiveness but also for cost-effectiveness. The process of learning needs to be engaging, convenient, user-friendly and of minimal cost, especially where it is most needed. Today's technology permits these characteristics to be integrated, along with further enhancement of the engagement process. We review the literature on the mechanics of CME learning that utilizes today's technology tools and propose a framework for more engaging, efficient and cost-effective approach that implements massive open online courses for CME, adapted for the twenty-first century.