Development and initial validation of an online engagement metric using virtual patients

The association between online class-related enjoyment and academic achievement of college students: a multi-chain mediating model

BACKGROUND

Based on the control-value theory of achievement emotion and self-determination motivation theory, this study attempted to examine the multi-chain mediating relationships among online class-related enjoyment, school motivation, learning engagement and academic achievement.

METHODS

This is an empirical study based on cross-sectional data. Online class-related enjoyment is the independent variable, academic achievement is the dependent variable, and school motivation and learning engagement are the mediating variables. Sample data were collected from 1294 Chinese college students, and SPSS macro program PROCESS 3.3 was used for data analysis.

RESULTS

The present study confirmed that students' online class-related enjoyment has a significant positive correlation with academic achievement. And there is a positive correlation between college students' school motivation with learning engagement and college students' learning engagement with academic achievement. In addition, online class-related enjoyment affects academic achievement through the chain mediating effect of school motivation and learning engagement.

CONCLUSIONS

Our study indicated that online class-related enjoyment has a significant impact on academic achievement. Both of these factors should be considered when determining the optimal multi-chain mediating model for Online Class-related Enjoyment and Academic Achievement of college students.

Student engagement in health professions education: AMEE Guide No. 152

This guide aims to support our colleagues to have comprehensive understanding of student engagement in health professions education. Despite the universal agreement about the significance of student engagement, there is lack of uniformity in conceptualizing and operationalizing this emerging construct. We review the theoretical basis explaining student engagement from three main perspectives: behavioral, psychological, and socio-cultural. In addition, we propose a contemporary and comprehensive framework for the student engagement in higher education, which is applicable to health professions education contexts. Drawing from this framework, we explain the conceptualization of the construct and its preceding factors, mediators, dimensions, spheres, and outcomes of student engagement. The proposed framework introduces student 'engagement through partnerships' as a novel component compared with the existing models of student engagement in higher education. This way, we are proposing a mixed model that not only considers the student as a 'customer' but also as a 'partner' in education. Engagement of students through partnerships include four areas: (1) provision of the education program, (2) scholarly research, (3) governance and quality assurance, and (4) community activities. This guide will provide practical applications on how to improve student engagement in health professions education. Finally, we highlight the current gaps in areas of research in the student engagement literature and suggested plans for future directions.[Box: see text].

Educators' perspectives of adopting virtual patient online learning tools to teach clinical reasoning in medical schools: a qualitative study

BACKGROUND

Learning tools using virtual patients can be used to teach clinical reasoning (CR) skills and overcome limitations of using face-to-face methods. However, the adoption of new tools is often challenging. The aim of this study was to explore UK medical educators' perspectives of what influences the adoption of virtual patient learning tools to teach CR.

METHODS

A qualitative research study using semi-structured telephone interviews with medical educators in the UK with control over teaching materials of CR was conducted. The Consolidated Framework for Implementation Research (CFIR), commonly used in healthcare services implementation research was adapted to inform the analysis. Thematic analysis was used to analyse the data.

RESULTS

Thirteen medical educators participated in the study. Three themes were identified from the data that influenced adoption: the wider context (outer setting); perceptions about the innovation; and the medical school (inner context). Participants' recognition of situations as opportunities or barriers related to their prior experiences of implementing online learning tools. For example, participants with experience of teaching using online tools viewed limited face-to-face placements as opportunities to introduce innovations using virtual patients. Beliefs that virtual patients may not mirror real-life consultations and perceptions of a lack of evidence for them could be barriers to adoption. Adoption was also influenced by the implementation climate of the setting, including positioning of CR in curricula; relationships between faculty, particularly where faculty were dispersed.

CONCLUSIONS

By adapting an implementation framework for health services, we were able to identify features of educators, teaching processes and medical schools that may determine the adoption of teaching innovations using virtual patients. These include access to face-to-face teaching opportunities, positioning of clinical reasoning in the curriculum, relationship between educators and institutions and decision-making processes. Framing virtual patient learning tools as additional rather than as a replacement for face-to-face teaching could reduce resistance. Our adapted framework from healthcare implementation science may be useful in future studies of implementation in medical education.

Measurement of student engagement in health professions education: a review of literature

Student engagement is a complex multidimensional construct that has attained great interest in health professions education (HPE). Definition and conceptualization of student engagement is an important step that should drive the development of the instruments for its measurement. We have recently proposed a comprehensive framework for student engagement in HPE with a definition of engagement as student investment of time and energy in academic and non-academic experiences that include learning, teaching, research, governance, and community activities. The dimensions of student engagement in this framework included the cognitive, affective, behavioral, agentic, and socio-cultural. Guided by the student engagement framework, this non-systematic review aims to identify, critically appraise, and summarize the existing methods for measuring student engagement in HPE. Extrapolating from higher education literature, we attempted to link the theoretical perspectives of student engagement with the published methods of its measurement in HPE context. In addition, we have described the different methods of measuring student engagement including self-report surveys, real time measures, direct observation, interviews/focus groups, and the use of multiple instruments. The span of engagement dimensions measured by self-report surveys ranges from one to five dimensions. However, measurement of agentic and sociocultural dimensions of engagement in HPE is still limited and further research is required. We have also reflected on the existing methods of measuring engagement of students as active partners in HPE. The review also describes the advantages, limitations, and psychometric properties of each method for measuring student engagement. We ended the review with a guiding conclusion on how to develop and select an instrument for measuring student engagement in HPE. Finally, we addressed the gaps in the literature about measuring engagement of HPE students and future research plans.

Enhancing Examination Success: the Cumulative Benefits of Self-Assessment Questions and Virtual Patient Cases

PURPOSE

Research on the learning benefits of the feedback-rich formative assessment environment of virtual patient cases (VPCs) has largely been limited to single institutions and focused on discrete clinical skills or topical knowledge. To augment current understanding, we designed a multi-institutional study to explore the distinct and cumulative effects of VPC formative assessments and optional self-assessment questions (SAQs) on exam performance.

METHOD

In this correlational study, we examined the records of 1,692 students on their family medicine (FM) clerkship at 20 medical schools during the 2014-2015 academic year. Schools utilized an established online curriculum, which included family medicine VPCs, embedded formative assessments, context-rich SAQs corresponding with each VPC, and an associated comprehensive family medicine exam. We used mixed-effects modeling to relate the student VPC composite formative assessment score, SAQ completion, and SAQ performance to students' scores on the FM final examination.

RESULTS

Students scored higher on the final exam when they performed better on the VPC formative assessments, completed associated SAQs, and scored higher on those SAQs. Students' SAQ completion enhanced examination performance above that explained by engagement with the VPC formative assessments alone.

CONCLUSIONS

This large-scale, multi-institutional study furthers the body of research on the effect of formative assessments associated with VPCs on exam performance and demonstrates the added benefit of optional associated SAQs. Findings highlight opportunities for future work on the broader impact of formative assessments for learning, exploring the benefits of integrating VPCs and SAQs, and documenting effects on clinical performance and summative exam scores.

Using the HyFlex model to deliver a capstone seminar course

INTRODUCTION

The HyFlex course structure allows students to attend class in-person or via synchronous videoconferencing technology. This model has been described, but no data are available in pharmacy curricula.

METHODS

Students enrolled in Grand Rounds (GR) were eligible. The GR Engagement Assessment Tool (GREAT) measured engagement three times during the semester. Eighteen statements across four domains were rated using a five-point Likert scale (1 = not true at all and 5 = completely true). Free-text responses were collected for qualitative analysis. The primary outcome was the difference in GR engagement between students attending in-person vs. remotely. Descriptive statistics were used for demographic information. Wilcoxon rank-sum tests compared Likert-scale responses between in-person and remote attendance.

RESULTS

Surveys included 128 responses from 88 unique students. There were no differences between remote and in-person attendance for the boredom and elaboration domains. In-person students reported listening more intently (median 4, IQR [3,4]; P = .03). In-person students felt the material was more practical (median 4, IQR [4,5]) than remote students (median 4, IQR [3,4]; P = .002) and more applicable to other situations (median 3, IQR [3,5]) than remote students (median 3, IQR [2,4]; P = .04). Qualitative analysis of the entire cohort demonstrated five themes for satisfaction: safety, flexibility, convenience, technology, and professionalism.

CONCLUSIONS

There were subtle differences in student engagement or satisfaction using the HyFlex model. This study supports the expansion of this methodology to similar courses where remote instruction is needed.

Development and psychometric testing of learning immersion scale in clinical simulation: A methodological study

BACKGROUND

Immersion during clinical simulation has been suggested to be important for learning effects. However, no valid and reliable instruments have been available for measuring the learner's immersion during simulation experience.

OBJECTIVES

To develop a Learning Immersion Scale in Simulation (LISS) and evaluate its psychometric properties.

DESIGN

A methodological study design was employed to develop and validate the instrument.

SETTINGS

Two universities in South Korea.

PARTICIPANTS

A convenience sample of 204 nursing students.

METHODS

A literature review and a focus group interview were conducted to determine the properties of learning immersion during simulation experience. Content validity was assessed by a panel of 10 experts. Nursing students who participated in high-fidelity patient simulation (n = 204) were asked to complete the preliminary LISS, after which Students Satisfaction and Self-Confidence in Learning Scale and Learning Flow Scale for Adults were administered for assessing the convergent and criterion validity. Data were analyzed using exploratory factor analyses, Pearson's correlation, and Cronbach's alpha.

RESULTS

Exploratory factor analyses extracted a four-factor solution, explaining 65.2% of the total variance. The convergent and criterion validity and internal consistency and half reliability were satisfied.

CONCLUSIONS

The LISS is a short multi-dimensional instrument with good psychometric validity and reliability that has potential utility for clinical simulation education and research.

Feasibility Study of a Fully Synchronous Virtual Critical Care Elective Focused on Learner Engagement

Background: The COVID-19 pandemic disrupted clinical education for medical students. With the rise of variants, meaningful in-person clinical experiences remain threatened. This report describes the design, implementation, and evaluation of a fully synchronous virtual critical care elective for medical students focused on learner engagement.

Methods: The two-week elective was offered during June and July 2020 in the COVID-19 extracorporeal membrane oxygenation (ECMO) unit. Medical students remotely participated in multidisciplinary rounds with the attending physician connected from the bedside via a head-mounted camera providing the first-person video view. Other team members connected outside the negative pressure area. Learners electronically completed daily intensive care unit (ICU) goals sheet (GS) for each patient. The daily completion percentage of the GS assessed the learner engagement, and the learners evaluated the experience with a five-point Likert scale survey.

Results: Nine medical students participated in two separate cohorts. Cohort A had 53 patient encounters, and Cohort B had 45 patient encounters totaling 301.5 total hours of supervised virtual patient interaction. The mean completion percentage of the daily ICU GS for the combined cohorts was 77.8%, (with a standard deviation of 9.6%), with sustained or increased completion from start to finish for all learners. All medical students agreed that the daily ICU GS was helpful for following rounds, organizing patient assessments and plans, and participating in patient care. The majority (88.9%) agreed that the elective increased their comfort in caring for critically ill patients.

Conclusions: During the COVID-19 pandemic, a fully synchronous virtual critical care elective successfully utilized the first-person view and daily ICU GS to promote and assess learner engagement.

Emergency Medicine Virtual Conference Participants’ Engagement with Competing Activities

Introduction: Residency didactic conferences transitioned to a virtual format during the COVID-19 pandemic. This format creates questions about effective educational practices, which depend on learner engagement. In this study we sought to characterize the competitive demands for learner attention during virtual didactics and to pilot methodology for future studies. Methods: This was a prospective, observational, cohort study of attendees at virtual didactics from a single emergency medicine residency, which employed a self-report strategy informed by validated classroom assessments of student engagement. We deployed an online, two-question survey polling across six conference days using random signaled sampling. Participants reported all activities during the preceding five minutes. Results: There were 1303 responses over 40 survey deployments across six nonadjacent days. Respondents were residents (63.4%); faculty (27.5%); fellows (2.3%); students (2%); and others (4.8%). Across all responses, about 85% indicated engagement in the virtual conference within the last five minutes of the polls. The average number of activities engaged in was 2.0 (standard deviation = 1.1). Additional activities included education-related (34.2%), work-related (21.1%), social (18.8%), personal (14.6%), self-care (13.4%), and entertainment (4.4%). Conclusion: Learners engage in a variety of activities during virtual didactics. Engagement appears to fluctuate temporally, which may inform teaching strategies. This information may also provide unique instructor feedback. This pilot study demonstrates methodology for future studies of conference engagement and learning outcomes.

Construção e validação de um vídeo educativo sobre o banho de imersão do recém-nascido

RESUMO Objetivo Construir e validar um vídeo educativo sobre o banho de imersão do recém-nascido. Método Pesquisa metodológica, de produção tecnológica, desenvolvida nas fases: pré-produção, produção e pós-produção no período de dezembro de 2020 a fevereiro de 2022, validado por enfermeiros doutores,profissionais da área da comunicação social, equipe de enfermagem, puérperas e familiares. Utilizou-se o Índice de Validade de Conteúdo para avaliar concordância entre juízes e público-alvo e Alfa de Cronbrach a confiabilidade dos itens. Resultados O vídeo tem oito minutos e 34 segundos e foi organizado emantes, durante e após o banho. Roteiro/script e storyboard avaliados quanto ao objetivo, conteúdo, relevância, ambiente, linguagem verbal e inclusão de tópicos e vídeo quanto a funcionalidade, usabilidade, eficiência, técnica audiovisual, ambiente e procedimento, todos alcançaram índices iguais ou maiores a 0,80. Conclusão O vídeo apresenta potencial tecnológico para ser utilizado durante ações de educação emsaúde e práticas de educação permanente.

The effectiveness of the virtual patient-based social learning approach in undergraduate nursing education: A quasi-experimental study

BACKGROUND

In nursing education, knowledge and competence in conducting physical assessments are crucial. Therefore, physical assessment knowledge has become a fundamental and essential education program for nursing students. However, most of the current nursing courses are taught via a didactic teaching approach, making it difficult for students to think deeply about relevant issues due to the lack of interaction and context. This may, in turn, have an impact on learning effectiveness and clinical judgment.

OBJECTIVE

A virtual patient (VP)-based social learning approach is proposed to enhance nursing students' performance and clinical judgment in education programs.

DESIGN

A quasi-experiment method was adopted to evaluate the effectiveness of the proposed approach.

PARTICIPANTS

A total of 40 senior nursing students participated in the study (VP-based social learning approach group = 20, control group = 20).

METHODS

The study involved a pre- and post-test to examine students' learning achievements, self-efficacy, and communication skills. The experimental group adopted the VP-based learning approach, while the control group adopted the conventional didactic learning approach. ANCOVA was employed to compare the performances of the two groups.

RESULTS

The experimental results indicate that using a VP for learning can enhance students' learning achievements, self-efficacy, and communication skills. In addition, based on the analysis of the results, students generally believed that learning with a VP makes learning more enjoyable.

CONCLUSION

The VP-based social learning approach would be an effective strategy to train nursing students who have limited opportunities to experience real clinical situations, in particular during the COVID-19 pandemic.

Construction and validation of an educational video on the newborn immersion bath

ABSTRACT Objective To build and validate an educational video about the immersion bath of the newborn. Method Methodological research, of technological production, developed in the phases: pre-production, production and post-production in the period from December 2020 to February 2022, validated by nurse practitioners, professionals in the area of social communication, nursing team, puerperal women and family members. The Content Validity Index was used to assess consistency and Cronbrach's Alpha reliability. Results The video is eight minutes and 34 seconds long and was organized into before, during and after the shower. The script/script and storyboard were evaluated regarding the objective, content, relevance, environment, verbal language and inclusion of topics and the video regarding functionality, usability, efficiency, audiovisual technique, environment and procedure, all of which achieved indices equal to or greater than 0,80. Conclusion The video has technological potential to be used during health education actions and in continuing education practices.