Applications of social theories of learning in health professions education programs: A scoping review

Out-BREAK!: An IDWeek 2023 Escape Room to Break Out of the Educational Mold

Background

An escape room is a cooperative game that has been adapted into medical education and major academic conferences.

Methods

We describe the design, development, and implementation of an educational ID-themed escape room activity entitled "Out-BREAK!" at an international conference, IDWeek 2023. An anonymous survey was conducted to collect demographic data, assess participant satisfaction with the escape room puzzles, and gauge participant interest in game-based learning.

Results

Thirty escape room sessions were held over 3 days and included 201 participants. Escape room survey respondents (n = 132) were younger and more likely to be trainees compared with in-person IDWeek attendants. Among 131 responses, all respondents enjoyed the experience and would recommend the escape room activity to friends. Survey respondents enjoyed the puzzle solving (93%), medical content (92%), and team building (79%) components. Only 35% of the respondents had ever previously participated in game-based learning; 95% thought the escape room was a valuable teaching method. Among the 72 survey respondents involved in medical education, almost all (90%) said they were interested in incorporating escape rooms into medical education.

Conclusions

The Out-BREAK! escape room at IDWeek 2023 was successfully implemented and well received. Despite only a third of participants having prior experience with game-based learning, almost all respondents perceived the escape room to be an effective teaching method.

Public health education using social learning theory: a systematic scoping review

BACKGROUND

Public health education (PHE) in social environments plays a crucial role in mitigating the impact of public health events, especially with the recent surge in global incidents. Social learning theory (SLT) provides a strong theoretical foundation for implementing PHE. The objective of this study is to conduct a systematic scoping review of PHE using SLT, synthesizing the target populations, types of research, main findings, and future directions.

METHODS

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) guidelines. We conducted a comprehensive search of five electronic databases (Web of Science, Scopus, PubMed, ProQuest, and APA PsycInfo) for English articles related to PHE using SLT. Two reviewers independently screened the titles and abstracts. Descriptive statistics were utilized to analyze the characteristics of the articles included in the study, followed by a comprehensive narrative analysis of the results.

RESULTS

Research on PHE using SLT mainly focuses on adolescents, students, special patients, and vulnerable populations. The study sample includes seven research types and nine commonly used experimental methods. Four modes of PHE using SLT are identified, along with four types of summarized research results.

CONCLUSION

PHE research based on SLT can be prioritized for preventing widespread infectious diseases, spreading fundamental public health information, and assisting patients with particular illnesses. To enhance the implementation of PHE, researchers and policymakers should integrate online and offline health education resources, ensure the accessibility of up-to-date information, and leverage digital technologies in PHE. More highly interactive and participatory health education courses will be established in social learning environments to encourage public participation in PHE.

Using active learning strategies during a quality improvement collaborative: exploring educational games to enhance learning among healthcare professionals

BACKGROUND

The Breakthrough Series model uses learning sessions (LS) to promote education, professional development and quality improvement (QI) in healthcare. Staff divergences regarding prior knowledge, previous experience, preferences and motivations make selecting which pedagogic strategies to use in LS a challenge.

AIM

We aimed to assess new active-learning strategies: two educational games, a card game and an escape room-type game, for training in healthcare-associated infection prevention.

METHODS

This descriptive case study evaluated the performance of educational strategies during a Collaborative to reduce healthcare-associated infections in Brazilian intensive care units (ICUs). A post-intervention survey was voluntarily offered to all participants in LS activities.

RESULTS

Seven regional 2-day LS were held between October and December 2022 (six for adult ICUs and one for paediatric/neonatal ICUs). Of 194 institutions participating in a nationwide QI initiative, 193 (99.4%) participated in these activities, totalling 850 healthcare professionals. From these, 641 participants responded to the survey (75.4%). The post-intervention survey showed that the participants responded positively to the educational activities.

CONCLUSION

The participants perceived the various pedagogical strategies positively, which shows the value of a broad and diverse educational approach, customised to local settings and including game-based activities, to enhance learning among healthcare professionals.

The Impact of Script Concordance Testing on Clinical Decision-Making in Paramedic Education

This study investigates the effectiveness of the Script Concordance Test (SCT) in enhancing clinical reasoning skills within paramedic education. Focusing on the Medical University of Lublin, we evaluated the SCT's application across two cohorts of paramedic students, aiming to understand its potential to improve decision-making skills in emergency scenarios. Our approach, informed by Van der Vleuten's assessment framework, revealed that while the SCT's correlation with traditional methods like multiple-choice questions (MCQs) was limited, its formative nature significantly contributed to improved performance in summative assessments. These findings suggest that the SCT can be an effective tool in paramedic training, particularly in strengthening cognitive abilities critical for emergency responses. The study underscores the importance of incorporating innovative assessment tools like SCTs in paramedic curricula, not only to enhance clinical reasoning but also to prepare students for effective emergency responses. Our research contributes to the ongoing efforts in refining paramedic education and highlights the need for versatile assessment strategies in preparing future healthcare professionals for diverse clinical challenges.

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.

Education Research: Virtual Patient Management Conference for Epilepsy Surgery in the Post-COVID-19 Era: An Educational Perspective

Background and Objectives

The primary objective of this study was to assess the potential educational value of a virtual patient management conference (PMC) with the introduction of inclusive anonymous polling at a comprehensive epilepsy center. The secondary objective was to evaluate differences between faculty and trainee polling results.

Methods

Two online surveys were sent 1 year apart seeking opinions about a transition to virtual PMC and completed by virtual PMC faculty participants (including representatives from neurology, neurosurgery, and neuropsychology). One online survey was sent to trainees (medical students, residents, and fellows) to assess the educational value of the conference. Anonymous electronic polls surveying treatment options were completed by both faculty and trainees after each virtual PMC presentation but before discussing the case. The results were collected and analyzed over 16 months, including over the course of 1 academic year. The degree of consensus was determined by the maximum percentage of votes that a single choice received.

Results

Eleven faculty and 22 trainees responded to their respective surveys. The initial faculty survey revealed that 60.0% of faculty had an "excellent" or "very good" experience with virtual PMC; 1 year later, this proportion increased to 100.0% while trainees reported 90.9%. Each virtual PMC component, including perceived standard of care, was found to be "excellent" or "very good" by most faculty and trainees, and most (91% faculty, 63.7% trainees) were equally comfortable or more comfortable expressing opinions during the virtual discussion. During virtual PMC polls, faculty members were significantly more likely to vote for vagus nerve stimulation as a treatment option, while trainees were more likely to opt for responsive neurostimulation. Linear regression over the course of the academic year showed stable consensus over time for both faculty and trainees; however, the match between faculty and trainee consensus significantly increased over the academic year.

Discussion

Our results demonstrate that the virtual PMC constitutes an effective educational experience as an alternative to in-person conferences for the management of patients with drug-resistant epilepsy.

Nursing students' emotional empathy, emotional intelligence and higher education-related stress: a cross-sectional study

BACKGROUND

Nursing is one of the critically important disciplines in healthcare. Due to its complexity and specificity, nursing students often face additional higher education-related stress. However, there is less research on higher education-related stress among nursing students. Therefore, the purpose of this study was to investigate the effects of emotional empathy and emotional intelligence on the dimensions of higher education-related stress among nursing students.

METHODS

This study utilized a multi-stage sampling design and was completed within the March-June 2023 period. A total of 1126 nursing students were recruited to complete the questionnaire. The self-administered questionnaire included the basic characteristics of the subjects, an emotional empathy scale, an emotional intelligence scale, and a higher education-related stress scale. One-way ANOVA/t-tests, correlation coefficients, and hierarchical linear regression analyses were used to explore the factors affecting higher education-related stress and the relationship between emotional empathy and emotional intelligence with the dimensions of higher education-related stress.

RESULTS

The mean (SD) scores of challenges and dissatisfaction dimensions of higher education-related stress among nursing students were 30.052 (7.466) and 8.270 (2.205), respectively. Emotional empathy was significantly and positively related to the challenges and dissatisfaction dimensions of higher education-related stress. Emotional intelligence was negatively correlated with the challenges dimension of higher education-related stress and positively correlated with the dissatisfaction dimension. Stratified multiple regression analyses revealed that nursing students' emotional empathy and emotional intelligence were significant predictors of the dimensions of higher education-related stress.

CONCLUSION

Overall, emotional empathy and emotional intelligence were significantly correlated with all dimensions of higher education-related stress. Consequently, in future interventions, the Chinese government and education sector can develop nursing students' ability to use emotional empathy and emotional intelligence rationally through emotional regulation strategies and emotional intelligence courses, to reduce the higher education-related stress they experience.

Perceptions and Experiences of Undergraduate Students Regarding Social Media as a Tool for Government COVID-19-Related Messages: A Qualitative Study in Nottingham, UK

The rise of social media has given way to its use as a form of public health communication. Previous research has shown social media-based interventions to be effective, particularly for university students. Social media was used as a tool for public health messaging during the COVID-19 pandemic; however, there is a lack of information regarding the experiences and perceptions of such messaging and its effectiveness among UK university students. A qualitative study was conducted to explore the perceptions and experiences of public health messaging on social media during the pandemic, as well as the effects of such messaging. Fourteen semi-structured interviews with undergraduate students at the University of Nottingham, UK, were conducted. Five main themes were identified: effects of COVID-19 on university students, use of social media by university students, COVID-19 messaging on social media, effects of public health messaging on social media in compliance with COVID-19 guidelines, and improving public health messaging for the future. This study provides a novel insight into the experiences and perceptions of undergraduate students at a UK university regarding public health messaging on social media during the COVID-19 pandemic.

Virtual Reality and Augmented Reality Training in Disaster Medicine Courses for Students in Nursing: A Scoping Review of Adoptable Tools

Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.

Examining the nexus between medical education and complexity: a systematic review to inform practice and research

BACKGROUND

Medical education is a multifarious endeavour integrating a range of pedagogies and philosophies. Complexity as a science or theory ('complexity') signals a move away from a reductionist paradigm to one which appreciates that interactions in multi-component systems, such as healthcare systems, can result in adaptive and emergent outcomes. This examination of the nexus between medical education and complexity theory aims to discover ways that complexity theory can inform medical education and medical education research.

METHODS

A structured literature review was conducted to examine the nexus between medical education and complexity; 5 databases were searched using relevant terms. Papers were included if they engaged fully with complexity as a science or theory and were significantly focused on medical education. All types of papers were included, including conceptual papers (e.g. opinion and theoretical discussions), case studies, program evaluations and empirical research. A narrative and thematic synthesis was undertaken to create a deep understanding of the use of complexity in medical education.

RESULTS

Eighty-three papers were included; the majority were conceptual papers. The context and theoretical underpinnings of complexity as a relevant theory for medical education were identified. Bibliographic and temporal observations were noted regarding the entry of complexity into medical education. Complexity was relied upon as a theoretical framework for empirical studies covering a variety of elements within medical education including: knowledge and learning theories; curricular, program and faculty development; program evaluation and medical education research; assessment and admissions; professionalism and leadership; and learning for systems, about systems and in systems.

DISCUSSION

There is a call for greater use of theory by medical educators. Complexity within medical education is established, although not widespread. Individualistic cultures of medicine and comfort with reductionist epistemologies challenges its introduction. However, complexity was found to be a useful theory across a range of areas by a limited number of authors and is increasingly used by medical educators and medical education researchers. This review has further conceptualized how complexity is being used to support medical education and medical education research.

CONCLUSION

This literature review can assist in understanding how complexity can be useful in medical educationalists' practice.

"Alive Day is the Day": A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Background

Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH.

Methods

We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi's phenomenological approach.

Results

Twenty-two respondents completed the interviews (aged 29-75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends' helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison).

Conclusion

The study reveals that multiple stressors drive MHD patients' LH. These salient phenomena demonstrate the importance of recognizing MHD patients' LH. We suggest that support services should be developed alongside a framework that addresses MHD patients' LH from the beginning of treatment.

To Effectively Address Complex Healthcare Problems, Continuing Professional Development Must Evolve

ABSTRACT

Continuing professional development aims to provide health professionals with the knowledge, skills, and competencies needed to improve care. Physicians and other clinicians increasingly practice within complex health care delivery organizations aiming to improve the care of populations of patients with multiple problems and differing needs. These organizations are composed of local units in different departments and venues; these teams and the patients they care for change over time. Improving outcomes within constantly changing complex organizations delivering population care takes time and persistence. It takes time to equip critical masses of clinicians and other personnel with knowledge and skills to effect change. Although some changes might be simple, those involving new workflows require implementation support. Not all change will be smooth; individuals need opportunities to learn from and adjust their early intervention efforts, measure effectiveness of change, and sustain successful practices. Longitudinal support is necessary to affect change over complex organizations. This essay proposes that to be more supportive and valuable to health care delivery organizations, continuing professional development needs to intentionally participate in longitudinal, collaborative, context-specific, team-based interventions. An expanded menu of evaluation approaches will better describe the role of continuing professional development in helping health care professionals and organizations address increasingly complex health care delivery problems and improve patient and population outcomes. Selected concepts to achieve these ends are introduced at a high level in this article. Readers are invited to explore concepts that resonate with their current situation in further detail.