Sociodemographic Factors Associated with the Satisfaction Level of Peruvian Dental Students with Virtual Classes During the Covid-19 Pandemic: A Prospective Bicentric Study

Background

The pandemic caused by Covid-19 impacted all areas of social, economic and educational activity. When there is a high risk of spreading highly infectious diseases, education is usually the first service to be suspended. The objective was to evaluate the sociodemographic factors associated with the satisfaction level of Peruvian dental students with virtual classes during the Covid-19 pandemic.

Methods

This observational, cross-sectional, analytical study evaluated 237 dental students from the capital city and one Peruvian province using a validated 13-item questionnaire to measure the level of satisfaction with virtual classes. Pearson's chi-square test and a logit model were used to evaluate the associated factors such as age group, sex, marital status, monthly family income, area of residence, place of origin, occupation and computer use, considering a significance level of p<0.05.

Results

Of all students, 50.6%, 40.1% and 9.3% presented a good, average and poor level of satisfaction, respectively, with the virtual classes received. In addition, those with a monthly family income of less than 500 US dollars were 3.15 times more likely to have poor satisfaction compared to those with a monthly family income of more than 1000 US dollars (AOR = 3.15; 95% CI: 1.23-8.05). The rest of the variables evaluated were not considered influential factors in the levels of satisfaction with the virtual classes received.

Conclusión

Of all students, 50.6% and 9.3% reported good and poor satisfaction with virtual classes during the COVID-19 pandemic, respectively. Monthly family income of less than 500 US dollars was an influential factor. In addition, the variables age group, sex, marital status, area of residence, place of origin, occupation and computer use were not found to be influential factors.

Co-design and development of the sit-stand e-guide: An e-training program for the optimal use of sit-stand workstations

This paper describes the co-design and development process of an evidence-informed e-training program (Sit-Stand e-Guide) to support the safe and optimal use of sit-stand workstations from ergonomics and behavioural change perspectives. Using an instructional system design process, supported by a participatory design approach, data was collected through three workshops with workplace consumers (staff [n = 5] and managers [n = 5]), and subject matter experts (n = 5). Content and learning activities were developed based on behaviour change principles and optimal pedagogy. Key topics identified for the e-training were sedentary behaviour and health; workstation set-up; and strategies for behaviour change. Learning activities (scenarios and reflection) to enhance knowledge retention and skills implementation and an interactive one-page guide on completion were included in the e-training. The relevance and usefulness of the training prototype were reviewed through one-to-one think-aloud sessions with the workshop consumers (n = 5) and external health and safety professionals (n = 5) receiving positive feedback. The Sit-Stand e-Guide is readily available for workplace implementation and evaluation. This paper serves as a practical guide for future training development.

Nursing Students' Perceptions on a Pain Management E- Learning Module: An Exploratory Quantitative Study

BACKGROUND

Nursing students are graduating ill-prepared to assess and manage pain in older adults. To address this gap, we developed an e-learning module on the topic.

AIM

To examine nursing students' perceptions on a pain management e-learning module focused on older adults.

METHODS

Utilizing an exploratory quantitative design, we assessed nursing students' perceptions of the e-learning module. We used a feedback survey (four 5-point, Likert-type items) and one open-ended question to assess students' perceptions. Descriptive statistics were used to summarize students' perceptions and demographic characteristics. Responses to the open-ended question were content analyzed.

RESULTS

A total of 181 of 249 students completed the module, of whom two-thirds were female. Students perceived that the module enhanced their knowledge, confidence, and perception in working with older people. Students also found the method of instruction interactive and enjoyable.

CONCLUSIONS

The e-learning module on pain management was viewed by nursing students to be helpful and its interactive method of learning improved their knowledge, confidence, and perceptions of working with older adults in pain.

Pharmacy Students' Attitudes Toward Distance Learning After the COVID-19 Pandemic: Cross-Sectional Study From Saudi Arabia

BACKGROUND

Electronic learning refers to the use of assistive tools in offline and distance learning environments. It allows students to access learning tools and materials anytime and anywhere. However, distance learning courses depend on several factors that affect the quality of learning, which consequently affect students' preferences in the settings and tools used to deliver educational materials.

OBJECTIVE

This study aimed to evaluate students' preferences for continuing distance learning after the pandemic and to assess the distance educational environment after the pandemic. It also aimed to identify the factors affecting distance learning and evaluate students' preferences regarding modes of communication with instructors.

METHODS

A web-based survey was used to conduct this cross-sectional study. The target participants of this study were students in the doctor of pharmacy program at Unaizah College of Pharmacy, Qassim, Saudi Arabia. All students enrolled from December 2022 to January 2023 received an invitation with a link to the web-based survey.

RESULTS

The survey was completed by 141 students (58 female students and 83 male students). The research results showed that most students (102/141, 72.3%) did not wish to continue distance education for laboratory courses, and 60.3% (85/141) did not wish to continue taking distance team-based learning after the pandemic. Additionally, 83.7% (118/141) of the students indicated that distance courses were simple. More than half of the participants (79/141, 56%) stated that having a camera on during class negatively impacted their learning, and only 29.1% (41/141) of the students stated that nonvisual communication with their fellow students impacted their learning. A large proportion of students (83/141, 58.9%) reported impairment of social engagement on campus, 44% (62/141) in-person interactions during classes, and 73.7% (104/141) were relieved that their classes were not disrupted.

CONCLUSIONS

Similar to all types of education, distance learning is characterized by advantages and disadvantages, as reported by students. Students felt that the course material was intelligible, and the distance course was uncomplicated. Moreover, they expressed relief that their studies were not disrupted. However, they also reported the loss of face-to-face contact during courses as the most significant drawback of distance learning versus face-to-face learning, followed by a lack of social connection on campus.

A Virtual Case Presentation Platform: Protocol Study

Gaining practical experience is indispensable for medical students. Therefore, when medical students were prevented access to hospitals during the COVID-19 pandemic in Romania, there was an urgent need to find a solution that would allow medical students to develop the skills they would usually develop in hospitals but without the need to be physically present in a hospital. This was the reason behind the idea of developing a Virtual Case Presentation Platform. The platform offers the possibility for medical students to reproduce virtually, in clinically valid scenarios, the diagnostic process and treatment recommendation, as well as the interactions with patients that usually take place in hospitals using natural language through speech and text. On the platform, the students receive valuable feedback from the professors about their performance. In order to reproduce the whole targeted experience for students, without missing anything, before starting the development of the platform, it was mandatory to identify and understand all the aspects that should be covered by the platform. The proposed platform covers the different aspects that have been identified for the diagnostic process and treatment recommendation. It enables medical students to develop essential skills for their future careers as doctors.

The effectiveness of web-based training for parents on post-traumatic stress disorder in children

Introduction

Post-traumatic stress disorder (PTSD) after an injury such as accidents is common in children and can affect their overall physical and mental functioning and quality of life. Early intervention can have significant health benefits for children. This study aimed to investigate the effectiveness of web-based training for parents on post-traumatic stress disorder in children.

Method

This was a quasi-experimental study with intervention and control group. 110 parents of children aged 10-18 years with PTSD after a traumatic event were selected through available sampling and assigned to intervention and control groups. Data was collected by a researcher-made demographic questionnaire and the Child Revised Impact of Events Scale (CRIES-8). Parents in the intervention group received a 4-week training course through a researcher-designed website, but the control group received routine care by the clinical team, which the main focus of care and training was on the physical aspects of the disease, and no intervention was done for PTSD. Two weeks after the intervention, the level of child stress was measured and compared in both groups. Data were analyzed using SPSS V.22.

Results

The difference between the mean score of total traumatic stress and its subscales before intervention was not statistically significant (p = 0.23). But after intervention, the mean score of total traumatic stress and its subscales decreased in the intervention group and increased in the control group and this difference was statistically significant (p < 0.001).

Conclusion

E-learning parent training has the potential to support children with PTSD. This available and cost-effective procedure can be recommended to help children with PTSD and possibly increase recovery in these patients.

Undergraduate Medical Education During the Pandemic: How do Academic Staff Members in Greece and Cyprus Feel About it?

This study used a questionnaire to examine how academic staff members in Greece and Cyprus feel about the changes in undergraduate medical education during the COVID-19 pandemic. In general, e-learning was not considered an adequate way of teaching and was less enjoyable. Participants aged 31-40 years experienced more (P = .001), while staff in higher academic ranks less difficulty (P < .001) in adjustment. There was a small increase in workload, which was higher among respondents researching into COVID-19 (P = .001). During the pandemic, daily screen use >6 h was increased from 28.8% to 57.5%. The majority (74.2%) stated that scientific and educational training opportunities were not affected by the pandemic. In conclusion, the pandemic has induced important changes in undergraduate medical education. This new condition was considered adequate but not pleasant, with younger faculty members being more burdened.

Impact of an e-learning training for interpreting intrapartum fetal heart rate monitoring to avoid perinatal asphyxia: A before-after multicenter observational study

INTRODUCTION

Perinatal asphyxia, a condition that results from compromised placental or pulmonary gas exchange during the birth process, is rare but can lead to serious neonatal and long-term consequences. The visual analysis of cardiotocography (CTG) is designed to avoid perinatal asphyxia, but its interpretation can be difficult. Our aim was to test the impact of an e-learning training program for interpreting CTG on the rate of avoidable perinatal asphyxia at term.

METHOD

We conducted a retrospective multicenter before-after study comparing two periods, before and after the implementation of e-learning training program from July 1, 2016 to December 31, 2016, in CTG interpretation for midwives and obstetricians in five maternity hospitals in the Paris area, France. The training involved theoretical aspects such as fetal physiology and heart rhythm abnormalities, followed by practical exercises using real case studies to enhance skills in interpreting CTG. We included all term births that occurred between the "before" period (July 1 to December 31, 2014) and the "after period (January 1 to June 30, 2017). We excluded multiple pregnancies, antenatal detection of congenital abnormalities, breech births and all scheduled caesarean sections. Perinatal asphyxia cases were analyzed by a pair of experts consisting of midwives and obstetricians, and avoidability of perinatal asphyxia was estimated. The main criterion was the prevalence of avoidable perinatal asphyxia.

RESULTS

The e-learning program was performed by 83 % of the obstetrician-gynecologists and 65 % of the midwives working in the delivery rooms of the five centers. The prevalence of perinatal asphyxia was 0.45 % (29/7902 births) before the training and 0.54 % (35/7722) after. The rate of perinatal asphyxia rated as avoidable was 0.30 % of live births before the training and 0.28 % after (p = 0.870). The main causes of perinatal asphyxia deemed avoidable were delay in reactions to severe CTG anomalies and errors in the analysis and interpretation of the CTG. These causes did not differ between the two periods.

CONCLUSION

One session of e-learning training to analyze CTG was not associated with a reduction in avoidable perinatal asphyxia. Other types of e-learning, repeated and implemented over a longer period should be evaluated.

Feasibility of Guided Internet-Based Cognitive Behavioral Therapy for Panic Disorder and Social Anxiety Disorder in Japan: Pilot Single-Arm Trial

BACKGROUND

Cognitive behavioral therapy (CBT) is effective in treating anxiety disorders. Accessibility to CBT has been limited in Japan due to the shortage of therapists. While an open-source e-learning system can be used to create a simple internet-based cognitive behavioral therapy (ICBT) program, the safety and outpatient acceptance of this treatment approach have not been explored in Japan.

OBJECTIVE

The aim of this study was to investigate whether outpatients with anxiety disorders could accept and successfully complete the ICBT program with guidance by CBT therapists when implementing therapeutic modules and CBT tasks. Due to being in the initial phase of a novel treatment in Japan, this study was intended for verification with a small sample size.

METHODS

In total, 6 adults, including 4 male participants and 2 female participants, were enrolled in a single-arm trial. The intervention involved guided ICBT comprising 12 sessions, including CBT text, comprehension confirmation tests, and explanatory videos about cognitive behavioral models, accessible through a website. The therapist guided the participants in accessing the ICBT program and answering their questions using a chat tool. The primary outcome was anxiety severity assessed using the State-Trait Anxiety Inventory-Trait. Secondary outcomes included the Panic Disorder Severity Scale, Liebowitz Social Anxiety Scale (LSAS), Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Working Alliance Inventory-Short Form (WAI-SF). Statistical analyses were performed using paired 2-tailed t tests to assess the changes in clinical symptoms. The total WAI-SF score at the final session was used to evaluate the therapeutic alliance. For statistical analyses, mean changes for total State-Trait Anxiety Inventory-Trait, BAI, Panic Disorder Severity Scale, LSAS, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 scores were analyzed using the paired 2-tailed t test. The 2-sided significance level for hypothesis testing was set at 5%, and 2-sided 95% CIs were calculated.

RESULTS

Most participants diligently engaged with the ICBT program. No adverse events were reported. The mean total scores for the primary outcome decreased by 11.0 (SD 9.6) points (95% CI -22.2 to 0.20; Hedges g=0.95), but it was not statistically significant. The mean total scores for the secondary outcomes that assess clinical symptoms decreased, with a significant reduction observed in the BAI of 15.7 (SD 12.1) points (95% CI -28.4 to -3.0; P=.03; Hedges g=1.24). The mean total scores for PDSS and LSAS decreased significantly, by 12.0 (SD 4.24) points (95% CI -50.1 to 26.1; P=.16; Hedges g=1.79) and 32.4 (SD 11.1) points (95% CI -59.7 to -4.3; P=.04; Hedges g=1.38), respectively. Of the participants, 67% (n=4) showed treatment response, and 50% (n=3) achieved remission after the intervention. The therapeutic alliance, measured using the WAI-SF, was moderate.

CONCLUSIONS

Guided ICBT may be feasible for the treatment of outpatients with panic disorder and social anxiety disorder in Japan.

TRIAL REGISTRATION

University Hospital Medical Information Network Clinical Trials Registry UMIN0000038118; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043439.

Effects of Exercise Habits and Gender on Sports e-Learning Behavior: Evidence from an Eye-Tracking Study

Background/Objective

In the post-epidemic era, an increasing number of individuals were accustomed to learning sports and physical activity knowledge online for fitness and health demands. However, most previous studies have examined the influence of e-learning materials and resources on learners and have neglected intrinsic factors such as experience and physiological characteristics. Therefore, we conducted a study to investigate the effect of exercise habits and gender on sports e-learning behavior via eye-tracking technology.

Methods

We recruited a sample of 60 undergraduate students (mean age = 19.6) from a university in Nanjing, China. They were randomly assigned into 4 groups based on 2 genders × 2 exercise habits. Their gaze behavior was collected by an eye-tracking device during the experiment. The cognitive Load Test and Learning Effect Test were conducted at the end of the individual experiment.

Results

(1) Compared to the non-exercise habit group, the exercise habit group had a higher fixation count (P<0.05), a shorter average fixation duration (P<0.05), a smaller average pupil diameter (P<0.05), and a lower subjective cognitive load (P<0.05) and better learning outcome (P<0.05). (2) Male participants showed a greater tendency to process information from the video area of interest (AOIs), and had lower subjective cognitive load (P < 0.05) and better learning outcomes (P < 0.05). (3) There was no interaction effect between exercise habits and gender for any of the indicators (P > 0.05).

Conclusion

Our results indicate that exercise habits effectively enhance sports e-learning outcomes and reduce cognitive load. The exercise habits group showed significant improvements in fixation counts, average fixation duration, and average pupil diameter. Furthermore, male subjects exhibited superior learning outcomes, experienced lower cognitive load, and demonstrated greater attentiveness to dynamic visual information. These conclusions are expected to improve sports e-learning success and address educational inequality.

Rebooting nuclear medicine specialist education under the COVID-19 pandemic: From plenary lectures to active e-learning

Despite major reforms of specialist training in the Nordic countries towards concrete learning outcomes and promoting active learning, most specialist courses continue to be based on lectures. We redesigned our mandatory 5-day course in clinical nuclear medicine (NM) that was last held in 2016 towards active learning. Thirty 1-h lectures were replaced with 10 thematic blocks of 3 h each. Each block was taught by a single teacher in a blend of short introductory lectures alternating with small groups of residents reading NM cases from our newly established national case library in diagnostic format. Due to COVID-19, the entire course in 2021 needed to be run on a videoconferencing system rather than in a computer laboratory as had been originally planned. At the end of the course, we conducted the same anonymized survey as in 2016. All 19 course participants responded. 74% fully agreed that the e-course format had been 'good'. One hundred per cent fully agreed that the practical exercises were 'useful' versus 50% in 2016 (p < 0.001). In their free text answers on the merits or downsides of e-learning, 12/12 respondents only mentioned advantages. Our newly established library of anonymized teaching cases within our national health network is an effective tool for organising courses based on active learning. Despite the change towards distance learning enforced by the pandemic, course participants reported the same high levels of satisfaction with active learning in small groups as in the earlier traditional lecture-based course format.

Evaluation of an online SBIRT training program

Background: While human ecosystem disruptions have happened in the past, the COVID-19 pandemic is the first situation to warrant such a large, world-wide transition to online education. The pandemic has increased the need for intervention with people in varying stages of substance use disorders.Objectives: In response to the need for more evidence-based, online educational and training options to address this need, this study used pre-posttest evaluations to determine the efficacy of an online training for a specific evidence-based intervention, Screening, Brief Intervention, and Referral to Services (SBIRT).Methods: Social Work students from two universities completed a 4-hour, online training in SBIRT which included a pre/posttest, demographic variables, a satisfaction scale, and a measure of self-efficacy. Mixed Effects Linear regression was used to model the repeated measures of SBIRT knowledge and efficacy, while a linear regression model was used to measure the relationship between satisfaction and participant characteristics.Results: Participants were mostly female (85.9%), mostly White/Caucasian (72.9%), and most already had a bachelor's degree (50%) or higher (9.6%). Individuals who were White, non-Hispanic/Latinx, or had master's level or doctoral level mental health training were more likely to have higher SBIRT scores. Those with the highest levels of self-efficacy had the lowest change scores on the knowledge test. Overall, there was an almost threefold increase in SBIRT knowledge posttraining, indicating the viability of this training format, which is similar to findings from studies of in-person trainings of SBIRT which also found increases in SBIRT knowledge.Conclusion: Recommendations based on the results are provided to encourage improved student outcomes from this type of e-learning.

Web-Based Scaffolds: The Feasibility of a Constructivist Approach to Oncology Fellow Learning

In this 2-institution feasibility pilot, oncology fellows used and updated freely available web-based learning tools (scaffolds) in a constructivist fashion.

Comparison of the teaching clinical biochemistry in face-to-face and the flex-flipped classroom to medical and dental students: a quasi-experimental study from IRAN

INTRODUCTION

Biochemistry is one of the main courses of basic sciences in the medical curriculum, along with other difficult subjects that are difficult to learn. The emergence of new technologies has made it possible to test new methods such as e-Learning. In this study, we compared two methods of Flex-Flipped Classroom (FFC) and face-to-face.

METHOD

A quasi-experimental research was done which involved both medical and dental students studying the clinical biochemistry course in the joint semester in 2019. A total of 100 medical students were trained in biochemistry through face-to-face teaching, and 60 dental students were trained in the same course through the FFC model. Three researcher-made tools were used to compare the two groups to assess the student's satisfaction, scores, and self-evaluation. The content validity of the tools was checked using the opinions of 10 experts through the CVI index. The results were analyzed using one-sample t-tests, independent t-tests, and ANOVA.

RESULTS

Both groups scored significantly more than the cut-off-point (Mean > 3.5) in their average scores of the total and sub-components of the self-evaluation questionnaire (P < 0.05). Face-to-face teaching was viewed more favorably than the FFC teaching except for considering the flexibility (4.14 ± 1.55), but the difference was not significant (P > 0.05). The students' knowledge score in the FFC was slightly higher than that in the face-to-face method, but this difference was not significant(P = 0.758).

CONCLUSION

Both face-to-face and FFC methods were effective according to the students, but the level of satisfaction with the face-to-face method was higher. It seems that teacher-student interaction is an important factor in students' preferences. However, the students preferred the flexibility of multimedia. It seems necessary to use the advantages of each method in a model appropriate to the students' conditions and available facilities.

Reducing Pharmaceuticals in Water, a New Module Integrated in the Pharmacy Game: Evaluating the Module's Effects on Students' Knowledge and Attitudes

Pharmaceutical residues end up in surface waters, impacting drinking water sources and contaminating the aquatic ecosystem. Pharmacists can play a role in reducing pharmaceutical residues, yet this is often not addressed in pharmacy undergraduate education. Therefore, we developed the educational module "Reducing Pharmaceuticals in Water" for pharmacy students; this was integrated in our pharmacy simulation game for third year Master of Pharmacy students at the University of Groningen. In this study, we aim to evaluate the effects of the module on students' knowledge of pharmaceutical residues in water, to describe students' experiences in taking the module, and to explore their attitudes towards green pharmacy education in general. This mixed-methods study included quantitative measurements, before and after students took the module (intervention group) and in a control group which did not receive the module. Data were collected between February 2023 and June 2023. Overall, 29 students took the module and 36 students were in the control group. The knowledge score of students in the intervention group (N = 29) increased significantly from 9.3 to 12.9 out of 22 (p < 0.001). The knowledge score of the students in the control group was (8.9 out of 22). Students found the e-learning and the patient cases the most exciting part of this module. Students also recognized the need to including environmental issues in pharmacy education. In conclusion, the module contributes towards improved knowledge and increased awareness of the impact of pharmaceuticals found in water. It represents a promising strategy to strengthen pharmacist's role in mitigating the amount and the effect of pharmaceuticals on water and the environment in the future.

Students' Perception of Online Versus Face-to-Face Learning: What Do the Healthcare Teachers Have to Know?

During the COVID-19 pandemic, educational institutions confronted the possibility of complete closure and took countermeasures by adapting e-learning platforms. The present cross-sectional study quantified the impact of the pandemic on medical education using a validated and reliable tool. The tool was used to explore the perceptions of 270 healthcare students about e-learning in comparison to traditional learning systems. Inferential statistics were employed using Pearson's chi-squared test. It was found that e-learning was advantageous because of its location flexibility (46.1%) and the ease of access to study materials (46.5%). However, in-person learning was found to lead to an increase in knowledge (44.9%), clinical skills (52.7%), and social competencies (52.7%). The study concluded that while e-learning offers flexibility, traditional face-to-face teaching is deemed more effective for skill development and social interaction. Hence, e-learning should complement rather than replace traditional methods due to limitations in replicating clinical environments.

Efficacy of a Novel Computerized Aid in Designing Removable Partial Dentures

BACKGROUND

 The development of computerized aids for dental education offers potential benefits in teaching complex procedures, such as the design of removable partial dentures (RPDs). This study aimed to assess the efficacy of a novel computerized tool in enhancing the ability of both dental students and practicing dentists to design RPDs, as well as to evaluate its utility as an interactive educational instrument.

METHODS

 A cohort comprising a total of 75 individuals (25 practicing dentists and 50 undergraduate dental students) was enlisted. Participants were introduced to an online interactive application tailored for the design of RPDs. They were tasked with resolving clinical scenarios that necessitated the formulation of an RPD. Throughout the exercise, users were provided with hints addressing errors made during the process, fostering self-directed learning for improved RPD design. Post-interaction, the perceptions of both dentists and students regarding the tool were gauged through a comprehensive questionnaire.

RESULTS

 The deployment of the online interactive application demonstrated significant promise in the effective design of RPDs, facilitated by self-directed learning. It also appeared to enhance the proficiency of practicing dentists in formulating partial dentures.

CONCLUSION

 The computerized aid evaluated in this study provided an effective platform for both dental education and practice. It not only supported self-directed learning in the design of RPDs but also improved the efficiency of professional dentists in their clinical design work.

Digital teaching: Developing a structured digital teaching competency framework for medical teachers

AIM

To explore the core competencies needed on part of the medical and dental teachers to carry out effective digital teaching for their students.

METHODS

It was a qualitative study which employed phenomenological approach. The data were collected from 12 teachers who were purposively selected for semi-structured interviews. They were all expert digital teachers. The data were transcribed verbatim, coded and analyzed thematically. Textural and structural description of the themes helped to develop a new competency framework.

RESULTS

The data yielded 47 selective codes with 15 sub-themes and five themes. The emergent themes included general digital competencies, specific digital teaching competencies, mastery of the subject matter, mastery of pedagogical strategies and proficiency in using innovative digital technologies for teaching. The themes 1, 2 and 5 relate to digital competencies only whereas the themes 3 and 4 are generic competencies which apply to both digital and non-digital teaching. These generic competencies form the basis of all kinds of teaching, hence equally important for digital teaching.

CONCLUSION

Medical teachers should possess diverse digital competencies. The competency framework that emerged in the current research encompasses the essential attributes that should be included in any future training program aiming at the digital capacity building of the teachers. This will keep them primed for effective digital teaching. Given its crucial importance, the digital teaching competency should be considered as a cross-cutting competency that applies to almost all of the famous eight roles of medical teacher.

Comparison of Blended Learning With Traditional Dermatology Learning for Medical Students: Prospective Evaluation Study

BACKGROUND

Novel internet-based applications and associated technologies have influenced all aspects of society, ranging from commerce and business to entertainment and health care, and education is no exception. In this context, this study was designed to evaluate the impact of a dermatology e-learning program on the academic performance of medical students in dermatology.

OBJECTIVE

The aim of this study is to develop a dermatology blended-learning course for undergraduate medical students, evaluate the knowledge gained by students exposed to this course, and compare the results to those of traditional teaching methods.

METHODS

In this prospective study, we evaluated the performance of fourth-semester medical students at the Federal University of Bahia, Brazil. Students who had been in their second year of the medical course in 2019 were considered the control group, while students in their second year in 2020 were considered the blended or hybrid group. The first group attended traditional classes, using printed material (books and handouts), while the second group used our web-based course and e-book as a supplement in a hybrid web-plus-traditional fashion. Neither participants nor evaluators were blinded. The students in both groups were subjected to the same pre- and postcourse face-to-face, multiple-choice, paper-based evaluations, and we compared their performances. The content of the classes was the same for both groups. All didactic activities were developed by a team of certified dermatologists and professors from the university.

RESULTS

A total of 129 students were selected and divided into 2 groups: the control group (n=57) and the hybrid group (n=72). The precourse tests did not indicate any difference between the control group (mean score 2.74, SD 1.25) and the hybrid group (mean score 3.2, SD 1.22 SD; P>.05). The hybrid group had better final-term grades (mean 8.18, SD 1.26) than the traditional group (mean 7.11, SD 1.04). This difference was statistically significant (P<.05).

CONCLUSIONS

This study explores pedagogical possibilities in the field of dermatology teaching for medical school students. The results suggest that the performance of undergraduate students who attended the course with additional e-learning material was superior when compared to the performance of those who participated in the traditional course alone.

Teaching Chest Tube Insertion by Blended Learning: A Multi-Dimensional Analysis

BACKGROUND

Emerging technologies are being incorporated in surgical education. The use of such technology should be supported by evidence that the technology neither distracts nor overloads the learner and is easy to use. To teach chest tube insertion, we developed an e-learning module, as part of a blended learning program delivered prior to in-person hands-on simulation. This pilot study was aimed to assess learning effectiveness of this blended learning, and cognitive load and the usability of e-learning.

METHODS

The interactive e-learning module with multimedia content was created following learning design principles. In advance of the standard simulation, 13 first-year surgical residents were randomized into two groups: 7 received the e-learning module and online reading materials (e-learning group); 6 received only the online reading materials (controls). Knowledge was evaluated by pre-and post-tests; technical performance was assessed using a Global Rating Scale by blinded assessors. Cognitive load and usability were evaluated using rating scales.

RESULTS

The e-learning group showed significant improvement from baseline in knowledge (P = .047), while controls did not (P = .500). For technical skill, 100% of residents in the e-learning group reached a predetermined proficiency level vs 60% of controls (P = .06). The addition of e-learning was associated with lower extrinsic and greater germane cognitive load (P = .04, .03, respectively). Usability was evaluated highly by all participants in e-learning group.

CONCLUSION

Interactive e-learning added to hands-on simulation led to improved learning and desired cognitive load and usability. This approach should be evaluated in teaching of other procedural skills.

Design and Development of Learning Management System Huemul for Teaching Fast Healthcare Interoperability Resource: Algorithm Development and Validation Study

BACKGROUND

Interoperability between health information systems is a fundamental requirement to guarantee the continuity of health care for the population. The Fast Healthcare Interoperability Resource (FHIR) is the standard that enables the design and development of interoperable systems with broad adoption worldwide. However, FHIR training curriculums need an easily administered web-based self-learning platform with modules to create scenarios and questions that the learner answers. This paper proposes a system for teaching FHIR that automatically evaluates the answers, providing the learner with continuous feedback and progress.

OBJECTIVE

We are designing and developing a learning management system for creating, applying, deploying, and automatically assessing FHIR web-based courses.

METHODS

The system requirements for teaching FHIR were collected through interviews with experts involved in academic and professional FHIR activities (universities and health institutions). The interviews were semistructured, recording and documenting each meeting. In addition, we used an ad hoc instrument to register and analyze all the needs to elicit the requirements. Finally, the information obtained was triangulated with the available evidence. This analysis was carried out with Atlas-ti software. For design purposes, the requirements were divided into functional and nonfunctional. The functional requirements were (1) a test and question manager, (2) an application programming interface (API) to orchestrate components, (3) a test evaluator that automatically evaluates the responses, and (4) a client application for students. Security and usability are essential nonfunctional requirements to design functional and secure interfaces. The software development methodology was based on the traditional spiral model. The end users of the proposed system are (1) the system administrator for all technical aspects of the server, (2) the teacher designing the courses, and (3) the students interested in learning FHIR.

RESULTS

The main result described in this work is Huemul, a learning management system for training on FHIR, which includes the following components: (1) Huemul Admin: a web application to create users, tests, and questions and define scores; (2) Huemul API: module for communication between different software components (FHIR server, client, and engine); (3) Huemul Engine: component for answers evaluation to identify differences and validate the content; and (4) Huemul Client: the web application for users to show the test and questions. Huemul was successfully implemented with 416 students associated with the 10 active courses on the platform. In addition, the teachers have created 60 tests and 695 questions. Overall, the 416 students who completed their courses rated Huemul highly.

CONCLUSIONS

Huemul is the first platform that allows the creation of courses, tests, and questions that enable the automatic evaluation and feedback of FHIR operations. Huemul has been implemented in multiple FHIR teaching scenarios for health care professionals. Professionals trained on FHIR with Huemul are leading successful national and international initiatives.

Designing and Developing Online Training for Diabetes Prevention Program Coaches Using an Integrated Knowledge Translation Approach: Development and Usability Study

BACKGROUND

e-Learning has rapidly become a popular alternative to in-person learning due to its flexibility, convenience, and wide reach. Using a systematic and partnered process to transfer in-person training to an e-learning platform helps to ensure the training will be effective and acceptable to learners.

OBJECTIVE

This study aimed to develop an e-learning platform for Small Steps for Big Changes (SSBC) type 2 diabetes prevention program coaches to improve the viability of coach training.

METHODS

An integrated knowledge translation approach was used in the first 3 stages of the technology-enhanced learning (TEL) evaluation framework to address the study objective. This included three steps: (1) conducting a needs analysis based on focus groups with previously trained SSBC coaches, meetings with the SSBC research team, and a review of research results on the effectiveness of the previous in-person version of the training; (2) documenting processes and decisions in the design and development of the e-learning training platform; and (3) performing usability testing. Previously trained SSBC coaches and the SSBC research team were included in all stages of this study.

RESULTS

Step 1 identified components from the in-person training that should be maintained in the e-learning training (ie, a focus on motivational interviewing), additional components to be added to the e-learning training (ie, how to deliver culturally safe and inclusive care), and mode of delivery (videos and opportunities to synchronously practice skills). Step 2 documented the processes and decisions made in the design and development of the e-learning training, including the resources (ie, time and finances) used, the content of the training modules, and how coaches would flow through the training process. The design and development process consisted of creating a blueprint of the training. The training included 7 e-learning modules, the learning modalities of which included narrated demonstration videos and user-engaging activities, a mock session with feedback from the research team, and a final knowledge test. Step 3, usability testing, demonstrated high levels of learnability, efficiency, memorability, and satisfaction, with minor bugs documented and resolved.

CONCLUSIONS

Using an integrated knowledge translation approach to the technology-enhanced learning evaluation framework was successful in developing an e-learning training platform for SSBC coaches. Incorporating end users in this process can increase the chances that the e-learning training platform is usable, engaging, and acceptable. Future research will include examining the satisfaction of coaches using the SSBC coach e-learning training platform, assessing coach learning outcomes (ie, knowledge and behavior), and estimating the cost and viability of implementing this training.

Biomedical students' satisfaction with and engagement in laboratory e-learning support are related to their self-regulation

Laboratory e-learning support tools can assist students' learning while preparing for laboratory classes. To successfully work in such virtual experimental environments (VEEs) outside class, students require self-regulated learning (SRL) skills. A deeper understanding of the continuous reciprocal interactions between SRL, satisfaction, and online engagement is needed to develop more effective online learning experiences. This study therefore aimed to explore the interconnection between students' satisfaction with, effort/importance and engagement in an exemplary VEE, and to relate this to their perceived SRL and learning outcomes. Based on surveys in 79 university students, SRL was related to VEE engagement, effort/importance, and satisfaction. VEE engagement and satisfaction were not related to learning outcomes, while SRL and effort were. Students with different SRL also tended to interact differently with the VEE and experienced differing degrees of procedural and feedback support by the e-environment. We conclude that, for optimal learning experience and outcomes, students' effort regulation and SRL need to be supported while interacting with the VEE, preferably by interventions that integrate personalized and adaptive features. This study has implications for designing and optimizing VEEs and indicates that future research should focus on VEEs taking students' SRL and effort regulation into account to support individual learners effectively.

Continuing Professional Development at Two Rural Hospitals in Ecuador

Background

E-learning Continuing Professional Development (CPD) is an activity demonstrated to improve the quality of healthcare delivery. The CPD of medical and nursing staff in high income countries (HICs) is commonplace. CPD of administrative staff is less common, but increasingly frequent. In low- and middle-income countries (LMICs), CPD of any kind is infrequent, particularly in rural and remote areas.

Objective

The aim of this study was to describe a hospital-based e-learning CPD program for clinical and non-clinical personnel as a unique example of a successful, ongoing educational pilot, quality improvement program involving a broad cohort of employees, in a country that does not require such activities.

Methods

Using the online educational platform Chamilo, e-learning modules were created for eight groups including clinical and non-clinical employees. Upon completion of each module, one to two paragraph discussions were provided for each incorrect answer submitted. Two additional chances were offered for the employee to achieve a passing score of 70%. This study reports on the first 10-month period of the program.

Findings

All participants achieved the 70% passing threshold after the first or second attempt. There was 100% participation by the employees required to complete the e-learning modules. Employee feedback suggested the modules were good for continuing education, but some felt the CPD was imposed on them.

Conclusion

E-learning CPD is an important and emerging element for CPD and may provide opportunities for healthcare service quality improvement as part of broader pedagogical modalities, such as conferences and directed readings, in rural and remote areas of LMICs. These pilot programs could provide important information to develop Spanish-language e-learning CPD programs across a broader region, promote collaboration with regional professional societies, and possibly contribute to the establishment of national health program CPD standards.

Face-to-face and e-learning during the COVID-19 pandemic: A Pakistani dental undergraduates perspective

BACKGROUND

Globally, educational institutes have been obliged to make a quick transition from traditional face-to-face teaching to e-learning during the coronavirus disease 2019 (COVID-19) pandemic, which has purportedly created various barriers to achieving desired learning outcomes.

OBJECTIVE

The aim of our study was to assess the perceptions of undergraduate dental students regarding online and physical learning in Pakistan.

METHODS

This cross-sectional study was conducted from January to March 2022. The study comprised dental students from 1st to 4th years who were above the age of 18 and of either gender. The Google Forms questionnaire was created to evaluate the quality and efficiency of online and physical learning among dentistry undergraduates.

RESULTS

In a survey of 246 students, 70.3% strongly agreed that they would prefer face-to-face instruction over e-learning. There was a statistically significant difference in the improvement of students' technical skills (p = 0.01), accessibility to instructors (p = 0.01) and classmates (p = 0.02), value of technology (p = 0.03), improvement of oral communication skills (p = 0.01), promotion of hybrid model learning after the pandemic (p = 0.01), and utilization of tutorial services (p = 0.04) between different year of study.

CONCLUSION

Pakistani dental students indicated satisfaction with numerous aspects of e-learning, such as technical skills, accessibility to instructors and classmates, the value of technology, improvement of oral communication skills, promotion of hybrid model learning, and utilization of tutorial services compared to face-to-face education concerning the year of study.

Facilities, challenges, attitudes, and preferences of nursing students related to e-learning in the Covid-19 pandemic in Iranian context: a cross-sectional study

BACKGROUND

During the Covid-19 pandemic, nursing schools worldwide were forced to deliver nursing courses in ways other than the traditional face-to-face classroom setting. Numerous lessons were learned by nurse educators regarding the use of electronic and online learning strategies. It is necessary to be aware of the factors affecting e-learning and identify the strengths and weaknesses to improve the student learning experience and process in nursing school.

AIM OF STUDY

The present study aimed to identify the abilities, attitudes, challenges, and preferences of nursing students regarding e-learning during the Covid-19 pandemic. Recognition of these factors can help nurse educators make needed modifications to teach more effectively.

METHODS

In this cross-sectional study, 228 undergraduate nursing students participated. The random sampling method used a standard questionnaire that students completed voluntarily. SPSS version 22 was used for data analysis.

RESULTS

During the Covid-19 pandemic, the majority of nursing students of Zanjan University of Medical Sciences participated in electronic classes at home using mobile phones. Students reported that logistical problems increased by participating in e-classes by their phones due to difficulty typing and frequent internet outages. Online classroom management for instructors was difficult due to students spontaneously leaving the virtual online classroom rather than attending the entire learning session. Despite the technical challenges, the attitudes of students towards the e-learning format were positive. There was a noted correlation between student attitude by gender and educational background. Students preferred that professors used more PowerPoint, showed instructional videos, and had interactive group discussion sessions rather than lecture only. Students objected to attending more than two online classes in one day if the duration lasted more than 60 min and had a rest time of fewer than 30 min between classes.

CONCLUSION

Despite the overall positive student satisfaction with e-learning, this method of education is still far from student preferences and requires planning for an effective learning experience that meets their priorities and preferences. Using a hybrid of face-to-face and e-learning approaches together can be a more effective teaching method than either strategy alone.

State-Aware Deep Item Response Theory using student facial features

This paper introduces a novel approach to Item Response Theory (IRT) by incorporating deep learning to analyze student facial expressions to enhance the prediction and understanding of student responses to test items. This research is based on the assertion that students' facial expressions offer crucial insights into their cognitive and affective states during testing, subsequently influencing their item responses. The proposed State-Aware Deep Item Response Theory (SAD-IRT) model introduces a new parameter, the student state parameter, which can be viewed as a relative subjective difficulty parameter. It is latent-regressed from students' facial features while solving test items using state-of-the-art deep learning techniques. In an experiment with 20 students, SAD-IRT boosted prediction performance in students' responses compared to prior models without the student state parameter, including standard IRT and its deep neural network implementation, while maintaining consistent predictions of student ability and item difficulty parameters. The research further illustrates the model's early prediction ability in predicting the student's response result before the student answered. This study holds substantial implications for educational assessment, laying the groundwork for more personalized and effective learning and assessment strategies that consider students' emotional and cognitive states.

Effect of e-learning program for improving nurse knowledge and practice towards managing pressure injuries: A systematic review and meta-analysis

AIM

The aim of this review was to determine the effectiveness of the e-learning programs for improving the knowledge and professional practices of nursing personnel in managing pressure injuries patients.

DESIGN

Systematic review and meta-analysis.

METHODS

Systematic search was done in EMBASE, SCOPUS, Cochrane library, MEDLINE, Google Scholar, ScienceDirect and Clinicaltrials.gov databases until August 2022. Meta-analysis was carried out using random-effects model, and the results were reported as pooled standardized mean differences (SMD), or odds ratios (OR) with 95% confidence intervals (CIs).

RESULTS

Eight studies were included in the analysis. Most of the studies had higher risk of bias. The pooled SMD for knowledge score and for the classification skill were 1.40 (95%CI: 0.45-2.35; I2  = 93.1%) and 1.75 (95%CI: 0.94-3.24; I2  = 78.3%) respectively. The pooled OR for the classification skills was 1.75 (95%CI: 0.94-3.24; I2  = 78.3%).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Development of an educational program for healthcare professionals who provide appearance care for patients with cancer: Feasibility study of an e-learning program

This study aimed to evaluate the feasibility and utility of an e-learning training program to improve healthcare professionals' knowledge about providing appearance care to patients with cancer. Healthcare professionals who provide appearance support were invited to participate voluntarily and complete a survey before and after the program. Participation request letters were distributed to 133 individuals, including 75 from four facilities invited via professional connections, and agreed to participate in the study and 58 participated in the National Cancer Center's appearance care training and indicated an interest in participating in the study. The 100 participants (75.2%) included 96 females, with an average age of 40.5 years. The participants reported high levels of satisfaction with the program, where more than 90% responded "satisfied" or "somewhat satisfied" and eager to use the content they learned in the program when they returned to their workplaces. However, the participants identified several barriers to applying their newly acquired knowledge including lack of knowledge (about 80%). Participant knowledge scores about appearance support were significantly higher after program participation. The survey results indicated the high feasibility of the e-learning program through improved knowledge about appearance care and high satisfaction with the program. The program needs further improvements for its practical utility.

Student's perspectives, satisfaction and experiences with online and classroom learning during the COVID-19 pandemic: Findings and implications on blended learning

Objectives

The coronavirus disease 2019 (COVID-19) pandemic disrupted classroom-based learning, necessitating the adoption of online learning in most universities. However, there has been a lack of information on university students' perspectives regarding online learning during the COVID-19 pandemic. This study assessed the perspectives, satisfaction and experiences with online and classroom learning among human health students at the University of Zambia.

Methods

This cross-sectional study was conducted among 737 students at the University of Zambia from October 2022 to April 2023. Data were analysed using Stata version 16.1.

Results

Of the 737 participants, 51.6% were female and 56.5% agreed that blended learning should continue even after the COVID-19 pandemic. However, 78.4% of the students believed that group discussions were more suitable in the classroom than online learning. Most students (67.1%) disagreed that they preferred online learning to classroom learning. Furthermore, 77.6% of the students disagreed that online learning gave more satisfaction than classroom learning.

Conclusions

This study found that most students recommended the continuation of blended learning after the pandemic. However, they believed that follow-up tutorials and assessments were better undertaken in physical classrooms than online learning. These findings are important in sensitising stakeholders in the education sector and governments to consider blended learning as a teaching strategy in the future. There is a need to develop and implement curricula that offer blended learning to students as well as ensure the students have the necessary facilities and equipment to support such learning.

Effectiveness of e-learning to promote oral health education: A systematic review and meta-analysis

BACKGROUND

In recent times during and after the COVID-19 pandemic, e-learning is increasingly being used to give oral health education. However, the efficacy of e-learning in improving and promoting the oral hygiene and oral health knowledge, attitude and practice is unclear. Therefore, this systematic review and meta-analysis aim to clarify the effectiveness of e-learning compared to other conventional education methods for providing oral health.

METHODS

An electronic database search was performed on PubMed-Medline, Scopus, and CENTRAL (Central Register Cochrane of Controlled trials). Randomized controlled trials (RCTs), including cluster or group RCTs, were collected in this study. The risk of bias was assessed with the Cochrane Handbook for Systematic Reviews of Interventions. Five different meta-analyses were conducted for plaque index, gingival index, oral health knowledge, oral health attitude, and oral health practice using a random effects model.

RESULTS

A total of 282 articles were found through the database search; 19 articles were included in the qualitative synthesis and 9 articles in the quantitative synthesis. The meta-analysis found that compared with conventional education, e-learning exhibited no positive effect. However, the use of e-learning was superior to conventional education methods for oral health practice for adults in subgroup analysis.

CONCLUSIONS

This paper could not indicate the effectiveness of e-learning in comparison with conventional education for oral health in total. However, for adults, it may be effective to get the oral health practice compared to the conventional education. Our study limitation is that there are only few studies that have assessed the effectiveness of e-learning. Therefore, numerous further high-quality studies should be conducted regarding the efficacy of e-learning compared with conventional education methods for oral health promotion.

Exploring Parental Experiences With School-Aged Children Receiving Web-Based Learning: Cross-Sectional Study

Background

Web-based learning has transformed education. Its ability to overcome physical barriers and deliver knowledge at the click of a button has made web-based learning popular and ensured that it will continue to be used in the future. The involvement of parents in web-based learning is fundamental to the success of the educational process, but limited attention has been paid to the impact of web-based learning on parents.

Objective

This study examined parental experiences with school-aged children receiving web-based learning in Jeddah, Saudi Arabia.

Methods

We sent cross-sectional, anonymous web-based questionnaires to school-aged children's parents. A total of 184 parents completed the survey.

Results

Parents' negative experiences of web-based learning (mean 4.13, SD 0.62) exceeded their positive experiences (mean 3.52, SD 0.65). The most negative experience reported by parents was their child's boredom due to prolonged sitting in front of a device (mean 4.56, SD 0.69). The most positive experience was their child's technological skill enhancement (mean 3.98, SD 88). Their child's lack of social interaction and friendship building promoted stress among parents (r=-0.190; P=.01). At the same time, their child's technological skill enhancement reduced stress among parents (r=0.261; P=.001). The most reported (63/184, 34.2%) obstacle to web-based learning was having multiple learners in the same household.

Conclusions

Web-based learning is a fundamental learning method and will continue to be used in the future because of its ability to overcome many barriers to education. Parental involvement in the continuity and success of the web-based learning process is crucial. However, the findings of this study illustrated that parents' experiences of web-based learning were more negative than positive. Parents who reported negative experiences reported an increase in stress and faced more obstacles due to web-based learning. Thus, more attention and intervention are needed to promote positive web-based learning experiences among parents.

Modelling and Simulation of the Combined Use of IABP and Impella as a Rescue Procedure in Cardiogenic Shock: An Alternative for Non-Transplant Centres?

The treatment of critically ill patients remains an evolving and controversial issue. Mechanical circulatory support through a percutaneous approach for the management of cardiogenic shock has taken place in recent years. The combined use of IABP and the Impella 2.5 device may have a role to play for this group of patients. A simulation approach may help with a quantitative assessment of the achievable degree of assistance. In this paper, we analyse the interaction between the Impella 2.5 pump applied as the LVAD and IABP using the numerical simulator of the cardiovascular system developed in our laboratory. Starting with pathological conditions reproduced using research data, the simulations were performed by setting different rotational speeds for the LVAD and driving the IABP in full mode (1:1) or partial mode (1:2, 1:3 and 1:4). The effects induced by drug administration during the assistance were also simulated. The haemodynamic parameters under investigation were aa follows: mean aortic pressure, systolic and diastolic aortic pressure, mean pulmonary arterial pressure, mean left and right atrial pressure, cardiac output, cardiac index, left and right ventricular end-systolic volume, left ventricular end-diastolic volume and mean coronary blood flow. The energetic variables considered in this study were as follows: left and right ventricular external work and left and right atrial pressure-volume area. The outcome of our simulations shows that the combined use of IABP and Impella 2.5 achieves adequate support in the acute phase of cardiogenic shock compared to each standalone device. This would allow further stabilisation and transfer to a transplant centre should the escalation of treatment be required.

Group Assessments to Help Build Online Learning Communities in Biomedical Science Distance Learning Programmes

Introduction: Biomedical Science distance learning courses offer flexibility in study while in employment. Asynchronous and self-learning approaches are common within such courses and often student-student interaction is limited. The aims of this study were to establish learning communities, develop confidence in participating in online teamwork and foster an appreciation of transferable skills including digital capabilities through remote group activities. Materials and Methods: Two cohorts of students (n = 20/n = 21) were enrolled in a microbiology module of an IBMS accredited MSc distance learning course. Groups of 4-5 students produced a digital output relating to current global infection-related issues, namely, assignment 1, production of a slide deck, which peers could use as learning resources and assignment 2, a voiceover PowerPoint debate, and infographic, voting assessment and peer/self-marking. Students also prepared reflections using written format and a FlipGrid video-recording. A qualitative content analysis was conducted on reflections from all students. Students completed a pre- and post-assignment survey focused on the development of transferable skills for the biomedical sector. Results: Students' skills and confidence increased following completion of the group assignment, as evident from the pre- and post-questionnaire responses, namely, possession of digital skills and digital creation abilities (29% v 83%), applying for jobs which require digital skills (54% v 89%), talking about examples of using digital media during job interviews (21% v 78%) and demonstration of creativity during assignment tasks (33% v 90%). Critical thinking was more commonly demonstrated during the debate in comparison to the slide deck activity (p = 0.001). The importance of developing digital skills, was higher following completion of the group activities (p = 0.03). Students reflected on the value of the group activities in relation to knowledge acquisition (85%, 86%), collegiality (70%, 71%), digital skills development (80%, 90%), the fact that the activities were enjoyable (70%, 67%) and the development of peer interaction and support (50%, 67%) in relation to assignment 1 and 2, respectively. Discussion: Increasingly digital technologies are being used in the healthcare sector resulting in updated HCPC Standards of Proficiency. This study highlights that virtual group activities promote the establishment of supportive learning communities and the development of transferable skills including digital capabilities for application within the biomedical science workplace.

The Effectiveness of Publicly Available Web-Based Interventions in Promoting Health App Use, Digital Health Literacy, and Media Literacy: Pre-Post Evaluation Study

BACKGROUND

According to the World Health Organization, implementing mobile health (mHealth) technologies can increase access to quality health services worldwide. mHealth apps for smartphones, also known as health apps, are a central component of mHealth, and they are already used in diverse medical contexts. To benefit from health apps, potential users need specific skills that enable them to use such apps in a responsible and constructive manner.

OBJECTIVE

This study aimed to evaluate the effectiveness of the free and widely used web-based intervention, The APPocalypse?. Besides providing knowledge about health apps, the web-based intervention was designed to promote digital health and media literacy by teaching skills that enable users to distinguish between trustworthy and less trustworthy health apps. It was hypothesized that after completing the web-based intervention, participants' knowledge in the domain of health apps, their digital health literacy, and their media literacy would be higher than it was before completing the web-based intervention.

METHODS

The study was divided into 3 parts. During part 1, participants (n=365; 181 female, 181 male, and 3 diverse; mean age 17.74, SD 1.391 years) provided demographic information and answered the pre- and postmeasurements. The measurements included questionnaires about participants' knowledge in the domain of health apps, digital health literacy, and media literacy. During part 2, participants had 1 week to complete the web-based intervention. During part 3, participants answered the pre- and postmeasurements again. Furthermore, they answered educational quality and user experience questionnaires. Bayesian paired samples 2-tailed t tests were conducted to test the hypotheses.

RESULTS

Overall, the results support the hypotheses. After completing the web-based intervention, participants demonstrated more elaborate knowledge in the domain of health apps. Specifically, they displayed higher competencies in the domains of subjective (Bayes factor10 [BF10]=1.475×1079; effect size δ=-1.327) and objective health app knowledge (BF10=8.162×1080; effect size δ=-1.350). Furthermore, participants demonstrated higher digital health literacy. Specifically, they displayed higher competencies in the domains of information appraisal (BF10=3.413×1043; effect size δ=-0.870), information searching (BF10=3.324×1023; effect size δ=-0.604), evaluating reliability (BF10=3.081×1035; effect size δ=-0.766), and determining relevance (BF10=3.451×1024; effect size δ=-0.618). Regarding media literacy, the results were mixed. Participants displayed higher competencies in the domain of technology literacy beliefs (BF10=1.533×1021; effect size δ=-0.570). In the domain of technology control beliefs, their competencies did not seem to improve (BF10=0.109; effect size δ=-0.058). In comparison to relevant benchmarks, the web-based intervention offers exceptional educational quality and a superior user experience.

CONCLUSIONS

The free web-based intervention The APPocalypse? might promote the constructive use of health apps, digital health literacy, and media literacy. Therefore, it may contribute to achieving the health-related United Nations Sustainable Development Goals.

The effect of e-learning on point-of-care ultrasound education in novices

BACKGROUND

Current studies assessed the learning efficacy of e-learning in ultrasound (US) training using questionnaires, or simulation in well-controlled conditions. This study investigates the effect of e-learning on the clinical US performance of the first postgraduate year (PGY-1) residents.

METHODS

In this prospective observational study, we enrolled PGY-1 and second postgraduate year (PGY-2) residents. The e-learning was introduced on the first day and each PGY-1 was authorized to access the e-learning platform. The point-of-care ultrasound (PoCUS) curriculum for the focused assessment of sonography for trauma (FAST) was conducted on the 7^th day for PGY-1 and the objective structured clinical examination (OSCE) followed. The PGY-2 received bedside one-to-one random learning before the study and did not have the authorization to access the e-learning. The FAST examinations performed by the PGY-1 and PGY-2 were collected on the 30th day. The clinical FAST performance was assessed by the instructor not involved in the curriculum and blinded to the use of e-learning, including numbers, image quality, and diagnostic accuracy between PGY-1 e-learning users, non-users, and the PGY-2.

RESULTS

One hundred and seventy PGY-1 with 736 FAST examinations and 53 PGY-2 residents with 134 examinations were included. Seventy PGY-1 used e-learning with a median time spent of 13.2 mins (IQR, 6.5-21.1 mins) at the first access. The PGY-2 had more PoCUS experience than the PGY-1, however, the 70 e-learning users performed more FAST examinations than the PGY-2 (median [IQR], 4 [2-6] vs. 2 [1-3], p = 0.0004) and had better image quality than the PGY-2 (3 [3-3.2] vs. 3 [2.7-3], p = 0.044). There were no significant differences in the diagnostic accuracy between the PGY-1 and PGY-2.

CONCLUSIONS

E-learning has a positive effect on US learning. The PGY-1 users had comparable performance with the PGY-2 and even better image acquisition although the PGY-2 had more PoCUS experience.

TRIAL REGISTRATION

NCT03738033 at ClinicalTrials.gov.

Dental Students' Perceptions Towards E-learning in Comparison With Traditional Classroom Learning

INTRODUCTION

Electronic learning (e-learning) has evolved into a popular educational approach since the coronavirus disease 2019 (COVID-19) pandemic. While this represents an additional model for teaching, traditional classroom learning fosters the development of interpersonal skills and enables students to share and discuss specific topics. However, existing research on the comparison of both these modes of learning in the field of dental education is inadequate. This study aimed to evaluate the perceptions of dental students towards both electronic and classroom learning.

METHODS

A cross-sectional questionnaire-based survey was conducted between November 2022 and January 2023 among dental students in Saudi Arabia. Students were questioned on their comparative perceptions of e-learning and classroom learning before, during, and after the COVID-19 pandemic. Questionnaire responses, including demographic data, were collected and tabulated, using electronic data management software. The tabulated data were analyzed to provide descriptive statistics and compare electronic and classroom learning with demographic variables and previous experience with e-learning.

RESULTS

Most respondents reported possessing average information technology (IT) skills and prior experience with e-learning. Blackboard Learning Management System (LMS) (Reston, VA: Blackboard Inc.), Zoom (San Jose, CA: Zoom Video Communications Inc.), and Microsoft Teams (Redmond, WA: Microsoft Corporation) were the most commonly used and advantageous e-learning platforms. While the majority of participants found both methods acceptable for problem-based learning sessions and theoretical lectures, they reported e-learning to be less effective than classroom learning for clinical and practical sessions. Regarding e-learning as a preferred method over classroom learning, most responses were "neutral" or "uncertain." Comparing the mean ranks of the ordinal responses for the different teaching methodologies and the nominal responses for e-learning as the preferred method, no statistically significant interactions were observed for demographic characteristics, IT-skill levels, or prior experience with e-learning.

CONCLUSION

Although enhanced performance and learning capacity are enabled through e-learning, the advantages of personal interactions and the feasibility of practical and clinical dental sessions are achieved only through classroom learning.

Health professions learners' evaluation of e-learning scenario-based case study design: Reinvigorating flipped classroom modalities

OBJECTIVES

Interactive scenario-based learning (SBL) cases were developed using the SoftChalk platform to deliver content about patients' barriers to accessing healthcare and patient management strategies connecting oral to systemic health. The interactive cases were designed to engage the digital-savvy learners, meet them where they are by leveling up, and seek their feedback to determine flipped (FC) or modified flipped classroom (MFC) content delivery approaches.

METHODS

Health professions students completed interactive SBL cases (Phase-I) using either FC as assigning content outside of class time preparation or MFC as allocating time at the beginning of the class deliveries, and a 12-item post-completion survey. The senior dental student cohort (Phase-II) completed an anonymous Qualtrics survey that assessed their confidence leading to clinical competence two years after the interactive SBL case deliveries. The final survey (Phase-III) of first-year dental students evaluated the improved interactive scenario-based cases post modifications. [Corrections added on 03 October 2023: After first online publication the first sentence of methods section has been updated.] RESULTS: No significant differences existed between the FC and MFC content delivery scores; however, learners preferred the structured time allotted in the MFC approach as a learning style for participants (N=989). The overall means percent score was 93.2% (n = 398) for FC and 96.5% (n = 591) for MFC. Thematic analysis of written responses indicated that learners felt the vignettes were relevant, thought-provoking, incorporated decision-making, and provided feedback. Four themes about strengths emerged as engaging, interactive, relevant, and critical. Design and technological challenges emerged as interactive SBL improvements. A follow-up report (74/103, 2021) revealed that 48% of senior dental students surveyed recollected the SBL cases when they delivered preventive, patient-centered dental services as juniors and seniors. They also recalled that the interactive cases prepared them for clinical success. The Final comments (2022) did not commend any significant improvements.

CONCLUSION

Interactive scenario-based approaches nurture active learning and critical thinking. The educator can engage learners by incorporating teaching modalities as SBL cases to enhance their knowledge and create educational environments by meeting learners where they are. Learners can be valuable partners as educators define their instructional strategies to be equitable and student-centered. [Correction added on 04 October 2023: after first online publication, abstract section has been revised.].

YouTube™ as a source of tooth avulsion information: A video analysis study

BACKGROUND/AIM

Evaluate the informative content in tooth avulsion videos intended for dentists available on YouTube™ and analyse their compliance with the International Association of Dental Traumatology (IADT) guidelines 2020.

MATERIALS AND METHODS

Google Trends was used to identify the most searched term for tooth avulsion. Tooth avulsion-related videos in Brazilian Portuguese intended for dentists were searched on YouTube™ with a 12-month filter. Two raters reviewed these videos to extract their features and evaluate and qualify them with two 9-point checklists based on the IADT 2020 guidelines. The emergency steps for tooth avulsion at the accident site were assessed before, during and after clinical management; each step received 1 point if present and 0 points if absent. The final score ranged from 0 to 9 points on each checklist (18 points total), and the total score was used to classify the videos as having poor, moderate or rich content. Reliability and video quality were evaluated by an adapted version of the DISCERN tool and global quality scale (GQS), respectively. The data were analysed with the Mann-Whitney U-test, Pearson chi-square test, and the Kappa statistic (p < .05).

RESULTS

Of 60 videos, 8 were included. All were uploaded by dental professionals or undergraduate students; the average duration was 11 min (range: 0.40-65 min), and the average number of views was 56.75. Half the videos (50%) had maximum completeness scores for questions about emergency dentist referral before clinical management, and more than half (75%) had maximum completeness regarding the steps required during and after treatment. Rich videos had higher GQS scores (p = .049) without significant correlation.

CONCLUSIONS

Although most videos in Brazilian Portuguese were considered high-quality according to the IADT checklist, half of them presented partial absence of information regarding orientations at the accident site.

Evaluating the utility of a global webinar for mentoring medical students and OBGYN residents in REI

BACKGROUND

In medical school and residency, clinical experiences influence trainee's decisions on what medical specialty they choose. Most trainees have limited access to opportunities to engage in the field of reproductive endocrinology and infertility (REI). Due to the COVID-19 pandemic and the shutdown of away electives, exposure to REI was especially limited. This study aims to evaluate the effectiveness of a live Q and A webinar on improving trainees' access to mentorship and knowledge of the path to becoming a reproductive endocrinology and infertility (REI) physician.

MATERIALS AND METHODS

This study is a prospective paired cohort study. Medical students and OBGYN residents participated in a global Q and A webinar featuring REI physicians and fellows. 70 pre- and post-webinar surveys were included in the analysis. Paired nonparametric tests (Wilcoxon signed-rank test) were performed to assess whether post-webinar knowledge was significantly different from pre-webinar knowledge.

RESULTS

Of the 268 registrants, 162 (60%) attended the live webinar. A majority of the respondents who completed both surveys were female (90%) and allopathic medical students (80%). Seventy-seven percent reported receiving only minimal advice about an REI career from their medical school or residency program, while 22% reported receiving some advice, and 1% extensive advice. Thirty-four percent had previously shadowed an REI physician and 23% had rotated in an REI office. Post-webinar significantly more trainees had a better understanding of the REI field, the path required to become an REI physician, opportunities to find mentors in the field, opportunities that are conducive to learning more about REI, and applying for rotations in the REI field (p = <.00001). Eighty-two percent agreed that their interest in REI increased due to this webinar.

CONCLUSIONS

A webinar featuring REI physicians and fellows was effective in providing mentorship and career advisement for prospective REI trainees who otherwise expressed having limited access to the field.

Digital support for quality assurance in 24-hour caregiving at home: a randomized controlled trial investigating the effects on quality of life and professional skills of paid 24h-caregivers

BACKGROUND

Regarding the care of older adults, 24-h home-care represents a cornerstone, with > 32,000 service users in Austria. Our research project 24hQuAALity aimed to develop and evaluate a distributed client-server software solution for the support and quality assurance of this home-care service. In this trial, we investigated the effects of this intervention on the quality of life and professional skills of paid 24h-caregivers in Austria.

METHODS

The application used in our study comprises an e-learning platform, an integrated emergency management, networking opportunities, and an electronic care documentation system in the native language of the 24h-caregivers. The trial was conducted using a parallel three-arm study design to evaluate (i) a control group, which performed usual home care, (ii) a partial intervention group, which used the e-learning and networking platforms, and (iii) a full intervention group, which used the entire intervention (e-learning platform, networking platform, and digital care documentation). Primary self-reported outcomes were the standardized ASCOT for Carers score and a score based on responses to project-specific efficacy questions.

RESULTS

Among the 110 24h-caregivers who were randomly classified into the three groups, ASCOT for Carers score data were available for 57 and 35 24h-caregivers at 5- and 9-month follow-up examinations, respectively. At 9 months, 24h-caregivers receiving any intervention rated the ASCOT for Carers score (not significantly) better than the controls (p = 0.05, ηp2 = 0.15), mainly in the domain "feeling encouraged and supported". At 9 months, 24h-caregivers receiving any intervention rated the project-specific Efficacy score significantly better than the controls (p = 0.02, ηp2 = 0.20), mainly due to better ratings in the subitems "satisfaction with current docu", "docu supports doing my job", " I'm well prepared for emergencies", "my professional skills are adequate for doing my job", and "communication with contacts".

CONCLUSIONS

Providing e-learning and e-documentation devices to 24h-caregivers improved their care-related quality of life, mainly because they felt more encouraged and supported. Moreover, these interventions improved their self-perceived professional skills. As an extrapolation of findings, we found that these interventions could empower 24h-caregivers and improve the quality of home-care services provided by them.

TRIAL REGISTRATION

Digital Support for Quality Assurance in 24-h Caregiving at Home was registered and posted on the ClinicalTrials.gov public website (ClinicalTrials.gov Identifier: NCT04581538).

Supporting Clinical Competencies in Men's Mental Health Using the Men in Mind Practitioner Training Program: User Experience Study

BACKGROUND

Engaging men in psychotherapy is essential in male suicide prevention efforts, yet to date, efforts to upskill mental health practitioners in delivering gender-sensitized therapy for men have been lacking. To address this, we developed Men in Mind, an e-learning training program designed to upskill mental health practitioners in engaging men in therapy.

OBJECTIVE

This study involves an in-depth analysis of the user experience of the Men in Mind intervention, assessed as part of a randomized controlled trial of the efficacy of the intervention.

METHODS

Following completion of the intervention, participants provided qualitative (n=392) and quantitative (n=395) user experience feedback, focused on successes and suggested improvements to the intervention and improvements to their confidence in delivering therapy with specific subpopulations of male clients. We also assessed practitioner learning goals (n=242) and explored the extent to which participants had achieved these goals at follow-up.

RESULTS

Participants valued the inclusion of video demonstrations of skills in action alongside the range of evidence-based content dedicated to improving their insight into the engagement of men in therapy. Suggested improvements most commonly reflected the desire for more or more diverse content, alongside the necessary adaptations to improve the learning and user experience. Participants also commonly reported improved confidence in assisting men with difficulty articulating their emotions in therapy and suicidal men.

CONCLUSIONS

The evidence obtained from this study aids in plans to scale Men in Mind and informs the future development of practitioner training interventions in men's mental health.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1186/s40359-022-00875-9.

Enhancing colposcopy training using a widely accessible digital education tool in China

BACKGROUND

Colposcopy is a cornerstone of cervical cancer prevention; however, there is a global shortage of colposcopists. It is challenging to train a sufficient number of colposcopists through in-person methods, which hinders our ability to adequately diagnose and manage positive cases. A digital platform is needed to make colposcopy training more efficient, scalable, and sustainable; however, current online training programs are generally based on didactic curricula that do not incorporate image analysis training. In addition, long-term assessments of online training are not readily available. Therefore, innovative digital training and an assessment of its effectiveness are needed.

OBJECTIVE

This study aimed to evaluate the short- and long-term effects of DECO (an online Digital Education Tool for Colposcopy) on trainees' colposcopy competencies and confidence.

STUDY DESIGN

DECO can be used both on laptops and smartphones and comprises 4 training modules (image interpretation; terminology learning; video teaching; and collection of guidelines and typical cases) and 2 test modules. DECO was tested through a pre-post study between September and November 2022. Participants were recruited in China, and DECO training lasted 12 days. Trainees initially learned basic theory before completing training using 200 image-based cases. Pretest, posttest, and follow-up testing included 20 distinct image-based questions, and was conducted on Days 0, 13, and 60. Primary outcomes were competence and confidence scores. Secondary measures were response distributions for colposcopic diagnoses, biopsies, and DECO training satisfaction. Multilevel modeling was used to determine improvement from baseline to posttraining and follow-up for the outcomes of interest.

RESULTS

Among 402 participants recruited, 96.8% (n=389) completed pretesting, 84.1% (n=338) posttesting, and 75.1% (n=302) follow-up testing. Colposcopic competence and confidence increased across this study. Diagnostic scores improved on average from 55.3 (53.7-56.9) to 70.4 (68.9-71.9). The diagnostic accuracy for normal/benign lesions, low-grade squamous intraepithelial lesions, and high-grade squamous intraepithelial lesions or worse increased by 16.9%, 13.1%, and 16.9%, respectively. Mean confidence scores increased from 48.1 (45.6-50.6) to 56.2 (54.5-57.9). These improvements remained evident 2 months after training. Trainees were also satisfied with DECO overall. Most found DECO to be scientific (82.5%), easy to use (75.2%), and clinically useful (98.4%), and would recommend it to colleagues (93.2%).

CONCLUSION

DECO is a useful, acceptable digital education tool that improves colposcopy competencies and confidence. DECO could make colposcopy training more efficient, scalable, and sustainable because there are no geographic or time limitations. Therefore, DECO could be used to alleviate the shortage of trained colposcopists around the world.

e-Learning Evaluation Framework and Tools for Global Health and Public Health Education: Protocol for a Scoping Review

BACKGROUND

There has been a significant increase in the use of e-learning for global and public health education recently, especially following the COVID-19 pandemic. e-Learning holds the potential to offer equal opportunities, overcoming barriers like physical limitations and training costs. However, its effectiveness remains debated, with institutions unprepared for the sudden shift during the pandemic. To effectively evaluate the outcomes of e-learning, a standardized and rigorous approach is necessary. However, the existing literature on this subject often lacks standardized assessment tools and theoretical foundations, leading to ambiguity in the evaluation process. Consequently, it becomes imperative to identify a clear theoretical foundation and practical approach for evaluating global and public health e-learning outcomes.

OBJECTIVE

This protocol for a scoping review aims to map the state of e-learning evaluation in global and public health education to determine the existing theoretical evaluation frameworks, methods, tools, and domains and the gaps in research and practice.

METHODS

The scoping review will be conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The initial search was performed in PubMed, Education Resource Information Center, Web of Science, and Scopus to identify peer-reviewed articles that report on the use of evaluation and assessment for e-learning training. The search strings combined the concepts of e-learning, public health, and health science education, along with evaluation and frameworks. After the initial search, a screening process will be carried out to determine the relevance of the identified studies to the research question. Data related to the characteristics of the included studies, the characteristics of the e-learning technology used in the studies, and the study outcomes will be extracted from the eligible articles. The extracted data will then undergo a structured, descriptive, quantitative, and qualitative content analysis to synthesize the information from the selected studies.

RESULTS

 Initial database searches yielded a total of 980 results. Duplicates have been removed, and title and abstract screening of the 805 remaining extracted articles are underway. Quantitative and qualitative findings from the reviewed articles will be presented to answer the study objective.

CONCLUSIONS

This scoping review will provide global and public health educators with a comprehensive overview of the current state of e-learning evaluation. By identifying existing e-learning frameworks and tools, the findings will offer valuable guidance for further advancements in global and public health e-learning evaluation. The study will also enable the creation of a comprehensive, evidence-based e-learning evaluation framework and tools, which will improve the quality and accountability of global health and public health education. Ultimately, this will contribute to better health outcomes.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49955.

Digital Transformation in Musculoskeletal Ultrasound: Acceptability of Blended Learning

BACKGROUND

ultrasound diagnostics have a broad spectrum of applications, including among diseases of the musculoskeletal system. Accordingly, it is important for the users to have a well-founded and up-to-date education in this dynamic examination method. The right balance between online and in-class teaching still needs to be explored in this context. Certifying institutions are currently testing digitally transformed teaching concepts to provide more evidence.

METHODS

this study compared two musculoskeletal ultrasound blended learning models. Model A was more traditional, with a focus on in-person teaching, while Model B was more digitally oriented with compulsory webinar. Both used e-learning for preparation. Participants completed evaluations using a seven-point Likert scale, later converted to a 0-1 scale. Digital teaching media (e-learning) were used for preparation in both courses.

RESULTS

the analysis included n = 41 evaluations for Model A and n = 30 for Model B. Model B received a better overall assessment (median: 0.73 vs. 0.69, p = 0.05). Model B also excelled in "course preparation" (p = 0.02), "webinar quality" (p = 0.04), and "course concept" (p = 0.04). The "gain of competence" (p = 0.82), "learning materials" (p = 0.30), and "tutor quality" (p = 0.28) showed no significant differences.

CONCLUSION

participants favorably assessed blended learning in ultrasound teaching. Certifying institutions should consider accrediting models that combine digital methods (e.g., internet lectures/webinars) and materials (e.g., e-learning) with hands-on ultrasound training. Further research is needed to validate these subjective findings for a stronger evidential basis.

Which virtual education methods do e‑students prefer? Design and validation of Virtual Education Preferences Questionnaire (VEPQ)

BACKGROUND

With the prevalence of new technologies and evolving student learning styles, virtual teaching methods have become increasingly popular. As a result, more and more students are opting to learn online. However, one common concern is that they may feel disconnected from their teachers, leading to feelings of loneliness and doubts about the quality of education they are receiving. To address this issue, a study was conducted to gather data on students' preferences for virtual education and to validate a tool for measuring students' preferences for virtual education.

METHODS

The research was conducted in a mixed method with a quantitative-qualitative sequence. A virtual education preferences questionnaire (VEPQ) for students with a total of 17 items was created and validated as part of the qualitative component by looking at the theoretical underpinnings and experts' opinions in the focus group. The scale of the six-point Likert questionnaire was from very high to very low. To validate the tool and determine preferences, exploratory factor analysis was used. A total of 155 samples answered the questions and the data were analyzed using SPSS-24 software.

RESULTS

A total of 155 complete questionnaires were returned; among them, 110 (71%) were filled out by women, 73 (47.1%) by respondents between the ages of 36 and 45, 107 (69%) were already employed in paramedical fields, and 48 (31%) were enrolled in a medical school. The opinions of ten experts were used to confirm the face validity of the questionnaire. With CVI = 0.924 and CVR = 0.805, content validity was verified. Using the internal consistency method of the questions with a Cronbach's alpha coefficient of R = 0.824, the validity of the entire questionnaire was confirmed. Exploratory factor analysis revealed that a total of five components-self-directed projects (29.58%), e-content (13.00%), online presentation (10.97%), face-to-face interactions (9.12%), and text interactions (7.11%) had the highest load, with a total of 69.77% of the structure explaining virtual education preferences. The factor analysis test and the suitability of the sample are both confirmed by the value of KMO = 0.721 and the significance of Pvalue < 0.001.

CONCLUSION

It appears that the highly valid tool developed can be used to ascertain the educational preferences of students. Also, the high factor load of self-directed educational methods and e-content shows that independence and flexibility in time and place are more important for students.

Caring for People with Severe Brain Injuries: Improving Health Care Professional Communication and Practice Through Online Learning

INTRODUCTION

Severe brain injuries can leave people in prolonged disorder of consciousness resulting in multifaceted medical, nursing, and rehabilitative needs that can be challenging for even the most experienced multidisciplinary team. The complexities of care, communication with families, and best interest decision-making about medical interventions means there is a need for ongoing training in clinical, social, ethical, and legal aspects.

METHODS

Using a combination of group discussions, interviews, and questionnaires with learners, this article reports an evaluation of designing and delivering an interprofessional, online work-based course to health care professionals caring for prolonged disorder of consciousness patients.

RESULTS

There were challenges for staff uptake because of COVID-19, but engaging with it increased knowledge in defining and diagnosing patients' conditions, understanding multidisciplinary team roles, communicating with families, and navigating legal and ethical issues. Course participation also enhanced critical and reflective thinking skills, provided a sense of connection to other professionals, and generated plans to improve service provision.

DISCUSSION

Online learning that enables health care professionals to engage at their own pace and also come together as an interprofessional community can provide invaluable continuing professional development and help to enhance joined up, holistic patient care. However, achieving this requires significant investment in creating research-led, multimedia, learning materials, and courses that include synchronous and asynchronous delivery to combine flexible study with the opportunity for peer networks to form. It also depends on a commitment from organizations to support staff online continuing professional development.

Perception and preference of pharmacy students toward e-learning during the COVID-19 pandemic

This study is designed to evaluate students' knowledge and perceptions about the online learning of pharmacy curricula in Iraq during the COVID-19 quarantine. A descriptive, cross-sectional study involving 278 pharmacy students was done between October 2020 and June 2021. About 42.44% preferred face-face lecturers over other modes of delivery for lectures in the pharmacy curriculum. Most participants preferred both active learning and face-face lectures. The results show that 72.66% of responders chose to stay at home as one of the privileges of e-learning. However, the main barriers that associated with e-learning were lack of patient involvement and some technical issues regarding IT equipment, (74.82%) and (62.23%), respectively. E-learning is seen as a lack of social presence, less social contact, and synchronization of connections. However, e-learning undoubtedly benefits students in several ways. Online learning is an essential podium for students to achieve their studies in periods of crisis.