Assessing medical students' perception and educational experience during COVID-19 pandemic

Mental health-promoting intervention models in university students: a systematic review and meta-analysis protocol

BACKGROUND

The transition to higher education represents a demanding adaptation process with several socioeconomic factors involved. Mental health problems among university students have been worsening since the beginning of the COVID-19 pandemic. Our objective is to create scientific evidence about the models of mental health-promoting interventions among higher education students applied in academic environments, as well as their effectiveness. We aim to synthesise the scientific evidence on the models of an intervention promoting mental health among university students applied in academic environments as well as their results.

METHODS AND ANALYSIS

A systematic review of the literature will be conducted. The research will be carried out using the EBSCO databases (CINAHL Complete, MEDLINE Complete, Psychology and Behavioral Sciences Collection), PubMed and Scopus. The research strategy includes the following MeSH or similar terms: Universities [Mesh], Students [Mesh], Education [Mesh], Undergraduate, "Higher Education", Universit*, College, Student*; "Psychosocial intervention" [Mesh], "Non-pharmacological", "Intervention model*", "Mental health promotion program*", Intervention*; "Randomized Controlled Trial", RCT; "Mental health" [Mesh], Depression [Mesh], Anxiety [Mesh], "Stress, psychological" [Mesh], "Quality of life" [Mesh], and "Psychological well-being" [Mesh]. All experimental studies with mental health-promoting interventions for university students that were published between January 2017 and November 2024 in English will be eligible. Two independent reviewers will apply the inclusion and exclusion criteria, analyse the quality of the data and extract it for synthesis. Disagreements will be resolved by a third reviewer. All randomised controlled trial studies with interventions in university students and their efficacy (with means and SD) will be included in the systematic review of the literature. The standardised mean difference will be used as the effect size to standardise individual results. Sensitivity analysis, subgroup analysis and meta-regression will be conducted to explore the causes of heterogeneity and the robustness of the results.

ETHICS AND DISSEMINATION

Ethical approval is not required for this study as it is based on the review of previously published data. The results will be disseminated through publication in peer-reviewed journals and presentations at academic conferences, as well as in events organised by student associations.

PROSPERO REGISTRATION NUMBER

CRD42022359608.

Multiple choice as formative assessment in dental education

INTRODUCTION

The effectiveness of multiple-choice questions (MCQs) in dental education is pivotal to student performance and knowledge advancement. However, their optimal implementation requires exploration to enhance the benefits.

MATERIALS AND METHODS

An educational tool incorporating MCQs was administered from the 5th to the 10th semester in a dental curriculum. The students filled out a questionnaire after the MCQ, which was linked to the learning management system. Four cohorts of four semesters generated 2300 data points analysed by Spearmen correlation and mixed model regression analysis.

RESULTS

Demonstrated a significant correlation between early exam preparation and improved student performance. Independent study hours and lecture attendance emerged as significant predictors, accounting for approximately 10.27% of the variance in student performance on MCQs. While the number of MCQs taken showed an inverse relationship with study hours, the perceived clarity of these questions positively correlated with academic achievement.

CONCLUSION

MCQs have proven effective in enhancing student learning and knowledge within the discipline. Our analysis underscores the important role of independent study and consistent lecture attendance in positively influencing MCQ scores. The study provides valuable insights into using MCQs as a practical tool for dental student learning. Moreover, the clarity of assessment tools, such as MCQs, remains pivotal in influencing student outcomes. This study underscores the multifaceted nature of learning experiences in dental education and the importance of bridging the gap between student expectations and actual performance.

Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated Factors

Background

The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life.

Aim

The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms.

Methods

A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann-Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05.

Results

Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being "better off dead." The study found lower anxiety and depressive symptoms (p < 0.05) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms (p < 0.05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (p < 0.001).

Conclusions

There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students' mental health.

Innovations in teaching during the COVID-19 pandemic: comparisons of the impacts of different teaching approaches in psychiatric nursing on undergraduate nursing students

BACKGROUND

Psychiatric nursing education was significantly impacted during the COVID-19 pandemic, and innovative teaching can be challenging. This study aims to compare the effectiveness of four approaches to psychiatric nursing education in the context of the pandemic.

METHODS

A quasi-experimental design was adopted. Students were subjected to different teaching designs: face-to-face teaching (Class A in 2021), blended teaching with flipped classroom using roleplay (Class B in 2021), live broadcast teaching (Class A in 2022), and online blended teaching with flipped classroom using case studies (Class B in 2022). Multivariable logistic regression was used to analyse the outcomes in terms of academic performance and course workload.

RESULTS

The number of valid data points was 270. The results indicated that compared with Class A in 2021, the two classes in 2022 achieved significantly higher academic performance scores, and Class B in 2021 exhibited a significantly lower workload. Compared with Class A in 2022, Class B in 2021 exhibited a significantly lower workload. Compared with Class B in 2022, Class B in 2021 exhibited a significantly lower workload and achieved lower academic performance scores.

CONCLUSION

This study demonstrated that innovative teaching designs for psychiatric nursing offer advantages with regard to either facilitating academic performance or optimizing learners' task loads. Furthermore, blended learning is a promising teaching approach in the context of the COVID-19 pandemic. Future teaching initiatives could adopt student-centred constructive learning designs and ensure feasible teaching.

At the limits of digital education. The importance of practical education for clinical competencies learning in the field of emergency medicine: A controlled non-randomized interventional study

Introduction

A high-quality education of future physicians is essential. Modern approaches interlock the acquisition of theoretical knowledge and practical skills in a spiral curriculum, leading to a mutual learning benefit for knowledge and application. This model was challenged by the elimination of hands-on trainings during the pandemic, which were often replaced by purely digital teaching models. Given the holistic nature of the spiral curriculum, we assumed that a purely digital model would have an impact on knowledge acquisition due to missing hands-on learning opportunities. The aim of the study was to investigate, using an emergency seminar as an example, whether purely digital training leads to a difference in theoretical knowledge compared to the traditional model.

Materials and methods

Study design: We used a two-groups design comparing a sample of medical students taught in 2020 with a purely digital teaching format (DF; n = 152) with a historical control group taught with a traditional format (TF; n = 1060). Subject of investigation was a seminar on emergency medicine, taking place in the 4th year. Outcome parameters: The primary outcome parameter was the students' acquired knowledge, measured by the score achieved in the final exams. Students' evaluation of the seminar was used as a secondary outcome parameter.

Results

Students in the DF group scored significantly lower than students in the TF group in the final exams. Students in the DF group rated the course significantly worse than students in the TF group.

Discussion

The study results illustrate that purely digital education leads to inferior knowledge acquisition compared to the traditional spiral curriculum. A possible explanation may lie in a deeper processing of the information (e.g., understanding the information by experience and analysis) and accordingly a better memory recall. Moreover, the students' critical appraisal of the DF may have had an unfavorable effect on learning performance. Moderating factors may be lower learning motivation or the “zoom fatigue” effect.

Conclusion

These study results clearly illustrate the importance of hands-on teaching for knowledge acquisition. The interlocking of theoretical knowledge and practical skills, as ensured by the spiral curriculum, is essential.