Factors affecting the acceptance of blended learning in medical education: application of UTAUT2 model

Shadows and light: navigating teachers' time poverty and blended teaching acceptance with social support and job satisfaction in EFL teachers' voyage

BACKGROUND

The increasing prominence of blended teaching in English instruction underscores its potential to enhance educational quality. However, the significant time commitment required may deter teachers from adopting this method due to prevalent time poverty. Despite the critical implications, research exploring the link between time poverty and acceptance of blended teaching is sparse.

METHODS

This study developed a theoretical model to investigate the effects of time poverty on the acceptance of blended teaching among teachers, incorporating job satisfaction as a mediating variable and social support as a moderating variable. A total of 793 English teachers from various Chinese universities participated, providing data through a structured questionnaire. The relationships were analyzed using regression and path analysis to validate the hypothesized model.

RESULTS

The analysis revealed that time poverty significantly and negatively influences university EFL teachers' acceptance of blended teaching. Job satisfaction was found to partially mediate this relationship, indicating that emotional well-being plays a critical role in shaping instructional openness under conditions of time stress. Notably, social support exhibited a dual moderating role: it exacerbated the negative impact of time poverty on both job satisfaction and blended teaching acceptance, while simultaneously enhancing the positive influence of job satisfaction on teachers' willingness to adopt blended methods.

CONCLUSIONS

These findings highlight job satisfaction as a pivotal psychological mechanism through which time-related stressors affect pedagogical innovation. The complex role of social support-being facilitative in some pathways yet detrimental in others-underscores the importance of evaluating not only the presence but also the alignment and perceived utility of support systems in educational settings. For university-level EFL teachers navigating digital transformation under high workload pressures, context-sensitive and needs-matched support strategies are essential. This study contributes to the literature by clarifying the interactive dynamics among time poverty, job satisfaction, social support, and blended teaching acceptance, and offers practical implications for the design of more effective teacher support mechanisms in the era of educational innovation.

Exploring the determinants on continuance participation of college students toward blended learning: the stimulating role of course characteristics and instructor support

Background

Blended learning (BL) has become an important learning method in the high education with the rapid advancement of "Internet + Education," however, college students face notable challenges, such as high dropout rates, low participation and low persistence, which largely reduce the learning effect of BL. Therefore, it is necessary to deeply analyze the question: "What factors will influence college students' continuance behavior in blended learning (CBBL)?"

Methods

Based on the stimulus-organism-response (SOR) framework and social cognitive theory, this study constructs an integrated model of "Contextual facilitators-Individual characteristics-Continuance behavior," to examine the relationships among the blended course characteristics (BCC), instructor support (IST), individual attributes, such as learning motivation (LM), self-efficacy (SEF) and learning engagement (LET), and college students' CBBL. Colleting 466 College students who participated in BL through Chinese university MOOCs, the structural equation modeling (SEM) approach was used to test the proposed hypotheses.

Results

The empirical results indicating that, (1) this integrated model explains 62.85% of the variance in college students' CBBL, and LM, SEF, and LET emerge as the key determinants influencing college students' CBBL. (2) BCC positively affects LM and LET but has no significant on SEF, and it promotes college students' CBBL through LM and LET rather than SEF. (3) ITS exerts a significant influence on LM, SEF, and LET, with the most pronounced impact on LET. Moreover, ITS significantly facilitates college students' CBBL via LM, SEF, and LET.

Originality/value

This study theoretically contributes to literature on BL and extends the application scope of SOR framework. Also, it reveals the antecedents of college students' CBBL in the BL environment, which is crucial for guiding their continuance learning and promoting the sustainable development of BL education.

Acceptance or satisfaction of blended learning among undergraduate nursing students: A systematic review of the literature

BACKGROUND

Blended learning is increasingly gaining popularity as an alternative method for delivering nursing education; however, there is no review regarding its acceptance or satisfaction among undergraduate nursing students.

OBJECTIVE

This systematic review aims to thoroughly explore and summarize the literature regarding the acceptance or satisfaction of blended learning among undergraduate nursing students.

METHODS

We conducted a comprehensive search of EMBASE, Cochrane, Web of Science, PubMed, and Scopus for English-language publications up to June 2024. Two researchers independently screened the literature and extracted the data.

RESULTS

The search strategy identified 710 potentially relevant articles, from which 27 studies were ultimately included. Our findings underscore a scarcity of high-quality questionnaires assessing students' acceptance or satisfaction with blended learning. Notably, undergraduate nursing students generally express high satisfaction with blended learning. Factors influencing their acceptance or satisfaction include online platform browsing speed, teachers' abilities and instructional styles, preparation efforts, and students' information and communication technology skills.

CONCLUSION

Blended education holds promise as a future teaching method in nursing education, given its positive reception among undergraduate nursing students. However, this review emphasizes a significant issue: the insufficient availability of high-quality questionnaires to assess this population's acceptance or satisfaction with blended learning. Addressing this gap through further research is essential to enhance our understanding and ensure the effective implementation of blended learning in nursing education.

A study of the purchase intention of alternative foods

Environmental pollution has drawn widespread attention to food safety. People are becoming more conscious of their health and the sustainable development of food, and are setting higher standards for food safety, which have led to the development of better alternatives to food. In this study, we examine the willingness of college students to buy alternative foods and the factors that influence their purchase decisions, as well as the sustainable development of alternative products. The purpose of this study is to investigate the relationship between social influence, food safety, nutrition confidence, exercise commitment, dietary habits, satisfaction, attitude, and purchase intention. We conducted a survey among 799 college students. According to the study, social influence, food safety, and dietary habits greatly influence the satisfaction, attitude, and purchase intention of college students when purchasing alternative food. Attitude and purchase intention are positively correlated with satisfaction. Moreover, nutritional confidence and attitude are significant predictors of purchase intentions. The findings of this study supplement the research of college students on the factors that influence the selection of insect foods as alternative foods within the context of frequent food shortages and safety concerns. To assist farmers, producers, consumers, and extension personnel in making informed decisions, we provide relevant information on factors affecting the supply and demand of alternative food.

Remote online learning reimagined: perceptions and experiences of medical students in a post-pandemic world

BACKGROUND

Blended learning is a key educational methodology, particularly in medical education, and involves integration of online and face-to-face interactions to enhance flexibility and engagement. Blended learning gained increased popularity during the COVID-19 pandemic due to social restrictions. Following control of the pandemic, face to face teaching and learning activities have been restored. However, some institutions continue to deliver some teaching online. This study explores the perceptions and experiences of undergraduate medical students from 15 institutions across seven countries regarding remote online learning in the post-pandemic era.

METHODS

This cross-sectional study utilized an online survey to gather insights into the use of learning resources, interactivity in online sessions, barriers to online learning, and preferences for learning modalities. Descriptive data were summarized by frequency, categorical comparisons were assessed with chi-squared tests, and t-tests were used for continuous data.

RESULTS

The findings of the current study show a general preference for blended learning (47.78%) over traditional face-to-face instruction (41.48%). Key benefits of blended learning reported by the participants by comfort, flexibility, reduced travel, and ability to learn at own pace. The key barriers identified were internet connectivity issues and family distractions. The study also highlighted the limitations of online learning in replacing clinical experience and practical skills acquisition, with 69.26% of respondents affirming that online learning does not sufficiently substitute for direct patient contact.

CONCLUSION

The findings underscore the importance of integrating face to face and remote online teaching and learning frameworks to align with educational objectives, particularly in fostering interactivity and practical skill development. The study suggests that while blended learning has many benefits, its effectiveness is highly context-dependent and requires thoughtful implementation to meet the diverse needs of medical education.

Intention to use eLearning-based continuing professional development and its predictors among healthcare professionals in Amhara region referral hospitals, Ethiopia, 2023: using modified UTAUT-2 model

BACKGROUND

Continuing Professional Development (CPD) is provided through in-service programs organized based on competency development and lifelong learning for healthcare professionals to stay fit with the required knowledge and skills. However, healthcare professionals' financial constraints and tight schedules sending them away from the workplace for CPD training is a challenge. eLearning is becoming the best solution to overcome those barriers and create accessible, efficient, flexible, and convenient professional development. However, evidence is limited on health professionals' intention to use eLearning-based CPD and its predictors. Hence this study aimed to assess healthcare professionals' intention to use eLearning-based CPD and its predictors in Amhara region referral hospitals, in Ethiopia.

METHODS

A cross-sectional study was conducted from March 28 to April 28, 2023. A total of 976 healthcare professionals participated in this study. Proportional allocation and simple random sampling were used to select participants for the study. UTAUT2 model was applied to develop a theoretical framework. A structured self-administered questionnaire was used and a 5% pretest was performed. Data were entered into Epi data 4.6 and exported to SPSS 26 for descriptive analysis. AMOS 23 SEM was also used to describe and assess the degree and significance of relationships between variables.

RESULTS

About 51.8% (506/976) (95% CI: 48.7-55.0) of participants have the intention to use eLearning for CPD. Performance expectancy (β = 0.233, p-value < 0.01), effort expectancy (β = 0.082, p-value < 0.05), facilitating condition (β = 0.102, p-value < 0.05), hedonic motivation (β = 0.199, P-value < 0.001), habit (β = 0.473, P-value < 0.001), and computer literacy (β = 0.116, p-value < 0.001) had a positive relationship with intention to use eLearning based CPD. Age and gender were also a moderator of the habit of using eLearning based on CPD.

CONCLUSION

and recommendation. Overall, healthcare professionals' intention to use eLearning-based CPD was found low. Performance expectancy, effort expectancy, facilitating condition, hedonic motivation, habit, and computer literacy had a significantly positive influence on the intention to use eLearning-based CPD. The development of a user-friendly eLearning-based CPD development that meets user expectations can enhance the intention to use.

Assessment of physical education teachers' use of distance teaching behavior under the influence of the COVID-19 pandemic

Background

For many physical education teachers, being suddenly forced to switch from traditional face-to-face teaching to online teaching without adequate mental preparation posed numerous challenges and difficulties. Therefore, the purpose of this study is to validate the use of distance teaching behavior models for physical education teachers under the influence of the COVID-19 pandemic.

Method

The unified theory of acceptance and use of technology (UTAUT) model was employed to explore the use intention and use behavior of distance teaching. The model contains four independent variables: performance expectancy (PE), effort expectancy (EE), social influence (SI), and facilitating conditions (FC), two dependent variables: behavioral intention (BI) and use behavior (UB) and three moderating variables: gender, age, and experience. A total of 400 questionnaires were distributed to elementary and junior high school physical education teachers with 364 valid responses. Partial least squares structural equation modeling (PLS-SEM) was used to test the relationships among variables.

Results

The results found PE, EE and SI had significant influences on BI and FC and BI had significant influences on UB. Experience had moderating effects among SI and BI.

Conclusions

Based on the results, recommendations for physical education teachers and schools are proposed. Furthermore, research limitations and future directions are discussed.

Redesigning Competency Assessment: A Blended Approach of Clinical Education for Oncology Nurses

A train-the-trainer model of clinical education was redesigned in one National Cancer Institute-designated cancer center to introduce a blended model of learning. Program outcomes were for oncology nurse trainers to affirm program engagement; successfully complete a new, web-based specialized oncology curriculum, with 80% accuracy; complete one live 8-hour training event; acquire competency validation of required skills, with 100% accuracy; and communicate one strategy for training staff in their respective clinical settings.

Unraveling the dynamics of ChatGPT adoption and utilization through Structural Equation Modeling

ChatGPT, an advanced Artificial Intelligence tool, is getting considerable attention in higher education. ChatGPT significantly changes the student learning experience through its AI-aided support, personalized study assistance and effective educational experiences, and it has become an object of particular interest in this context. This research aimed to build a technology acceptance and usage model that encapsulates the elements influencing students' adoption and utilization of ChatGPT, drawing on constructs from the 'Unified Theory of Acceptance and Use of Technology' and 'Flow Theory'. The proposed model was found valid and prolific, with the credibility of the results relying on the self-reported surveys of 505 students from three universities in Pakistan. Structural Equation Modelling (SEM) was used to analyze data that confirmed the robustness and validity of the proposed model of the study. The study findings supported nine out of the ten proposed hypotheses. Perceived playfulness was declared the paramount predictor of behavioral intention, while perceived values and performance expectancy were the next-level predictors. Additionally, behavioral attention was a high and inspiring determinant of ChatGPT usage behavior, followed by attention focus. This analysis demonstrates a need for a thorough investigation of AI tools like ChatGPT in higher education.

Exploring user usability perceptions and acceptance of chording-enabled keyboards: A perspective between human-computer interaction

In recent years, a variety of alternative keyboard designs have emerged with the primary goal of enhancing user comfort and productivity compared to conventional keyboards. The objective of this study was to determine the variables affecting the acceptance and perceptions of people towards chording-enabled keyboards. A holistic analysis was done with the use of an extended framework of unified theory of acceptance and use of technology (UTAUT2), analyzed through partial least square structural equation modeling. Gathering a total of 430 valid respondent through purposive sampling, perceived usability, behavioral intention, usage behavior, habit, performance expectancy, social influence, and hedonic motivation were seen to be important factors in adopting chord-enabled keyboards. From the output, it was posited that the attributes of the keyboards' functionality, ease of use, adaptability, and people's willingness to use it, significantly affected their intention of using the keyboard. The findings and suggestions included in this study will benefit not only users but also the developers by providing insights into user preferences. Efficiently improving and marketing chording enabled keyboards could be considered as suggested in the implications. Moreover, the study's model construct could also be utilized in other studies related to user acceptance of technology in different countries.

Investigating older adults users' willingness to adopt wearable devices by integrating the technology acceptance model (UTAUT2) and the Technology Readiness Index theory

Objective

With the continuous advancement of wearable technology, smart wearable devices are increasingly recognized for their value in health monitoring, assessment, and intervention for the older adults, thus promoting intelligent older adults care. This study, based on the theoretical framework of the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) and the Technology Readiness Index (TRI) model, aims to identify and explore the key factors influencing older adults consumers' willingness to adopt smart wearable devices and their impact mechanisms.

Method

A questionnaire survey was conducted to collect valid data from 389 older adults respondents. Empirical analysis validated the model's applicability and explored the key factors influencing acceptance.

Results

Factors influencing the use of smart wearable devices by the older adults include performance expectancy (β = 0.152, p < 0.001), effort expectancy (β = 0.154, p < 0.001), social influence (β = 0.135, p < 0.05), facilitating conditions (β = 0.126, p < 0.05), hedonic motivation (β = 0.166, p < 0.001), price value (β = 0.182, p < 0.001), and digital health literacy (β = 0.189, p < 0.001). Additionally, optimism (β = 0.208, p < 0.001), innovativeness (β = 0.218, p < 0.001), and discomfort (β = -0.245, p < 0.001) significantly positively influenced performance expectancy, while optimism (β = 0.282, p < 0.001), innovativeness (β = 0.144, p < 0.01), discomfort (β = -0.239, p < 0.001), and insecurity (β = -0.117, p < 0.05) significantly positively influenced effort expectancy. Insecurity did not significantly influence performance expectancy. Performance expectancy and effort expectancy partially mediated the relationship between personality traits (optimism, innovativeness, discomfort, and insecurity) and behavioral intention. Digital health literacy significantly negatively moderated the relationship between performance expectancy and behavioral intention, as well as between effort expectancy and behavioral intention.

Discussion

The study confirms that integrating the UTAUT2 model and TRI theory effectively explains the acceptance of smart wearable devices among older adults consumers, emphasizing the importance of enhancing digital health literacy in the design and promotion of smart health devices. The findings provide guidance for developers, increasing the acceptance and usage rate of these devices among the older adults.

Blended learning: An innovative teaching strategy to teach dermatology to the family medicine residents of a teaching hospital

Context

Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies.

Objective

To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital. Methodology: It was interventional (pre and post) study with purposive sampling. All the Family Medicine residents enrolled at The Aga Khan University Hospital participated in the study after giving consents. The course covered most common skin conditions. Multiple slide sessions, online lectures, clinical presentations, case-based scenarios, and quizzes were included in the course. Knowledge was assessed through pre- test by multiple choice questions. Post tests were taken after completion of the modules to assess the improvement in the knowledge of residents about basic dermatological conditions by multiple choice questions. After completion of sessions a survey questionnaire was administered to evaluate the perception of participants about blended learning strategy.

Results

The tests scores were significantly higher in the post test. The majority of the residents were satisfied with the course delivery. A statistically significant difference was found between pre and post test results with a P value 0.000.

Conclusions and Recommendation

Blended learning is an effective and innovative teaching strategy that helped family medicine residents to enhance their learning more effectively. We recommend that this method of teaching strategy should be used in other clinical disciplines in different contexts.didifferent contexts.

Development of a Web App to Enhance Physical Activity in People With Cystic Fibrosis: Co-Design and Acceptability Evaluation by Patients and Health Professionals

BACKGROUND

Cystic fibrosis (CF) is a genetic disease affecting the respiratory and digestive systems, with recent treatment advances improving life expectancy. However, many people with CF lack adequate physical activity (PA). PA can enhance lung function and quality of life, but barriers exist. The Cystic Fibrosis Decisional Balance of Physical Activity questionnaire assesses the decisional balance for PA in adults with CF, but it is not optimal for clinical use. A digital app might overcome this limitation by improving the efficiency of administration, interpretation of results, and communication between patients and health care professionals.

OBJECTIVE

This paper presents the development process and reports on the acceptability of a web app designed to measure and monitor the decisional balance for PA in people with CF.

METHODS

This study comprised two stages: (1) the co-design of a digital app and (2) the evaluation of its acceptability among health care professionals and people with CF. A participatory approach engaged stakeholders in the app's creation. The app's acceptability, based on factors outlined in the Unified Theory of Acceptance and Use of Technology 2, is vital for its successful adoption. Participants volunteered, gave informed consent, and were aged >18 years and fluent in French. Data collection was performed through qualitative interviews, video presentations, surveys, and individual semistructured interviews, followed by quantitative and qualitative data analyses.

RESULTS

In total, 11 health care professionals, 6 people with CF, and 5 researchers were involved in the co-design phase. Results of this phase led to the coconstruction of an app named MUCO_BALAD, designed for people with CF aged ≥18 years, health care professionals, and researchers to monitor the decisional balance for PA in people with CF. In the acceptability evaluation phase, the sample included 47 health care professionals, 44 people with CF, and 12 researchers. The analysis revealed that the acceptability measures were positive and that app acceptability did not differ according to user types. Semistructured interviews helped identify positive and negative perceptions of the app and the interface, as well as missing functionalities.

CONCLUSIONS

This study assessed the acceptability of an app and demonstrated promising qualitative and quantitative results. The digital tool for measuring the decisional balance in PA for people with CF is encouraging for health care professionals, people with CF, and researchers, according to the valuable insights gained from this study.

Behavioral intentions of university teachers and students toward the adoption of the hyb-blended learning method: Evidence from Bangladesh

Hyb-blended learning is a novel method that can serve as a substitute for conventional classroom-based learning activities, demonstrating effectiveness in both pandemics like COVID-19 and other crises, as well as in non-pandemic situations. The successful application of this method in the field of education depends on the users' intentions to adopt it. Therefore, this study aims to understand the behavioral intentions of teachers and students at Bangladeshi universities toward the adoption of the hyb-blended learning method. A correlational, cross-sectional, and sample survey-based research design was employed. Two structured questionnaires, one for teachers and one for students, were used to collect data from 171 teachers and 713 students from 11 public and 8 private universities in Bangladesh. The conceptual model of the study was developed on the theoretical underpinnings of the "Unified Theory of Acceptance and Use of Technology (UTAUT)." The study used a structural equation modeling technique to test the hypotheses. The results of the study revealed that the proposed learning method would increase teaching and learning opportunities for both teachers and students in Bangladeshi universities. They would adopt this method without relying on the experiences of others or what others think or say. Unlike teachers, the study also found that students would use it if they received support and influence from friends, fellow students, university authorities, and other external factors. However, their intentions toward adopting this method depend on the availability of resources and support for adopting it, as well as adequate and necessary understanding and talent to use it effectively. Results also revealed that they would adopt the method if it was found to be simple to use. The study has a notable practical implication, as it has proposed an alternative learning and teaching method that would be effective in Bangladeshi universities during the COVID-19 pandemic or other crises and in non-pandemic situations as well.

Analyzing Preceding factors affecting behavioral intention on communicational artificial intelligence as an educational tool

During the pandemic, artificial intelligence was employed and utilized by students around the globe. Students' conduct changed in a variety of ways when schooling returned to regular instruction. This study aimed to analyze the student's behavioral intention and actual academic use of communicational AI (CAI) as an educational tool. This study identified the variables by utilizing an integrated framework based on the Unified Theory of Acceptance and Use of Technology (UTAUT2) and self-determination theory. Through the use of an online survey and Structural Equation Modeling, data from 533 respondents were analyzed. The results showed that perceived relatedness has the most significant effect on the behavioral intention of students in using CAI as an educational tool, followed by perceived autonomy. It showed that students use CAI based on the objective and the possibility of increasing their productivity, rather than any other purpose in the education setting. Among the UTAUT2 domains, only facilitating conditions, habit, and performance expectancy provided a significant direct effect on behavioral intention and an indirect effect on actual academic use. Further implications were presented. Moreover, the methodology and framework of this study could be extended and applied to educational technology-related studies. Lastly, the outcome of this study may be considered in analyzing the behavioral intention of the students as the teaching-learning environment is still continuously expanding and developing.

Factors affecting medical students' intention to use Rain Classroom: a cross-sectional survey

BACKGROUND

Rain Classroom was one of the most popular online learning platforms in Chinese higher education during the pandemic. However, there is little research on user intention under the guidance of technology acceptance and unified theory (UTAUT).

OBJECTIVE

This research aims to determine factors influencing students' behavioural intention to use Rain Classroom.

METHODS

In this cross-sectional and correlational investigation, 1138 medical students from five medical universities in Guangxi Province, China, made up the sample. This study added self-efficacy (SE), motivation (MO), stress (ST), and anxiety (AN) to the UTAUT framework. This study modified the framework by excluding actual usage variables and focusing only on intention determinants. SPSS-26 and AMOS-26 were used to analyze the data. The structural equation modelling technique was chosen to confirm the hypotheses.

RESULTS

Except for facilitating conditions (FC), all proposed factors, including performance expectancy (PE), effort expectancy (EE), social influence (SI), self-efficacy (SE), motivation (MO), anxiety (AN), and stress (ST), had a significant effect on students' behavioural intentions to use Rain Classroom.

CONCLUSIONS

The research revealed that the proposed model, which was based on the UTAUT, is excellent at identifying the variables that influence students' behavioural intentions in the Rain Classroom. Higher education institutions can plan and implement productive classrooms.

Predicting the employment of teledentistry in clinical practice by the Saudi dental community using a theoretical model

Introduction

There are very few scholastic studies applying a theory-driven methodology to analyse the employment of teledentistry in clinical practice by the Saudi dental community. The objective of this research was to predict the employment of teledentistry in clinical practice by the Saudi dental community using the UTAUT (Unified Theory of Acceptance and Use of Technology) model.

Methods

A countrywide survey was executed from November 2022 to April 2023 among the dental community (pre-graduate students, graduates, post-graduate students, general dentists, and specialist dentists) involved in clinical practice. The survey employed the UTAUT model, which has four fundamental constructs: performance expectancy (PE), effort expectancy (EE), social influence (SI) and facilitating conditions (FC). These constructs are known to impact the user's behavioural intention (BI). The four fundamental constructs were independent, and BI was the dependent variable. A Likert scale with five scores was used to record each variable. Descriptive statistics were used to describe all the constructs. Cronbach's alpha scores were used to measure the inner consistency of the Likert scale. Simple linear regression and multiple linear regression were used to determine the correlation between all the constructs and the overall model's prediction. The Statistical Package for the Social Sciences was applied for analysis. The study had 80% power and an alpha threshold of .05.

Results

The electronic survey was sent to 3000 participants, out of whom 2143 responded (response rate = 71.43%). PE (R2= 26%, p < .01) was the most significant predictor of the Saudi dental community BI to employ teledentistry in clinical practice, followed by SI (R2= 24%, p < .01), EE (R2= 19%, p < .01) and FC (R2= 6%, p < .01). With statistically significant predictive power, the UTAUT model explained 32% of the variance in the BI (R2= 0.32, p < .01).

Conclusions

Each UTAUT construct and the entire model were significantly correlated with the employment of teledentistry in clinical practice by the Saudi dental community. PE had the most salient correlation, followed by SI, EE and FC. The participants have perceived the benefits of teledentistry, increasing the future likelihood of its utilisation. The Saudi government could consider the UTAUT constructs to promote teledentistry in tandem with Vision 2030.

Factors That Enhance and Hinder the Retention and Transfer of Online Pre-Clinical Skills Training to Facilitate Blended Learning

Purpose

During the SARS-CoV-2 pandemic, various online instructional strategies in clinical skills training were piloted. The sudden transition to the remote platform circumvented the rigorous planning associated with curriculum reform. This study aimed to explore students' and tutors' perceptions of factors that promoted or hindered successful learning transfer and to propose a blended conceptual model to guide affective, cognitive, and psychomotor clinical skills training in the pre-clinical phase of medical education.

Methods

A mixed-method quasi-experimental study assessed third-year students' transfer of clinical skills and knowledge following online learning in 2021. Students and their tutors completed online surveys that included open and closed-ended questions regarding factors influencing their experience of the adapted teaching methods. Descriptive statistical analysis was used for the quantitative data. Qualitative responses were thematically analyzed.

Results

One hundred fourteen students (48%) and seven tutors (100%) responded to the surveys. The questionnaires' internal consistency and construct validity were determined using Cronbach's α-Coefficient. There was an overall positive response (86%) to the acceptability of the online platform in clinical skills training. Using online simulations with targeted onsite practice was reported as effective in clinical skills training. Tutors perceived students as well-prepared for the skills laboratory. Five emergent themes, qualified by a linear model of asynchronous and synchronous online and onsite teaching with the evaluation of the instructional design and institutional support, informed the proposed blended learning guide for clinical skills training in the pre-clinical phase.

Conclusion

Blended clinical skills learning that included the flipped classroom concept was well-accepted. Virtual patients proved a convenient cognitive preparation tool for skills training and potentially optimized teaching delivery. The study found that the adapted teaching frameworks incorporating an online clinical skills component into a modified onsite curriculum augmented learners' ability to transfer knowledge to the clinical skills laboratory. An integrated five-step blended model is proposed for future interventions.

Exploring factors that influence the behavioural intention of medical students to use 3D gastroscopic model to learn how to operate gastroscope using UTAUT Model

BACKGROUND

The application of virtual reality (VR) in gastroscopic operation teaching can be safe and effective, but the advantages can be realized only when students accept and use it. This study aims to identify the factors influencing Chinese clinical medical postgraduates on their intention to use the 3D gastroscopic model constructed based on VR technology using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Students' demographic factors are also taken into consideration.

METHODS

All methods were carried out in accordance with relevant guidelines. Data were collected from clinical medical postgraduates students in China using stratified sampling. A total of 292 questionnaires including valid responses were used in this study. Data were processed using Amos 24.0 and SPSS 26.0 software and the statistical analysis technique was based on structural equation modeling (SEM).

RESULTS

The results showed that different from the mediator of home location and year of clinical learning, mediator of gender, university kind and graduate degree did not affect the behavioral intention. In addition, performance expectancy, facilitating condition, and social influence directly and indirectly have effect on behavioral intention. Also, the significance between social influence and performance expectancy, social influence and effort expectancy were verified.

CONCLUSIONS

This study manifested that the proposed framework based on the UTAUT had explanatory power to identify the factors influencing the students' behavioral intention to use the 3D gastroscopic model constructed based on VR technology. Whereas, an important variable of effort expectancy in the frame of the SEM were not certified, thereby indicating that particular attention should be paid to this variable by universities and teachers before applying 3D gastroscopic model constructed based on VR technology in teaching. Added preparatory work is required such as explaining the basic knowledge of the operating steps of VR model and make students adequately understand its accessibility, which can probably improve the intentions of them to use it. The positive effects of social influence on performance expectancy and effort expectancy we proposed was also verified in this study, which provided a direction for future research.

Acceptance of Smart Technologies in Blended Learning: Perspectives of Chinese Medical Students

Smart technologies are essential in improving higher education teaching and learning. The present study explores the factors that influence students' behavioural intentions to adopt and use smart technologies in blended learning. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT2) model, a survey of 305 students was conducted to collect data. A structural equation model was applied to analyse the data. The findings show that adopting smart technologies requires appropriate social context and organizational support. Moreover, the data indicated that performance expectancy, effort expectancy, social influence, hedonic motivation, and habit are vital in determining students' behavioural intention to use smart technologies. However, facilitating conditions and price value were found to have no significant impact on the students' behavioural intention to use smart technologies. The study contributes to a better understanding of the nexus of blended learning and smart technologies, thus improving students' experiences in blended learning settings.

A comparative analysis of the impact of online, blended, and face-to-face learning on medical students' clinical competency in the affective, cognitive, and psychomotor domains

BACKGROUND

The Coronavirus Disease-2019 (COVID-19) pandemic in South Africa compelled medical schools to switch to a purely online curriculum. The innovative changes transformed the standard clinical skills curriculum to increase learning transfer to bridge the theory-practice gap. The efficacy of this intervention remains unknown. This study aims to measure medical students' clinical competency in the affective, cognitive, and psychomotor domains by assessing clinical skills knowledge retention and transfer from the online platform compared to face-to-face and blended learning.

METHODS

A non-random cross-sectional quasi-experimental study assessed third-year medical students' knowledge retention and learning transfer in three domains of clinical skills competence. Data were obtained using a score sheet during a directly observed formative and a trial online summative assessment. One hundred and one third-year medical students volunteered for the formative onsite assessment that tested the psychomotor domain. Two hundred and thirty-nine students were evaluated on the affective and cognitive domains in the summative online trial mini-objective structured clinical examination (tm-OSCE). The OSCE scores were analysed using descriptive statistics. The significance of the findings was evaluated by comparing OSCE scores with the pre-pandemic 2019 third-year medical students.

RESULTS

Statistically significant differences were found between the two cohorts of medical students from both years (p < 0.05). The 2021 blended group's (n = 101) medians were 90%, 95%CI [86, 92], 82%, 95%CI [80, 85], and 87%, 95% CI [84, 90] for the psychomotor, affective, and cognitive skills, respectively. The e-learning group's affective and cognitive skills medians were 78%, 95%CI [73, 79] and 76%, 95%CI [71, 78], respectively. The 2019 face-to-face cohort (n = 249) achieved medians of 70%, 95% CI [69, 72] and 84%, 95%CI [82, 86] for the affective and psychomotor skills, respectively.

CONCLUSION

Medical students demonstrated near and far transfer bridging the theory-practice gap in three clinical skills domains. The blended group performed significantly better than the e-learning and face-to-face groups. Medical schools and educators play a vital role in overcoming learning challenges and achieving higher transfer levels by adopting multiple student-centered teaching delivery approaches and arranging immediate application opportunities. This study offers medical educators suggestions that encourage the transfer of online learning to face-to-face practice, decentralising medical education with a revised blended learning strategy.

Factors affecting business school students’ performance during the COVID-19 pandemic: A moderated and mediated model

The COVID-19 pandemic has directly influenced higher education by converting traditional face-to-face (F2F) learning to blended learning (BL). Because of this dramatic change in the academic environment, it is essential to evaluate student views and preferences and how the BL setting affects their academic performance. Therefore, the current research aims to investigate the relationship between Unified Theory of Acceptance and Use of Technology (UTAUT) constructs (performance expectancy, effort expectancy, and facilitating condition) and student academic performance through student attitude. We also examined the moderating role of trust in technology between UTAUT constructs and student performance. The study uses a sample of 1050 business management university students for mediation/moderation analysis using the Hayes Bootstrap technique. The results demonstrate that student attitude mediates the relationship between UTAUT constructs and student academic performance, with trust in technology strengthening the relationship. The study offers implications for universities and policymakers.

Factors predicting University students' behavioral intention to use eLearning platforms in the post-pandemic normal: an UTAUT2 approach with 'Learning Value'

The use of eLearning platforms has made it possible to continue the learning process in universities, and other educational institutions, during the Covid pandemic. Students' acceptance of eLearning is important because it is associated with their engagement in the online teaching-learning environment. This study used the Unified Theory of Acceptance and Use of Technology (UTAUT2: Venkatesh et al., 2012) to determine the factors predicting the behavioral intention of university students' to use eLearning platforms in the post-pandemic era. UTAUT2 was extended to include the constructs 'Learning Value' and 'Empowerment in Learning'. 314 students from different universities across Greece participated by completing an online questionnaire. Performance Expectancy, Social Influence, Hedonic Motivation, Learning Value and Habit had a significant impact on students' intention to use eLearning platforms to learn, while Facilitating Conditions and Learning Value had a direct impact on actual use. The findings enhance the research applying the UTAUT2 model, with the Learning Value, for the investigation of students' intention to use eLearning platforms in the post-Covid era. We suggest for Learning Value to be included in future research in an educational context.

The Effects of Contextual Factors, Self-Efficacy and Motivation on Learners' Adaptability to Blended Learning in College English: A Structural Equation Modeling Approach

Objective

Few research efforts have substantially introduced relevant studies on Chinese students' adaptability in relation to the ineffectiveness of blended learning mode in College English. This study is guided by social cognitive theory, and related literature has been reviewed concerning adaptability. In this study, we aim to examine the involved relationships among contextual factors, self-efficacy, motivation, and adaptability to blended learning mode among non-English majored Chinese learners in the College English course.

Methods

The quantitative research method was employed in this study, and 595 respondents were eventually collected to enable the data analysis. The structural equation modeling (SEM) approach was used to analyze the data.

Results

(1) The non-English majored learners' adaptability to blended learning mode in College English was at a low level with a mean value of 2.26, indicating that students still suffer difficulties from class conducted in blended learning; (2) the fit indices were at the level of good fit, and it suggested the structural model had an overall good fit to the data as shown: x 2/df = 2.496, RMESA = 0.050, GFI = 0.956, AGFI = 0.936, NFI = 0.968, RFI = 0.959, IFI = 0.980, TLI = 0.975, CFI = 0.980; (3) adaptability was positively related to contextual factors, self-efficacy, and motivation (p < 0.001); (4) contextual factors exerted an indirect effect on the adaptability not only through the separate mediating role of self-efficacy and motivation, but through the chain mediating role of self-efficacy and motivation (p < 0.01).

Implications

This study theoretically extends previous studies on adaptability by investigating the affecting factors in the framework of social cognitive theory. More practically important is that this study sheds light on the impact mechanism of positive and enjoyable environment, self-efficacy and motivation on non-English majored learners' adaptability to blended learning mode in English course, which would provide a vital insight for administrators and College English instructors to reconsider the role of learners' responses in the mixed mode to improve their English achievement more effectively, as well as to enhance and promote their user experience of the offered blended learning service.

Determining Factors Affecting the Acceptance of Medical Education eLearning Platforms during the COVID-19 Pandemic in the Philippines: UTAUT2 Approach

eLearning has been the medium of delivery of medical educational institutions to address the scarcity of medical professionals during the COVID-19 pandemic. In this study, the Unified Theory of Acceptance and Use of Technology (UTAUT2) was extended to determine the factors affecting the acceptance of eLearning platforms to medical education in the Philippines during the COVID-19 pandemic. A total of 360 medical students voluntary participated and answered an online questionnaire that consisted of 40 questions. Structural Equation Modeling (SEM) indicated that performance expectancy was found to have the highest effect on behavioral intention, which was followed by learning value and instructor characteristics. A high behavioral intention was found to affect the actual use of eLearning platforms. Interestingly, social influence and habit were found not to be significant to behavioral intentions. This study is the first study that has explored the acceptance of eLearning platforms among medical students in the Philippines during the COVID-19 pandemic. The findings can be a theoretical guideline of the Commission on Higher Education of the Philippines for eLearning platforms. Finally, the framework would be very valuable for enhancing the open innovation in eLearning platforms in medical fields worldwide.

Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students' learning outcome about approach to coma

BACKGROUND

New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma.

METHODS

We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students' learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software.

RESULTS

Students' familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = - 2.457, P = 0.019).

CONCLUSION

Students' learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students' learning.