Effectiveness of Blended Versus Traditional Refresher Training for Cardiopulmonary Resuscitation: Prospective Observational Study

BACKGROUND

Generally, cardiopulmonary resuscitation (CPR) skills decline substantially over time. By combining web-based self-regulated learning with hands-on practice, blended training can be a time- and resource-efficient approach enabling individuals to acquire or refresh CPR skills at their convenience. However, few studies have evaluated the effectiveness of blended CPR refresher training compared with that of the traditional method.

OBJECTIVE

This study investigated and compared the effectiveness of traditional and blended CPR training through 6-month and 12-month refresher sessions with CPR ability indicators.

METHODS

This study recruited participants aged ≥18 years from the Automated External Defibrillator Donation Project. The participants were divided into 4 groups based on the format of the CPR training and refresher training received: (1) initial traditional training (a 30-minute instructor-led, hands-on session) and 6-month traditional refresher training (Traditional6 group), (2) initial traditional training and 6-month blended refresher training (an 18-minute e-learning module; Mixed6 group), (3) initial traditional training and 12-month blended refresher training (Mixed12 group), and (4) initial blended training and 6-month blended refresher training (Blended6 group). CPR knowledge and performance were evaluated immediately after initial training. For each group, following initial training but before refresher training, a learning effectiveness assessment was conducted at 12 and 24 months. CPR knowledge was assessed using a written test with 15 multiple-choice questions, and CPR performance was assessed through an examiner-rated skill test and objectively through manikin feedback. A generalized estimating equation model was used to analyze changes in CPR ability indicators.

RESULTS

This study recruited 1163 participants (mean age 41.82, SD 11.6 years; n=725, 62.3% female), with 332 (28.5%), 270 (23.2%), 258 (22.2%), and 303 (26.1%) participants in the Mixed6, Traditional6, Mixed12, and Blended6 groups, respectively. No significant between-group difference was observed in knowledge acquisition after initial training (P=.23). All groups met the criteria for high-quality CPR skills (ie, average compression depth: 5-6 cm; average compression rate: 100-120 beats/min; chest recoil rate: >80%); however, a higher proportion (98/303, 32.3%) of participants receiving blended training initially demonstrated high-quality CPR skills. At 12 and 24 months, CPR skills had declined in all the groups, but the decline was significantly higher in the Mixed12 group, whereas the differences were not significant between the other groups. This finding indicates that frequent retraining can maintain high-quality CPR skills and that blended refresher training is as effective as traditional refresher training.

CONCLUSIONS

Our findings indicate that 6-month refresher training sessions for CPR are more effective for maintaining high-quality CPR skills, and that as refreshers, self-learning e-modules are as effective as instructor-led sessions. Although the blended learning approach is cost and resource effective, factors such as participant demographics, training environment, and level of engagement must be considered to maximize the potential of this approach.

TRIAL REGISTRATION

IGOGO NCT05659108; https://www.cgmh-igogo.tw.

Assessment of a Teaching Module for Cardiac Auscultation of Horses by Veterinary Students

Auscultation of heart sounds is an important veterinary skill requiring an understanding of anatomy, physiology, pathophysiology and pattern recognition. This cross-sectional study was developed to evaluate a targeted, audio-visual training resource for veterinary students to improve their understanding and auscultation of common heart conditions in horses. Fourth- and fifth-year 2021 and 2022 Bachelor of Veterinary Science students at the University of Queensland (UQ) were provided the learning resource and surveyed via online pre- and post-intervention surveys. Results were quantitatively analyzed using descriptive statistics and Mann-Whitney U tests. Open-ended survey questions were qualitatively analyzed by thematic analysis and Leximancer™ Version 4 program software analysis. Over the two-year period, 231 fourth-year and 222 fifth-year veterinary students had access to the resource; 89 completed the pre-intervention survey and 57 completed the post-intervention survey. Quantitative results showed the resource helped students prepare for practicals and their perception of competency and confidence when auscultating equine cardiac sounds improved (p < 0.05). Compared to fifth-year students, fourth-year students felt less competent at identifying murmurs and arrythmias prior to accessing the learning resource (p < 0.05). Fourth-year and fifth-year students' familiarity with detection of murmurs improved after completing the learning resource (p < 0.001). Qualitative analysis demonstrated a limited number of opportunities to practice equine cardiac auscultation throughout the veterinary degree, especially during the COVID-19 pandemic, and that integrated audio-visual resources are an effective means of teaching auscultation.

Creation and evaluation of a self-directed, first-year intervention for pre-health undergraduates: setting students up for success

University-established modalities to help undergraduate students navigate the path to medical school are often implemented toward the end of college or following graduation. This imposes cost and time burdens that may be contribute to the high rate of premedical attrition, especially for students who are members of a marginalized community. In the fall 2022 semester, an asynchronous, self-directed pre-health module was offered to biology majors at the University of North Carolina at Chapel Hill enrolled in a required introductory biology research skills course. The objective of the five-lesson intervention was to enhance student understanding of the path to becoming a successful applicant early in their college career. The module aimed to increase the accessibility of pre-health advising and was designed to be easily shared and adapted across various learning management systems. A pre- and post-module survey was administered to assess changes in students' perceived understanding of and confidence for success on the pre-health track following completion of the course.

Are YouTube videos about skull bone anatomy useful for students?

The aim of this study was to evaluate the content, quality, and functionality of YouTube videos on the anatomy of skull bones and to measure their educational usefulness. In this cross-sectional study, the keywords "skull bones" and "skull anatomy" were searched in the YouTube search tab. Demographic data such as type, source, duration, upload date, and view rates of the videos were recorded. The quality and content of the videos were measured using the total content score (TCS), modified DISCERN scale, JAMA score, and Global Quality Scale (GQS). SPSS 26.0 software was used for statistical analysis. Twenty-five (34.7%) of the first 72 videos found by keyword searches were included in the study. According to the GQS criteria, six of them (24%) were considered useful and 19 (76%) not useful. There was a strong statistically significant correlation between the GQS and DISCERN scores (r = 0.813, p < 0.001). There were strong statistically significant positive correlations between TCS and GQS scores (r = 0.887, p < 0.001) and between TCS and modified DISCERN scores (r = 0.691, p < 0.001). Additionally, there was a moderately strong statistically significant positive correlation between GQS and JAMA scores (r = 0.507, p < 0.05). There were also moderately strong statistically significant correlations between JAMA score and DISCERN score (r = 0.521, p < 0.001), video length (r = 0.416, p < 0.05), number of comments (r = 0.457, p < 0.05), and number of "likes" (r = 0.608, p < 0.001). There was a moderately strong statistically significant positive correlation between TCS and JAMA scores (r = 0.431, p < 0.05). Most YouTube videos have insufficient information about skull bones to meet the expectations of medical and dental school curricula. Anatomists and institutions should be encouraged to prepare and present YouTube videos using assessment systems such as DISCERN, JAMA, GQS, and TCS, in line with current anatomy curricula.

Education and learning: potential methodological and ethical issues in systematic reviews containing a meta-analysis: some critical reading suggestions for junior doctors

Junior doctors make clinical decisions regularly; therefore, they need to adequately interpret the evidence supporting these decisions. Patients can be harmed if clinical treatments are supported by biased or unreliable evidence. Systematic reviews that contain meta-analyses of randomized controlled trials are a relatively low-biased type of evidence to support clinical interventions. Therefore, it is reasonable to think that doctors will likely select this type of study to answer clinical questions. In this article, doctors are informed about potential methodological and ethical issues in systematic reviews that contain a meta-analysis that are sometimes not easily identified or even overlooked by the current tools developed to assess their methodological quality or risk of bias. The article presents a discussion of topics related to data extraction, accuracy in reporting, reproducibility, heterogeneity, quality assessment of primary studies included in the systematic review, sponsorship, and conflict of interest. It is expected that the information reported will be useful for junior doctors when they are reading and interpreting evidence from systematic reviews containing meta-analyses of therapeutic interventions, mainly those doctors unfamiliar with methodological principles.

What means civic education in a digitalized world?

The hope of reaching diverse and large target groups has motivated civic education practitioners to offer their content on social media. The question has therefore long ceased to be whether civic education should take place on the internet, but rather how civic education goals can be implemented digitally to foster civic literacy. At first glance, the possibility of reaching a broad audience in a short time seems tempting. At a second glance, social media reveals several challenges that can impair educational processes. The present paper discusses the following questions: What are the opportunities and pitfalls of civic education in social media? How can we ensure successful civic education in a digitalized world? In our article, we want to provide an interdisciplinary perspective on the topic by drawing among others from the literature in the fields of media psychology, communication studies, and education science. By integrating insights from various disciplines, our paper seeks to enrich the academic dialogue and to promote a nuanced understanding of the evolving dynamics of civic education in the digital realm. With its practical focus, our paper further aims to underscore the applicability of scientific research.

What Do Pediatric Subinterns Say About Their Learning and Assessment? A Qualitative Analysis of Individual Learning Plans

OBJECTIVE

To perform a qualitative content analysis of learning and assessment strategies that pediatric subinterns describe in Individualized Learning Plans (ILPs) and to explore barriers and facilitators to their learning.

METHODS

We analyzed ILPs from medical students enrolled in pediatric subinternships at 10 US medical schools that utilized a standardized curriculum and were recruited to reflect diversity in geographic location, funding, and enrollment. Students used an ILP to record 3 or more selected learning objectives, rationale for selection, and reflection on learning and assessment strategies. Investigators used the constant comparative method to perform a content analysis of the ILPs, grouping codes into themes, and verifying relationships between codes within themes.

RESULTS

Two hundred and four ILPs that included student reflections on 850 learning objectives were analyzed. Content was analyzed in 5 categories: rationale for selecting objectives, learning strategies, assessment strategies, challenges to learning, and facilitators of learning. Students showed strong commitment to individualized, self-directed learning, developed a wide range of creative learning strategies, and relied heavily on self-reflection to assess their progress. The learning environment both helped and hindered students' ability to make and assess progress on their selected learning objectives.

CONCLUSIONS

Through ILP-guided reflection and a formal curriculum, students can choose well-justified learning objectives and demonstrate resourcefulness and independence in developing self-directed learning and assessment strategies. The strategies that students identified in this study provide a menu of learning and assessment options for subinterns. Identified challenges and facilitators of learning provide guidance for educators who seek to enhance the clinical learning environment.

Innovative Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise (SPLICE) modules promote critical thinking skills, early clinical exposure, and contextual learning among first professional-year medical students

Medical education is undergoing various transformations to promote a more personalized and contextual way of learning. In light of this, the innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) modules were designed, implemented, and evaluated for medical students in the first professional year as a strategy for early clinical exposure in a collaborative and self-directed way of learning. This is a mixed methods study involving first-year medical students. Students were divided randomly into the control and the intervention groups. Six SPLICE modules were administered to the intervention while the control group followed the traditional curricula. The educational outcome was compared using an end-of-module assessment. In addition, 13-item and 8-item questionnaires were administered to students to evaluate the SPLICE and plenary sessions on a 5-point Likert scale. Furthermore, students' feedback was obtained on a 10-point rating scale and in in-depth small-group interviews. The majority of students perceived that the SPLICE module improved their communication and encouraged meaningful, active learning. Students found the plenary sessions to be well organized, with sufficient interaction with professionals. Students also gave excellent scores for feedback on SPLICE modules, demonstrating the effectiveness of the innovation. In terms of test scores used in assessing learning outcomes, the intervention group outperformed the control group (P < 0.0001). The innovative SPLICE curriculum facilitated early clinical exposure and active self-directed learning. Students perceived SPLICE modules to be highly helpful in terms of promoting meaningful learning and the future application of knowledge.NEW & NOTEWORTHY The very essence of this innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) curriculum is the team-based learning of integrated pre-, para-, and clinical learning objectives right from the first professional year of study serving as an early clinical exposure. This unique way of learning creates a holistic educational environment by combining both academic and professional development thereby empowering the next generation of physician leaders to take autonomy of their own learning strategies and emerge as competent lifelong learners.

E-classroom as a Blended Learning Tool: A Structural Equation Modelling Analysis Using Modified Technology Acceptance Model

BACKGROUND

E-classrooms help teachers save time, keep classes organized, and improve communication with students. This study aims to assess Google Classroom's usefulness in enhancing medical students' knowledge and acceptance of new technology for in-depth learning.

MATERIAL AND METHOD

This educational interventional study was carried out on 100 students in the 3rd year of the M.B.B.S., Part 1. After a briefing about Google Classroom and educational topics, enrolled students and faculty were allowed to discuss the topic for two months. Following this, the descriptive approach was utilized to describe the respondents' technology acceptance through the administration of the technology acceptance model (TAM) survey questionnaire.

RESULTS

Students were actively involved in discussion, with a 67% response rate. Nearly 85% of students agreed that Google Classroom is a satisfactory way for in-depth knowledge acquisition. On factor analysis, it was observed that the goodness of fit was 0.985, suggesting that the model is acceptable. It was also found that perceived usefulness (PU) had a significant positive effect on motivation towards self-directed learning (SDL), and perceived ease of use (PEOU) had a positive effect on both behavioural intention and actual use.

CONCLUSION

Google Classroom is a valuable tool for learning that can enhance active self-learning and increase behavioural intention and actual use. It should be incorporated into day-to-day teaching activities to overcome time constraints.

Twelve tips for teaching culturally and socially responsive care to medical students

In recent years, discourse on topics like cultural humility, social determinants of health (SDOH), and health disparities and inequities has greatly increased in medical education as attention to their impact on health has magnified. Unfortunately, traditional medical education models may fail to optimize learning in this area. To address these complex social health issues, we must find innovative ways to engage students in an educational partnership in which they are challenged to critically think and reflect on their attitudes, role, and actions in health equity and culturally responsive care. Through reviews of existing literature coupled with our own experience with iterative implementation of a model that includes interpersonal engagement paired with individual self-directed learning, we assembled 12 tips on how to prepare diverse students to practice lifelong cultural humility and provide culturally and socially responsive care in an ever-changing social landscape.

Student-directed learning in a LIC: How do they find it? An exploration into the medical students' perceptions of the utility of the self-directed component ('white space') of the Longitudinal Integrated Clerkship in the ScotGEM curriculum

BACKGROUND

Scottish Graduate Entry Medicine (ScotGEM) is a new four-year graduate entry medical programme. During the third year, students undertake a Longitudinal Integrated Clerkship (LIC) where they are integrated into one General Practice for two and a half days a week. The remaining time is 'white space', allowing students to undertake placements and portfolio work; while directing their learning.

AIMS

To explore the students' perceptions of the utility of the 'white space' of the ScotGEM LIC. Secondary aims were to explore the positive aspects of this space, the challenges of utilising this space and to explore any difference in the 'white space' between LIC regions.

METHODS

An explorative case study methodology was utilised and semi-structured interviews were conducted with third and fourth-year students. 13 interviews were transcribed for inductive thematic analysis.

FINDINGS

Four themes were established: the students' usage of the 'white space'; the tools they used to guide learning in this space; regional variations in LIC experiences and they offered suggestions to improve the utility of this space.

DISCUSSION AND CONCLUSION

The findings are detailed and integrated with relevant literature to inform recommendations for future LIC practice and suggestions for future research are offered.

Information and Communication Technology Adoption Strategies Among Iranian Older Adults: A Qualitative Evaluation

In today's world, it is unavoidable for older adults to use technology, which causes some challenges for them. In this qualitative study, we used grounded theory to evaluate information and communication technology (ICT) adoption strategies among Iranian older adults. The participants included 18 older adults, five experts, and five family members of older adults. The data collection method included conducting semi-structured interviews, taking field notes, and observation. The data were analyzed using the Corbin and Strauss approach. Three main themes were extracted as follows: support from others, effort for learning, and smart choice. The subthemes of support from others included creativity in educating older adults; having access to an educational supporter; and receiving informational, emotional, and financial support. The subthemes of effort for learning included utilizing aids, adaptive measures, shortcut techniques, and self-learning. The subthemes of smart choice included physical characteristics, technical features, price sensitivity, and availability of an active sales representative. Accordingly, it is essential to teach older adults to increase their ICT adoption rate and continued use of technology. In this respect, developing a standard ICT manual for older adults can be beneficial.

A 10-Step Process to Align Problem-Based Learning With Accreditation Expectations for Self-Directed and Lifelong Learning

OBJECTIVE

Self-directed and lifelong learning (SDLL) skills are essential skillsets in both undergraduate and graduate medical education (UME and GME). Hence, medical schools' accreditation bodies emphasize the requirements to acquire these skills in their accreditation standards. For example, in the United States, the Liaison Committee on Medical Education (LCME) clearly defines the components of the SDLL process in Element 6.3 of Accreditation Standard Six. Among the active learning pedagogies, problem-based learning (PBL) provides ample learning opportunities where SDLL skills are effectively applied. The aim of this article is to streamline the process of developing, delivering, and evaluating PBL sessions in line with the SDLL accreditation requirements through a 10-step design and implementation process.

METHODS

Our 10-step process, detailed in the article, starts with developing learning objectives that inform the content of the PBL case and the required embedded learning triggers. The process carefully addresses the components of the SDLL process and other aspects of the accreditation needs within the framework of PBL. The approach to implementation, feedback, assessment, and evaluation is explicitly described to meet the regulatory expectations.

DISCUSSION

In addition to the essential role in UME and GME, SDLL skills are vital requisites for continuing medical education of all physicians. Instilling this skillset early in medical students helps to cultivate their ability to apply these skills in their future professional roles. Using accreditation standards as a foundation for creating learning experiences, for example, PBL, requires careful content development and sequencing. Such a process needs explicit standardized steps that should not only be feasible, but also transferable for usage by different medical schools.

CONCLUSION

Our streamlined 10-step process of designing and delivering an SDLL-oriented PBL experience can easily be adopted by other medical schools to address the SDLL skills acquisition as well as meeting the accreditation requirements.

The effects of musical feedback training on metacognition and self-directed learning

Introduction

Metacognition and self-directed learning are key components in educational research, recognized for their potential to enhance learning efficiency and problem-solving skills. This study explores the effects of musical feedback training on these competencies.

Methods

The study involved 84 preservice teachers aged 18 to 21. Participants were randomly assigned to either an experimental group, which received musical feedback training, or a control group.

Results

The findings indicate that musical feedback training effectively improved metacognitive abilities. However, its impact on the readiness for self-directed learning was inconclusive. A notable difference in metacognition and self-directed learning readiness was observed between the experimental and control groups during the session, indicating a significant interaction effect. Furthermore, a positive correlation was identified between metacognition and self-directed learning.

Discussion

These results contribute to educational discourse by providing empirical evidence on the utility of musical feedback training in fostering metacognition. They also highlight the importance of consistent and long-term engagement in self-directed learning practices. The significance of these findings advocates for incorporating music feedback training into music education curricula to enhance metacognition and improve overall learning efficiency.

Planning and implementation of participant-centric group activity on research methodology: perceptions of postgraduate medical students in physiology

Knowledge about the key steps in "research methodology" is necessary for all postgraduate students who are enrolled in the medical profession. The objective of the present study was to plan, design, and implement a participant-centric postgraduate skill development activity to inculcate the key principles and components of research methodology. It included 3 goal-oriented component group exercises, namely, 1) framing a research question, 2) critiquing a research article, and 3) writing a research protocol. Out of 25 eligible postgraduate students of our department, 20 participated in all three component group exercises, and they were included in the study. Feedback was obtained from them on a five-point Likert scale after the group exercises. In addition, students were also asked to provide open-ended comments for further improvement of the session. Data from participants' feedback suggested that the majority of the participants expressed satisfaction regarding the plan, conduct, and learning experience of the postgraduate activity. Therefore, participant-centric group activity could be an innovative approach in postgraduate medical education to inculcate the basics of research methodology. It can provide additional emphasis on the components of self-directed learning through individual exercises and unsupervised group dynamics. Supervised group dynamics can inculcate skills in critical thinking, acceptance, communication skills, and teamwork.NEW & NOTEWORTHY Postgraduate medical education is underpinned by supervised and unsupervised learning processes. The current study incorporates an innovative approach to inculcate the basic skills of "research methodology" through three goal-oriented participant-centric group exercises, namely, 1) framing a research question, 2) critiquing a research article, and 3) writing a research protocol. The activities encompass components of self-directed learning through unsupervised group dynamics. They focus on critical thinking, acceptance, communication skills, and teamwork during supervised group dynamics.

Strategies to support self-regulated learning in integrated, student-centered curricula

PURPOSE

With undergraduate medical education shifting to an integrated, student-centered approach, self-regulated learning (SRL) skills are critical for student success. Educational research holds that learning strategy effectiveness is context dependent. Our study aims to explore what strategies medical students use to support SRL when engaged in the specific context of an integrated, student-centered curriculum.

APPROACH

This study took place in two medical schools with integrated, student-centered curricula. Semi-structured interviews were conducted with first-year medical students from both schools, asking them to reflect on the learning strategies they used throughout their first year of medical school. Interview data was analyzed first deductively using the SRL framework and then inductively to understand the specific strategies being used.

FINDINGS

Students engaged in strategies to support SRL in ways that were unique to the integrated, student-centered context. We found that medical students developed strategies to plan for integration and building connections across material during all three phases of self-regulated learning.

INSIGHTS

By identifying specific tasks and behaviors students utilized during their first year of medical school, this study provides a roadmap that students and educators can use to help students become self-regulated learners.

Effects of Infection Control Education Program Using Flipped Learning Based on the ARCS Model for Nursing Students: A Mixed Method

This study was conducted to verify the effect of an infection control education program, using flipped learning based on the ARCS model, for nursing students. The study was a mixed-method study, composed of a nonequivalent control group, a pretest-posttest design, and focus group interviews. The total number of participants was 37, with 18 in the experimental group and 19 in the control group. The mean age of the participants was 24.32 ± 5.60 years, consisting of three males (8.1%) and thirty-four females (91.9%). The collected data were analyzed using a linear mixed-effects method. The data regarding experiences of participation were analyzed using conventional content analysis. The experimental group had a higher degree of learning motivation, self-directed learning ability, and confidence in infection control practice than the control group. In the results of the focus group interviews, the themes were derived from 'Engaging learning experience, although difficult, in new ways of learning'. It was confirmed that the infection control education program, using flipped learning based on the ARCS model, was an effective intervention for improving nursing students' self-directed learning ability. Therefore, it is strongly recommended to use the educational program developed in this study for infection control education for nursing students and new nurses.

Guided self-study in preclinical physiotherapy students - A feasibility study

Background

Literature describing the impact of guided self-study (G-SS) in knowledge changes and skills improvements in undergraduate students is scarce.

Objectives

The aims of our study were to evaluate the feasibility of a G-SS programme in a full-time undergraduate physiotherapy degree course and to assess the effectiveness of the G-SS on changes in knowledge and development of skills (hands-on).

Method

Fifty-three first-semester undergraduate physiotherapy students were randomly divided into a G-SS group and a control group (CG). The G-SS group received six clinical cases and prepared each case during an 8-day cycle. The control group received self-study learning units of the original curriculum content. Primary outcome parameters were (1) time of task, (2) responsiveness of students and (3) programme differentiation. Knowledge changes and skills changes were tested using a multiple-choice questionnaire and the objective structured clinical examination (OSCE).

Results

Students' responsiveness was 32%. This was below the a priori set 83%. No differences in programme differentiation were found. The OSCE grade was significantly higher in the G-SS compared to CG (p = 0.003).

Conclusion

The G-SS programme in its current form was not feasible regarding students' responsiveness. Therefore, a slight modification of our study protocol (e.g., better time planning in the academic calendar) is needed to improve students' willingness to participate in the G-SS programme.

Clinical implications

Adaptation of the school timetable should allow undergraduate physiotherapy students to prepare clinical cases under conditions of lower workload. Guided self-study as compared to CG is superior in knowledge change and (hands-on) skills improvement.

Initial efforts to improve medical student information-seeking behavior with embedded library instruction

Background

Medical students must develop self-directed information-seeking skills while they are learning vast amounts of foundational and clinical skills. Students will use different resources for different phases of their training. Information literacy training provided to students will be more impactful when it is embedded into courses or assignments that mimic real-world scenarios. The retention of these skills is also improved by early and frequent instruction sessions, paired with formative feedback from librarian-educators.

Case Presentation

Librarians received student responses to an information literacy question during two cycles of a Grand Rounds activity. Data were analyzed as follows: sources were grouped according to resource type and assessed for quality, and search terms were aggregated and analyzed to determine frequency of use. A librarian-educator presented the compiled data, making suggestions for improving searching and clarifying expectations for how to improve their resource choices for a second Grand Rounds session. Comparing the M2 Grand Rounds case to the M1 case of the same cohort, the frequency of evidence summary and diagnostic tool use increased and the frequency of search engine, textbook/lecture material, and journal article/database use decreased.

Discussion

In the real-world application of back-to-back Georgetown University's Medical Center Grand Rounds exercises, librarian-led instruction on clinical-specific resources appears to be correlated with an improvement in medical students' searching behavior. This trend supports the argument that introducing students early to librarian-led education on clinical-specific resources, and providing feedback on their searches, improves students' information-seeking behavior.

Assessing the Merits and Effectiveness of Peer Teaching in Small Groups through the Employment of Different Learning Media

Background  Peer teaching is a well-acknowledged method to facilitate teaching and learning among medical students. The objective of the study was to assess the merits and effectiveness of peer teaching in small groups using a student-centered approach through the employment of different learning media. Methods  This was a cross-sectional descriptive study conducted among a group of 34 students from third professional year. Purposive sampling was used, wherein students were subdivided into five small groups. At the beginning, a pretest consisting of 10 multiple-choice questions was conducted on the topic "Epidemiology of Hypertension." This topic was further subdivided into five subtopics, and five separate learning media (viz., video, PowerPoint, white board, chalk-and-talk, and chart) were allocated using the lottery method. Each group discussed the allotted topic and then presented their findings in the large group using the assigned learning media, while other groups gave feedback, and the best group was decided through multivoting. Posttest was administered and the results were compared with the pretest. Data entry was done in Microsoft Excel and analysis was done using SPSS 16. Descriptive statistics and paired t -test was used to compare the results in pretest and posttest at p level < 0.05. Results  This innovative session of peer teaching featured 34 students, with a mean age of 22 ± 1.3 years. While carrying out the Kirkpatrick Level 1 evaluation, almost 90% students liked the role of the facilitator in stimulating interest in the topic. There was a mean average increase of 1.7 marks on comparing the scores of posttest with pretest (Kirkpatrick Level 2), and the reported difference was statistically significant. Joyful learning 24 (66.7%) and group discussion 23 (63.9%) emerged as the most liked aspects of the session. Conclusion  In conclusion, peer teaching through learning media is an effective method as it promotes active learning, improves communication skills, and improves the academic performance of students. Peer teaching using different learning media proved to be quite effective in improvement of knowledge about epidemiology of hypertension, the pros and cons of different learning media, and encouraged creativity among students.

Predicting student-teacher self-directed learning using intrinsic and extrinsic factors: a Theory of Planned Behavior adoption

Introduction

This study set out to develop a model that illustrates the causal relationship between factors influencing Thai student-teacher self-directed learning (SDL). To achieve this, the authors analyzed and applied the Theory of Planned Behavior (TPB) to investigate the role of family support, teacher support, friend support, fellow students, and the university in influencing SDL.

Methods

The research used a sample of 468 student-teachers from five academic majors randomly selected from the King Mongkut's Institute of Technology Ladkrabang (KMITL) Bachelor of Industrial Education Program during the 2021 academic year. The authors developed a questionnaire which was evaluated from both a panel of experts and a 30 student-teacher pilot test which found that item reliability was acceptable. LISREL 9.10 was used to analyze the data from the study's structural equation model path analysis.

Results

The results revealed that all the causal variables in the model positively influenced SDL, explaining the variance of influencing factors on SDL (R2) at 51%. SDL comprised five variables, when ranked in order of importance these were fellow students (FSt), teacher support (TS), family support (FS), friend support (FrS), and their university (Uni). The study also highlighted issues concerning each student-teacher's learning time management ability and their perception of the university's ability/willingness to allow each individual to choose their course, thus enhancing their SDL learning ability skills.

Discussion

It was speculated that some university educators even today perceive SDL as an adult education tool which they perceive is not appropriate at the university level. The authors also felt that for younger student-teachers that the COVID-19 medical emergency limited teacher/student/university interaction, thus contributing to student misconceptions about support availability. This study contributes significantly to the literature by investigating how TPB intrinsic and extrinsic factors impact a university student's self-directed learning.

Effect of blended self-directed learning on nursing students: Quasi-experimental approach

BACKGROUND

Higher education institutions are adapting and innovating like never before to provide highly individualized learning environments for both traditional and non-traditional students. This seismic upheaval in the higher education landscape is being observed across the world. The present study aimed to evaluate the effectiveness of a blended learning approach on nursing students' self-directed learning readiness.

MATERIALS AND METHODS

This study is a quasi-experimental approach in which a non-equivalent control group was used in a post-test design. A comparison was carried out with two separate semester cohort students representing the control and intervention groups which had 24 and 30 students, respectively. This study included first-year nursing students that enrolled in a course called "Anatomy and Physiology" course of nursing education at a private university. The control group received all their teaching face-to-face, and the intervention group used information technology and prescribed activities in their online e-book. The self-directed learning readiness (SDLR) tool measures the learners' readiness in self-directed learning in both groups. This scale comprises three subscales which are "self-management," "desire for learning," and "self-control." An independent-samples t-test was conducted to compare self-directed learning readiness in the control and intervention groups. Data were analyzed using IBM SPSS Statistics 25 software to measure the independent t-test.

RESULTS

The self-directed readiness scores were significantly higher in the intervention group with P = 0.019. The intervention group showed a higher mean value on the subscales of self-management and self-control, which demonstrated a significant difference with P values of 0.018 and 0.028, respectively. The subscale desire for learning was insignificant with a P value of 0.166.

CONCLUSION

This study concluded that the overall results demonstrate that incorporating blended learning using e-books for anatomy and physiology courses in nursing education can contribute to students' readiness for self-directed learning. Specifically, the blended learning teaching and learning strategy had a positive impact on nursing students' capacity for self-management and self-control.

Predicting Academic Self-Efficacy Based on Self-Directed Learning and Future Time Perspective

The purpose of this study was to investigate the relationship between teacher candidates' academic self-efficacy, self-directed learning, and future time perspective. A dual-stage analytical approach, utilizing both traditional structural equation modeling (SEM) and Machine Learning Classification Algorithms, was employed to test the proposed hypotheses. The study included a sample of 879 teacher candidates. The SEM analysis revealed that self-directed learning had a significant positive effect on academic self-efficacy. Furthermore, future time perspective was found to significantly predict academic self-efficacy. The combined endogenous constructs accounted for a substantial portion of the explained variance. Additionally, the study employed LMT and Multiclass classifiers from Machine Learning algorithms to predict academic self-efficacy. In summary, the findings of this study suggest that self-directed learning and future time perspective are significant factors in predicting teacher candidates' academic self-efficacy. The study utilized both traditional SEM and Machine Learning algorithms to provide a comprehensive analysis of the relationships between these variables.

Direct and indirect effects of self-directed learning on creativity in healthcare undergraduates: a chain mediation model of openness to challenge and diversity and creative self-efficacy

Background

Creativity and self-directed learning (SDL) are prominent for undergraduate healthcare students to provide quality patient care in an increasingly complex healthcare environment. Research suggested that SDL is linked with creativity, yet the mechanism underlying the relationship between SDL and creativity has not been fully understood.

Objective

This study examined the relationship between SDL and creativity and constructed a chain mediation model to identify the mediating effect of openness to diversity and challenge (ODC) and creative self-efficacy (CSE).

Methods

Through convenience sampling, 575 healthcare undergraduates (average age = 19.28 years, SD = 1.124 years) were surveyed from Shandong Province in China. Creativity, SDL, ODC, and CSE were assessed using corresponding scales. Pearson's correlation analysis, hierarchical multiple linear regression analysis, a serial multiple mediation analysis, and bias-corrected percentile Bootstrap method were conducted by using structural equation modeling by AMOS 26.0.

Results

The direct path between SDL and creativity was significant. SDL can positively predict both ODC and CSE, and the latter two variables can significantly and positively predict creativity. ODC and CSE played a significant partial mediating role in the relationship between SDL and creativity. The mediating effect consists of three indirect effects: SDL → ODC → creativity (the mediating effect value is 0.193, p = 0.012), SDL → CSE → creativity (the mediating effect value is 0.096，p = 0.001), and SDL → ODC → CSE → creativity (the mediating effect value is 0.035, p = 0.031).

Conclusion

SDL can positively predict creativity. ODC and CSE had significant mediating effects between SDL and creativity, including single partial mediating effects of ODC and CSE and chain mediating effects of ODC-CSE.

Application of problem-based self-designed experiments in physiology laboratory teaching

A physiology laboratory course plays an important role in improving the scientific abilities of medical students. This study involved a teaching reform based on problem-based self-designed experiments in a physiology laboratory course. The study subjects were divided into two groups, i.e., students enrolled in 2019 were assigned to the traditional course control group (n = 146) and students enrolled in 2021 were assigned to the improved course test group (n = 128). Students in the test group were required to conduct self-designed experiments based on the questions for each experimental theme, in addition to completing the specified experimental items. At the end of the course, the differences in academic achievements between the two groups were compared. The results showed that compared to the control group, the students in the test group spent less time finishing the specified experimental items (P < 0.05). More students in the test group obtained good results in the operation assessment for the specified experiments (P < 0.05), and a significant increase in the number of winners in discipline-wise competitions, participants in scientific research projects, and academic publications was observed in the test group. Most of the students in the test group agreed that the self-designed experiment promoted their scientific thinking, helped them better understand theoretical knowledge, and improved their hands-on operation and team cooperation abilities. Our research showed that our teaching reform promoted students' self-directed learning and problem-solving abilities, stimulated their enthusiasm for scientific research, and was conducive to the cultivation of innovative medical talents.NEW & NOTEWORTHY This study involved a teaching reform based on problem-based self-designed experiments in a physiology laboratory course. Students in the test group were required to conduct self-designed experiments based on questions for each experimental theme, in addition to completing the specified experimental items. The results showed that the teaching reform promoted the students' self-directed learning and problem-solving ability, stimulated their enthusiasm for scientific research, and was conducive to cultivating innovative medical talents.

Transformative community projects in East Germany's rural spaces: exploring more sustainable forms of learning, working, and living

Increasingly people experience alienation in educational institutions, in work life, and fragmentation in their personal life. This study explores more self-determined, healthy, and sustainable forms of working, learning, and living through a dynamic process that began in 2020 with the purchase of an old homestead in Eastern Germany. Through the remodeling of the buildings and grounds, the first social and cultural references emerged. Along with practical uses, the farm project sees itself as a future workshop or think tank. The resulting consideration includes ideas of compulsory schooling woven into a self-designed format and the introduction of an unconditional basic income. These components could lead to thousands of such projects in rural and urban areas. Drawing from communitarianism, the belief is that an active civil society must take on social, economic, and educational responsibilities and offer children and young people improved conditions in which to grow up. Theory development on the individual components exists, such as entrepreneurship, transformation, community-building, basic income, or self-directed learning but not on the interaction of these variables in the overall context. We tentatively call this integrated design a transformative community project.

Barriers and Facilitators to the Learning and Acquisition of Research Competencies among Nursing Students through Active Methodologies: A Qualitative Study Using Reflective Writing

BACKGROUND

The development of educational research, critical thinking skills, and evidence-based practice requires proposals for educational innovation. The purpose of this study was to explore the perspectives of undergraduate nursing students on the barriers and facilitators after the implementation of a novel activity within the course of research methodology, composed of three active learning strategies: (a) project-based learning; (b) small-group learning; and (c) self-directed learning.

METHODS

A qualitative exploratory study using reflective writing was conducted at the Nursing Department of the Red Cross School (Spain). Seventy-four nursing students participated in the study, enrolled in the research methodology course. Purposive sampling was used. Online reflective notes were collected from a script of open-ended questions. An inductive thematic analysis was performed.

RESULTS

The new proposals facilitated learning of the subject matter and its contents. They were useful and enabled the students to put the contents into practice. In addition, they improved the students' organization, planning, and involvement. The barriers identified were a lack of time, ambiguity, inadequate tutoring or novelty of the work, and inequity in the distribution of tasks and workloads.

CONCLUSIONS

Our findings shed light on the barriers and facilitators identified by nursing students when implementing an educational innovation proposal, using three active learning methodologies as learning tools for the subject of nursing research.

The Effectiveness of Online-Only Blended Cardiopulmonary Resuscitation Training: Static-Group Comparison Study

BACKGROUND

Basic life support (BLS) education is essential for improving bystander cardiopulmonary resuscitation (CPR) rates, but the imparting of such education faces obstacles during the outbreak of emerging infectious diseases, such as COVID-19. When face-to-face teaching is limited, distance learning-blended learning (BL) or an online-only model-is encouraged. However, evidence regarding the effect of online-only CPR training is scarce, and comparative studies on classroom-based BL (CBL) are lacking. While other strategies have recommended self-directed learning and deliberate practice to enhance CPR education, no previous studies have incorporated all of these instructional methods into a BLS course.

OBJECTIVE

This study aimed to demonstrate a novel BLS training model-remote practice BL (RBL)-and compare its educational outcomes with those of the conventional CBL model.

METHODS

A static-group comparison study was conducted. It included RBL and CBL courses that shared the same paradigm, comprising online lectures, a deliberate practice session with Little Anne quality CPR (QCPR) manikin feedback, and a final assessment session. In the main intervention, the RBL group was required to perform distant self-directed deliberate practice and complete the final assessment via an online video conference. Manikin-rated CPR scores were measured as the primary outcome; the number of retakes of the final examination was the secondary outcome.

RESULTS

A total of 52 and 104 participants from the RBL and CBL groups, respectively, were eligible for data analysis. A comparison of the 2 groups revealed that there were more women in the RBL group than the CBL group (36/52, 69.2% vs 51/104, 49%, respectively; P=.02). After adjustment, there were no significant differences in scores for QCPR release (96.9 vs 96.4, respectively; P=.61), QCPR depth (99.2 vs 99.5, respectively; P=.27), or QCPR rate (94.9 vs 95.5, respectively; P=.83). The RBL group spent more days practicing before the final assessment (12.4 vs 8.9 days, respectively; P<.001) and also had a higher number of retakes (1.4 vs 1.1 times, respectively; P<.001).

CONCLUSIONS

We developed a remote practice BL-based method for online-only distant BLS CPR training. In terms of CPR performance, using remote self-directed deliberate practice was not inferior to the conventional classroom-based instructor-led method, although it tended to take more time to achieve the same effect.

TRIAL REGISTRATION

Not applicable.

Development and implementation of a self-directed learning readiness scale for undergraduate health professional students

BACKGROUND

To motivate students toward the path of lifelong learning, it is important to train them for a self-directed learning (SDL) approach, where they identify the need of learning the content as well as look forward to attaining the learning outcome, independently. The level of readiness for SDL will allow the learner to be self-disciplined, self-organized, an effective team builder and communicator, a self-assessor, and a self-reflector, thus being a self-learner with the ability to accept and give constructive feedback. The aim of the study was to develop, validate, and implement the SDL readiness scale for health professional students.

MATERIALS AND METHOD

The readiness scale of 43 items was used in four sub-titles (awareness, learning strategies, and style, motivation, team building) was developed using the Delphi method with 12 experts and was implemented for the medical students at Karamsad, Gujarat as a cross-sectional survey after a pilot trial scale from May 2021 to September 2021, using mean, the standard deviation for each item, and arrived sub-titles. The ANOVA test was used to find differences in readiness scores as per different years of the medical program.

RESULT

The result demonstrates that the maximum score was obtained for the first-year medical student (149.89 ± 24.72), which dropped in year 2 (136.35 ± 32.26) but increased by the final year (147.67 ± 56.66), although not as high as the initial joining year. However, a statistically significant difference per gender was identified for a few items of the scale [(items 24 (P < 0.034), 26 (P < 0.0005), 37 (P < 0.035), and 40 (P < 0.013)]. The logistic regression analysis showed no statistical significance for the DSVS-self-directed learning readiness scale (SDLRS) score and demographic variables.

CONCLUSION

The outcome of the study strongly suggests training/sensitization sessions for students to highlight the importance of a SDL approach in a digital millennium. Moreover, a longitudinal follow-up needs to be conducted for the readiness score of the students based on the developed scale and subsequent training sessions need to be organized for students as well as faculty for better outcomes for the students toward SDL sessions.

Development and implementation of a self-directed learning module on antimicrobial resistance for Phase 2 MBBS students

Background

The first objective of the Global Action Plan proposed by the WHO in preventing and controlling Antimicrobial resistance is to improve awareness and understanding of antimicrobial resistance through effective communication, education and training. Self-directed learning is a student oriented teaching learning method ideal for imparting lasting knowledge on topics of national and global importance such as antimicrobial resistance among medical students, which will help them develop an in-depth understanding of the topic and hence the aim of this study was to develop and implement a Self Directed Learning Module on Antimicrobial Resistance.

Material and Methods

The study was conducted in the department of Microbiology with the Phase 2 medical students. Four self-directed learning sessions were developed and disseminated which included case scenarios, class assignments, obtaining antibiotic history from admitted patients, brain storming sessions, final assessment and feedback from students and faculty.

Results

62 out of 80 students gave their consent for the study. 72.6% students attended all the SDL sessions. 55 students gave their final assessments and feedback and all students scored above 50% marks. More than 70% of students said that the SDL aroused curiosity about the topic, while making it interesting, interactive and enjoyable.

Conclusions

The self-directed learning module on antimicrobial resistance evoked interest and enthusiastic participation among the medical students. The discussions, assignments and the brainstorming sessions helped to deepen their knowledge on this emerging threat at the local, national and global levels.

Self-directed Learning Predicts Online Learning Engagement in Higher Education Mediated by Perceived Value of Knowing Learning Goals

Online education has made it possible to implement the “classes suspended but learning continues” policy during the COVID-19 outbreak. However, the intangible sense of the online educational setting requires self-directed learning (SDL) and may force students to know the goals of learning that may impact their engagement. To understand the effect, based on situated expectancy-value theory, this study considered SDL as attitude and approach and constructed a research model to explore the mediating power of perceived value of knowing learning goals (PVKLG) related to participants’ online learning engagement during the COVID-19 lockdown. Data were collected from 497 higher education students in China. After the confirmatory factor analysis with structural equation modeling, the results reported that SDL attitude and approach positively predicted learning engagement mediated by PVKLG. The results suggest that only when students have a high level of PVKLG will they be able to regulate their learning process through the two types of SDL and enhance their engagement in online learning contexts during the COVID-19 lockdown.

Nexus of Emotional Intelligence and Learning Outcomes: A Cross-Country Study of China and Pakistan Higher Educational Institutes

The purpose of this empirical study is to investigate the effects of emotional intelligence (EI) on learning outcomes (e.g., social, cognitive, and self-growth outcomes) and satisfaction with the university experience of academics and administrative staff at Chinese and Pakistani research universities. This study also investigates the mediation of self-directed learning (personal autonomy, personal responsibility, and personal growth) and knowledge management processes (KMPs) concerning the relationship between EI and learning outcomes. Moreover, this study explores the relationship between learning outcomes and creative performance (creative self-efficacy and leadership/supervisor support). The survey method was considered appropriate for the data collection and was completed simultaneously through paper and electronic mediums. The partial least squares structural equation modeling (PLS-SEM) method with a measurement assessment, structural assessment, mediation, and multi-group analysis was applied to a sample of 729 academics and administrative staff from Chinese and Pakistani research universities. A few dissimilarities surfaced with regard to EI and learning outcomes while evaluating the higher education institutions (HEIs) from both countries. Moreover, an indirect relation between EI and learning outcomes was established via self-directed learning and KMPs. Lastly, the intended direct statistical association between learning outcomes and creative performance was also documented. This study may serve as an initiative to equate and differentiate EI in relation to learning outcomes and creative performance among higher education professionals in China and Pakistan. The considered framework is novel and supports both EI and learning outcomes while adhering to the perceived value of the two adjacent regions.

Self-reported vaccination-related behavior patterns among healthcare workers and the association with self-directed learning frequency: A nationwide cross-sectional survey

Background

Healthcare workers play an essential role in improving the public's vaccination uptake, but the full picture of such workers' engagement in vaccination-related behaviors has not been appropriately identified. According to the Integrated Theory of Health Behavior Change, self-directed learning may be a promising intervention for fostering engagement in vaccination-related behaviors, but the association between self-directed learning and such behaviors remains unclear. This study aimed to determine Chinese healthcare workers' level of engagement in behaviors for combatting vaccine-preventable diseases and assess the association between frequency of performing vaccine-focused SDL and engagement in vaccination-related behaviors.

Materials and methods

An online cross-sectional survey was conducted from January 27 to February 21, 2022, using the survey platform "wjx." Respondents were restricted to healthcare workers aged 18-65 years. A Sankey diagram and bar plots were constructed to determine patterns of engagement in a vaccination-related-behavior chain. Unconditional binary logistic regression models were fitted to determine the association between frequency of performing vaccine-focused self-directed learning and engagement in vaccination-related behaviors.

Results

Of the 2,248 survey respondents, data for 2,065 were analyzed. Participants who had received influenza or pneumococcal vaccination, routinely recommended vaccination to patients, tracked patients' vaccination status, and recommended efficiently accounted for 43.2%, 50.8%, 40.3%, and 36.4% of the total participants, respectively. When only considering those who routinely made such recommendations, the proportion of those who performed tracking and efficient recommendation was 28.8% and 26.2%, respectively. When compared to performing self-directed learning "never to less than once/six months," performing self-directed learning "more than once/week" was positively associated with being vaccinated (OR, 95% CI: 2.30, 1.74-3.03), routinely recommending vaccination (OR, 95% CI: 4.46, 3.30-6.04), and tracking the status of patients so recommended (OR, 95% CI: 6.18, 4.35-8.76).

Conclusions

Chinese healthcare workers' pattern of engagement in vaccination-related behaviors must be improved. Higher frequencies of engagement in self-directed learning are associated with more active engagement in vaccination-related behaviors, meaning raising such frequencies could be a promising intervention for fostering behavior changes in this regard and ultimately increasing vaccination coverage.

Nursing students' self-directed learning experiences in web-based virtual simulation: A qualitative study

BACKGROUND

Since the start of the COVID-19 pandemic, virtual reality simulation, including web-based simulation, has increased in nursing education. This study explored nursing students' self-directed problem-solving in web-based virtual simulation experiences.

METHOD

Convenience sampling yielded 16 Korean senior nursing students who had experienced clinical practice in the last semester. Data were collected from August 2020 to January 2021 through in-depth Zoom video interviews and organized using NVivo version 12.0. Thematic analysis was applied to analyze the data.

RESULTS

The following four themes were identified from nursing students' learning experiences during the web-based virtual simulations: "self-awareness of a lack of nursing competency in virtual reality," "applying new learning strategies learned from failure," "voluntary learning behavior," and "cognitive shift toward a holistic understanding." Web-based virtual simulations activated various cognitive and metacognitive factors of self-directed learning, and the system's prompt feedback and students' reflections facilitated learning effects. Nursing students corrected their cognitive errors while learning from their failures and mistakes and gained a holistic view of nursing practice.

CONCLUSION

In this study, web-based self-directed learning activated the metacognition of nursing students in a virtuous cycle. The virtual environment with no actual harm to the patient has become a space for learners to experience a sense of confidence, achievement, and satisfaction. Web-based virtual simulation can be an effective teaching method to improve nursing students' self-directed learning abilities and nursing competency.

Acceptability of a Smartphone Application to Enhance Healthcare to Female Genital Mutilation Survivors in Liberia: A Qualitative Study

In Liberia, female genital mutilation/cutting (FGM/C) is a legally allowed initiation ritual in the secret Sande society. Due to the secrecy, Liberian healthcare providers receive little education on FGM/C and its health consequences. As mobile learning approaches proved to efficiently increase providers' knowledge and skills, a mobile application ('app') was designed to support self-learning, decision-making, and the follow-up of FGM/C survivors' health. The 'app' was introduced in a capacity-building project in 2019 and evaluated through this qualitative study to assess healthcare provider's needs and acceptance. We conducted 22 semi-structured interviews and eight focus group discussions with 42 adult healthcare providers in three Liberian counties. A thematic approach grounded in descriptive phenomenology guided data analysis and led to three main themes: the 'app', mobile learning and health education, and personal impression. Healthcare providers judge the 'app' useful to broaden their knowledge and skills, which might lead to better FGM/C detection and management. The 'app' might further facilitate patient and community education about the negative health consequences of FMG/C, possibly contributing to a reduction of FGM/C prevalence.

Using an OSCE to Explore the Role of Structured Debriefing and Self-Directed Learning in Simulator-Based Clinical Skill Training in Production Animal Reproductive Medicine

Self-directed learning is associated with several benefits in simulation-based clinical skill training and can be complemented by feedback in the form of post-event debriefing. In this study, final-year veterinary medicine students (n = 111) were allocated into one of three groups and practiced four clinical skills from the domain of production animal reproductive medicine in a clinical skills laboratory. Group 1 completed an instructor-led practice session (I), group 2 completed a self-directed practice session with post-event debriefing (D), and group 3 completed a self-directed practice session without debriefing (control, C). Each practice session included two clinical skills categorized as being directly patient-related (patient) and two clinical skills involving laboratory diagnostics or assembling equipment (technical). Students evaluated the practice session using Likert-type scales. Two days after practice, 93 students took part in an objective structured clinical examination (OSCE). Student performance was analyzed for each learning station individually. The percentage of students who passed the OSCE did not differ significantly between the three groups at any learning station. While the examiner had an effect on absolute OSCE scores (%) at one learning station, the percentage of students who passed the OSCE did not differ between examiners. Patient learning stations were more popular with students than technical learning stations, and the percentage of students who passed the OSCE was significantly larger among students who enjoyed practicing at the respective station (90.9%) than among those who did not (77.8%).

Self-Efficacy in the Prediction of GPA and Academic Computer Use in Undergraduate Translation Students at a Saudi University

Since the beginning of the COVID-19 pandemic, academic institutions have faced the challenge of understanding the social-psychological features that produce better academic performance among translation students in an online learning environment. Although self-efficacy is widely studied in a variety of teaching and learning models, few studies have examined self-efficacy in regard to translation students. This empirical study aims to examine the roles of general self-efficacy and computer self-efficacy in terms of the academic achievement and computer use of translation students during the COVID-19 pandemic. The participants included 83 undergraduate translation students at the English Language Department of Umm Al-Qura University, Saudi Arabia. They completed the General Self-Efficacy Scale and Computer Self-Efficacy Scale questionnaires. The results found self-efficacy scores were a significant predictor of overall GPA scores, highly predictive of computer self-efficacy, and also predicted an increased typing frequency and computer usage. This study suggests that translation students with greater levels of self-efficacy will be more likely to possess social-psychological features that align with the independent, self-directed nature of online learning environments.

Measuring Readiness for Self-Directed Learning in Medical Undergraduates

PURPOSE

To measure the readiness for self-directed learning in medical students for the evaluation of self-directed learning in the study population.

MATERIALS AND METHODS

The survey was conducted in undergraduate students. The instrument used was Fisher's readiness scale comprising of self-management, desire for learning, and self-control domains. The data were analyzed by Mann-Whitney U-test and bivariate and partial correlations. The results were compared with the reported ones.

RESULTS

Total students surveyed were 300. Of these, 96 responded - 73 (76%) of preclinical and 23 (24%) of clinical classes. The mean readiness score was 124. The mean domains' scores for self-management, desire for learning, and self-control were 38, 38, and 48, respectively. The preclinical group had a mean score of 122 for readiness,  37 for self-management and desire for learning each, and 48 for self-control. The clinical group's scores were 129, 40, and 49, respectively. Preclinical and clinical groups differed significantly in self-management domain (P = 0.03). The difference was not significant in desire for learning (P = 0.08), self-control domains (P = 0.40) and readiness score (P = 0.12). The domains of self-control and desire for learning had a positive correlation if self-management was controlled, and self-control and self-management had a positive correlation if desire for learning was controlled (P < 0.05).

CONCLUSION

The measurement of readiness for self-directed learning helps in knowing the true value of self-directed learning in a particular setting. Relatively lower scores in our study mean self-directed learning alone cannot be relied upon to achieve optimum students' learning. There is also a need for implementing strategies that will help students in improving their readiness for independent learning.

Musculoskeletal ultrasound training encourages self-directed learning and increases confidence for clinical and anatomical appreciation of first-year medical students

Best-practice guidelines have incorporated ultrasound in diagnostic and procedural medicine. Due to this demand, the Arizona College of Osteopathic Medicine initiated a comprehensive integration of ultrasound into its first-year anatomy course attended by more than 280 students. Ultrasound workshops were developed to enhance student conceptualization of musculoskeletal (MSK) anatomy through visualizing clinically important anatomical relationships, a simulated lumbar puncture during the back unit, carpal tunnel and shoulder evaluations during the upper limb unit, and plantar fascia, calcaneal tendon, and tarsal tunnel evaluations during the lower limb unit. A 5-point Likert scale survey evaluated if ultrasound improved students' self-perceived anatomical and clinical comprehension of relevant anatomy, improved students' ability to orient to ultrasound imagery, and prompted further independent investigation of the anatomical area. Ultrasound examination questions were added to the anatomy examinations. Two-tailed one-sample t-tests for the back, upper limb, and lower limb units were found to be significant across all Likert survey categories (P < 0.001). Positive student responses to the Likert survey in conjunction with examination question average of 84.3% (±10.3) demonstrated that the ultrasound workshops are beneficial to student education. Ultrasound enhances medical students' clinical and anatomical comprehension and ability to orient to ultrasound imagery for MSK anatomy. This study supports early ultrasound education as a mechanism to encourage students' independent learning as evidenced by many undertaking voluntary investigation of clinical concerns associated with MSK anatomy. This study establishes the successful integration of MSK ultrasound into a large medical school program and its benefit to student clinical education.

The Influence of Affective Feedback Adaptive Learning System on Learning Engagement and Self-Directed Learning

The outbreak of the two-year corona virus has made a great difference on existing methods of learning and instruction. Online education has become a crucial role to maintain non-stop learning after the post-epidemic period. The advanced technologies and growing popularity of network equipment have made it easy to deploy remote connections. However, teachers still face challenges when they actually implement distance courses. During the learning process, the quality of learning can be improved if the researchers consider multiple factors, including emotions, attitudes, engagement, cognition, neuroscientific and cultural psychology. After analyzing these factors, instructors can have better understanding of students' mental building and cognitive understanding in their process of learning, and be familiar with the way of interaction with students and appropriately adjust their teaching. Therefore, the current study established a learning system that aimed to understand learners' emotional signals during learning by applying the adaptive-feedback emotional computing technology. The purpose of the system was to allow learners to (1) self-examine their learning condition, (2) enhance their self-directed learning, (3) help learners who are in negative learning emotions or settings to lower anxieties, and (4) promote their learning attitudes and engagement. Result showed that the system with the adaptive-feedback emotional computing technology has significantly improved the learning effectiveness, lowered learning anxieties and increased students' self-directed learning.

Effects of a Self-Directed Clinical Practicum on Self-Confidence and Satisfaction with Clinical Practicum among South Korean Nursing Students: A Mixed-Methods Study

In self-directed learning, students take the initiative to identify learning goals, choose learning strategies, and evaluate learning outcomes. This study aimed to explore the effects of a self-directed clinical practicum on nursing students' self-confidence and satisfaction with the clinical practicum. This mixed-methods study used a non-equivalent control group with a pre- and post-test quasi-experimental design and content analysis. Participants were 111 nursing students (experimental group = 55, control group = 56). Quantitative (self-confidence and satisfaction with the clinical practicum) and qualitative (reflective diaries) data were collected. The experimental group had significantly increased scores for self-confidence and satisfaction with the clinical practicum compared with the control group. Four themes regarding the experience of the self-directed clinical practicum were identified: perceived linking of academic knowledge and practice, perceived development of nursing competency, enjoying the clinical practicum, and establishing nursing identity as a student. The self-directed clinical practicum developed as part of this study was found to be an effective education method for nursing students.

Enabling Self-Directed Academic and Personal Wellbeing Through Cognitive Education

Background

The international crisis of declining learner wellbeing exacerbated by the COVID-19 pandemic with its devastating effects on physical health and wellbeing, impels the prioritization of initiatives for specifically enabling academic and personal wellbeing among school learners to ensure autonomous functioning and flourishing in academic and daily life. Research emphasizes the role of self-directed action in fostering wellbeing. However, there is limited research evidence of how self-directed action among school learners could be advanced.

Aim

We explore the effectiveness of an intervention initiative that exposes teachers to foregrounding Cognitive Education – the explicit and purposeful teaching of thinking skills and dispositions to learners that would advance self-regulated action - to establish the latent potential of the intervention for assisting learners to develop self-regulating abilities that progressively inspires increased self-directed action.

Method

We illuminate the qualitative outcomes of an exploratory pilot study with a heterogeneous group of willing in-service teachers from two public primary schools (n = 12), one private primary school (n = 3), and one pre-school (n = 2) in South Africa who received exposure to an 80-h intervention that comprised seven study units. The article delineates the experiences of the teachers concerning their participation in the intervention as reflected in their written reflections, as well as their perceptions about the value of the intervention probed with semi-structured one-on-one interviews after completion of the intervention.

Results

The findings revealed that exposure to the intervention holds benefits for equipping teachers with teaching strategies to create classroom conditions that nurture the development of thinking skills and dispositions that are important for self-regulating, and ultimately self-directing academic and personal wellbeing.

Conclusion

Cognitive Education is a form of strengths-based education that can play an indispensable role in enabling self-directed academic and personal wellbeing among school learners.

Wuhan College Students' Self-Directed Learning and Academic Performance: Chain-Mediating Roles of Optimism and Mental Health

This study explored the chain-mediating roles of optimism and mental health in the relation of self-directed learning with academic performance among college students in Wuhan during long-term online teaching. In total, 473 valid responses were obtained from students at three Wuhan universities. Self-directed learning, optimism, mental health, and academic performance scales were used as measurement instruments; a 5-point Likert scale was employed for all items. To examine the instruments' reliability and validity, a measurement model was constructed; moreover, structural models were employed for assessing the chain mediation model. This study confirmed that self-directed learning was a positive predictor of academic performance in Wuhan college students. Optimism and mental health were two mediators and partially jointly mediated the relation of self-directed learning with academic performance. The results revealed that self-directed learning only partially positively predicted academic performance. The aforementioned relationship was partially mediated by optimism and mental health, highlighting the essential roles of optimism and mental health in the learning and learning outcomes of Wuhan college students.

Online Problem-Based Learning Intervention on Self-Directed Learning and Problem-Solving through Group Work: A Waitlist Controlled Trial

Background: Small group work embraces independent study and interactive learning, which enhance knowledge acquisition and skills. Self-directed learning (SDL) and problem-solving (PS) are essential skills in the development of the nursing profession. During the coronavirus pandemic, virtual learning was indispensable. However, little is known about how students develop SDL and PS abilities through online learning through group work. Objective: To evaluate the effects of the online intervention on SDL and PS abilities through interactive group work. Methods: A randomised waitlist-control trial was carried out. A structured intervention using problem-based learning (PBL) as a guideline was used to direct student learning in small group work. Assessments were scheduled at Time 0 (baseline), Time 1 (8th week), Time 2 (16th week), and Time 3 (28th week). Results: The mean student age was 21.45 (SD = 0.86). About 78% of students were female. There was no significant difference in demographic characteristics and analysis at the baseline. Students in the intervention group reported greater improvement in the SDLRS and PSI at the 8th week, whereas those in the waitlist control group reported greater improvement in the SDLRS and PSI at the 16th week. Sustained effects in the SDLRS and PSI were observed in both the intervention and waitlist control groups at the 16th and 28th weeks, respectively. A repeated-measure analysis was performed to compare the SDLRS and PSI in different periods and revealed statistically significant results (p < 0.001) in all subscales of SDLRS and PSI in the four study periods. Conclusions: The guidelines appear to be an effective treatment for SDL and PS ability enhancement with sustainable effects through interactive group work. The guidelines with explicit instructions and learning objectives provide directions and guidance to students to learn more effectively. The educator plays a vital role in facilitating the students’ SDL and PS ability improvement.

Self-Directed Learning During the COVID-19 Pandemic: Perspectives of South African Final-Year Health Professions Students

PURPOSE

Self-directed learning (SDL) has been advocated for effective training of final-year health professions students. COVID-19 challenges conventional teaching, learning, and assessment in the clinical environment. This study aimed to identify and explore enablers and barriers to SDL among final-year health professions students training during the COVID-19 pandemic.

METHODS

Adopting the SWOT (strengths, weaknesses, opportunities and threats) framework, this study explored the clinical learning and training experiences of final-year health professions students during the pandemic. A survey was conducted via online platforms. Data from 155 respondents were thematically analyzed.

RESULTS

Personal attributes such as reflection, self-determination, motivation, resilience, and positive learning behaviors and skills were identified as SDL enablers. Collaborative learning networks and online learning platforms facilitate learning needs and goals. Fear and anxiety, untrusted learning sites, uncertainty about graduation, financial issues and challenges in the learning environments were the major themes related to barriers to SDL.

CONCLUSION

The importance of SDL as a skill for uncertain times warrants further investigation in the training of future healthcare professionals. Inclusive planning and engagement with final-year health professions students to address identified stressors, as well as the creation of shared platforms where students are part of the decision-making processes for clinical learning and training are recommended. Responsive curricula that optimize unpredictable disruptions in clinical training are needed to equip students to diagnose their own learning needs and implement appropriate learning strategies.

Did Self-Directed Learning Curriculum Guidelines Change Taiwanese High-School Students’ Self-Directed Learning Readiness?

With the rapid changes in globalization and technology advancement, self-directed learning is argued repeatedly as a key competency needed to survive in the twenty-first century. In August 2019, the Taiwan Ministry of Education implemented the new Curriculum Guidelines for 12-Year Basic Education. Being Taiwan’s first official curriculum that promoted self-directed learning, this study contributed to the emerging knowledge of how the introduction of the curriculum guidelines affected students’ readiness for self-directed learning. Three cohorts of high school students from seven schools returned 10,020 valid surveys. The Self-Directed Learning Readiness Scale (SDLRS), a reputable instrument developed by Lucy Guglielmino (2000), was used in the study. The results provided a bird’s-eye view of evidence supporting our explanations for the positive, though slight, effect of implementing new curriculum guidelines in fostering self-directed high-school learners. Moreover, the progression of self-directed learning readiness appeared differently among schools and among different demographic associations. We suggest that future researchers both (a) qualitatively explore how specific latent variables were changed in different instructional interventions, and (b) conduct panel studies to advance our understanding of curriculum reform and learners’ self-direction.

Anatomy of the physical examination: A small group learning approach for increasing engagement and learning in a medical gross anatomy course

The ability to perform and interpret the physical examination requires an understanding of human anatomy and how to apply that content in the clinical setting. Previous work has shown that students understand and retain information more effectively when they are actively engaged in the learning process and it is clearly linked to other coursework and their future needs. We developed a series of learning activities, based on the general physical examination, designed to enhance engagement and encourage durable learning of anatomical principles that are important in performing and interpreting the physical examination. Activities were designed for use in small group settings with faculty supervision and input as needed. We describe these activities and provide comments from students regarding the perceived value of these learning activities. Students reported that the applied anatomy learning activities were engaging and aided in their learning of human anatomy. Additionally, students appreciated the connection between the applied anatomy activities and the skills being learned in concurrent coursework focusing on the physical examination. We observed that applied human anatomy exercises modeled after components of the general physical examination and embedded in an anatomy course enhanced student engagement and helped students appreciate the importance of anatomical principles. We note that sensitivity to and acceptance of personal preferences and religious matters must be shown when using learning activities that involve close physical interactions to teach anatomical topics.

Self-Directed Learning versus Problem-Based Learning in Korean Nurse Education: A Quasi-Experimental Study

Effective teaching methods are vital for cultivating advanced professional skills in nurses and equipping them with the necessary training. Problem-based learning (PBL) and self-directed learning (SDL) have been consistently used in nurse education. Therefore, their effects on nursing students’ academic performance warrant comparison. This study compared the effects of PBL and SDL on an adult nursing university curriculum. Participants in this quasi-experimental study with a pre-post non-equivalent control group design were 106 third-year nursing students divided into the PBL and SDL groups. Data collection, conducted from April to June 2019, included a pre-test before an eight-week intervention, followed by a post-test. Changes in the scores of each group were analyzed for learning motivation, self-directed learning ability, self-efficacy, learning confidence, learning satisfaction, and academic performance using paired and independent t-tests. The PBL group scored higher on learning motivation, self-directed learning ability, and academic performance than the SDL group. Based on these results, the PBL method was more effective than the SDL method in an adult nursing curriculum. To maximize the learning effect in adult nursing education, it is necessary to apply SDL education, including the PBL method, with a clearer learning process.

Students Teaching Students: Student-Led Ultrasound Curriculum in Medical School Education

Introduction

With the expanding use of point-of-care ultrasound throughout medical specialties for the rapid bedside assessment integral to patient care, medical schools have sought to incorporate ultrasound education into their curriculum. Second-year medical students (MS2s) at our institution met this demand by forming the Ultrasound Student Instructor Cadre (USSIC), a longitudinal ultrasound curriculum where MS2s teach first-year medical students (MS1s). The objectives of this study were to assess the ultrasound knowledge of medical students and their perceptions of ultrasound incorporation into their medical education.

Methods

Our flipped classroom curriculum consisted of four lessons (cardiopulmonary, gastrointestinal, genitourinary, and musculoskeletal) composed of videos, didactic lessons, and hands-on probe-time, with 15-minute pre- and post-assessments. Paired Wilcoxon signed-rank tests were performed to evaluate the differences in the pre- and post-assessment scores for each teaching session. Additionally, an end-of-the-year survey assessed the perceived preparedness and overall satisfaction of the MS1s with the course.

Results

The differences between the pre- and post-assessments for each teaching session were statistically significant: cardiopulmonary (45.6 ± 16.9% vs. 82.9 ± 9.4%, p < 0.0001, n = 55), gastrointestinal (53.9 ± 18.0% vs. 84.1 ± 13.5%, p < 0.0001, n = 54), genitourinary (68.9 ± 19.1% vs. 91.4 ± 14.4%, p < 0.0001, n = 64), and musculoskeletal (33.6 ± 14.7% vs. 78.2 ± 18.2%, p < 0.0001, n = 55).

Conclusion

Our study suggests that MS1s met the learning objective for each teaching session. Furthermore, MS1s who became USSIC instructors as MS2s felt more prepared and were more satisfied with the course. This study demonstrates the efficacy of student-led instruction in ultrasound, and we offer our model for adoption into other medical schools.

Examining the Role of Structured Debriefing in Simulator-Based Clinical Skills Training for Namibian Veterinary Students: A Pilot Study

Post-event debriefing has been described as an effective tool in improving learning achievements in simulator-based teaching. This article examines the effect of structured post-event debriefing sessions in simulator-based veterinary clinical skills training. Nineteen Namibian veterinary students took part in instructor-led practice, self-directed practice with structured post-event debriefing and self-directed practice without debriefing (control) at three different learning stations in a veterinary clinical skills laboratory. Students evaluated their practice experience using Likert-type scales, and learning achievements were assessed using an objective structured clinical examination (OSCE). The results show that the choice of practice model had no significant effect on learning achievements overall. However, at individual learning stations, different practice models showed significant differences regarding effect on learning achievements. Students generally preferred practice sessions with some form of instructor involvement but the importance of instructor guidance was rated differently at each individual learning station.