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Objective: This study explored the effectiveness of combining problem-based learning (PBL) and case-based learning (CBL) in the clinical teaching of ectopic pregnancy., Methods: Fifth-year students majoring in clinical medicine were recruited from the Department of Gynecology at the Hengyang Central Hospital and Hainan General Hospital between September 2023 and June 2024. The students were randomly assigned to either the combined PBL-CBL or the traditional group. At the end of the class, both groups of students were required to complete a post-class quiz and an anonymous questionnaire., Results: The basic knowledge score in the combined PBL-CBL group was significantly higher than that in the traditional group (42.6 ± 3.6 vs 35.0 ± 2.3, p = 0.000). Similarly, the case analysis score was higher in the combined PBL-CBL group than that in the traditional group (37.1 ± 6.2 versus 33.8 ± 5.7, p = 0.013). The scores for learning motivation, understanding, student-teacher interaction, communication skills, clinical thinking skills, self-learning skills, knowledge absorption, and satisfaction with the course in the combined PBL-CBL group were significantly higher than those in the traditional group (p < 0.05). However, the score for the amount of free time consumed by the combined PBL-CBL group was significantly higher than that of the traditional group (p < 0.05)., Conclusion: The study suggests that the combined PBL-CBL teaching method might be a promising new mode of gynecological education., Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Heng Yang Central Hospital. Written informed consent was obtained from all the participating students. Consent for publication: Written consent was obtained from the participants. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Oral health care programs offer a platform for experiential learning that include prospects for skills development; opportunities for knowledge application and for the creation of an awareness of community responsibilities. Gaining experience in the care for special needs patients is ideally achieved through exposure in special needs settings such as the school community., Aim: This study investigated the perceptions and reflections of experiential learning by final year oral hygiene students in a special need's oral health care program at the University of Western Cape., Methods: This study incorporated a concurrent triangulation study design that included final year Oral Hygiene students who participated in a special need's oral health care program. Students completed an on-line self-administered questionnaire, a reflective journal and participated in a focus group discussion., Results: All respondents understood the concept of experiential learning. The predominant dispositions that emerged included student adaptation, awareness, empathy, and experience which were regarded as particularly important for personal growth. With regards to academic growth, facets of confidence, theory translation, clinical skill development and improved communication were identified as critical elements in development. Challenges included lack of cooperation from the learners and lack of kills in non-verbal communication. An increased awareness and a strong willingness to participate in community projects was also reported amongst the student respondents., Conclusion: The experiential learning opportunity in the school-based special needs oral health care program was invaluable to the children as well as the students. This community -based program supported personal and academic growth and it provided authentic learning opportunities; facilitated professional development, improved clinical skills and competence, enhanced problem solving and communication skills and raised awareness on social responsibility. Challenges experienced pertained to cooperation and communication with the children. Suggestions included maintaining access to care for the children through oral care program initiatives, as well as ongoing rotation of Oral Hygiene students who are ideally positioned to provide promotive and preventive oral care to special needs individuals. Schools for special needs children provide an ideal platform to facilitate access to care and to provide experiential learning opportunities in authentic settings., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics and consent to participate was obtained from Biomedical Research and Ethics Committee at the University of Western Cape: Reference is (BM/23/4/7). Consent to participate was also obtained from the final year oral hygiene students. Clinical Trial Number in the manuscript. This study was approved by the Biomedical Research and Ethics Committee of The University of Western Cape, (BM23/4/7). All methods and processes in this study were performed in accordance with the relevant guidelines and regulations of the Biomedical Research and Ethics Committee of The University of Western Cape. Written informed consent was obtained from the participating undergraduate students at the University of Western Cape. Approval to conduct this study was also obtained from the Western Cape Department of Education (1645DCF18000045-20230609) Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Self-Directed Learning (SDL) is a subjective concept with no universally agreed definition. The aim of this project was to obtain the perspectives of Orthopaedic trainee registrars on SDL., Methods: Seven Orthopaedic trainees in the Southwest Peninsula region were recruited in person by the primary author as an Orthopaedic trainee on the same programme as the participants. A one-hour Microsoft teams video interview was arranged at a mutually convenient time exploring several topics including learning resources, experiential learning, learning strategies, training programme requirements and assessment. The interviews were audio recorded and transcribed verbatim. Transcripts were coded using Corbin's and Strauss's published coding method and analysed to develop a model of SDL in this training context., Results: Six learning stages were identified from the coded transcripts and these stages were like Knowles's stages of SDL. Participants felt less autonomous during the identification of knowledge gaps, goal setting and evaluation of learning stages. Participants perceived to have more control over the selection of strategies, and learning stages of SDL. The factors which influenced autonomy at various stages of SDL included supervisors, experiential learning opportunities, service provision competing with learning opportunities, training programme requirements and the power dynamic between trainees and supervisors. Self-advocacy by the trainees for experiential learning opportunities and for their progression was an additional action relevant to SDL that was evident. Online learning resources such as Orthobullets.com, YouTube videos, external revision courses, collaboration and webinars encouraged more autonomy with SDL., Conclusions: Although the United kingdom's Trauma and Orthopaedic curriculum is described as trainee led and SDL is encouraged, in practice Orthopaedic trainees felt limited autonomy with the various stages of SDL due to external factors including their level of experience and the training environment. Trainees' experiences around self-advocacy highlighted the importance of a collaborative and supportive learning culture emphasising dialogue, receiving high quality feedback, and openness for successful progression., Competing Interests: Declarations Ethics approval and consent to participate The study proposal was submitted to and approved by the Schools of Medicine and Life Sciences Research Ethics Committee (SREC) at the University of Dundee (SMED REC Number 21/60). Informed consent for participation in the study was obtained from all seven participants. Consent for publication Informed consent for publication was obtained from each participant. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: The triple jump examination (TJE) has been instituted at the Ostrow School of Dentistry of the University of Southern California (OSDUSC) since 2001 as an assessment tool of critical thinking skills for its learner-centered pedagogy. A 2013 study detailed the TJE's design, validity, and initial outcomes. The current study focused on its 13-year sustainability including a transition from in-person to hybrid TJE by assessing outcomes from the graduating Classes of 2014 through 2026., Methods: The study was approved by the USC Institutional Review Board (#UP-21-00272-AM001). To assess sustainability, the study first examined agreements among TJE faculty raters based on a total of 10,512 TJEs given to 1872 students from the 13 classes. Next, to determine whether the effectiveness of TJE was impacted by the transition from traditional to hybrid TJE, an independent t-test was performed to examine student performance between the two exam delivery methods based on 4896 TJEs given to 864 students., Results: The study observed a high level of agreement among faculty raters throughout the study period. The general agreement rates, exact agreement rates, and disagreement rates averaged 99.2%, 77.3%, and 0.8%, respectively. Students' TJE performance was similar between the traditional and hybrid delivery methods (p-value = 0.629 > 0.05, t critical two-tail = 2.074, t stat = 0.489)., Conclusion: The TJE at OSDUSC proves to be a sustainable and reliable instrument with high internal consistency among raters when evaluating students' performance. The transition from traditional to hybrid TJE has no impact on the TJE's effectiveness., (© 2024 American Dental Education Association.)

Aim: This study aimed to investigate the impact of bedside case-based learning on critical thinking and capacity for self-directed learning in a group of midwifery students in China., Background: Bedside teaching is a well-established educational tool to improve the clinical practice of medical, nursing, and midwifery students. A new pedagogical approach; bedside case-based learning (BCBL) is an interactive teaching approach involving small-group, student-educator discussion to describe the etiology and management of a patient case. This new approach has been gradually integrated into Chinese midwifery education programs to promote clinical problem-solving skills, knowledge application, teamwork, and collaboration., Design: A quasi-experimental pre-test-post-test group design., Methods: This study used a quasi-experimental pre-test-post-test group design. A convenience sample of 67 third-year students majoring in midwifery at the university were prospectively enrolled in this study. Pre- and post-BCBL class surveys were conducted using the Self-Rating Scale of Self-Directed Learning (SRSSDL) and the Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) to assess changes in self-learning and critical thinking abilities before and after the intervention., Results: Following bedside case-based learning, the total scores for self-directed learning capacity and critical thinking increased, although there were no statistically significant differences (P > 0.05)., Conclusions: Although there were no statistically significant differences between pre- and post-test results, students' self-assessed scores in self-directed learning and critical thinking improved between pre- and post-test., Competing Interests: Declarations Ethical approval and consent to participate This study was approved by the Research Ethics Committee at the Nursing School of Zhejiang Chinese Medical University and conducted according to the Helsinki Declaration. Informed consent was obtained from all the participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

In response to the pervasive challenges posed by online health misinformation, our objective was to develop a training program aimed at enhancing the skills and confidence of healthcare workers in recognizing and effectively responding to misinformation, with a particular focus on vaccinations. This article discusses the design of a training program aimed at equipping healthcare workers with the skills to combat health misinformation, offering theoretical foundations for integrating evidence-based strategies into problem-based learning to help learners retain and apply information, and also shares examples and insights gained from its application across diverse learner groups. The training curriculum integrates evidence-based misinformation intervention strategies, learner engagement strategies and draws from authentic scenarios across diverse cultural contexts. The trainings were administered from January through July 2023 to 287 participants across eight countries (Cameroon, Guyana, India, Kenya, Mozambique, Nigeria, Philippines, and the United States) in English, French, Spanish, and Portuguese. Throughout the implementation of the training, a key emphasis was placed on a learner-driven approach that fostered real-world application. Participants engaged in role-playing exercises and problem-solving sessions, enabling them to practice their newfound skills in a controlled setting. Our findings contribute to the literature of participatory, problem-based learning for healthcare professionals and vaccine communication and misinformation response, and can serve as a resource for practitioners implementing similar trainings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: This study explored the effectiveness of a Problem-based Learning (PBL) teaching model on the WeChat public platform for radiation oncology residency training programs., Materials and Methods: The WeChat PBL program was initiated in 2019. The study recruited student participants, on a voluntary basis, who were in their first and second years of standardized training in radiation oncology. We selected classic and trending issues in radiation oncology as the two main teaching topics. Students in the PBL group searched for relevant literature, summarizing PowerPoint presentations or academic speeches on specific issues published on the professional WeChat public platform after an in-depth review by teachers. The final national standardized training examination scores for resident physicians were used to evaluate teaching effectiveness. The graduation scores of the PBL and non-PBL groups were compared, and a stratified analysis was conducted based on the year of participation to assess the teaching effectiveness of this model. Moreover, questionnaires were administered to evaluate students' experiences., Results: Among the 36 students who joined the study in 2019, 16 (44.0%) voluntarily joined the PBL teaching group. Nine students started teaching PBL in their first year of residency, accounting for 47.4% of that year, and seven started in their second year, accounting for 41.2%. The average graduation scores of the PBL group were superior to those of the non-PBL-focused group for the same grade. The rate of high scores among students in the PBL group (56.3%) was higher than that of students in the non-PBL group (25%). Specifically, first-year residents who joined the PBL group had an average score of 92.3 ± 2.2, significantly higher than their non-PBL counterparts, who scored an average of 88.6 ± 4.6, showing a statistically significant advantage (p = 0.042). All students were satisfied with the PBL WeChat teaching and would recommend the PBL WeChat course to others., Conclusion: The PBL residency teaching model on the WeChat platform improved residency scores and garnered student satisfaction., Competing Interests: Declarations Ethics approval and consent to participate All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Human Research Ethics Committee of Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College. This study meets the requirement for exemption from informed consent to participate. Consent for publication Written informed consent for publication was obtained from all participants. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Procrastination is characterized by the deliberate postponement of assigned educational tasks and is correlated with low academic achievement and depression. Concern about procrastination is particularly high among medical students, as it has a strong association with aspects such as low self-efficacy, lack of organization, low intrinsic motivation, inefficient effort regulation and time management problems. On the other hand, it was found that students' use of study strategies is significantly related to better academic results. The relationship between students' tendency to procrastinate and the adoption of effective study strategies remains little explored, leaving a critical space for investigation. This study aims to fill this gap by exploring how procrastination affects the selection and effectiveness of study strategies adopted by students., Methods: This cross-sectional study was conducted in Brazil and included medical students from the first to the seventh semester of the Unichrsitus Medical School. The validated procrastination scale and the Learning and Study Strategies Inventory were used. Generalized linear regression multivariate models with robust errors were used to verify the association between the study variables., Results: 447 students participated, 70.2% of whom were female, with an average age of 23 years. The domain of "study aids" scored higher among younger students, who self-referred as black and who studied in private schools prior to the Medical School. Higher procrastination scores were statistically associated with higher main idea selection, concentration, time organization and anxiety scores and with lower study aids and study preoccupation scores (p values < 0.05). In addition, active methodology was associated with higher scores in the domains of study aids and time organization., Conclusions: Procrastination is associated with the study strategies used by medical students, which can be modified through training and ultimately improve their performance. Students in traditional models, who are older, white and from public schools may especially benefit from this training., Competing Interests: Declarations Ethics approval and consent to participate Written informed consent was obtained from participants. The survey was approved by the Research Ethics Committee of Unichristus in Brazil under the opinion number 67715223.2.0000.5049. All methods were carried out in accordance with relevant guidelines and regulations. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Problem-based learning (PBL) is a well-known teaching method which promotes self-directed learning (SDL) in many medical programs worldwide. This study aimed to examine the perceptions of Sudanese physiologists on applying PBL in teaching their physiology courses or sessions., Methods: A cross-sectional survey was conducted with 82 physiologists (70% of the total Sudanese physiologists). The data were collected using questionnaires that included questions about attitudes towards, effectiveness of, and barriers to PBL implementation. The internal reliability of the questionnaire (over 0.7) was good, as measured by Cronbach's alpha. The Mann‒Whitney U test, Kruskal-Wallis test, multiple linear regression and correlation (Spearman) analysis were performed to assess various factors associated with physiologists' perceptions of the research domains., Results: Physiologists generally had a positive attitude (overall score percentage of 76.9 ± 23.97%) towards PBL compared to other teaching methods and had good perceptions of the effects of PBL (overall score percentage of 77.1 ± 25.13%) on the student learning process. Furthermore, physiologists had a notable knowledge gap about common challenges affecting PBL application (overall score percentage was 56.93 ± 19.43%) at their relevant institutes. Physiologists' perceptions of common factors affecting PBL application were significantly related to participants currently working inside or outside Sudan (p value = 0.010) and applying PBL at their relevant institutes (p value = 0.008). In addition, the attitude score was significantly associated with the current workplace (governmental/private) classification (B= -14.083, p = 0.031). Additionally, attitude toward PBL had a significant positive correlation with age (r = 0.233, p = 0.005) and the perception score of PBL's effects on students' learning processes (r = 0.788, p < 0.001)., Conclusion: In general, physiologists have good attitudes towards and perceptions of PBL's effectiveness, although they are unaware of the main challenges that PBL faces. The findings of this study can help the Federal Ministry of Higher Education make informed decisions about how to improve teaching methodology by implementing such novel approaches., (© 2024. The Author(s).)

Background: Dietetics, as an autonomous profession guided by evidence-based practice, requires a dynamic and adaptable workforce to meet evolving challenges in healthcare, public health nutrition and epidemiological research. This study aimed to explore the opportunities presented by the transition to online education of preparing dietetic students for professional demands, particularly, through the lens of problem-based learning (PBL) within the Community of Inquiry (CoI) framework., Methods: This paper examines the shift from traditional classroom and practice placement education to online and blended learning accelerated by the COVID-19 pandemic. It focuses on the application of PBL, rooted in constructivist theories and the CoI framework, which includes social, cognitive and teaching presences., Results: PBL encourages active and collaborative learning, aligning with the multifaceted roles of dietetic professionals. The CoI framework guides the development of effective online learning environments, emphasising the importance of social, cognitive and teaching presence., Conclusion: The transition to online education presents significant opportunities for dietetic education. Careful instructional design and effective teaching strategies are crucial for creating successful online learning environments, as demonstrated through an illustrative case study., (© 2024 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Traditional pharmacy education often relies on fragmented, subject-centered curricula, which may inadequately prepare students for the complexities of advanced healthcare. This study evaluates the effectiveness of an integrated pharmacy education approach in enhancing foundational knowledge and practical skills., Methods: An integrated course focused on respiratory diseases was developed and implemented for final-year pharmacy students at Tabriz University of Medical Sciences. The course utilized case-based learning and incorporated elements from various disciplines such as pharmacology, medicinal chemistry, and pharmaceutics. An educational controlled trial was conducted, comparing an intervention group (integrated course) with a control group (traditional course)., Results: Survey results revealed that over 60% of students reported substantial improvements in their ability to manage respiratory cases. The intervention group demonstrated significantly higher clinical decision-making skills, with an average test score of 31.4 compared to 15.75 in the control group (p < 0.05). Student feedback highlighted the value of integrated education, advocating for its broader inclusion in the curriculum and the addition of more diverse topics and case studies., Conclusions: Integrated pharmacy education, through a case-based approach, significantly enhances student competency and practical skills, better preparing them for real-world pharmacy practice. The study supports the implementation of integrated courses across pharmacy schools to develop curricula and improve educational outcomes. Future recommendations include continuous curriculum integration and expansion of topics to further enrich pharmacy education., (© 2024. The Author(s).)

Introduction: While musculoskeletal disorders are leading causes of medical visits, musculoskeletal education is underrepresented in US medical curricula. Previous studies have demonstrated that undergraduate medical students often fail to demonstrate competency surrounding musculoskeletal disorders. More educational content is needed to support musculoskeletal knowledge in learners., Methods: We developed an online, case-based musculoskeletal module for second-year medical students alongside their standard course material and presented clinical cases with multiple-choice question quizzes regarding the presentation, diagnosis, and anatomic correlation of musculoskeletal conditions. Cases, under 10 minutes each, targeted common, medically important areas of musculoskeletal health., Results: Grades in the required musculoskeletal course were significantly and positively correlated with online module quiz performance. 258 (73%) of 354 students completed at least one quiz, and students completed an average of 14 out of 15 quizzes. Learners who completed more than 50% of the quizzes performed significantly better in the course than those who completed fewer quizzes; this was true for a formative internal course exam ( p = .035), an NBME customized assessment ( p = .008), and the course overall ( p = .021). Additional analyses of students' perceptions revealed that students valued the self-directed online learning environment. The high completion rate (73%) for the online module also signaled student value in the content and format., Discussion: This module represents educational material that has been demonstrated to improve medical student musculoskeletal learning. Additionally, the module could be expanded to address inadequacies in orthopedic education among other students, such as allied health learners., (© 2024 Robertson et al.)

In this article, we explore the connections between two distinct approaches: experiential learning (EL) and 4E cognition. EL emphasizes the role of concrete experiences as the building blocks of learning, whereas 4E cognition views cognition as arising from the interactions that an individual has with their physical and social environment. Despite their divergent theoretical frameworks, methodologies, and interests, we argue that both frameworks share a common vision of cognition and that their integration could mutually enhance their respective fields. This article outlines the historical origins and underlying assumptions of both frameworks, highlighting the potential links that can be established between them. Specifically, we explore the significance of embodiment, embeddedness, extended cognition, and enactive processes in learning and cognition. To bridge these frameworks, we propose employing the concept of "concrete experience" as an active engagement of individuals with their physical and social surroundings. By encompassing the essential aspects assigned to concrete experiences in EL, as well as the embodiment, situatedness, extended cognition, and enactive features of 4E cognition, this notion serves as a unifying element. Ultimately, the article suggests that combining the insights from EL and 4E cognition can offer a richer, more holistic understanding of representation., (© 2024 The Author(s). Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of The New York Academy of Sciences.)

Objective: This study aims to evaluate the impact of redesigning an entrustable professional activities (EPAs) assessment tool on the accuracy of student performance assessment within pharmacy education., Methods: The study used retrospective programmatic data for students on clinical rotations over a 3-year period and compared entrustment levels assigned by preceptors with suggested entrustment levels. This tool was redesigned to separate formative EPA feedback from final grade determination. Data were analyzed using chi-squared tests to identify trends in students ABOVE, AT, or BELOW the suggested entrustment levels. Additionally, to account for intercohort variability, the relationship between students ABOVE the suggested level of entrustment and postgraduate metrics was examined., Results: After the implementation of the revised tool, there was a significant decrease (-3%) in the percentage of students scoring ABOVE the suggested entrustment levels and an increase in the percentage of students scoring AT (+1%) or BELOW (+2%) the suggested entrustment levels. Changes were also observed in individual patient care settings, with a decrease in grade inflation and an increase in accurate assessments. North American Pharmacist Licensure Examination (NAPLEX) pass rates, residency match rates, and grade point average did not correlate with entrustment levels., Conclusion: The redesigned EPA assessment tool demonstrated a decrease in grade inflation resulting in more accurate assessments. The tool's focus on holistic grading and narrative descriptors contributed to better alignment between preceptor assessment and school-suggested achievement levels. This study suggests that EPA assessments in pharmacy education could benefit from a stronger emphasis on formative feedback and the use of holistic assessment methods for final grade determinations. The findings underscore the potential advantages of considering a separation between EPA scoring and final grades, prompting the Academy to explore their assessment practices to better reflect student performance in clinical experiences., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Objective: There are increasing calls to improve the representation of diversity within case-based learning materials, yet it is unclear how students interpret the inclusion of diversity data when synthesizing case information. The objective of this study was to determine factors that influence students' interpretation of written case data for visualization of a patient case., Methods: This was a qualitative study using interviews. Entry-to-practice pharmacy students from Dalhousie University in Canada were recruited to review 6 cases, each with varying representations of diversity (eg, race, sexual orientation, gender, relationship status, disability, or none). Students were prompted to state how they visualized the case patient and what factors influenced their perceptions. Interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis was conducted to interpret themes., Results: Interviews were conducted with 18 students. Students relied on 5 factors when interpreting case data in the presence of diversity. In addition to the case data itself, these included personal experience (relating to themselves or personal relationships), professional experience (through work or school), population stereotypes, and perceived societal norms., Conclusion: This study found that students rely on their personal and professional experiences, perceptions, and social conditioning when interpreting the presence of diversity within learning materials. Findings support the notion that educators should deliberately and conscientiously expose students to a broad representation of diverse populations to increase students' knowledge and understanding of populations, and to create intentional time and space to challenge existing stereotypes that contribute to the inequities in health care., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Dental schools have a primary responsibility to devise a curriculum that enhances students' confidence and knowledge in orthodontic case analysis. This study aims to compare the confidence levels and performance of undergraduate students in orthodontic case screening, moderated by faculty in a lecture-based format against their self-analysis of the same cases 1 year later, using a case-based and flipped learning approach., Materials and Methods: This study involved 100 fifth-year students. The same group received predoctoral orthodontics training through an instructor-centered, didactic approach in their fifth year and a case-based, student-centered, flipped classroom approach in their sixth year. At the end of each semester, the students completed an orthodontic case analysis and a self-reflection survey., Results: This study found no significant differences in diagnostic capabilities for orthodontic findings between the two methods studied. However, the self-evaluation survey data revealed an increase in students' confidence levels. This was specifically in terms of carrying out independent orthodontic case diagnosis, effectively communicating with orthodontic specialists, and their comfort in approaching orthodontic cases following the flipped classroom approach. Despite increased confidence in case diagnosis, the results showed that final-year students are uncertain about creating initial treatment plans and referring cases at an early stage., Conclusion: Despite no observed improvement in students' orthodontic diagnostic abilities after another semester of student-centered learning, their confidence in diagnosing orthodontic cases was notably enhanced., (© 2024 American Dental Education Association.)

Objective: To compare the efficacy of Jigsaw and Inquiry-Based Learning (IBL) methods in promoting effective learning outcomes within diverse dental educational settings., Methods: A total of 188 dental undergraduate students were recruited for the study and divided into Batch A (n = 96) and Batch B (n = 92). Each batch underwent two teaching sessions, one using the Jigsaw method and the other using IBL. A structured questionnaire using five-point Likert scales assessed students' preferences between the two methods. Pre- and post-intervention tests were conducted to measure knowledge acquisition. Statistical analysis was performed using Student's t-test with STATA version 17, with a p-value of < 0.05 considered significant., Results: Both Jigsaw and IBL methods significantly improved students' knowledge, with mean scores showing a significant difference before and after interventions (p < 0.001). IBL was more effective in comprehensive topic coverage (99.46%) and enhancing subject understanding. Both methods yielded comparable outcomes in terms of improving communication skills. The Jigsaw method was simpler and more enjoyable, encouraging active participation and enhancing communication skills. IBL promoted critical thinking, research skills, and deeper comprehension of concepts., Conclusion: Jigsaw and IBL methods are both effective in enhancing dental education. The choice between these methods depends on the specific learning objectives, the complexity of the topic, and the preferences of the dental educator and students., (© 2024 The Author(s). Journal of Dental Education published by Wiley Periodicals LLC on behalf of American Dental Education Association.)

Abstract: Team-based learning (TBL) is an evidence-based teaching-learning strategy increasingly used in nursing education to improve student learning outcomes. Few studies have focused on its effects on the critical thinking disposition of second-degree nursing students enrolled in accelerated, entry-level master's programs. The purpose of this study was to evaluate the impact of TBL on the critical thinking disposition of entry-level master's nursing students. Critical thinking disposition scores did not significantly improve, but students' confidence in reasoning skills and intellectual curiosity were strengthened, suggesting that TBL is an instructional strategy worth pursuing in entry-level master's nursing programs., Competing Interests: The author has declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Introduction: Student engagement is influenced by several variables, among which are the teaching styles employed by faculty. In problem-based learning (PBL), the role of faculty is to facilitate the learning of the tutorial group as they work through clinical problems. However, the influence of tutor intervention styles and group process on engagement of students in PBL tutorials is unclear., Methods: The study was conducted with year 2 and 3 medical students (n = 176) in PBL tutorial groups at the end of an integrated PBL course. Students evaluated their behavioural, cognitive and emotional engagement in PBL tutorials using a pre-validated 11-item questionnaire. Students also filled in a modified version of a previously published tutor intervention profile (TIP) questionnaire. The modified TIP questionnaire represents three constructs (1) steering the learning process (6 items), (2) stimulating student autonomy (4 items) and (3) establishing relatedness with students (3 items). In addition, PBL group process was evaluated using a 5-item nominal scale: (1) tutorial atmosphere, (2) listening and information sharing, (3) group performance, (4) decision making and (5) reaction to leadership., Results: Establishing sense of relatedness in the group by PBL tutors was the most important predictor of emotional engagement (F = 41.213, ΔR 2  = 0.191, β = 0.438, P = 0.000). On the other hand, steering the learning process was a significant predictor of behavioural engagement (F = 19.0, ΔR 2 =0.098, β = 0.314, P = 0.000). However, stimulating student autonomy was not a significant predictor of student engagement in PBL tutorials. On the other hand, enhancing the group process in PBL tutorials significantly predicts student engagement with strong impact on emotional and cognitive engagement of students., Conclusions: Establishing the sense of relatedness in the group and steering the learning process by PBL tutors as well as improving PBL group process are significant predictors of student engagement in PBL tutorials with emotional and cognitive engagement being the most sensitive variables affected., (© 2024 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Purpose: to analyze which factors are associated with students' engagement and participation in video-based lectures in a flipped classroom environment., Methods: A single-center experience with video-based lectures in undergraduate medical education is described. The activity was applied to the subject of Neurosurgery during two consecutive courses (2021/22 and 2022/23). The videos were available prior to face-to-face classes through the online application Edpuzzle. Information was obtained from the own platform at the end of each course. Multivariable linear regression analyses were performed to assess the association between different variables and the percentage of video viewing, the early dropout rate, and the percentage of audience retention., Results: A total of 109 students registered in Edpuzzle (87.2% of all enrolled students). Fifty-one videos were uploaded each course to cover 11 topics. Mean video viewing rate was 41%. Those videos linked to the earliest classroom lessons showed more percentage of viewing and audience retention than those programmed at the end of the course. With mandatory classroom assistance and homework assignments, the seminar videos were viewed more but retained less audience. Shorter videos were associated with higher viewing and audience adhesion, but the presence of questions embedded throughout the clip did not significantly engage students. No significant difference was observed regarding lesson topics., Conclusions: It is essential to emphasize the importance of designing strategies to initially engage learners since more than half of our students never connected to the clips. Decreasing engagement was associated with the end of the course and video length. Seminar videos were viewed more but retained less audience. Active learning activities such as quizzes embedded throughout the clips did not significantly engage learners., (© 2024. The Author(s).)

Background: Critical thinking has been regarded as an essential skill for college students, which is especially imperative for medical students to possess the ability to have in-depth insight into complex clinical situations. Medical Immunology is an overarching principle connecting multiple medical subjects, which emphasizes that immunity is both beneficial and harmful to the host, thus putting higher demands on students' critical thinking. The utilization of Nobel Prize stories has been cited as a thematic framework for classroom teaching of other courses, showing numerous educational benefits. Therefore, this study rejuvenated a case-based teaching approach by creating and introducing a vibrant material library centered on numerous iconic Nobel Prize cases in Medical Immunology and evaluating its effects on the critical thinking of medical students., Methods: A total of 70 second-year medical undergraduates from the Beijing University of Chinese Medicine were divided into a control group and an experimental group of 35 cases each. Throughout the semester, the control received the traditional teaching method, and the experimental group adopted case-based teaching based on the Nobel prize-centered material library. The process of teaching design and practice was described using "Antitoxin and immunoserum therapy" as a classical example. A unified assessment of the critical thinking dispositions of participants was conducted at the beginning and end of the semester using the Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV)., Results: Intra-group longitudinal comparisons and inter-group parallel evaluations indicated that, compared with the conventional teaching approach, Nobel Prize case-based learning induced a statistically significant increase in the overall score of the CTDI-CV, as well as the scores within the subdimensions of truth-seeking, analyticity, and maturity in judgment (p < 0.05). Pearson correlation analysis further indicated a positive correlation between the total score of the CTDI-CV and the final grade (p < 0.05), which emphasized the crucial role of critical thinking dispositions in academic achievement., Conclusion: The case-based classroom teaching centered on Nobel Prize cases for Medical Immunology can effectively improve the critical thinking dispositions of medical undergraduates, which contributes to cultivating high-level medical and healthcare talents with excellent comprehensive quality in the new era., (© 2024. The Author(s).)

Objective: This study aims to assess the impact of LearnGuide, a specialized ChatGPT tool designed to support self-directed learning among medical students., Materials and Methods: In this 14-week randomized controlled trial (ClinicalTrials.gov NCT06276049), 103 medical students were assigned to either an intervention group, which received 12 weeks of problem-based training with LearnGuide support, or a control group, which received identical training without AI assistance. Primary and secondary outcomes, including Self-Directed Learning Scale scores at 6 and 12 weeks, Cornell Critical Thinking Test Level Z scores, and Global Flow Scores, were evaluated with a 14-week follow-up. Mann-Whitney U tests were used for statistical comparisons between the groups., Results: At 6 weeks, the intervention group showed a marginally higher median Self-Directed Learning Scale score, which further improved by 12 weeks (4.15 [95% CI, 0.82 to 7.48]; p  = 0.01) and was sustained at the 14-week follow-up. Additionally, this group demonstrated notable improvements in the Cornell Critical Thinking Test Score at 12 weeks (7.11 [95% CI, 4.50 to 9.72]; p  < 0.001), which persisted into the 14-week follow-up. The group also experienced enhancements in the Global Flow Score from 6 weeks, maintaining superiority over the control group through 12 weeks., Conclusions: LearnGuide significantly enhanced self-directed learning, critical thinking, and flow experiences in medical students, highlighting the crucial role of AI tools in advancing medical education.

Background: Team-based learning (TBL) and problem-based learning (PBL) are two effective educational approaches used in medical education for increasing knowledge acquisition, learning motivation, and collaborative and communication skills among students. Few studies have been conducted in Saudi Arabia to evaluate medical students' perceptions of these approaches., Aim of the Study: The present study aimed to evaluate the perceptions of current or previous preclinical students at the College of Medicine, Najran University (NU) about the effectiveness of PBL and TBL and to assess students' perceptions regarding the strengths and limitations of both educational approaches and their preferences., Methods: A cross-sectional survey was conducted on 106 preclinical students at NU, Saudi Arabia. The survey questionnaire was validated by a pilot study and designed based on Kirkpatrick's evaluation model. Descriptive statistics was used to analyze the collected data through IBM SPSS Statistics 2.0., Results: 73.6% of participants enjoyed PBL and found it motivating compared to TBL and classic lectures. PBL was reported as more effective for knowledge acquisition (50%), teamwork (62.3%), and high academic performance (58%)., Conclusion: It is concluded that PBL was more favored by the students regarding the learning outcomes. TBL was reported to need more individual preparation and effort and require lecturer involvement, suggesting the need for structured facilitation in this learning approach and potentially indicating the challenges associated with coordinating team-based activities., (© 2024. The Author(s).)

Aim: This study aimed to evaluate the effects of problem-based learning integrated with the nursing process on clinical reasoning, communication skills attitude and nursing process competency of nursing students., Background: Systematic and integrated application of nursing process in various nursing scenarios are necessary as an alternative to limited learning experiences during conventional lectured-based learning. Thus, an innovative nursing curriculum should be developed by adopting problem-based learning integrated with the nursing process, the effectiveness of this process should be tested to improve the quality of nursing education and explore effective educational strategies., Design: A quasi-experimental non-equivalent control group pre-test and post-test design., Methods: The study was conducted from September to October, 2023. Third-year nursing students who were selected by intentional sampling were allocated to the control (n=69) and experimental (n=87) groups. The control group participated in conventional lectures, whereas the experimental group participated in the problem-based learning integrated with the nursing process (six sessions) regarding various high-risk obstetrics and gynecology nursing. Thereafter, the students completed structured questionnaire on Google surveys including items on clinical reasoning, communication skills attitude and nursing process competency., Results: Clinical reasoning (t=-4.599, p=<.001), communication skills attitude (t=-1.848, p=.033) and nursing process competency (t=-3.795, p<.001) increased significantly more in the post-test for the experimental than the control group., Conclusions: This study shed light on the learning effects that enable effective communication and enhance confidence in nursing students for applying clinical reasoning and the nursing process based on various high-risk obstetrics and gynecology nursing modules. Moreover, learners are expected to experience knowledge expansion and transfer through reasoning and application. Therefore, modules of high-prevalence diseases should be developed for various nursing major courses and problem-based learning integrated with the nursing process linked to these modules should be designed for use in nursing classes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Team-Based Learning (TBL) has garnered considerable attention in education research. To consolidate the existing evidence, we conducted an umbrella review with four objectives: (a) to identify TBL review characteristics, (b) to synthesize findings from previous reviews regarding TBL effectiveness and outcomes, (c) to determine which student groups benefit most, and (d) to identify the most and least researched elements., Methods: The Joanna Briggs Institute (JBI) methodology was followed: [1] Search strategy and literature search [2] Screening and Study Selection [3] Assessment of methodological quality [4] Data collection, and [5] Data summary. We utilized Endnote, Excel, and MAXQDA for efficient project management and analyzing data., Results: Analyzing twenty-three reviews spanning from 2013 to 2024, we found a peak in TBL research in 2022 including more than 312 unique primary studies involving more than 63,987 participants. Notably, the United States and China accounted for over 61% of the total primary articles focused on students from medicine, nursing, pharmacy, and dentistry. Evidence supports the superiority of TBL in enhancing cognitive outcomes. However, findings related to retention are mixed. Insufficient evidence exists to draw robust conclusions when comparing TBL with other active learning methods. TBL demonstrates favorable outcomes in terms of clinical performance and engagement. Non-technical skills show mixed results. Notably, TBL positively impacts self-study, learning ability, decision-making, and emotional intelligence. Faculty experiences reveal an initial increase in workload, but generally hold positive attitude. Faculty development remain limited in duration and scope. Freshmen, academically weaker students, undergraduates, Chinese female students, and nursing students appear to benefit most from TBL. Team formation and size are the most frequently studied elements., Conclusion: TBL holds promise for improving learning outcomes, but ongoing investigation is essential to maximize its impact in diverse educational contexts. This umbrella review underscores the need for further research in specific areas i.e. effective pre-class learning methods and faculty workload., (© 2024. The Author(s).)

Background: Modification of the learning environment enhances academic performance, and meta-motivational skills. Yet it is largely unknown which underlying cause potentiates these effects. The study's goal is to analyse flipped classroom (FC) effect on basic psychological needs and self-esteem., Methods: 40 undergraduate medical students participated in a one-site two phased study. In Phase I, students attended a traditional lecture-based classroom (TC). In Phase II, the same group attended FC. Upon completion of each Phase students completed two questionnaires: Basic Psychological Need Satisfaction and Frustration Scale, and Rosenberg self-esteem scale., Results: Autonomy satisfaction was significantly higher in FC (n = 40, z = 5.520, p < .001), the same tendency was seen for Competence satisfaction in FC (n = 40, z = 5.122, p < .001). As for the frustration of all three needs, the statistical difference was observed for all three subscales between TC and FC. In FC, autonomy (n = 40, z = - 5.370, p < .001), relatedness (n = 40, z = 4.187, p < .001), and competence (n = 40, z = - 5.323, p < .001) frustration was significantly lower. Self-esteem was significantly higher in FC (n = 40, z = 5.528, p < .001). In TC self-esteem negatively correlated with autonomy frustration, (r(38) = - 0.430, p < .01), and competence frustration, (r(38) = - 0.379, p < .05). In FC, self-esteem positively correlated with autonomy satisfaction (r(38) = 0.316, p < .05), and competence satisfaction (r(38) = 0.429, p < .01)., Conclusions: FC better fulfils students' basic psychological needs, specifically needs for autonomy and competence, and self-esteem compared to TC. Collaborative work, and academic scaffolding, contributes to behavioural engagement of students in the learning process. FC with the main focus on students' active involvement may better meet millennials' needs. Implementing validated questionnaires to measure students' psychological needs should become a regular practice in medical schools, specifically during the process of curriculum redesign., (© 2024. The Author(s).)

Background: The main objectives of the study were to analyse the use of the Objective Structured Clinical Examination (OSCE) to evaluate the skills of medical students in paediatric basic life support (PBLS), to compare two resuscitation training models and to evaluate the measures to improve the teaching program., Methods: Comparative, prospective, observation study with intervention in two hospitals, one undergoing a PILS course (Paediatric Immediate Life Support) and another PBLS. The study was performed over three phases. 1º. PBLS OSCE in 2022 three months after the resuscitation training 2. Measures to improve the training program in 2023 3. PBLS OSCE in 2023. Overall results were analysed and comparison between both sites and those for 2022 and 2023 were made., Results: A total of 210 and 182 students took part in the OSCE in 2022 and 2023, respectively. The overall mean score out of 100 was 83.2 (19), 77.8 (19.8) in 2022 and 89.5 (15.9) and 2023, P < 0.001. Overall cardiopulmonary resuscitation (CPR) effectiveness was adequate in 79.4% and 84.6% of students in 2022 and 2023, respectively. The results of hospital students undergoing a PILS course were better (86.4 (16.6) than those undergoing a PBLS. 80.2 (20.6) p < 0.001. The results from both hospitals improved significantly in 2023., Conclusions: The OSCE is a valid instrument to evaluate PBLS skills in medical students and to compare different training methods and program improvements. Medical students who receive a PILS attain better PBLS skills than those who undergo a PBLS course., (© 2024. The Author(s).)

Introduction: Team-Based Learning (TBL) is a highly structured active learning methodology shown to have positive learning outcomes in undergraduate medical education (UME). While many medical schools have increasingly adopted TBL, there is considerable variation reported in the literature in the implementation of the standard sequence and key components of TBL. The extent to which this variation affects the benefits of TBL is not well understood. This study aims to assess the impact of implementing the standardized framework of the TBL process on student perception of the benefits of TBL., Methods: Faculty at our institute were surveyed to determine the frequency of implementation of TBL standards, as described in the literature. Second-year osteopathic medical students (OMS II) were surveyed for their perception of the experience of TBL at the beginning of the academic year. Curricular interventions targeting the enforcement of the standard steps and key components of TBL were implemented in a particular 6-week system course. The students were re-surveyed at the end of the course. Descriptive and thematic analyses were performed on quantitative and qualitative data., Results: Twenty four of 31 (77.4%) faculty participated in the faculty survey, 53 of 105 OMS II students (50.4%) participated in the pre-intervention survey, and 72 of 104 OMS II students (69.2%) participated in the post-intervention survey. Faculty survey results indicated inconsistent implementation of key steps and components of the TBL process. Comparisons of student pre- and post-survey means of the perceived value of various aspects of TBL showed significant improvement in multiple aspects of the TBL process, including readiness assurance tests, immediate feedback, and application activities. Both before and after the intervention, students highly rated the value of teamwork and opportunities for practical application of concepts within TBL., Conclusion: While medical students value teamwork in UME and professional development, their perception of TBL can be less than positive if not conducted deliberatively. Assessment of the implementation of the standard TBL steps and components and development of corresponding targeted interventions may improve the TBL experience of medical students. Our process could be generalized to help educators interested in improving TBL in their home institutes., (© 2024. The Author(s).)

Human learning essentially involves embodied interactions with the material world. But our worlds now include increasing numbers of powerful and (apparently) disembodied generative artificial intelligence (AI). In what follows we ask how best to understand these new (somewhat 'alien', because of their disembodied nature) resources and how to incorporate them in our educational practices. We focus on methodologies that encourage exploration and embodied interactions with 'prepared' material environments, such as the carefully organized settings of Montessori education. Using the active inference framework, we approach our questions by thinking about human learning as epistemic foraging and prediction error minimization. We end by arguing that generative AI should figure naturally as new elements in prepared learning environments by facilitating sequences of precise prediction error enabling trajectories of self-correction. In these ways, we anticipate new synergies between (apparently) di s embodied and (essentially) embodied forms of intelligence. This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

The use of small-group collaborative case-based learning methodologies has been growing both in interest and implementation across veterinary college curriculums in recent years. The ability of this pedagogical approach to solidify and deepen learning outcomes is well-established in the broader education literature. However, to achieve this positive impact, students must interact in productive discussions that expand the scope of their understanding. The present study focused on analyzing the ways in which professional veterinary students interact as they work collaboratively through clinical cases, in the context of a Team-Based Learning-intensive curriculum. This data was used to draw connections between the questions posed in the clinical case activities and the resulting intragroup collaborative outcomes, which can assist veterinary educators in sparking more robust student discussions through facilitation and instructional design. Fourteen participants formed two student groups that worked on 49 case questions across five sessions, providing 98 episodes of collaboration for analysis. The findings of this study revealed how professional veterinary students negotiated perspectives to come to consensus on in-class case-based learning tasks, including eight primary types of statements they made and seven overall patterns of group collaboration. This study highlighted specific elements of instructional design that influenced student collaboration including: allowing for multiple perspectives, sparking disagreement, perceived difficulty, learning outcome level, and the level of consensus required by the question structure. We present specific recommendations for veterinary educators to consider while designing questions for veterinary student groups.

Objective: This study explores the application and feasibility of problem based learning (PBL), integrating case based learning (CBL), and the mini clinical evaluation exercise (Mini-CEX) into the standardized training of residents in nephrology department, in order to assess their clinical skills in a comprehensive manner., Methods: This prospective study enrolled 60, three years residents majoring in clinical medicine, from June 2022 to December 2023 in Nephrology Department of Baoding No.1 Central Hospital. These participants were randomly allocated into either the combined PBL-CBL and Mini-CEX teaching group (experimental group) or the traditional lecture-based teaching group (control group). Two groups were evaluated with Mini-CEX assessments and test scores upon exit the department, followed by a questionnaire survey to measure satisfaction levels for the teachers., Results: There was no statistically significant difference in age, sex, year of graduate school, specialty and student source between the two groups of residents upon the entering the department (P>0.05). Upon the completion, the experimental group, which received PBL-CBL and Mini-CEX teaching methods, demonstrated significantly higher scores in all aspects compared to the control group, with a statistically significant difference (P<0.01). Furthermore, compared the control group, most residents in the experimental group agreed that the PBL-CBL and Mini-CEX teaching methods improve curiosity and enthusiasm for learning (73.3%), communication and expression abilities (73.3%), self-learning abilities (80%), understanding of diseases (76.7%), and like this teaching method (86.7%)., Conclusions: PBL-CBL and Mini-CEX may be an effective method for improving medical residents' performance and enhancing their clinical skills, which is worthy of promotion in the standardized training of the residents., Competing Interests: Conflict of Interests: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Aim: To conduct unfolding case studies and test their effectiveness in improving clinical reasoning, teamwork and self-directed learning among postgraduate students., Background: Postgraduate students, as advanced nursing professionals in clinical settings, are the driving force behind the rapid development of the nursing profession. Effective clinical reasoning is a fundamental nursing skill that postgraduate students must cultivate, having a direct impact on patient health outcomes. The development and usation of unfolding case studies, which reflect the evolving conditions of patients, combined with think-aloud teaching methods, can enhance postgraduate students' clinical reasoning abilities and foster communication and self-reflection, thereby achieving this goal., Design: Mixed methods design., Methods: The Nurses' Clinical Reasoning Scale and the Nursing Students' Self-Directed Learning Ability Scale were used to evaluate the clinical reasoning and self-directed learning abilities of nursing students. A qualitative exploratory design with a think-aloud interview technique was employed to explore the clinical reasoning process of nursing students in unfolding cases. Twenty-one nursing students completed the questionnaire survey. Data analysis was conducted using Wilcoxon signed-rank tests, Spearman correlations, regressions and inductive content analysis., Results: After implementing the case study, there was a statistically significant improvement in students' clinical reasoning, self-directed learning and teamwork abilities. Think-aloud analysis revealed that the cognitive strategies most employed by students in clinical reasoning were 'Making choices', 'Forming relationships', 'Searched for information' and 'Drawing conclusions'., Conclusion: Unfolding case studies combined with think-aloud strategies provide a conducive learning environment for postgraduate students, effectively enhancing their clinical reasoning and self-directed learning abilities., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Learning 2D sectional anatomy facilitates the comprehension of 3D anatomical structures, anatomical relationships, and radiological anatomy. However, the efficacy of technology-enhanced collaborative instructional activities in sectional anatomy remains unclear, especially if theoretical frameworks, namely the Cognitive Theory of Multimedia Learning (CTML), are applied in instructional design. Thus, this study compared the educational impact of distinct 45-min-long technology-enhanced collaborative learning tasks in sectional anatomy. A sample of 115 first-year medical students was randomly divided into three experimental groups that used different supporting technologies to learn the sectional anatomy of the chest: IMAIOS e-learning platform and Microsoft Surface Hub (n = 37); anatomage table (n = 38); anatomage table with CTML-based presets (n = 40). Prelearning and postlearning tests revealed that significant knowledge gains in sectional anatomy were obtained by all groups even though no inter-group differences were found. Moreover, a five-point Likert scale questionnaire showed that the learning session was highly valued by all participants and that users of the anatomage with CTML-based presets reported higher enjoyment than users of the IMAIOS system (mean difference = 0.400; p = 0.037). In addition, students using the IMAIOS system and the anatomage with CTML-based presets provided System Usability Scale (SUS) scores of 67.64 and 67.69, respectively, reaching the benchmark of usability. By contrast, students using the anatomage table without presets awarded a SUS score of 64.14. These results suggest that the integration of multimedia technologies in anatomy teaching and learning should be grounded on CTML principles of instructional design. Otherwise, students' perceptions of ed-tech usability are potentially hindered., (© 2024 The Author(s). Clinical Anatomy published by Wiley Periodicals LLC on behalf of American Association of Clinical Anatomists and British Association of Clinical Anatomists.)

Research coursework can be challenging for occupational therapy students, thus potentially compromising their engagement in learning. A student engagement framework was used to design and implement an innovative assignment called Researchers' Theater with a cohort of 38 first-semester occupational therapy students. At the beginning of each class, a small group of students led a creative activity to review topics from the preceding week. Student feedback survey results and instructors' observations suggest this framework contributed to students' affective, behavioral, and cognitive engagement. Findings also highlight the potential value of student-led, game-based learning for reinforcing course content.

Background: Nurses are expected to base practice on evidence from research, which requires an understanding of the research process. However, baccalaureate nursing students may find research courses uninteresting or feel unprepared to conduct research. Participation in experiential research projects may affect their research attitudes, knowledge, and skills., Method: Nursing investigators engaged nursing students in an experiential, active learning research project centered on the effects of pet interaction involving university students. Faculty mentored and partnered with nursing students, immersing them in all research processes., Results: Students confirmed that participation in the project enhanced their understanding of research, improved their clinical and communication skills, and fostered professional growth. Students presented results in a scientific poster at the University's research event., Conclusion: Collaborative faculty-student research projects enhance students' interest in and appreciation of evidence-based research, and support professional development, confidence in assuming research roles, and feelings of connection with faculty, each other, and the university. [ J Nurs Educ . 2024;63(10):713-715.] .

Purpose of the Article: Medical undergraduates at St George's, University of London (SGUL) study a weekly clinical case during their clinical science years. Audit of the human stories demonstrated lack of diversity, mono-professionalism, and objectification of some patients. A collaborative partnership with staff, student and patient representation implemented curriculum change, including an inclusive case-writing initiative. We explored whether the reformed written cases supported the development of positive attitudes by sampling perceptions of the cases amongst students., Methods: Sixteen semi-structured interviews were conducted (Feb-November 2022) with first year medical students. We applied an interpretative phenomenological analysis approach. Verbatim transcripts were coded and analysed to elucidate themes., Results: Four themes were identified: (i) effective learning, (ii) clinical authenticity, (iii) authentic human stories, and (iv) opportunity for rehearsing the role of a doctor. Students perceived the cases as an effective, contextual learning method, with a high degree of clinical authenticity, allowing mentalisation of doctor attitudes and behaviours in relation to patient-centredness, multidisciplinary team working and diversity., Conclusion: The results suggest the reformed cases created positive attitudinal change amongst students and supported transition to clinical roles. Memorable human stories had the greatest impact. Dynamic, inclusive, and collaborative case writing initiatives which integrate realism, diversity and multi-professionalism may help to foster positive experiences in students undertaking CBL sessions.

Purpose: This paper explores experiences of a physician who in one life-altering day awoke in intensive care and had to embark on a complex journey as full-time patient. It identifies the important literature, albeit limited, from a unique dual lens view of physician turned patient, and analyzes the potential for advancing medical education by recognizing the expertise that patients possess from lived experience., Methodology: An autoethnography study was undertaken to unpack data obtained from lived patient experience during a two-and-a-half-year long hospitalization. Themes were captured in a series of eleven scenarios. Findings included critical reflection from the patient, medical educator, and research perspectives. Data was cross-referenced with relevant literature., Results: Seven themes emerged upon critical analysis of the eleven scenarios that described real-life healthcare encounters of the physician turned patient. These often-neglected themes from medical education include experiential learning, reflection, what counts as medical care, vulnerability, patient-centred care, agency, and patient expertise., Conclusions: This study highlights differences between intellectual-experiential knowledge, and challenges medical education to harness the expertise that patients possess. It contributes to scholarly discourses by demonstrating the utility of autoethnography in medical education, critiques traditional medical education models, expands the breadth of what constitutes knowledge, and invites medical educators to actively involve patients as equal stakeholders in curricula.

Objective: This study aimed to assess the effectiveness of an interactive education approach in oral and maxillofacial radiology for dentists, utilizing the online interactive educational program Mentimeter., Method: Seven continuing education sessions for dentists in oral and maxillofacial radiology were conducted employing Mentimeter. Following these sessions, surveys gauged participants' responses to the learning method and its effectiveness. The questionnaire comprised 20 questions categorized into convenience, active learning, academic achievement, time management, and lecture quality., Result: Among about 300 participants, 222 responded to the survey, with 74 (33.3%) having prior experience in similar education. Across categories of active learning, academic achievement, and lecture quality, participants consistently rated the method with an average score exceeding 4 out of 5, indicating a highly positive response. Statistically significant gender differences were observed in 9 out of 20 questions, with female respondents providing more positive evaluations than males. Respondents without prior similar education reported enhanced focus and understanding compared to those with experience. No statistically significant differences were observed in other survey questions., Conclusion: In the realm of continuing education in oral and maxillofacial radiology for dentists, the interactive educational program Mentimeter emerges as an effective tool, fostering positive academic achievements through active learning., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction and Aim: Self-directed learning (SDL) has become an essential learning principle in medical curricula and a requirement of the professional accreditation standards. It has been advocated that SDL is an effective learning strategy for medical students to develop competence in knowledge acquisition and in promoting life-long learning. Although it has been presumed that problem-based learning (PBL) improves the learner's SDL readiness (SDLR), its effects are still debatable. This study aimed to investigate the readiness for self-directed learning readiness (SDLR) among undergraduate medical students in problem-based learning (PBL) and non-PBL programs, examining the influence of gender, academic performance, and program year level., Methods: This cross-sectional study used a validated instrument, the SDLR instrument (SDLRI), to assess self-directed learning readiness. It consists of 20 items classified into the following four domains: learning motivation (six items), planning and implementation (six items), self-monitoring (four items), and interpersonal communication (four items) based upon a five-point Likert scale. Additionally, demographic data like academic year level, gender, and the student's final grade from the previous semester were collected. Questionnaires were administered to students in their first, third, and fifth (final) academic year across three different medical colleges in the United Arab Emirates (UAE). One of these colleges adopts a hybrid problem-based learning (PBL) approach, while the other two follow non-PBL programs. A total of 386 responses were collected, with 200 students (51.8%) from the hybrid PBL program and 186 students (48.2%) from the non-PBL programs., Results: The overall mean SDLR score was 59.0±18.2. In both programs, the high-achieving students scored SDLR of 64.7±18.0 (n=112), which was statistically significantly higher than the eight medium- and low-achieving students, 57.8±17.2 (n=224). However, the overall SDLR score showed no significant difference in gender or between PBL and non-PBL programs. Although the SDLR increased as PBL students advanced in the program, it decreased in the non-PBL curricula. However, this difference was not statistically significant., Conclusion: The high-achieving students displayed a higher level of SDLR than 10 of the medium- or low-achieving students, regardless of the educational program. This highlights the essential effect of the intrinsic factor for undertaking SDL and implies that students should initiate the process. Moreover, enhancing personal development and SDL educational practices might be effective in improving SDLR if partly implemented in medical programs., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research Ethics Committee of University of Sharjah issued approval #REC-19-01-19-01-S. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nosair et al.)

Background:  The Nursing Education Programme was affected during the coronavirus disease 2019 (COVID-19) pandemic, resulting in nursing students being unable to participate in the clinical experiential learning required by the South African Nursing Council., Objectives:  The study seeks to explore and describe nursing students' experiences of clinical experiential learning during the COVID-19 pandemic., Method:  A qualitative, explorative and descriptive, research design was used in the study. A non-probability purposive sampling method was used, and 55 nursing students participated in the study. Data were collected through six focus group discussions, consisting of 8-12 nursing students in each group. Data were analysed following Tesch's open coding method., Results:  Three themes emerged from the study's findings: The impact of COVID-19 on the clinical experiential learning of nursing students, the effects of COVID-19 on the mental well-being of nursing students, and nursing students' experiences of support during the COVID-19 pandemic. Notably, 11 sub-themes emerged., Conclusion:  The findings of this study reveal that the COVID-19 pandemic severely disrupted the Nursing Education Programme, highlighting the challenges of inadequate clinical hours, restricted clinical access and the significant psychological impact on students.Contribution: This study adds to the literature on students' experiences during clinical experiential learning in South Africa during the COVID-19 pandemic.

Inquiry-based learning (IBL) is a type of problem-based learning. While IBL aims at reflecting the work of practicing researchers, only some students will pursue an academic career. We therefore designed a course that provides opportunities for IBL by applying participant observation to internship work experience inside and outside academia. Using this internship course as an example, we investigated, how master's students in health science executed an IBL assignment regarding the application of participant observation and presentation of findings. In addition, the understanding of occupational fields provided through the IBL assignment was examined.To determine whether learning objectives were met, a document analysis of IBL assignments comprising presentation slides and field protocols was performed. Within content analysis, a category grid was used examining (a) suitability of chosen research objectives, (b) execution of field protocols, (c) sufficiency of reporting and (d) extent of reflection.49 IBL assignments from the years 2020-2022 were included. Sides of IBL observations were: (a) organizations providing health care (n = 28); (b) administrations of health care (n = 8); and (c) research institutes (n = 13). Within students' field protocols, the level of detail of descriptions differed. 30 assignments included reflection on the methods used and research experience. In about a third of IBL assignments, indication of observation type, theoretical background and data analysis was missing.Using participant observation of internship work-experience for IBL can serve as a teaching tool for students to develop methodological skills. For future courses, we developed a checklist to strengthen reporting, reflection and use of theory. As internships are often integrated in degree programs in health sciences similar courses could be implemented in different programs, given qualified methodological guidance., (© 2024. The Author(s).)

Background: Bedside teaching remains a challenging endeavor for clinical doctors and medical students, as the students often encounter difficulties in applying their knowledge to clinical situations. This study aims to evaluate the efficacy of combining case-based learning (CBL) with a flipped classroom (FC) approach in nephrology bedside teaching., Methods: A total of 92 medical students were enrolled in this study, including clerks and interns. The students were assigned into two groups. The CBL/FC group students received the combined teaching approach of CBL and FC (CBL/FC). Students who received the traditional lecture-based teaching (LBT) approach were treated as the control group. General knowledge tests, clinical case scenarios, and questionnaires were used to evaluate the teaching efficacy., Results: Ninety-two students were included in this study. Overall, 46 students were assigned to the CBL/FC group, while the other 46 students were assigned to the LBT group. The students in both groups showed comparable performance in the knowledge test. However, in clinical case scenarios, students in the CBL/FC group demonstrated superior performance compared to those in the LBT group. Additionally, the analysis of questionnaires revealed that the CBL/FC group students expressed more positive attitudes toward their proficiency in medical history taking, physical examination, medical record documentation, clinical reasoning, and consideration for patients' welfare. Moreover, the students from the CBL/FC group regarded the CBL/FC teaching approach as an effective and satisfying method without increasing the learning burden., Conclusion: This study reveals that the CBL/FC combined teaching approach shows promise in nephrology education and provides an effective and alternative format for medical teaching., (© 2024. The Author(s).)

Background: Breaking bad news is one of the most difficult aspects of communication in medicine. The objective of this study was to assess the relevance of a novel active learning course on breaking bad news for fifth-year students., Methods: Students were divided into two groups: Group 1, the intervention group, participated in a multidisciplinary formative discussion workshop on breaking bad news with videos, discussions with a pluri-professional team, and concluding with the development of a guide on good practice in breaking bad news through collective intelligence; Group 2, the control group, received no additional training besides conventional university course. The relevance of discussion-group-based active training was assessed in a summative objective structured clinical examination (OSCE) station particularly through the students' communication skills., Results: Thirty-one students were included: 17 in Group 1 and 14 in Group 2. The mean (range) score in the OSCE was significantly higher in Group 1 than in Group 2 (10.49 out of 15 (7; 13) vs. 7.80 (4.75; 12.5), respectively; p = 0.0007). The proportion of students assessed by the evaluator to have received additional training in breaking bad news was 88.2% (15 of the 17) in Group 1 and 21.4% (3 of the 14) in Group 2 (p = 0.001). The intergroup differences in the Rosenberg Self-Esteem Scale and Jefferson Scale of Empathy scores were not significant, and both scores were not correlated with the students' self-assessed score for success in the OSCE., Conclusion: Compared to the conventional course, this new active learning method for breaking bad news was associated with a significantly higher score in a summative OSCE. A longer-term validation study is needed to confirm these exploratory data., (© 2024. The Author(s).)

Background: Health Advocacy is considered one of the most difficult skills to teach. Many medical learners feel ill-equipped in social competencies and identify it as a significant gap in their medical training. Experiential learning has recently been emerging as a more effective method to teach health advocacy. The Post Graduate Medical Education (PGME) Health Advocacy Day is a new experiential learning curriculum designed to teach important competencies of health advocacy and social accountability to post-graduate medical residents at the University of Ottawa in Ottawa, Canada. The objective of this mixed-methods study was to assess resident experiences., Methods: Second-year trainees from all adult residency programs attended the Advocacy Day as part of a mandatory academic day. All participants completed a mandatory pre-and post-session quiz to assess knowledge of key topics before and after the course. We also distributed a voluntary survey to all participants and invited residents to participate in semi-structured interviews to provide feedback on the course. We used descriptive statistics to analyze quiz scores and survey results and conducted a paired t-test of pre and post-test quiz scores. We also performed a thematic analysis of qualitative feedback, specifically survey comments and semi-structured interviews., Results: One hundred and eighty-three residents participated in the Advocacy Day and 112 (61.2%) completed the post-course survey. Ten residents volunteered to be interviewed. Respondents were generally satisfied by the session and felt it was of good quality. Most residents felt the course enhanced their ability to advocate for individual patients or communities (N = 80; 71.5%) and understand patients and families' lived experience with illness (N = 87; 77.5%). Most residents also felt the course improved their knowledge of the impact of social determinants of health (N = 91; 81.2%) and increased their awareness of local resources that can support patients and their families (N = 88; 78.3%). Visiting community sites in-person and meeting persons with lived experiences were highlighted as the most valuable components of the course., Conclusion: Experiential learning can be integrated within post-graduate medical curricula to teach health advocacy competencies. Future studies should examine the longitudinal impact of the curricula, to determine whether shifts in perspectives persist over time., (© 2024. The Author(s).)

Background: Case-based learning (CBL) utilizing three-dimensional (3D) printed hip joint models is a problem-solving teaching method that combines the tactile and visual advantages of 3D-printed models with CBL. This study aims to investigate the impact of integrating 3D printing with CBL on learning developmental dysplasia of the hip (DDH)., Methods: We conducted a prospective study from 2022 to 2023, including 120 fourth-year clinical medical students at Xuzhou Medical University. Students were randomly allocated into two groups of 60 participants each. The CBL group received conventional CBL teaching methods, while the 3D + CBL group utilized 3D-printed models in conjunction with CBL. Post-teaching, we analyzed and compared the theoretical and practical achievements of both groups. A questionnaire was designed to assess the impact of the educational approach on orthopedic surgery learning., Results: The theory scores of the CBL group (62.88 ± 7.98) and 3D + CBL group (66.35 ± 8.85) were significantly different (t = 2.254, P = 0.026); the practical skills scores of the CBL group (57.40 ± 8.80) and 3D + CBL group (63.42 ± 11.14) were significantly different (t = 3.283, P = 0.001). The questionnaire results showed that the 3D + CBL group was greater than the CBL group in terms of hip fundamentals, ability to diagnose cases and plan treatments, interesting teaching content, willingness to communicate with the instructor and satisfaction., Conclusions: The integration of 3D printing with case-based learning has yielded positive outcomes in teaching DDH, providing valuable insights into the use of 3D-printed orthopedic models in clinical education., (© 2024. The Author(s).)

Background: Efficient learning strategies and resource utilization are critical in medical education, especially for complex subjects like renal physiology. This is increasingly important given the rise in chronic renal diseases and the decline in nephrology fellowships. However, the correlations between study time, perceived utility of learning resources, and academic performance are not well-explored, which led to this study., Methods: A cross-sectional survey was conducted with second-year medical students at the University of Bergen, Norway, to assess their preferred learning resources and study time dedicated to renal physiology. Responses were correlated with end-of-term exam scores., Results: The study revealed no significant correlation between time spent studying and overall academic performance, highlighting the importance of study quality over quantity. Preferences for active learning resources, such as Team-Based Learning, interactive lessons and formative assignments, were positively correlated with better academic performance. A notable correlation was found between students' valuation of teachers' professional competence and their total academic scores. Conversely, perceived difficulty across the curriculum and reliance on self-found online resources in renal physiology correlated negatively with academic performance. 'The Renal Pod', a locally produced renal physiology podcast, was popular across grades. Interestingly, students who listened to all episodes once achieved higher exam scores compared to those who listened to only some episodes, reflecting a strategic approach to podcast use. Textbooks, while less popular, did not correlate with higher exam scores. Despite the specific focus on renal physiology, learning preferences are systematically correlated with broader academic outcomes, reflecting the interconnected nature of medical education., Conclusion: The study suggests that the quality and strategic approaches to learning significantly impact academic performance. Successful learners tend to be proactive, engaged, and strategic, valuing expert instruction and active participation. These findings support the integration of student-activating teaching methods and assignments that reward deep learning., (© 2024. The Author(s).)

Although the concept of Social Determinants of Health (SDOH) has been around for more than two decades, teaching methods and standards of curricula for nursing education related to SDOH are relatively new concepts. Here, we explore pedagogical frameworks, national standards, and recent progress in the study and implementation of SDOH curricula and the top teaching strategies implemented in various nursing and healthcare disciplines and across educational levels (undergraduate and graduate programs). Selected examples are used to illustrate lessons learned across disciplines in effective teaching strategies related to SDOH. Effective teaching strategies include experiential learning, longitudinal and community-based interactions, reflective opportunities, and structured assessment., (Copyright © 2024. Published by Elsevier Inc.)

Background: Precision health is rapidly becoming a means to individualized approaches to managing health and thus necessitating a nursing workforce with an understanding of genomics and genetics. However, today's nurse in has limited knowledge in precision health, impacting the ability to educate patients and families., Method: To address this gap, an interprofessional PhD-prepared faculty team comprised of a nurse educator and a molecular biologist developed an undergraduate genetics course. The multiple teaching strategies include active learning modules, problem-based learning and a final debate., Results: The teaching methods were augmented multiple times based on student feedback. The debate activity replaced a poster assignment and student feedback has been overwhelmingly positive., Conclusion: Multiple strategies were used to deliver genomics and genetics content to nursing students that culminate in application-based activities such as case studies and the debate activity have potential to broaden student perspectives. Prospective course changes include increasing the credits for the course, adding time during the debate for rebuttal development and inviting speakers., (Copyright © 2024 Elsevier Inc. All rights reserved.)