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Electronic portfolios offer many advantages to their paper-based counterparts, including, but not limited to working on ICT skills, adding multimedia and easier sharing of the portfolio. Previous research showed that the quality of a portfolio does not depend on the medium used. In this article the perceived support for self-reflection of an electronic portfolio and a paper-based portfolio in the same ecological setting are compared. We made use of the fact that during this study about half of the first year medical students was using an electronic portfolio (n = 157) and the other half a paper-based portfolio (n = 190). Nine questions were added to the standard end of the block evaluation, which is handed to 25 percent of year one educational groups. Findings suggest that perceptions about the support for self-reflection, and the usefulness of compiling a portfolio, do not differ between students using an electronic portfolio and students using a paper-based portfolio.

This paper investigates whether paper and video triggers stimulate different social and cognitive processes during PBL. The study focused on how medical students identified and described problems, and how they built shared cognitions that lead them to diagnose and solve problems. The results showed that students who used video triggers put more effort into communicating their understanding of the problem and relevant knowledge than students who used paper triggers. The findings contribute to discussions on how to evaluate the effectiveness of different PBL triggers in order to better integrate them into the curriculum.

In the veterinary professional curriculum, methods of examination in many courses are transitioning from the traditional paper-based exams to electronic-based exams. Therefore, a controlled trial to evaluate the impact of testing methodology on examination performance in a veterinary physiology course was designed and implemented. Formalized surveys and focus group discussions were also used to determine student attitudes toward the examination formats. In total, 134 first-year veterinary students and 11 PhD/MS students were administered a total of 4 exams throughout 1 semester (2 on paper and 2 electronically) using a split-halves design. The paper (P) and electronic (E) exams contained 25 identical multiple-choice questions. Students were randomly assigned to two groups and were given exams in one of two sequences (E-P-E-P or P-E-P-E). Participants consented to and completed two anonymous surveys vis à vis their experience. Out of a maximum raw score of 25, the mean score for electronic examinations (20.8; 95% confidence interval, 20.3-21.2) was significantly (P = 0.01) greater than that for paper examinations (20.3; 95% confidence interval, 20.0-20.7). However, students expressed numerous concerns with the electronic examination format, and, at the completion of the study, 87% preferred to take their examination on paper rather than the electronic format. These data show that student attitudes concerning the examination format are not primarily determined by examination results, and that the additional anxiety related to the electronic examination format plays a large role in student attitudes.

Background: Academic paper writing holds significant importance in the education of medical students, and poses a clear challenge for those whose first language is not English. This study aims to investigate the effectiveness of employing large language models, particularly ChatGPT, in improving the English academic writing skills of these students. Methods: A cohort of 25 third-year medical students from China was recruited. The study consisted of two stages. Firstly, the students were asked to write a mini paper. Secondly, the students were asked to revise the mini paper using ChatGPT within two weeks. The evaluation of the mini papers focused on three key dimensions, including structure, logic, and language. The evaluation method incorporated both manual scoring and AI scoring utilizing the ChatGPT-3.5 and ChatGPT-4 models. Additionally, we employed a questionnaire to gather feedback on students' experience in using ChatGPT. Results: After implementing ChatGPT for writing assistance, there was a notable increase in manual scoring by 4.23 points. Similarly, AI scoring based on the ChatGPT-3.5 model showed an increase of 4.82 points, while the ChatGPT-4 model showed an increase of 3.84 points. These results highlight the potential of large language models in supporting academic writing. Statistical analysis revealed no significant difference between manual scoring and ChatGPT-4 scoring, indicating the potential of ChatGPT-4 to assist teachers in the grading process. Feedback from the questionnaire indicated a generally positive response from students, with 92% acknowledging an improvement in the quality of their writing, 84% noting advancements in their language skills, and 76% recognizing the contribution of ChatGPT in supporting academic research. Conclusion: The study highlighted the efficacy of large language models like ChatGPT in augmenting the English academic writing proficiency of non-native speakers in medical education. Furthermore, it illustrated the potential of these models to make a contribution to the educational evaluation process, particularly in environments where English is not the primary language. [ABSTRACT FROM AUTHOR]

We present the experience of journal editors in improving the quality of published papers. As the editors of the Croatian Medical Journal, a journal from the so-called scientific periphery, we realized, very early after the start of the journal in 1991, that our authors needed significant assistance with their articles. We worked individually with journal authors and then moved this activity to the next stage – intensive workshops for authors. The work with the journals enabled us to extend these activities to graduate and postgraduate students – future authors.

About four decades ago, Perl and collaborators were the first ones who unambiguously identified specifically nociceptive neurons in the periphery. In their classic work, they recorded action potentials from single C-fibers of a cutaneous nerve in cats while applying carefully graded stimuli to the skin (Bessou P, Perl ER. Response of cutaneous sensory units with unmyelinated fibers to noxious stimuli. "J Neurophysiol" 32: 1025-1043, 1969). They discovered polymodal nociceptors, which responded to mechanical, thermal, and chemical stimuli in the noxious range, and differentiated them from low-threshold thermoreceptors. Their classic findings form the basis of the present method that undergraduate medical students experience during laboratory exercises of sensory physiology, namely, quantitative testing of the thermal detection and pain thresholds. This diagnostic method examines the function of thin afferent nerve fibers. We collected data from nearly 300 students that showed that 1) women are more sensitive to thermal detection and thermal pain at the thenar than men, 2) habituation shifts thermal pain thresholds during repetititve testing, 3) the cold pain threshold is rather variable and lower when tested after heat pain than in the reverse case (order effect), and 4) ratings of pain intensity on a visual analog scale are correlated with the threshold temperature for heat pain but not for cold pain. Median group results could be reproduced in a retest. Quantitative sensory testing of thermal thresholds is feasible and instructive in the setting of a laboratory exercise and is appreciated by the students as a relevant and interesting technique.

The goal of medical education is to produce the physician we would like to see if we are sick - Melinkoff In all educational developments, one of the most troublesome questions is that of evaluation. Written examination is the most widely used tool in evaluation and assessment of the competency of the medical students. At present, questions are prepared casually just before the examination and are not subjected to any quality check, which may lead to confusion or wrong understanding of the questions by the students. This article is aimed at providing guidelines and a scientific method to frame good question papers to improve the quality of evaluation and assessment of medical students. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 64-67

Introduction: The National Scientific Congress (NSC) is an annual event held in Peru in which medical students from all over the country present their research work. Objectives: To determine the publication rate in indexed scientific journals of research papers submitted to the NSCs held between 2010 and 2014, as well as the factors associated with their publication, and to describe the characteristics of the published papers. Materials and methods: Retrospective study in which 407 abstracts of research papers were reviewed. A publication time window of 6 years (from submission) was considered. A bivariate analysis was performed to assess differences between categorical and numerical variables using the chi-square and Mann-Whitney U tests, respectively. In addition, a multivariate analysis was performed using Poisson regression models (a crude and an adjusted model), calculating relative risk (RR) values with their respective 95% confidence intervals (95%CI) to determine the factors associated with the publication of papers. A significance level of p

The landscape of medical specialty choice is dynamic, undergoing significant changes as students' progress through undergraduate and graduate medical training. These shifts are influenced by various factors, with financial considerations becoming increasingly relevant among medical students' preferences. This study conducts a retrospective analysis of specialty match rates and physician compensation, suggesting a potential trend where primary care fields, though fundamental to healthcare, appear less competitive and often associated with less financial reward compared to other specialties. The existence of this disparity is not without consequences. It contributes significantly to the ongoing and anticipated primary care physician shortages. This situation requires a comprehensive approach to tackle the complex factors influencing medical students' career choices. Understanding these dynamics is critical for healthcare policy and planning. This paper investigates how financial considerations sway medical students' specialty choices, emphasizing the economic disparities between primary care and other specialties.

Background: Problem-based learning (PBL) remains a valid and effective tool for small-group medical education. Using Virtual patients (VP) case simulation in PBL is a recognizable educational method that has successfully prepared students to focus learning on core information that uses realistic patient-based cases relating to everyday clinical scenarios. Using other modalities as the virtual patient in PBL instead of the paper-based methods remains debatable. This study aimed to evaluate the effectiveness of using VP case simulation mannequin in PBL versus the PBL in paper-based cases in improving the cognitive skills by comparing the grades of a multiple-choice question test and assess its ability to reach students' satisfaction using questionnaire with Likert survey instrument. Methods: The study was conducted on 459 fourth-year medical students studying in the pulmonology module of the internal medicine course, Faculty of Medicine, October 6 University. All students were divided into 16 PBL classes and randomly divided into groups A and B by simple manual randomization. The groups were parallel with a controlled cross-over study between paper-based and virtual patient PBL. Results: The pre-test showed no significant difference between both, while post-test scores were significantly higher in both VP PBL cases 1 discussing COPD (6.25 ± 0.875) and case 2 discussing pneumonia (6.56 ± 1.396) compared to paper-based PBL (5.29 ± 1.166, 5.57 ± SD1.388, respectively) at p < 0.1 When students in Group A experienced PBL using VP in case 2 after paper-based PBL in case 1, their post-test score improved significantly. (from 5.26 to 6.56, p <.01). Meanwhile, there was a significant regression in the post-test score of the students in Group B when they experienced the paper-based PBL session in case 2 after using PBL using VP in case 1, (from 6.26 to 5.57, p <.01). Most of the students recommended using VP in PBL as they found VP was more engaging and inducing concentration in gathering the information needed to characterize the patient's problem than in a classroom- paper-based cases session. They also enjoyed the teaching of the instructor and found it a suitable learning style for them. Conclusion: Implementing virtual patients in PBL increased knowledge acquisition and understanding in medical students and was more motivating for students than paper based PBL to gather the needed information. [ABSTRACT FROM AUTHOR]

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The goal of the paper is to pay attention to some important techniques and approaches including adequate designations as a tool for unambiguous understanding and a key to success in solving problems, vivid visual images as a mnemonic techniques, and special formulas as a universal tool for solving typical problems, when teaching medical students of mathematics. The motivation for this paper is to help non-mathematics students understand complicated mathematical topics in an easy, natural, and simple way.

First-year medical students are often challenged by the rapid pace and large volume of content that must be learned. Peer teaching has emerged as a supportive educational strategy. However, the most effective strategies for training peer tutors (PTs) for their role are not known. This paper examines the use of an Objective Structured Teaching Exercise (OSTE) to augment PT training sessions. Applying deliberate practice as a conceptual framework, an OSTE was used to provide tutors with an opportunity to practice their skills and receive feedback about their performance when meeting with a student presenting with a challenge. The newly trained PTs were required to assess a standardized student, determine challenge(s) being experienced, and present options to address the challenge(s). Standardized students evaluated the tutors' performance and a pre- and post-OSTE questionnaire was used to determine whether the OSTE was effective in increasing the confidence level of PTs to effectively assess and support students seeking help. Participants reported an increase in confidence in their ability to assess areas requiring improvement, understand the active learning strategies, and suggest appropriate active learning study strategies. Evaluations completed by standardized students documented that newly trained PTs accurately diagnosed the challenge presented in the OSTE and in most cases PTs asked all relevant questions to assess. Increased self-efficacy promotes PT's capacity to perform their work and feedback during an OSTE can further advance required skills. Aggregate OSTE results can also inform efforts to enhance the PT training program.

The competency-based undergraduate medical curriculum in the preclinical years requires clinical topics to be taught using a linker clinical case for students to appreciate the clinical application of basic sciences. The objective of this study was to evaluate student and faculty satisfaction regarding the construct and delivery of an aligned and integrated curriculum that involved the use of linker clinical cases. We aimed at evaluating the perceptions and performance of students when paper cases were supplemented with a simulated patient (SP) video. This interventional study was conducted by inviting 250 medical students from the first professional phase from the 2020-2021 batch. Integrated modules were prepared for two clinical conditions: myocardial infarction (MI) and nephrotic syndrome (NS). The topic NS was taught with a paper-based case while the topic MI was supplemented with an SP video. Feedback from students and faculty was collected using a newly developed and validated questionnaire and focused group discussions. The students performed significantly better in the assessment conducted after the topic MI compared to NS. The majority of the students (80%) expressed a preference for the video to understand the clinical relevance when compared to the paper case. Overall, the students (83-87%) expressed satisfaction with integrated teaching sessions using clinical cases. Using linker clinical cases in an aligned and integrated preclinical curriculum allowed students to interrelate the subjects and apply them to clinical contexts. The SP videos prepared from an authentic setting facilitated learner engagement with a better understanding of the clinical relevance of the basic sciences.

Several authors have underlined the negative consequences of the COVID-19 pandemic on mental health in several populations, including medical students, such as increases in anxiety, depression and burnout symptoms. Furthermore, previous studies showed that anxiety and depressive symptoms are positively associated with affective empathy and negatively associated with cognitive empathy. Given the adverse pandemic effects highlighted by several authors, the present study sought to determine whether medical students' empathy has been potentially impacted, with higher affective empathy and lower cognitive empathy score in the pandemic cohort compared to pre-pandemic cohorts. Medical students (n = 395) were recruited during the COVID-19 pandemic and completed the "Interpersonal Reactivity Index" (IRI) and the "Basic Empathy Scale" (BES). This cohort was then compared with two pre-pandemic cohorts (one used the BES [n = 1168], and the other used the IRI [n = 342]). Similar results were found on both scales: the pandemic cohort displayed significantly higher scores in affective empathy and personal distress (affective empathy domain) and, surprisingly, significant higher scores in cognitive empathy, fantasy, and perspective-taking (cognitive empathy domains). As stressed by previous studies, we posited that the higher scores in affective empathy, personal distress, and fantasy might indicate emotional difficulties. The paper concludes with the identification of empathy components that should be promoted in the curriculum of medical students.

This study was designed to see whether electronic feedback positively affects medical students' academic writing performance. Two groups of medical university students were randomly selected and participated in this study. In order to see whether the provision of electronic feedback for the compulsory academic writing course for medical students is effective, the researchers divided 50 medical students to the traditional (n=25) and intervention groups (n=25). Pre-test and post-test were conducted at the beginning and at the end of the semester. Electronic feedback was given to the medical students in the intervention group, while the medical students in the traditional group received the traditional pen and paper feedback. By comparing the scores of two written assignments at the beginning and the end of the semester, regarding the application of electronic feedback, the results showed that not only medical students' overall writing performance improved after providing them electronic feedback, but every single writing component was also enhanced after the intervention. There was a significant difference in the post-test academic writing scores between the traditional and intervention groups (P < 0.001). This difference was not significant in our control group who was given pen-and-paper feedback. In terms of specific writing components, the most affected components in this approach were content followed by organization, language use, vocabulary, and sentence mechanics, respectively. Although this study focused on medical students' academic writing ability and reported the effect of electronic feedback on medical students' writing performance, electronic feedback can be equally beneficial for enhancing student-practitioners' practical clinical skills.

In this paper, we outline a case study describing the incorporation of active learning and flipped classroom techniques in a renal physiology module in 1st year medical school. The module was redesigned over a 2-year period within the teaching for understanding (TfU) framework (generative topics, understanding goals, performances of understanding and ongoing assessment) to include more active learning exercises (clicker response systems centered on clinically relevant problem sets and classroom assessment techniques -- CATs), which culminated in flipping the classroom entirely during the 2nd year. The goal, was to evaluate student perceptions of the flipped classroom model and to reflect on the use of active learning generally. In the 1st year, clicker response systems were favorably received by students, however the anonymous nature of the clicker configuration meant it was not possible to track progress of individual students. CATs revealed that content areas without active learning exercises were often deemed the most unclear by students. Student feedback indicated that the flipped classroom model in the 2nd year was positively received, with students noting it encouraged them to attend classes more regularly and they believed it assisted in developing collaborative learning and knowledge application.

For many instructional designers (ID), subject matter experts (SMEs) are viewed as a necessary evil. Depending upon their day job, SMEs can be challenging to work with due to their schedules and responsibilities outside the ID's project. They can be unaware of the eLearning process, learning models and theories, and expensive -- a SME can easily add thousands of dollars to an already stretched budget. However, if the ID does not have the "expert" knowledge of the content for students to achieve the learning outcomes successfully, it is improbable that the learning event will be meaningful. This paper explores students' learning outcomes in a case-based simulated learning event before and after the inclusion of a SME on an instructional design team.

The performance evaluation of e-learning in medical education has been the subject of much research lately. Researchers are yet to achieve a consensus on the definition of performance or the suitable constructs, metrics, models, and methods to help understand student performance. Through a systematic review, this study put forward a working definition of what constitutes performance evaluation to reduce the ambiguity, arbitrariness, and multiplicity surrounding performance evaluation of e-learning in medical education. A systematic review of published articles on performance evaluation of e-learning in medical education was performed on the SCOPUS, Web of Science, PubMed, and EBSCOHost databases using search terms deduced from the PICOS model. Following the PRISMA guidelines relevant published papers were searched and exported to Endnote. Screening and quality appraisal were done on Rayyan. Three thousand four hundred and thirty-nine published studies were retrieved and screened using predetermined inclusion and exclusion criteria. One hundred and three studies passed all the criteria and were reviewed. The reviewed literature used 30 constructs to operationalize performance. The leading constructs are knowledge and effectiveness. Both constructs were used by 60% of the authors of the reviewed literature to define student performance. Knowledge gain, satisfaction, and learning outcome are the most common metrics used by 81%, 26%, and 15% of the reviewed literature to measure student performance. The study discovered that most researchers forget to evaluate the "e" or electronic component of e-learning when evaluating performance. The constructs operationalized and metrics measured were primarily focused on learning outcomes with minimal focus on technology-related metrics or the influence of the electronic mode of delivery on the learning process or evaluation outcome. Only 6% of the reviewed literature applied evaluation models to guide their evaluation process -- mostly the Kirkpatrick evaluation model. Also, most of the included studies used randomization as an experimental control method, mainly using pre- and post-test surveys. Modern evaluation methods were rarely used. Only 1% of the reviewed literature used Google Analytics, and 2% used data from a learning management system. This study increments the existing body of knowledge in performance evaluation of e-learning in medical education by providing a convergence of constructs, metrics, models, and methods and proposing a roadmap to guide students' performance evaluation process from the synthesis of findings and the gaps identified through the systematic review of existing literature in the domain. This roadmap will assist in informing researchers of grey areas to consider when evaluating performance to ensure more quality research outputs in the domain.

The metaverse is known as the hypothetical iteration of the Internet as a single, connected, universal and immersive virtual world that can be accessed via immersive technology devices. One approach to this concept can be achieved through the use of multi-user immersive virtual reality applications. Immersive virtual reality (IVR), which uses gadgets that allow the user to visualize and interact in an enveloping way, is a very attractive technology for teaching purposes. There are many references in the scientific literature about its use for this purpose, including encouraging results in the field of medicine. However, there have not been enough studies assessing how much this type of technology really contributes to learning medicine. This work investigates the feasibility of using the metaverse as an educational tool in medicine. We propose a multi-user immersive virtual reality application for implementing a scene of the metaverse in which medical students are taught. Our work considers that in order to ensure this type of technology is useful in the education of medical students, the technology itself (multi-user IVR) must be designed and implemented for a medical student profile. They usually spend too much time for adapting themselves to use and manage this kind of technology when they are exposed to it for learning. The technology should not be a barrier to acquiring, or disseminating the academic contents themselves. It should act as a catalyst that enhances the speed and capacity for learning medical educational topics. Thus, we present design and user experience specifications that we implemented in an anatomical dissection room in the metaverse, and with which we conducted experiments with 114 sixth-grade medical students. Our results indicate that, based on the design and user experience characteristics that we propose in this paper, the metaverse can indeed serve as a useful and effective educational resource whose technological complexity is no barrier to medical teaching.

Aim: Better training in scientific skills, such as the ability to conduct research independently, has been one of the main drivers of reform in medical education. The aim of this article is to report on the scientific term paper module in the modular curriculum of medicine (MCM) at the Charité. This module is an established example of undergraduate medical students conducting their own scientific investigations. Project outline: A faculty-wide, outcome-oriented process resulted in a four-week module for writing a scientific term paper in the 6th semester of the MCM as part of a longitudinal science curriculum. Acquired competencies were assessed through a written term paper and an oral presentation. Two student cohorts (winter terms 2013 and 2014) were surveyed on how they rated the module concept, organizational aspects and the quality of support. We further analysed the chosen topics of the papers as well as student assessment results. Results: The student evaluation (return rates of 193 and 197, 71% and 77%) showed high overall satisfaction with the module. This result was evident in the high rating of the module concept and organizational aspects, a positive attitude towards scientific research, and strong motivation to pursue further scientific research. There was a wide spectrum of term paper topics with a focus on literature reviews. Most of the student work was assessed as good or very good. Conclusion: The scientific term paper module has proven itself as a curricular concept for students to perform own scientific research in the MCM, with strong acceptance and good performance by students. This project report can serve as basis and guidance for development and further improvements to promote scientific competencies in undergraduate medical education in other faculties. [ABSTRACT FROM AUTHOR]

Background: Appropriate and timely response in urgent situations requires vast knowledge and physical and mental preparedness. Since emergency medical technicians are the first professional respondents in the health system, selecting the right people to study in this field is very important. Because there is no specific model in Iran to propose the indicators in the selection of applicants for this field, the present study was conducted to offer some indicators for the admission of prehospital emergency medical students. Materials and Methods: This research was conducted using a mixed qualitative and quantitative approach in three steps: reviewing the relevant texts, meetings of scientific and operational experts, and determining the validity and reliability of the content. After finalizing, the areas and indicators of student selection were used in the interview process of candidates in 2020. SPSS v. 24 software was used for quantitative data analysis. Results: The selection tool for prehospital emergency medical students included 4 areas (with 26 criteria): 1) general qualifications area with 8 criteria (documents concerning degree and identity, written GPA of diploma, entrance exam score, type of diploma, special abilities, working in relief organizations, gaining a scientific-sports position, and interviewing of faculty members); 2) physical health with 7 criteria (height, body mass index, visual health, hearing health, stuttering, organ dysfunction-physical disability, and chronic debilitating diseases); 3) psychological status with 5 criteria (orderliness, responsibility, quick and correct decision making, stress management, and belief in teamwork); and 4) physical fitness with 6 criteria (1600-m run, 45-m speed-run, 4x9 m run, sit-up, long jump, and Swedish swimming in 30 s). Conclusion: Given the vital importance of prehospital emergency medical jobs as the front line of the health system response, selecting the right people will play a significant role in increasing the quality of services provided, increasing patient satisfaction, and ultimately improving health of the community. [ABSTRACT FROM AUTHOR]

With increasing globalisation and internationalisation, student mobility, and a need for income generation, most universities in the UK and other parts of the world now seek to attract greater numbers of international students. Non-traditional approaches to teaching and learning delivery have been incorporated into modern medical education curricula. These pose additional challenges to the international medical students compared to their home student counterparts. Evidence suggests that international medical students underperform compared with home students, with odds of failure about 2.5 times higher. It has been proposed that far more guidance and support are required, but little attention has been given to the students' specific academic support challenges. This paper explores ways to address the academic support needs of this group of students.

This research paper seeks to determine learner autonomy level in relation to incidental vocabulary acquisition (IVA), out of the realization of both concepts as prominent factors in language learning in general, and English for Specific Purposes (ESP) in particular. The paper particularly aims at examining the influence of participants', medical and applied medical sciences students, selflearning for specialized vocabulary on their autonomy levels. It assumes that leaving the task of acquiring specialized vocabulary to learners' endeavors, completely, leads to a positive effect on their autonomy levels. Participant autonomy levels were self-assessed through pretest and posttest quantitative surveys. The survey items aimed at assessing the participants' learning levels according to two categories of dependency and independency. The quantitative data was analyzed using SPSS to generate descriptive data. The overall results were generated through computing mean scores for each category of items at both phases, i.e. pretest and posttest. No significant differences between the two categories' data were indicated. Yet, a positive change occurred to the independency category in comparison to that of dependency, which remained somehow static through the period of the study. Although the results of this latter category indicated the learners' need for teacher guidance regarding the specialized vocabulary, the change in the first category should not be ignored. That is, IVA can be a positive agent in fostering learners' control of their learning, namely, autonomy. Simultaneously, since the results of both categories are somehow convergent, both approaches of explicit and implicit instructions should be considered in IVS approaches in the realm of ESP.

Since its inception, the College of Medicine and Medical Sciences (CMMS) at the Arabian Gulf University (AGU) has adopted the problem based (PBL) pedagogy in Medicine relying on paper-based trigger material. However, delivery of such paper-based triggers during tutorial sessions was not optimal to promote medical student interactivity and engagement within tutorial sessions. As involvement of multimedia resources and tools in PBL are more valuable than simple print textual modes of learning and can have a positive impact on learning and knowledge integration, we aimed to digitize all our trigger material. Over the past three years CMMS has integrated after customization to PBL standards, the cloud-based operating system, UNIO into its problem-based learning (PBL) curriculum. The aim of UNIO integration was to digitize text triggers and enhance the quality of visual triggers in order to improve medical student interactivity and engagement within tutorial sessions. UNIO electronic platform was customized from a teacher-centered design to fit a PBL pedagogy. It was utilized to link student and tutor hardware within a group together for promoting interaction and collaborative learning. The effect of this teaching approach was evaluated from student responses to an in-house validated survey at the end of the fifth PBL module. Customization and integration of UNIO within the PBL curriculum resulted in an entirely paperless learning process. It created an integrated PBL system combining conventional text trigger in a digital form with digital media such as images, videos and other multimedia, while maintaining face-to-face setup. It also provided online and off-campus access to content embedded at campus and open access to open source content online to both tutors and students. Results of the student satisfaction survey pointed to a predominantly neutral attitude towards integration of UNIO within our PBL tutorial sessions, but the item related to effectiveness of media triggers within UNIO received favorable responses from students. Further evaluation for a longer term is necessary for additional student feedback. Other forms of evaluation may be required in the aim of improvement and for justification of subsequent implementation of UNIO within our PBL curriculum.

Training and development programs are increasingly delivered online with numerous studies reporting no differences in learning outcomes between online and traditional learning. However, there are no established standardized methods to evaluate the effectiveness of online learning. This review aims to map the state of research around health-related education to determine what elearning evaluation methods are being used, the strengths or deficiencies of these methods, and which are appropriate for measuring the effectiveness of online education. Databases searched were PubMed, ProQuest, Education Resources Information Centre, Cumulative Index to Nursing and Allied Health Literature, Scopus, PsychInfo, and Medline. Studies were included if they were published between 2011 and 2021, reported health-related online education and included an evaluation component. Thirty studies were obtained from numerous countries with varied methodologies and designs. Participants ranged from undergraduate students to medical professionals. Evaluation methods included student participation, students' reaction to the training program, self-efficacy, knowledge assessment, long-term performance, and the Kirkpatrick Evaluation Framework. The review identified that course evaluations, such as measuring student satisfaction scores alone, are insufficient when used to quantify learning effectiveness for online education. This was particularly important as studies are reporting these single metrics as positive effects of training interventions without justification. Suggestions within the reviewed papers were to adopt and implement an appropriate validated method within the course curriculum to evaluate learning outcomes.

This paper investigates the phenomenon of technostress in medical students and its predictors during pandemic-prompted distance education. From a sample of 259 students in a school of medicine at a public university in Turkey, the data were collected using convenience sampling through an online questionnaire based on person-environment misfit theory and were analyzed by means of descriptive and inferential statistics. Descriptively, the participant students reported experiencing relatively mild level of technostress. As a result of the multiple regression analysis, regular attendance and participation, adequate learning environment, perceived negativity of distance education, perceived need for psychological support, and year at medical school were all found to be significant predictors of technostress in medical students. This is the first study evaluating technostress on medical students. Students who do not attend classes regularly, do not have an adequate learning environment, have higher degree of perceived negativity of distance education, have need for psychological support and are at higher grade levels experience more technostress. Finally, according to the person-environment misfit theory the major component of technostress in medical students originated from the tool-related component. Although the level of technostress was relatively low, technological tools generate pressure even on the digital native generation.