Search

Writing anxiety has been identified as a significant obstacle for English as a Foreign Language (EFL) learners in China, with previous studies indicating that it can negatively affect writing performance. Despite this, most research on writing anxiety in the Chinese EFL context has focused on the relationship between writing anxiety and writing performance, with limited attention paid to exploring writing anxiety during the writing process and its sources in depth. This study applied a qualitative method to explore Chinese EFL learners' writing anxiety in the writing process. Thematic analysis was used for analyzing data collected through semistructured interviews with 18 Chinese EFL learners. The results revealed seven primary themes, including lack of knowledge about the writing topic, inexperience with the genre, challenges with brainstorming or coming up with ideas, trouble with structuring or arranging information, difficulty with integrating sources, linguistic difficulty, and negative or no feedback from instructors. The findings indicated that writing anxiety accompanies throughout the writing process. EFL learners need strategies to alleviate writing anxiety, including clear instructions on how to approach writing tasks, provision of appropriate resources, individualized feedback, and a supportive learning environment.

During the COVID-19 pandemic, numerous schools halted face-to-face teaching and instead resorted to online classes. The impact of online learning on students' academic worries, social relationships, and psychological well-being has received growing attention. Based on a sample of 1095 students aged 14-16 in 12 secondary schools in Hong Kong, structural equation modeling was used to investigate the association between online learning problems, academic worries and performance, social interaction, and psychosocial well-being during the pandemic. The path relationships among variables were compared by gender groups and socio-economic status (SES). Online learning problems were found to be negatively associated with psychosocial well-being through academic worries and social interaction as mediators. The effect of mediation among female students was larger than that of males, whereas the impact of academic worries on both psychosocial well-being and social interaction was stronger and significant only in the low SES group. As the COVID-19 pandemic significantly impacted the learning and well-being of students, attention should be given to gender and SES difference among students.

Generic competency development activities (GCDAs) help students develop critical thinking, problem-solving, innovation, creativity, communication and social skills. This study evaluated students' acceptance of a machine learning-assisted recommendation system (MARS) developed to recommend GCDAs for students in a higher education institution. This study adopted a quantitative approach to evaluate the higher education students' perceived usefulness of MARS based on a new appropriate model derived from three widely used models related to technology adoption and leisure activities. In August 2023, the participants of orientation for freshmen were invited to complete an online questionnaire after they tried MARS. 351 valid responses were analyzed using multiple regression. The results revealed that the students positively perceive accepting MARS as a useful tool for choosing GCDAs and indicated the students' perceptions were affected more by their programs of study, career development and personal interests than by social influence and facilitating conditions on their selection of GCDAs. These findings based on the new model provide implications for the implementation of education technology for generic competency development.

The global talent gap is a consequence of skills mismatch among job seekers. Although micro-credentials appeared to be a potential solution to narrow the talent gap, it is unclear how they can be effectively implemented in a structured academic pathway. The purpose of this study is to explore the potential of a proposed micro-credential model for formal education via the Accreditation of Prior Experiential Learning Micro-credentials (APEL.M), to support the talent gap challenges faced by companies in Malaysia. The study used a qualitative case study method with data collected mainly from a focus group discussion among relevant faculty heads, administrators, and senior management team members. The findings indicated that despite potential challenges and issues towards implementing the new micro-credential model, the proposed model is significant for policymakers, higher education providers, and industry stakeholders interested in addressing the talent gap and creating alternative pathways to formal academic qualifications.

This study examines the effort of one higher education college in China to see how it secures external funding resources to enhance its educational programs. The college is known for its success in getting external funding in addition to public revenue appropriations. The researchers took a case study approach by first reviewing the current literature to find out what has been done by other universities worldwide to secure external funding. Data in this study were retrieved by reviewing relevant documents in the college files. Additionally, five college administrators were interviewed to solicit their experiences in seeking external funding for the college. The findings of this study disclosed that the college administrators and staff have contributed tremendous effort to secure external resources to help achieve the college goals. The findings were also discussed relating to the current literature and the implications for educational planning.

Simulation-based learning has the potential to foster a transformative learning culture within the Open and Distance Learning (ODL) environment. This report is based on a research project, integrating a simulation into a digital ODL classroom, conducted in Wawasan Open University, an ODL university in Malaysia. The report highlights how a simulation can be valuable to ODL students as an effective learning tool and by creating an immersive learning experience for the students.

The usage of video conferencing tools in teaching and learning has become a norm in today's higher educational institutions, recognized across various academic settings. The experience gained by most educators in using video conferencing tools for teaching during the COVID-19 pandemic could be leveraged to enhance these tools. The study aims to capture the current practices and explore the issues of using video conferencing for teaching and learning in Malaysian higher educational institutions. It focuses on three target groups with hands-on experience: academicians, students, and e-learning consultants or information technology (IT) support staff. Interview and focus group protocols were developed based on the four elements of the PACT framework: People (P), Activities (A), Contexts (C), and Technologies (T). Data were gathered through focus group discussions and in-depth interviews with the target groups. There were 24 participants involved in three focus group discussions and 28 participants in individual in-depth interviews. The PACT framework was employed to analyze the data, aiding in understanding the current situation, identifying areas for improvement, and envisioning future scenarios. Qualitative data were transcribed and categorized based on the four PACT elements. The study identified differences in the People element with four scenarios/practices on physical differences, six on psychological differences, three on mental models, and five on social differences. A total of twenty differences were identified under the Activities element, with six on temporal aspects, four each on cooperation, complexity, and safety-critical aspects, and two on the nature of the content. Under the Context element, one scenario/practice was identified for organizational circumstances, five for social circumstances, and three for physical circumstances. In the Technology element, five scenarios/practices were identified: two related to the input part of technologies and one each for the output, communication, and content parts of technologies. From the scenarios/practices of the responses, a total of fifty-two issues related to using video conferencing for teaching and learning were identified. These findings will serve as the basis for ideation in developing innovative video conferencing toolkits for teaching and learning.

A significant gender gap continues to exist within computer science (CS) education, despite nationwide emphasis in the U.S. on improving CS education equity and access. To explore this issue, we conducted an ethnographic case study within a classroom at Forest View High School (FVHS, pseudonym) where girls' participation in CS was consistently higher than state averages over 12 years. We sought to understand teacher and student experiences within this gender-inclusive program. Data were collected over three months through observations, interviews, course documents, and reflections. Results indicate three strategies for supporting a more gender-inclusive classroom: (1) Providing personalized and relevant learning experiences; (2) focusing on growth mindset development; and (3) creating a welcoming environment. Implications for practice include providing assignment choice and personalized one-on-one support for students, modeling a growth mindset and providing opportunities to learn from failure, and building personal relationships with students and incorporating humor. Overall, teachers can act as agents of social change within the CS classroom, and play an essential, central role in broadening participation and equity initiatives. However, this work must also be supported by administrators, counselors, and other school stakeholders to be effective for enacting change.

Experimental research on perception and cognition has shown that inherent and manipulated visual features of mathematics problems impact individuals' problem-solving behavior and performance. In a recent study, we manipulated the spacing between symbols in arithmetic expressions to examine its effect on 174 undergraduate students' arithmetic performance but found results that were contradictory to most of the literature (Closser et al., 2023). Here, we applied educational data mining (EDM) methods to that dataset at the problem level to investigate whether inherent features of the 32 experimental problems (i.e., problem composition, problem order) may have caused unintended effects on students' performance. We found that students were consistently faster to correctly simplify expressions with the higher-order operator on the left, rather than right, side of the expression. Furthermore, average response times varied based on the symbol spacing of the current and preceding problems, suggesting that problem sequencing matters. However, including or excluding problem identifiers in analyses changed the interpretation of results, suggesting that the effect of sequencing may be impacted by other, undefined problem-level factors. These results advance cognitive theories on perceptual learning and provide implications for educational researchers: online experiments designed to investigate students' performance on mathematics problems should include a variety of problems, systematically examine the effects of problem order, and consider applying different analytical approaches to detect effects of inherent problem features. Moreover, EDM methods can be a tool to identify nuanced effects on behavior and performance as observed through data from online platforms.

Background: Walk tests are common gait speed and endurance assessments. Shorter test versions could benefit adults with intellectual disability. Thus, the concurrent validity of shorter tests was studied. Methods: Thirty-five adults with mild to moderate intellectual disability, aged 21-64 years, were assessed with the 4-m walk test, 10-m walk test for gait speed, 2-min walk test, and 6-min walk test for endurance. Correlation and Bland--Altman plots analyses were used to establish concurrent validity between shorter and standard tests. Results: Strong positive relationships were found for gait speed tests, r = 0.94, p < 0.001, and endurance tests, r = 0.83, p < 0.001, and differences between shorter and standard tests were within limits of agreement. Conclusions: The concurrent validity of shorter walk tests was established in this study. This would mean that adults with intellectual disability with lower levels of fitness could be assessed.

Postpartum depression is a significant public health issue that occurs within the first 12 weeks after childbirth. It is more prevalent among teenage mothers compared to adults. However, the findings of the existing interventional studies cannot be readily applied to teenage mothers due to their unique psychosocial concerns. Furthermore, these findings have shown inconsistencies regarding the benefit of psychological and psychosocial interventions in reducing the incidence of postpartum depression. The current review is aimed at investigating the effectiveness of psychosocial interventions in preventing postpartum depression, specifically among teenage mothers. The preferred reporting items for systematic reviews and meta-analysis manuals were utilized to identify and select relevant articles for this review. The articles were retrieved using population, intervention, control, and outcome models. The quality of each article was assessed using the Cochrane risk of bias tool. Statistical analysis was conducted using STATA version 17. The effect size of the intervention was estimated using the standard mean difference in depression scores between the intervention and control groups. Heterogeneity among the studies was assessed using the I[superscript 2] statistic and Q statistic, while publication bias was evaluated through funnel plot asymmetry and Egger's test. A total of nine eligible articles were included. While psychosocial interventions have been demonstrated to decrease the incidence of postpartum depression compared to usual maternal health care, it is worth noting that the mean difference in depression scores was significant in only three of the included studies. The meta-analysis revealed that psychosocial interventions were effective at preventing postpartum depression, with a pooled effect size of -0.5 (95% CI: -0.95, -0.06) during the final postpartum depression assessment. The heterogeneity was substantial, with an I[superscript 2] value of 82.3%. Although publication bias was not observed, small studies had a significant effect on the pooled effect size. The findings of this review suggest that psychosocial interventions can effectively prevent PPD, particularly within the first 3 months of the postpartum period. This review highlights the scarcity of interventional studies in low-income countries, indicating the need for further research in diverse communities.

With the rise of accountability measures in education, many policymakers have also argued the need to record, assess, and certify students' holistic development. However, using China as a case, we caution how a policy-driven reform on the assessment of holistic development might fall into the pitfall of performativity. Borrowing from Ball's (Ball, Journal of Education Policy 18:215-228, 2003) seminal work on policy technologies, we investigate the ways in which management cultures, market logic, and performance indicators have figured in China's assessment policies on students' holistic development. Using the findings as a base, we further discuss and problematize how these policies could have rendered students "managed," "marketized," and "performative," influencing what it means to become a "holistic" student.

Guided by Fanon's constructs of racial epidermal schema, this study explored youth's experiences with anti-Asian racism (AAR) and their perspective on how AAR is formed and maintained. We recruited 36 Asian youth (age range 14-23 years) residing in a metropolitan city in Canada to attend a semi-structured focus group. Results from the reflexive thematic analysis indicated the tenuous lines of invisibility and visibility of AAR--in a Whiteness dominant racial schema. When Asian youth are objectified within the boundary of Whiteness norms, AAR is pervasive but inconspicuous, happening early and frequently in their life but unrecognized. When they are objectified as threats to Whiteness dominance such as during the COVID-19 pandemic, AAR is visible in forms of overt discrimination, violence, and hate against Asians. Youth attributed roots of AAR to White supremacy and critically discussed their racialization process. Their reflexive insights serve as a form of resistance to AAR.

This study aimed to examine (1) the psychometric properties of The Teachers' Sense of Efficacy Scale (TSES) in early childhood (EC) preservice (N = 202) and in-service (N = 182) teachers, and (2) the effect of teaching experience on efficacy beliefs. Findings indicated that EC teachers' efficacy beliefs were best represented by a bifactor model (i.e., one general and three specific factors); teachers generally perceived their capabilities in teaching at a more general level rather than specific to different classroom functions. Teaching experience had a significant effect on efficacy beliefs for preservice but not for in-service teachers. This study fills a gap in our understanding of EC teachers' sense of efficacy by providing empirical evidence on the structure of efficacy beliefs and the effect of teaching experience on efficacy beliefs in preservice and in-service EC teachers. In this study, a new efficacy factor named Responsive Teaching emerged, capturing an element of in-service EC teachers' perceptions of their capabilities that may be specific to the EC setting. Findings regarding the effects of experience on preservice EC teachers' sense of efficacy may provide guidance on targeted instruction to increase sense of efficacy.

Parents and teachers are significant authority figures that substantially impact adolescents' psychological and cognitive development, including their creativity. The current study investigated the relationship between adolescents' attitudes toward authority (parents and teachers) and innovative behavior and examined the mediating effects of social support and perspective taking. According to attachment theory, adolescents' attitudes toward authority may derive from early interaction with primary caregivers, primarily parents. Individuals internalize these interaction experiences and form internal working models, which will be applied in later life stages when interacting with authority figures. These early life experiences also influence individuals' sense of support and empathy abilities. Through analyzing a sample comprising 1,498 adolescents from Taiwan, this study unveils a significant association between adolescents' perceptions of authority and their proclivity for innovative conduct, as well as their levels of social support and capacity for perspective taking. Employing structural equation modeling (SEM), the empirical findings accentuate the mediating role of social support and perspective taking in delineating the nexus between adolescents' attitude toward authority and their manifestation of innovative behavior. The results revealed that adolescents with positive attitudes toward authority are likely to sense support, stand from other viewpoints, and further benefit creativity.

This study estimated the prevalence of autism spectrum disorder in a 5-year inpatient cohort of children and adolescents diagnosed with first-episode psychosis in two Hong Kong teaching hospitals, and explored the clinical characteristics predicting first-episode psychosis-autism spectrum disorder comorbidity. The autism spectrum disorder diagnoses of 103 patients with first-episode psychosis were confirmed by Autism Diagnostic Interview-Revised. Based on the (1) "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.) diagnostic checklist; and (2) Autism Diagnostic Interview-Revised, three major observations were reported: (1) the prevalence of autism spectrum disorder among children and adolescents with first-episode psychosis was 28.2% (95% confidence interval = [19.7%, 37.9%]); (2) after administering the Autism Diagnostic Interview-Revised, an additional 31.0% of first-episode psychosis patients met the clinical diagnostic cut-off for autism spectrum disorder; and (3) multivariate binary logistic regression analysis showed that first-episode psychosis patients with a comorbid autism spectrum disorder diagnosis were more likely to be a male than a female (adjusted odds ratio = 3.57, 95% confidence interval = (1.29, 9.86), p = 0.014). Adding to the current literature, this study examined first-episode psychosis-autism spectrum disorder comorbidity with a large Chinese, inpatient sample with first-episode psychosis. Consistent with studies conducted overseas, we show that autism spectrum disorder is a common comorbidity among Chinese first-episode psychosis patients. A comprehensive autism spectrum disorder assessment that incorporates both observation-based and parent-report diagnostic tools is warranted for children and adolescents, especially boys, with psychosis.

The interest in Computational Thinking (CT) development among young learners increases with the number of studies located in literature. In this study, a meta-analysis was conducted to address two main objectives: (a) the effectiveness of empirical interventions on the development of CT in children aged of 3-8 years; and (b) the variables that influence the effectiveness of the interventions. Following PRISMA procedures, we identified 17 empirical studies with 34 effect sizes and 1665 participants meeting the inclusion criteria from Web of Science database. Overall, we found a statistically significant large effect size (d = 0.83 [95% CI: 730, 0.890]; p < 0.001) on the CT development of 3-8 years old children, which provides empirical support for having young children to engage in CT experiences. The effect size was significantly influenced by moderating variables including gender, scaffolding, and education level. Intervention length showed a marginally significant effect. Therefore, educators could refer to the significant moderators when designing tailored interventions for CT development in early childhood education while a call for more empirical studies of CT development in young children is proposed.

The home math environment is vital for early math development. Yet, there is limited understanding of how parents translated their attitudes towards helping children learn math (HCLM) into actions to influence their young children's math-related outcomes. Thus, the present study examined whether parents' perceived competence, value, and pressure about HCLM contributed to young children's math competence through parents' interest in HCLM, home math activities, and children's interest in math. One hundred forty-seven parents were surveyed about their attitudes, practices, and their children's math interest. Meanwhile, their children were individually tested on applied math problem solving. Results showed that parents' perceived competence and value about HCLM predicted their interest in HCLM, while parents' pressure about HCLM predicted children's math interest. Parents' interest in HCLM is positively linked to children's applied math problem solving via children's math interest. This study shed light on the importance of promoting parents' positive attitudes towards HCLM.

Currently there is a severe lack of research on autism and Indigenous people in Canada. This scoping review explores this literature gap and assesses the same literature from an Indigenous perspective. Scoping reviews are an effective means to explore the literature in a specific area, in this case, autism and Indigenous people in Canada. We explored existing literature as it pertains to Indigenous populations and autism in Canada. To support this review, the Indigenous Quality Assessment Tool (QAT) was adapted to appraise the quality of literature. In total, there were a total of 212 articles identified of which 24 met the inclusion criteria: (1) some focus on autism, (2) a component specific to Indigenous people, and (3) specific to Canada. Of the 24 articles and reports, 15 were peer-reviewed and the rest considered grey literature. Most articles focused on program delivery with some literature using primary data (quantitative and/or qualitative). Overall, the quality of the research was appraised as poor, as determined by the QAT. Findings reaffirm the critical need for research that addresses autism in Indigenous communities within Canada and show the importance of having research done in full partnership with, or led by, Indigenous people.

Prevalence of hearing loss in children with autism spectrum disorder (ASD) is uncertain, as it is more challenging to assess hearing function in children with developmental difficulties (DD). We aimed to determine the prevalence and profiles of hearing loss in preschool children with ASD in a Southeast-Asian population who passed newborn hearing screening. A retrospective study of preschool children with DD (ASD, Global Developmental Delay (GDD), and Speech and Language Delay (SLD)) attending the Child Development Unit (CDU) at our hospital was performed. Three hundred and thirty-three children (ASD: n = 129; GDD: n = 110; and SLD: n = 94) underwent hearing assessments. Of these, 10.8% of children (n = 36, comprising 15 with ASD, 12 with GDD and 9 with SLD) had confirmed hearing loss. Hearing loss was predominantly bilateral in children with ASD and GDD; in those with SLD, unilateral and bilateral hearing loss were equally common. Conductive hearing loss occurred as frequently as sensorineural hearing loss in children with ASD and SLD, but was the dominant subtype in those with GDD. Moderate to severe hearing loss (n = 2) was noted only in children with ASD. Children with ASD and GDD required significantly more audiology visits and procedures to obtain conclusive hearing test results, compared to those with SLD. The need to identify hearing loss and monitor for resolution is particularly important in vulnerable populations with communication deficits, such as in those with ASD.

Interoception, the sense of the physiological condition of our body, is impaired in individuals with autism spectrum disorders. Evidence suggests that subclinical autistic traits are mild manifestations of autistic symptoms, present in the general population. We examined the resting-state functional connectivity (rsFC) associating with interoception and autistic traits in 62 healthy young adults. Autistic traits correlated negatively with the rsFC between the lateral ventral anterior insula and anterior cingulate cortex. Interoceptive accuracy and sensibility correlated positively with the rsFC between interoceptive brain networks and the cerebellum, supplementary motor area, and visual regions. The results suggest that a negative relationship between interoception and autistic traits is largely accounted for by both self-report measures and decreased rsFC amongst the interoceptive brain network.

Concept mapping is widely used as a tool for assessing students' understanding of science. To fully realize the diagnostic potential of concept mapping, a scoring method that not only provides an objective and accurate assessment of students' drawn concept maps but also provides a detailed understanding of students' proficiency and deficiencies in knowledge is necessary. However, few of the existing scoring methods focus on the latent constructs (e.g., knowledge, skills, and cognitive processes) that guide the creation of concept maps. Instead, they focus on the completeness of the concept map by assigning a composite score, which makes it difficult to generate targeted diagnostic feedback information for advancing students' learning. To apply the diagnostic classification model to the quantitative analysis of concept maps, this study introduced the novel application of the item expansion-based diagnostic classification analysis (IE-DCA) for this purpose. The IE-DCA can not only assess students' concept mapping abilities along a continuum but also classify students according to their concept mapping attributes when constructing the concept maps. The application and benefits of this approach were illustrated using a physics concept-mapping item related to particle and rigid body. Results showed that the estimated attribute profiles via the IE-DCA provided more detailed information about students' latent constructs than the composite score. Overall, this study illustrates the feasibility and potential of applying IE-DCA to analyze concept maps. Future applications of IE-DCS in other assessments in science education are discussed.

As evidence from evaluation and experimental studies continue to influence decision and policymaking, applied researchers and practitioners require tools to derive valid and credible inferences. Over the past several decades, research in causal inference has progressed with the development and application of propensity scores. Since their inception, propensity scores have made an important contribution to the improvement in estimation of causal impacts, particularly in the absence of randomization. When certain core assumptions hold, propensity score-based methods allow for bias-reduced estimation of average treatment effects. In addition to their important role in causal studies, propensity scores have also been integral in improving generalizations from causal studies, specifically when study samples are not randomly selected from a target population of inference. The current study provides an overview of propensity scores, a discussion of the assumptions needed to ensure their validity, and an illustration of the methods both for causal inference and generalization. We highlight the importance of propensity score methods and discuss current applications and directions for ongoing and future research.

Background: Parents' high academic expectations are positively associated with young children's mathematical abilities. However, minimal attention has been devoted to whether, and how, different ways of conveying the performance targets would result in different outcomes. Aims: The current study investigated whether and how parents' perfectionistic strivings and concerns were associated with young children's mathematical abilities through home mathematical activities, children's approach motivation to learn mathematics, and children's avoidance motivation to learn mathematics. Sample: Participants included 211 kindergarteners in Hong Kong and their parents. Methods: Data were collected through individual child tests and parent questionnaires. Results: Structural equation modelling revealed that parents' perfectionistic strivings had a direct positive link with children's mathematical abilities, an indirect link via approach motivation to learn mathematics, and an indirect link via home mathematical activities, and then approach motivation. Parents' perfectionistic concerns had a direct negative link with children's mathematical abilities, an indirect link via approach motivation to learn mathematics, and an indirect link via avoidance motivation to learn mathematics. Conclusions: Early childhood practitioners are recommended to raise parents' awareness of how to communicate high-performance targets to children in a constructive manner.

The synchronous hybrid learning model, which involves simultaneous face-to-face and remote learning, suffers from a disparity in the lesson experience and outcomes provided by the different learning modes. Moreover, the online medium allows little opportunity for teachers to exhibit non-verbal immediacy behaviours to improve cognitive engagement and motivation to learn in remote students, further exacerbating the disparity. This work describes the implementation of chroma key compositing that livestreamed weatherman style composite videos to remote students over the online medium during hybrid lessons at a lecture hall. A green screen was used to perform background removal and the teacher was digitally inserted in front of the course content in real time, visually mimicking classroom teaching for remote students, without requiring an on-site camera crew. This work also presents an implementation mode that unifies the view of both face-to-face and remote students. Aggregate results of student surveys indicate that more than 80% of remote students perceived significant improvement in visibility of lecture delivery, teacher presence and capture of attention, while 91% of face-to-face respondents indicated that their in-person learning experience was not significantly affected. Categorical data analysis on itemised responses indicates that students who only adopted the remote learning mode have at least a 90% likelihood of moderately or strongly favouring the setup and implementation. As a whole, our results indicate strong evidence that our setup and implementation has significantly reduced the disparity in learning experiences.

This study aims to investigate factors affecting students' intention to join blended learning courses in higher education sector using Community of Inquiry framework and Unified Theory of Acceptance and Use of Technology (UTAUT) model. Stimulus-Organism-Response (S-O-R) model was employed to develop a new research framework while constructs in the Community of Inquiry are Stimulus and constructs from UTAUT are considered as Organism and Response. A survey was conducted with undergraduate students in a Hong Kong higher institution. It was found that Teaching Presence (TP), Social Presence (SP) and Cognitive Presence (CP) were associated with performance expectancy, social influence and effort expectancy respectively. Performance expectancy and effort expectancy were associated with social influence. Social influence was associated with students' attitude towards blended learning. Institution support was not related to the students' attitude towards blended learning in the post-pandemic period. Attitude towards blended learning was associated with their behavioral intention to participate in blended learning. Online and offline tools could be adopted to improve the students' acceptance towards the blended learning approach.

The Caregiver Strain Questionnaire assesses the three dimensions of caregiver strain, namely the objective, subjective externalized and subjective internalized strain. It was validated among caregivers of children with Autism Spectrum Disorder (ASD) in the United States and Mainland China with promising psychometric properties. This study aimed to develop and validate the Chinese (traditional script) version of the Caregiver Strain Questionnaire (C-CGSQ) among 198 caregivers of children with ASD in Hong Kong. The C-CGSQ showed excellent internal consistency ([alpha] = 0.958) and test-retest reliability (Spearman's r = 0.966). Concurrent, convergent, divergent validity and a three-factor structure (consistent with previous studies) were established. The C-CGSQ demonstrated promising psychometric properties in measuring caregiver strain among caregivers of Chinese ASD children in Hong Kong.

Students with special education needs (SEN) face challenges in developing career adaptability and self-efficacy. Using a sample of 355 students with SEN in Hong Kong, this study evaluated effects of social connectedness and meaning in life on career adaptability and career self-efficacy. Data were collected twice, participants completing self-report measures at baseline and 18 months later. Analysis found that meaning in life significantly and positively predicted both variables. At follow-up, social connectedness directly predicted presence of meaning, while indirectly predicting career adaptability and self-efficacy. Interventions for SEN students should seek to strengthen their social connectedness and meaning in life.

COVID-19 pandemic has brought drastic and unprecedented challenges to the medical education and medical students, affecting them physically, mentally and emotionally. While progressing through the post-pandemic recovery phase, it is crucial to comprehensively evaluate the pandemic's consequences and tackle the underlying problems. To investigate the impact of COVID-19 pandemic on medical students' mental health, social well-being, and academic progression. A cross-sectional study was carried out with voluntary sampling of students from both government and private medical schools in Malaysia. A self-administered online survey form containing three validated psychological tools was distributed (Hospital Anxiety and Depression Scale HADS, Rosenberg Self-esteem Scale, NIH Toolbox Social Relationship Scales). There were also questions regarding the challenges faced by medical students and their academic performance during COVID-19 pandemic. Scores of each questionnaire were tabulated, analyzed and interpreted according to their specific cut-points. Two hundred and thirteen responses were received. 89.2% (n = 190) were domestic students while 10.8% (n = 23) were international students. Out of 32 medical universities in Malaysia, the participants were from 19 of them (9 public and 10 private universities). About half of the participants had contracted COVID-19 infection during the study period (n = 124, 58.2%). Majority had chosen "Lack of on-campus learning and training session causing incompetency" as the most relevant impact of COVID-19 on their academic progression (n = 85, 39.9%). Above 90% of participants passed their Final Academic Assessment in 2020 (91.5%) and 2021 (93.9%). About half of them (n = 86, 40.4%) were having symptoms considerable of anxiety while only 19.2% (n = 41) were having symptoms considerable of depression. Majority had normal self-esteem (n = 177, 83.1%). For social relationship, around two-third of them had great social support and companionship. However, more than half had social distress. The median for the period of time having absolute online classes, absolute physical classes and hybrid classes were 18, 4, and 9 months, respectively. Having absolute online classes of >18 months was associated significantly with higher perceived hostility (16.49 vs. 14.47, p = 0.012). In addition, being infected with COVID-19 was associated significantly with higher self-esteem (26.88 vs. 25.85, p = 0.009). Large proportion of students were affected by COVID-19 pandemic. Absolute online classes has huge impact on emotions of medical students especially from the aspect of perceived hostility. Hence, implementation of online medical education during COVID-19 era requires modifications and improvements.

While prior research has shown higher mindfulness is associated with lower problematic smartphone use (PSU), the contexts of these studies were not related to education or student performance. As such, whether and how mindfulness can reduce the adverse effects of PSU on academic self-efficacy remains unknown. This study proposed a model for testing whether and how mindfulness exerts its effects on PSU and academic self-efficacy through different pathways in which self-esteem, academic motivation, and smartphone time serve as mediators. To this end, a questionnaire survey, comprising Smartphone Addiction Scale (Short Version), Mindful Attention Awareness Scale, Short Academic Motivation Scale, Rosenberg Self-esteem Scale, and Educational Self-efficacy Scale, was administered to a sample of 821 university students from Hong Kong during the COVID-19 pandemic in 2022. The findings of this study show that mindfulness reduces the adverse effects of PSU on academic self-efficacy. Four different mediation pathways were identified, showing how the effects of mindfulness on PSU and academic self-efficacy are mediated through self-esteem, academic amotivation, and smartphone time. Specifically, mindfulness has a direct negative effect on PSU and a direct positive effect on academic self-efficacy. Mindfulness also exerts indirect effects on PSU mediated serially by self-esteem, academic amotivation, and smartphone time.

Internationalization policy in higher education facilitates a nation's economic growth and demonstrates generosity to other nations. This study investigates the impact of the International Higher Education Scholarship Program of the International Cooperation and Development Fund on recipients' perceptions of and experiences in Taiwan. Based on the management, education, medical science, and engineering programs of four case study universities, it finds attitudinal changes, increased intercultural competence, and signs of institution transfer and knowledge network formation. Socialization has fostered scholarship holders' cultural affinity and shared identity with Taiwan. As higher education institutions promote knowledge sharing and cultural diffusion, international students are also a nexus of cultural diplomacy, the attractions of which are more conspicuous than knowledge diplomacy's benefits. The empirical evidence of this study helps delineate theoretical frameworks of diplomacy in international higher education. Its longitudinal observation of alumni career trajectories can enrich cross-sectional evaluation.

In recent years, international students' settlement experiences have emerged as a new focus in migration studies. This qualitative study examines the study-to-work transition experiences of 30 mainland Chinese graduates living in Hong Kong and deepens the current discussion of these students-turned-migrants' socio-cultural integration. Specifically, mainland Chinese students-turned-migrants experience ongoing challenges in their study-to-work transitions. Adaptation difficulties in their university years, including limited Cantonese proficiency, meagre cultural understanding of the host society, and weak connections with locals, continue to affect their subsequent employment and social integration. Our findings underscore the crucial links between international students' prior socio-cultural adaptation and their post-study settlement experiences. We also reveal everyday workplace microaggressions, which should receive greater attention from scholars interested in international students' and students-turned-migrants' intra-ethnic interactions. Our findings have implications for immigration policy, university student services, and local companies.

Medical improvisation (improv) applies theater principles and techniques to improve communication and teamwork with health professionals (HP). Improv curricula have increased over time, but little is known about best practices in curricula development, implementation, and assessment. We sought to complete a state-of-the-art review of medical improv curricula to teach HP learners communication skills. A literature search of MEDLINE and 8 other databases on HP medical education and medical improv communication curricula occurred. We screened 1869 articles published from 2012 to 2022. Seventeen articles were selected for extraction and synthesis. Common curricular goals included improving interprofessional, interpersonal, and empathetic communication. Curricula often lacked alignment between learning objectives and improv exercises. Sessions occurred once (65%) or were longitudinal (35%). Only 24% reported a full description of their intervention. Few reported details on the content of curricula. Evaluations often focused on feasibility and acceptability. Heterogeneity exists in the development, implementation, and assessment of improv curricula. Low-quality evidence was provided to support the use of medical improv to teach communication skills to HP learners. Improv curricula were feasible, and acceptable to learners. We offer recommendations to guide future medical improv curricula development.

Screening for autism in childhood has been advocated as a part of standard care. Challenges exist with screening implementation and performance of screening tools in clinical practice. This study aimed to examine the validity and feasibility of using the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) for screening of autism in Singapore. Caregivers completed the M-CHAT-R/F as a part of the routine 18-month well-child visit in seven primary care clinics. Screening and follow-up interviews were administered by trained nursing staff. Children screened positive and a subset of those screened negative underwent diagnostic assessments for autism, which included an Autism Diagnostic Observation Schedule, Second Edition. Participants were 5336 multiethnic children (mean age 18.6 ± 0.9 months, 51.3% male gender). In total, 113 (2.1%) were screened positive, of which 54 (1.0%) were classified to have autism after their diagnostic assessment. Sensitivity of the M-CHAT-R/F was 88.6%, specificity 71.4%, and positive predictive value 90.7% for an autism diagnosis. The majority of respondents rated the screening process as feasible within the clinic setting. The M-CHAT-R/F had acceptable psychometric properties and high feasibility when used in primary care settings in Singapore. Recommendations for implementation of systematic screening and future research are presented.

Immersive virtual reality (i-VR) is a powerful tool that can be used to explore virtual models in three dimensions. It could therefore be a valuable tool to supplement anatomical teaching by providing opportunities to explore spatial anatomical relationships in a virtual environment. However, there is a lack of consensus in the literature as to its effectiveness as a teaching modality when compared to the use of cadaveric material. The aim of our study was to compare the effectiveness of i-VR in facilitating understanding of different anatomical regions when compared with cadaveric prosections for a cohort of first- and second-year undergraduate medical students. Students (n = 92) enrolled in the MBBS program at Queen Mary University of London undertook an assessment, answering questions using either Oculus i-VR headsets, the Human Anatomy VR™ application, or prosection materials. Utilizing ANOVA with Sidak's multiple comparison test, we found no significant difference between prosections and i-VR scores in the abdomen (p = 0.6745), upper limb (p = 0.8557), or lower limb groups (p = 0.9973), suggesting that i-VR may be a viable alternative to prosections in these regions. However, students scored significantly higher when using prosections when compared to i-VR for the thoracic region (p < 0.0001). This may be due to a greater need for visuospatial understanding of 3D relationships when viewing anatomical cavities, which is challenged by a virtual environment. Our study supports the use of i-VR in anatomical teaching but highlights that there is significant variation in the efficacy of this tool for the study of different anatomical regions.