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Background: Conducting health assessments and physical examinations are essential skills for independent practice. Exploring how to teach these skills effectively is essential. Purpose: This study was designed to validate the effectiveness of a self-directed learning program in improving nursing student outcomes in terms of their learning health assessment and physical examination skills. Method: A quasi-experimental design was used, and secondyear nursing students enrolled in a health assessment and physical examination course at a university of science and technology in central Taiwan were recruited using purposive sampling. Both the control and experimental groups were taught using a traditional teaching method. The experimental group additionally participated in a self-directed learning program. Structured questionnaires, including the Chinese version of the SelfDirected Learning Readiness Scale, Scales of Motivation and Learning Strategies, Interpersonal Skills Assessment Tool, the Course Satisfaction Evaluation Scale, and the Perception of Health Assessment and Physical Examination Competence Scale, were used to collect data at three time points. Results: After controlling for the effects of pretest scores, after the intervention, the experimental group achieved significantly higher scores than the control group for self-directed learning (creative learning and love of learning), learning motivation (goal orientation, work value, expected success, and test anxiety), and cognitive strategies (total score, elaboration strategy, recitation strategy, and monitoring strategy). In addition, the health assessment exercise improved interpersonal and communication skills, and learning satisfaction was significantly higher in the experimental group than the control group. Conclusions/Implications for Practice: A physical examination and health assessment course designed using the selfdirected learning framework can effectively improve student competence in related skills to enhance their ability to assess patient health problems in clinical settings. This study presents an alternative approach to teaching health assessment and physical examination courses and validates the positive effect of this approach on student learning outcomes. [ABSTRACT FROM AUTHOR]

The pediatric dentistry courses are lacking in our six-year undergraduate dental education. The purpose of this study was to evaluate the implication of instructional design for deciduous tooth identification in a dental morphology course for undergraduate dental students through students' perspectives. A total of 34 s-year dental students who took this dental morphology course were invited to fill out the questionnaire for survey of instructional design for deciduous tooth identification after the class. Of the 34 dental students, 32 of them participated in the survey with a valid response rate of 94.1%. The results showed that most students found the learning activity of instructional design for deciduous tooth identification to be helpful for improving their knowledge about deciduous dentition. Most of them also had positive attitude towards this instructional design. Since the proportion of pediatric dentistry courses in the undergraduate dental education is very low and children's oral problems are indeed faced by all dentists, it is important to add learning units of pediatric dentistry-related knowledge in different undergraduate dental professional courses or to propose strategies to promote students' awareness of self-directed learning about pediatric dentistry. This study may serve as a model for other undergraduate dental courses in Taiwan. [ABSTRACT FROM AUTHOR]

Purpose: To facilitate the use of YouTube as an important global video portal for self-directed learning (SDL), it is important to understand YouTube users' distinctive learning experiences across cultures. This study examines factors influencing YouTube SDL based on the personal responsibility orientation (PRO) model. In addition, the two markets, US and Taiwan, were chosen to explore if national cultural differences affect YouTube users' SDL frequency and goals along with PRO variables. Design/methodology/approach: A self-administered online survey of 372 college aged-YouTube users in the US and Taiwan was conducted to obtain the self-reported SDL behavior on YouTube and other demographic and video usage variable information. Findings: Frequent video sharing and information seeking motives likely facilitate general YouTube SDL, while initiating online video search leads to specific goal-oriented SDL such as problem-solving and skill-improvement. Although American students use YouTube more frequently for SDL than Taiwanese students, Taiwanese students use YouTube more for specific skill improvement. Social implications: YouTube's social affordance enables YouTube users' informal and SDL across different national cultures and thus the role such social media play in encouraging lifelong learning needs further attention. Originality/value: This study contributes to understanding how YouTube fosters the informal learning process through functions enabling YouTube users' self-directed information seeking, sharing and engaging with online videos with a cross-national comparison. This study is also expected to offer insights to promote the use of YouTube for SDL as a first cross-national study applying the PRO model in the context of YouTube SDL. [ABSTRACT FROM AUTHOR]

Background: Implementing English medium instruction (EMI) has become a proliferating measure in higher education to embrace globalization. Nevertheless, university students reported various challenges in taking EMI courses. Objectives: This study investigated the effect of the computer‐mediated terminology pretraining on university students' EMI success, regarding their efficacy in taking EMI courses, self‐directed learning (SDL), and EMI performance. Methods: Participants were 86 university students enrolled in two EMI educational psychology courses. Students in the experimental group were assigned computer‐mediated terminology pretraining tasks for 13 consecutive weeks, while those in the control group did not receive the pretraining assignment. Both groups were taught using the problem‐based learning (PBL) pedagogy with a computer‐mediated structured whiteboard. Results and Conclusion: The study findings showed that the computer‐mediated terminology pretraining enhanced learners' response efficacy. Both groups increased their SDL under the PBL pedagogy. Besides, multigroup comparison results demonstrated that efficacy in EMI positively predicted SDL, which was related to better EMI performance in the experimental group but not in the control group. Notably, students conducting computer‐mediated terminology pretraining remitted the influence of English ability on their EMI performance. Major Takeaways from the Study: Implications for instruction were made to use the combined strategy of the computer‐mediated terminology pretraining and PBL in EMI courses to facilitate university students' efficacy in taking EMI courses, self‐directed learning behaviours, and EMI performance. Lay Description: What is already known about this topic?: Implementing English medium instruction (EMI) courses has become a prevalent measure for higher education to embrace globalization.Some students hold positive attitude toward taking EMI courses, while others hold negative attitude toward taking EMI courses.Correlational research showed that individual differences, such as English proficiency, self‐efficacy in EMI, and academic language skills, are associated with EMI success. What this paper adds: This study adds to the literature in EMI success to investigate how computer‐mediated terminology pretraining under problem‐based learning (PBL) pedagogy will affect learners' efficacy in EMI, self‐directed learning (SDL), and EMI performance.The computer‐mediated terminology pretraining enhances learners' efficacy that their efforts or responses in taking the EMI course are effective.Students' efficacy in taking EMI courses promotes their self‐directed learning; moreover, self‐directed learning behaviours in EMI is associated with better EMI performance for students with computer‐mediated terminology pretraining but not for those in the control group due to the influence of English ability.The computer‐mediated terminology pretraining can compensate the effect of individual differences in English ability on EMI performance. Implications for practice and/or policy: Instructors can assign the computer‐mediated terminology pretraining before the face‐to‐face EMI session to prepare learners with the basic understanding of the professional concepts for the complex PBL activities.Effective pedagogical support, such as combined strategy use of computer‐mediated terminology pretraining and PBL, can enhance learners' efficacy in EMI and help them plan and prioritize their learning progress to achieve better EMI performance. [ABSTRACT FROM AUTHOR]

Background: Continuing education (CE) is essential for health professionals to improve competence in clinical practice, yet many medical technologists still experience barriers to learning in complex clinical settings. To better manage CE and address medical technologists' learning needs, we developed a learner-centred electronic book (e-book) to promote self-directed learning for medical technologists. Methods: A cross-sectional study was conducted to explore the acceptability and learning impacts of the e-book as CE material for medical technologists in two medical centres in Taiwan. We designed the learner-centred context in the e-book based on medical technologists' practice requirements and learning needs. Moreover, we adopted The New World Kirkpatrick Model with four levels (reactions, learning, behaviours and results) to evaluate the e-book's learning impacts on medical technologists. A total of 280 medical technologists were invited to complete a questionnaire and a post-test, providing learning patterns as well as their satisfaction with the e-book and their learning outcomes after using it. Results: Most readers had positive learning experiences and better learning outcomes, including knowledge acquisition and behavioural change, after reading the e-book. The e-book became a new CE activity and reached medical technologists in various types of laboratories. Conclusions: The low-cost and learner-centred e-book effectively overcame CE learning barriers for medical technologists. The interactivity and flexibility of e-learning particularly helped learners to engage in clinical scenarios in laboratory medicine. This study could pave the way for medical educators to build a high-quality e-learning model in CE. [ABSTRACT FROM AUTHOR]

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

Background: Team-Based Learning (TBL) is a potentially effective method of instruction that has been applied only infrequently in nursing education in Taiwan. Purpose: This study was developed to examine the effects of incorporating the TBL strategy into the course "Advanced Medical Nursing English". Methods: A quasi-experimental, single group, and pre-post test design was adopted. Nursing students who took the "Advanced Medical Nursing English" elective course used the TBL strategy for 8-weeks. Students were assigned to heterogenic groups of 12 students each based on their scores on an English pre-test. The collected data included the scores on individual and group readiness tests, a self-directed learning questionnaire, learning satisfaction, and an English posttest. Self-completed reflection papers and focused group interviews were used for qualitative appraisal. Results: A total of 72 students were enrolled. Nearly all (93.1%) were female and 21-22 years of age. The results of a paired samples t-test applied to examine the effects of the TBL strategy on learning outcomes showed that English posttest and self-directed learning ability scores had both improved significantly (all p < .05). The results of ANOVA tests showed that students with lower pre-test scores improved more than those with higher pre-test scores. The results of a sample t-test with a test value of 4.0 applied to examine learning satisfaction found a non-significant change (p > .05), indicating no change in perceived satisfaction. The qualitative analysis identified four themes regarding perceptions of the TBL strategy, including "friendships in learning", "harmonious atmosphere and participations", "inertial shock and adjustments", and " excessive learning load". Conclusion: TBL was shown to be an effective learning strategy for RN-BSN students in a Medical Nursing English Course, particularly those with relatively low pre-test scores. Future studies should focus attention on reading assignments to avoid overburdening students. The results of this study may serve as a reference for medical nursing English education. [ABSTRACT FROM AUTHOR]

This study utilizes the design of an informal, semi-structured self-directed English listening program beyond the classroom in a university in Taiwan. The purpose was to examine Mandarin-speaking EFL learners' autonomous learning processes and their perceptions toward the program. Twenty-two participants voluntarily signed up for the ten-week program, in which TED videos were used as the listening materials. Except for the orientation during the first week, all learning activities took place outside of the classroom at each learner's pace. Data included 446 listening logs, end-of-program questionnaires, and interviews. The findings reveal that during the autonomous learning process the participants adopted various strategies at the stages of setting goals, selecting materials, developing learning methods, and evaluating learning outcomes. The strategies and self-regulation skills were shaped by both personal and contextual factors. Active metacognitive processes were also observed. Although learners' participation decreased over time, they valued the opportunity to exercise control over their learning by having greater flexibility than that of taking a course. This study extends our understanding of learner autonomy in a specific context, which could shed light on the future designs of the self-directed language program. [ABSTRACT FROM AUTHOR]

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Aim: To examine the effects of using different teaching sequences on knowledge acquisition, knowledge retention, self‐directed learning and teamwork in a nursing administration project. Background: Compared to other professional courses, nursing administration is relatively difficult, and it is important for nursing administration students to spend long hours working in hospitals. As such, better teaching strategies utilizing proper sequencing may yield better learning outcomes for students. Methods: A longitudinal quasi‐experimental design was used. A total of 129 students were assigned to two groups with which different teaching sequences were used. The investigated learning outcomes were knowledge acquisition, knowledge retention, self‐directed learning and teamwork. Generalized estimating equations were used to measure the learning outcomes. Results: There was no significant difference between the two teaching sequences in terms of learning effects. One teaching strategy, problem‐based learning (PBL), yielded effective student learning outcomes. Conclusion: PBL increased the students' self‐directed learning and teamwork. This strategy can be applied to side‐by‐side co‐teaching and post‐graduate year training programmes. Implications for Nursing Management: The results from this study may help hospitals retain nurses and find potential nursing leaders. Instructors and nurse managers should discuss learning goals with students in advance to enhance the students' learning outcomes. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates the use of an item response theory (IRT) approach in reexamining self-directed instrument (SDL) for different nursing education programs in Taiwan. Noted was the conduct of a stratified random sampling having probabilities proportional to size. Results indicate that 18 items had exhibited very high discrimination while two other items and high discrimination suggesting greater precision in estimating SDL among nursing students.

Background: Fostering self-directed learning skills in nursing students may provide a foundation for improving the specialty knowledge of these nurses. Purpose: This study examines the current status of nursing student self-directed learning behavior and explores how different background factors impact self-directed learning. Methods: This research design used a cross-sectional survey and convenience sampling. A total of 550 questionnaires were distributed to participants in enrolled in nursing programs at a 2-year nursing program at an institute of technology in northern Taiwan and a 4-year nursing program at an institute of technology in southern Taiwan. A convenience sampling was used to collect data, with 537 valid questionnaires used in data analysis. Results: Results indicated that the self-directed learning and self-management of nursing students between 20-21 years old was significantly higher than those of students between 18-19 years old. Self-directed learning, desire of learning and self-control in 2-year nursing students were significantly higher than in 4-year and extension education department nursing student participants. Two-year nursing students had the highest self-management scores, followed by extension education department participants and 4-year nursing students. Finally, participants who associated highly with the nursing profession earned the highest self-directed total score, followed by those participants who associated generally and those who associated mildly. Conclusions / Implications for Practice: The results recommend that teachers at nursing institutes help students develop self-directed learning. Results also recommend teachers increase their students' association with the nursing specialty through understanding the impact of different background factors on self-directed learning. [ABSTRACT FROM AUTHOR]

Background: An effective preceptor is a vital component of a strong learning experience for learners. Many clinical preceptors provide on-site supervision and clinical teaching but lack the skills necessary to be effective teachers. Few studies have "examined the factors related to teaching competence among clinical nurse preceptors. Purpose: This article is a report of a study that examined (a) the differences in teaching competence by preceptor background, (b) the influence of locus of control on self-evaluated teaching competence, (c) the association between self-directed learning and self-evaluated teaching competence, and (d) the predictors of self-evaluated teaching competence among clinical nurse preceptors. Methods: This descriptive and correlational study used a cross- sectional survey of a convenience sample of 243 clinical nurse preceptors from a medical center in northern Taiwan. Of these, 242 completed questionnaires for an effective response rate of 99.6%. The self-evaluated Teaching Competencies Scale, Internal-External Scale, and Self-Directed Learning Instrument were used to assess teaching competencies and related factors among clinical nurse preceptors. Descriptive statistics, one-way ANOVA, Mann-Whitney test, and multivariate linear regression were used to analyze data. Results: Clinical nurse preceptors averaged 4.03 in teaching competence, indicating a moderately above average score. Higher teaching competence was associated with older age, being married, >10-year work experience, not assigned by unit manager, and good internal locus of control. Self-directed learning significantly correlated with teaching competence (r = .62). Internal locus of control and self-directed learning were significant independent predictors of teaching competence after adjusting for age, marital status, total years as a clinical nurse preceptor, and willingness to be a clinical nurse preceptor. Together, these accounted for 33.6% of teaching competence variance. Conclusions: Nurse managers should recognize all factors and characteristics of clinical nurse preceptors that influence teaching competence to help achieve optimal learning outcomes for nursing staff and students. [ABSTRACT FROM AUTHOR]

Background: Tube dislodgment has been ranked as the top three medical accidents for five years consecutively in Taiwan. Chest tube care accidents affect patient's health and life significantly. Typically, education on chest tube care focuses on the knowledge transmission with limited guiding nursing students in learning clinical reasoning. The Generation Z students prefer mobile devices. It is crucial to incorporate mobile applications to learning., Purpose: The purpose of this study was to evaluate effectiveness of the teaching intervention program ("iLearning app for chest tube care") in improving nursing students' clinical reasoning ability and self-directed learning., Method: A quasi-experimental study with a cluster sample was used. A total of 107 nursing students were recruited with the intervention group (n = 53) using the "iLearning app" to learn chest tube care, and the comparison group (n = 54) using the "traditional teaching". Data were collected before the intervention, one week and one month after the intervention., Result: The result showed that there was no difference in clinical reasoning and self-directed learning between groups before the intervention. However, the intervention group showed significantly higher clinical reasoning and self-directed learning scores than the comparison group (p < .05) one week and one month after the intervention. It indicated that the students' clinical reasoning abilities and self-directed learning improved with implementation of the intervention., Conclusion: The results indicated that the "iLearning app" intervention improved the clinical reasoning and self-directed learning in nursing students. This intervention used situated learning with concept mapping to guide student learning and demonstrated effectiveness in improving their clinical reasoning ability. Immediate feedback of the course instructor might trigger deeper learning and self-correction of clinical reasoning. The "iLearning app" could be used as a tool to improve students' clinical reasoning and self-directed learning, and thus enhance lifelong learning., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Team-Based Learning (TBL) is a potentially effective method of instruction that has been applied only infrequently in nursing education in Taiwan., Purpose: This study was developed to examine the effects of incorporating the TBL strategy into the course "Advanced Medical Nursing English"., Methods: A quasi-experimental, single group, and pre-post test design was adopted. Nursing students who took the "Advanced Medical Nursing English" elective course used the TBL strategy for 8-weeks. Students were assigned to heterogenic groups of 12 students each based on their scores on an English pre-test. The collected data included the scores on individual and group readiness tests, a self-directed learning questionnaire, learning satisfaction, and an English posttest. Self-completed reflection papers and focused group interviews were used for qualitative appraisal., Results: A total of 72 students were enrolled. Nearly all (93.1%) were female and 21-22 years of age. The results of a paired samples t-test applied to examine the effects of the TBL strategy on learning outcomes showed that English posttest and self-directed learning ability scores had both improved significantly (all p < .05). The results of ANOVA tests showed that students with lower pre-test scores improved more than those with higher pre-test scores. The results of a sample t-test with a test value of 4.0 applied to examine learning satisfaction found a non-significant change (p > .05), indicating no change in perceived satisfaction. The qualitative analysis identified four themes regarding perceptions of the TBL strategy, including "friendships in learning", "harmonious atmosphere and participations", "inertial shock and adjustments", and " excessive learning load"., Conclusions: TBL was shown to be an effective learning strategy for RN-BSN students in a Medical Nursing English Course, particularly those with relatively low pre-test scores. Future studies should focus attention on reading assignments to avoid overburdening students. The results of this study may serve as a reference for medical nursing English education.

Effective professional development enhances teachers' instructional skills and in turn improves students' learning. This study adopts a multilevel perspective to investigate the interplay of self-directed learning ( SDL), professional self-awareness, and the supportive organizational climate in terms of their effects on the professional development of high school teachers in Taiwan. The study confirms that individual SDL and a supportive organizational climate positively affect teachers' professional development. Specifically, professional self-awareness mediates the relationship between SDL and professional development at the individual level. The cross-level moderation of the supportive organizational climate is confirmed on the relationship between SDL and professional development. It is concluded that teachers with a greater degree of individual SDL and professional self-awareness, combined with a supportive organizational climate, will be more involved in professional development. Implications and suggestions for future research are also discussed. [ABSTRACT FROM AUTHOR]