Journal of Educational Evaluation for Health Professions

Review

Psychometric properties of instruments assessing the ethics of teaching: a COSMIN-based systematic review: Kesinee Chaimo, Sureeporn Thanasilp; J Educ Eval Health Prof. 2026;23:12. Published online May 28, 2026; DOI: https://doi.org/10.3352/jeehp.2026.23.12

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Abstract PDF Supplementary Material: Purpose
This systematic review aimed to identify and critically evaluate instruments assessing the ethics of teaching and related moral constructs among educators, with a focus on their psychometric properties and applicability to health professions education.
Methods
A systematic search was conducted in PubMed, ERIC, Scopus, and Emerald Insight databases through January 31, 2026. Only English-language studies were included. Measurement properties were evaluated using COSMIN (consensus-based standards for the selection of health measurement instruments) and COSMIN-modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approaches.
Results
Of 246 records, 6 instruments met the inclusion criteria: ESSQ (Ethical Sensitivity Scale Questionnaire), ELS (Ethical Leadership Scale), EEQ (Ethical Evaluation Questionnaire), TEPI (Teaching-Profession Ethical Principles Inventory), TCPERSS (Teachers’ Compliance with Professional Ethics in Relations with Students Scale), and MCI (Moral Competency Inventory). Psychometric properties were sufficiently reported for selected domains, primarily internal consistency and structural validity (Cronbach’s α=0.74–0.97). However, construct validity (hypothesis testing), test–retest reliability, and cross-cultural validation were inconsistently reported. The quality of evidence was moderate because of limited cross-context validation. Notably, no tools were specifically developed for health professions education. Most identified instruments focused on classroom pedagogy, potentially overlooking clinical instruction, bedside teaching, and workplace-based learning, where power dynamics and clinical pressures coexist. Developing tools that capture the “ethics of the clinical encounter” would help more accurately reflect the realities faced by health professions educators.
Conclusion
Existing instruments demonstrate sufficient psychometric properties in general education but reveal critical measurement gaps for health professions education. These findings provide an empirical basis for developing context-specific instruments to improve the evaluation of ethical teaching in clinical and healthcare settings.

Research articles

Evaluation of an infectious‑disease response training program for primary care physicians in Korea using Kirkpatrick’s 4 levels and the Context, Input, Process, and Product model: a mixed‑methods study: Kyung Hee Chun, Jin Seo Lee, Seon Young Jeong, Young Soon Park; J Educ Eval Health Prof. 2025;22:40. Published online December 31, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.40

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Abstract PDF Supplementary Material: Purpose
This study systematically evaluated the effectiveness of a training program designed to enhance infectious disease response capabilities among primary care physicians. Using a mixed-methods design, the evaluation applied Kirkpatrick’s 4-level model and the Context, Input, Process, and Product (CIPP) framework to assess program outcomes and identify areas for improvement.
Methods
The study focused on a national infectious disease training program for primary care physicians conducted in 2022 (N=1,718). Quantitative pre- and post-training data were analyzed from 100 randomly selected participants, along with qualitative data obtained through in-depth interviews with 10 participants. Validated assessment tools, developed by psychometricians and content experts, were used to measure satisfaction (Kirkpatrick level 1), learning achievement (level 2), practical application (level 3), and organizational contribution (level 4).
Results
Overall training satisfaction was high (3.96±0.72). Learning achievement (level 2) demonstrated statistically significant improvement from pre-training to post-training assessments (F=12.922, P<0.001). Scores for practical application (level 3; 3.19±0.86) and organizational contribution (level 4; 3.47±0.70) indicated both strong motivation to apply newly acquired knowledge and institutional readiness to implement response strategies.
Conclusion
This study confirmed that the training program effectively enhanced both individual competencies and organizational response capacity across all 4 Kirkpatrick levels. The integrated application of the Kirkpatrick and CIPP models provided a robust framework for evaluating learning transfer and guiding program improvement. These findings highlight the importance of continued investment in diverse training initiatives, systematic evaluation processes, and the dissemination of successful practices to the broader healthcare community.

A new performance evaluation indicator for the LEE Jong-wook Fellowship Program of Korea Foundation for International Healthcare to better assess its long-term educational impacts: a Delphi study: Minkyung Oh, Bo Young Yoon; J Educ Eval Health Prof. 2024;21:27. Published online October 2, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.27

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Abstract PDF Supplementary Material

Purpose
The Dr. LEE Jong-wook Fellowship Program, established by the Korea Foundation for International Healthcare (KOFIH), aims to strengthen healthcare capacity in partner countries. The aim of the study was to develop new performance evaluation indicators for the program to better assess long-term educational impact across various courses and professional roles.
Methods
A 3-stage process was employed. First, a literature review of established evaluation models (Kirkpatrick’s 4 levels, context/input/process/product evaluation model, Organization for Economic Cooperation and Development Assistance Committee criteria) was conducted to devise evaluation criteria. Second, these criteria were validated via a 2-round Delphi survey with 18 experts in training projects from May 2021 to June 2021. Third, the relative importance of the evaluation criteria was determined using the analytic hierarchy process (AHP), calculating weights and ensuring consistency through the consistency index and consistency ratio (CR), with CR values below 0.1 indicating acceptable consistency.
Results
The literature review led to a combined evaluation model, resulting in 4 evaluation areas, 20 items, and 92 indicators. The Delphi surveys confirmed the validity of these indicators, with content validity ratio values exceeding 0.444. The AHP analysis assigned weights to each indicator, and CR values below 0.1 indicated consistency. The final set of evaluation indicators was confirmed through a workshop with KOFIH and adopted as the new evaluation tool.
Conclusion
The developed evaluation framework provides a comprehensive tool for assessing the long-term outcomes of the Dr. LEE Jong-wook Fellowship Program. It enhances evaluation capabilities and supports improvements in the training program’s effectiveness and international healthcare collaboration.

Citations

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Multi-stage compound drought–heatwave stress elevates cotton yield-loss risk across contrasting climate regimes of the China-Pakistan economic corridor
Lei Gong, Yi Li, Ben Niu, Maokai Song, Shie-Yui Liong, Darrell Tang
Atmospheric Research.2027; 344: 109332. CrossRef
Long-term impact of health policy and management training for health experts from the LMICs: 2022 Dr. LEE Jong-wook fellowship program
Vasuki Rajaguru, Jun Su Park, Soo Hyeok Choi, Sunmin Kim, Jungeun Seo, Yumin Kim, Hyejin Jung, Tae Hyun Kim
International Health.2026;[Epub] CrossRef
An index system for evaluating the data security in trauma centers: a modified Delphi study in China
Feifei Jin, Guozheng Cao, Wei Huang, Tianbing Wang
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Review

Attraction and achievement as 2 attributes of gamification in healthcare: an evolutionary concept analysis: Hyun Kyoung Kim; J Educ Eval Health Prof. 2024;21:10. Published online April 11, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.10

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Abstract PDF Supplementary Material

This study conducted a conceptual analysis of gamification in healthcare utilizing Rogers’ evolutionary concept analysis methodology to identify its attributes and provide a method for its applications in the healthcare field. Gamification has recently been used as a health intervention and education method, but the concept is used inconsistently and confusingly. A literature review was conducted to derive definitions, surrogate terms, antecedents, influencing factors, attributes (characteristics with dimensions and features), related concepts, consequences, implications, and hypotheses from various academic fields. A total of 56 journal articles in English and Korean, published between August 2 and August 7, 2023, were extracted from databases such as PubMed Central, the Institute of Electrical and Electronics Engineers, the Association for Computing Machinery Digital Library, the Research Information Sharing Service, and the Korean Studies Information Service System, using the keywords “gamification” and “healthcare.” These articles were then analyzed. Gamification in healthcare is defined as the application of game elements in health-related contexts to improve health outcomes. The attributes of this concept were categorized into 2 main areas: attraction and achievement. These categories encompass various strategies for synchronization, enjoyable engagement, visual rewards, and goal-reinforcing frames. Through a multidisciplinary analysis of the concept’s attributes and influencing factors, this paper provides practical strategies for implementing gamification in health interventions. When developing a gamification strategy, healthcare providers can reference this analysis to ensure the game elements are used both appropriately and effectively.

Citations

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Gamified Assessment of Cognitive Impulsivity in Eating Disorders and Mental Ill-Health: Mixed Methods Study Incorporating Lived Experience Co-Design and Evaluation
Emily Colton, Courtney McLean, Alexandra Anderson, Lauren Hanegraaf, Antonio Verdejo-Garcia
JMIR Serious Games.2026; 14: e79784. CrossRef
Informing food safety trainings in low- and middle-income countries: a novel evaluation of training materials and design
Himadri Pal, Judy Bettridge, Paula Dominguez-Salas, Delia Grace
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Gamified occupational therapy program for adolescents with Duchenne muscular dystrophy: A study protocol for randomized controlled trial
Başak Çağla Arslan, Sedef Şahin
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Amaia Sánchez-Arlegui, Jacinto Muñoz-Pardeza, Ignacio Hormazábal-Aguayo, Sonia Abio-Abero, María Laura Bertholt-Zuber, Pablo Alonso-Rubio, Elisabet Burillo-Sánchez, María J. Chueca-Guindulain, Claudia Cifuentes-Zamalloa, Sofía Congost-Marín, Ignacio Díez-
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The effect of DECO-MOM mobile application for a prenatal environmental health program on environmental health behaviors: a pilot test
Hae Kyung Jo, Hyun Kyoung Kim
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Virtual reality-enhanced rehabilitation for improving musculoskeletal function and recovery after trauma
Phani Paladugu, Rahul Kumar, Joshua Ong, Ethan Waisberg, Kyle Sporn
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Emotional distress among medical students before and after the first exposure to a full cadaver dissection: a quantitative study using DASS-21
Miral Nagy Fahmy Salama, Ahmed Mohamed Abdelkhalek, Mayssah Ahmed El Nayal, Ramya Rathan, Mona Ghazi Sayegh, Marwa Mady
Medical Education Online.2025;[Epub] CrossRef
Short-Term Impact of Digital Mental Health Interventions on Psychological Well-Being and Blood Sugar Control in Type 2 Diabetes Patients in Riyadh
Abdulaziz M. Alodhialah, Ashwaq A. Almutairi, Mohammed Almutairi
Healthcare.2024; 12(22): 2257. CrossRef

Research articles

Enhanced numeracy skills following team-based learning in United States pharmacy students: a longitudinal cohort study: Rob Edwin Carpenter, Leanne Coyne, Dave Silberman, Jody Kyoto Takemoto; J Educ Eval Health Prof. 2022;19:29. Published online October 27, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.29

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Abstract PDF Supplementary Material

Purpose
The literature suggests that the ability to numerate cannot be fully understood without accounting for the social context in which mathematical activity is represented. Team-based learning (TBL) is an andragogical approach with theoretical links to sociocultural and community-of-practice learning. This study aimed to quantitatively explore the impact of TBL instruction on numeracy development in 2 cohorts of pharmacy students and identify the impact of TBL instruction on numeracy development from a social perspective for healthcare education.
Methods
Two cohorts of students were administered the Health Science Reasoning Test-Numeracy (HSRT-N) before beginning pharmacy school. Two years after using TBL as the primary method of instruction, both comprehensive and domain data from the HSRT-N were analyzed.
Results
In total, 163 pharmacy student scores met the inclusion criteria. The students’ numeracy skills measured by HSRT-N improved after 2 years of TBL instruction.
Conclusion
Numeracy was the most significantly improved HSRT-N domain in pharmacy students following two years of TBL instruction. Although a closer examination of numeracy development in TBL is warranted, initial data suggest that TBL instruction may be an adequate proxy for advancing numeracy in a cohort of pharmacy students. TBL may encourage a social practice of mathematics to improve pharmacy students’ ability to numerate critically.

Citations

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Critical Thinking Engagement and Assessment in Didactic Pharmacy Education: A Scoping Review
Anna Nogid, Jennifer Beall, Lisa Killam-Worrall, Erenie Guirguis
American Journal of Pharmaceutical Education.2026; 90(5): 101966. CrossRef
Team-Based Learning in Mathematics Education: A Literature Review
Nike Astiswijaya, Turmudi, Kusnandi, Dadang Juandi
Journal of Physics: Conference Series.2026; 3276(1): 012034. CrossRef
Hybrid Team-Based Learning-Personalized Education Teaching (HTBL-PE)—A New Teaching Strategy to Maximise Success
Tam Ha, Byron Kemp, Janine Delahunty
Teaching and Learning Inquiry.2026; 14: 1. CrossRef
Unraveling the connection: A systematic review of learning styles and mathematics achievement
Dewi D. Hariri, Hilda Mahmudah, Fayza S. Wibawa, Nia Kania
Pedagogical Research.2025; 10(1): em0232. CrossRef

Content validity test of a safety checklist for simulated participants in simulation-based education in the United Kingdom: a methodological study: Matthew Bradley; J Educ Eval Health Prof. 2022;19:21. Published online August 25, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.21

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Abstract PDF Supplementary Material

Purpose
Simulation training is an ever-growing means of healthcare education and often involves simulated participants (SPs), commonly known as actors. Simulation-based education (SBE) can sometimes endanger SPs, and as such we have created a safety checklist for them to follow. This study describes how we developed the checklist through a quality improvement project, and then evaluated feedback responses to assess whether SPs felt our checklist was safe.
Methods
The checklist was provided to SPs working in an acute trust simulation service when delivering multidisciplinary SBE over 4 months. Using multiple plan–do–study–act cycles, the checklist was refined by reflecting on SP feedback to ensure that the standards of the safe simulation were met. We collected 21 responses from September to December 2021 after SPs completed an SBE event.
Results
The responses showed that 100% of SPs felt safe during SBE when using our checklist. The average “confidence in safety” rating before using the checklist was 6.8/10, which increased significantly to 9.2/10 after using the checklist (P<0.0005). The checklist was refined throughout the 4 months and implemented in adult and pediatric SBE as a standard operating procedure.
Conclusion
We recommend using our safety checklist as a standard operating procedure to improve the confidence and safety of SPs during safe and effective simulations.

Citations

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The effect of structured checklist-assisted multimedia interactive education on postoperative pain management and quality of life in patients with lower extremity varicose veins: a randomized controlled trial with 1-year follow-up
Jing Huang, Ling Li, Min Li, Li Ren, Yukui Ma, Huanrui Hu
Frontiers in Public Health.2026;[Epub] CrossRef
Addressing under-appreciated risk in healthcare simulation
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Advances in Simulation.2026;[Epub] CrossRef

Doctoral physical therapy students’ increased confidence following exploration of active video gaming systems in a problem-based learning curriculum in the United States: a pre- and post-intervention study: Michelle Elizabeth Wormley, Wendy Romney, Diana Veneri, Andrea Oberlander; J Educ Eval Health Prof. 2022;19:7. Published online April 26, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.7

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Abstract PDF Supplementary Material

Purpose
Active video gaming (AVG) is used in physical therapy (PT) to treat individuals with a variety of diagnoses across the lifespan. The literature supports improvements in balance, cardiovascular endurance, and motor control; however, evidence is lacking regarding the implementation of AVG in PT education. This study investigated doctoral physical therapy (DPT) students’ confidence following active exploration of AVG systems as a PT intervention in the United States.
Methods
This pretest-posttest study included 60 DPT students in 2017 (cohort 1) and 55 students in 2018 (cohort 2) enrolled in a problem-based learning curriculum. AVG systems were embedded into patient cases and 2 interactive laboratory classes across 2 consecutive semesters (April–December 2017 and April–December 2018). Participants completed a 31-question survey before the intervention and 8 months later. Students’ confidence was rated for general use, game selection, plan of care, set-up, documentation, setting, and demographics. Descriptive statistics and the Wilcoxon signed-rank test were used to compare differences in confidence pre- and post-intervention.
Results
Both cohorts showed increased confidence at the post-test, with median (interquartile range) scores as follows: cohort 1: pre-test, 57.1 (44.3–63.5); post-test, 79.1 (73.1–85.4); and cohort 2: pre-test, 61.4 (48.0–70.7); post-test, 89.3 (80.0–93.2). Cohort 2 was significantly more confident at baseline than cohort 1 (P<0.05). In cohort 1, students’ data were paired and confidence levels significantly increased in all domains: use, Z=-6.2 (P<0.01); selection, Z=-5.9 (P<0.01); plan of care, Z=-6.0 (P<0.01); set-up, Z=-5.5 (P<0.01); documentation, Z=-6.0 (P<0.01); setting, Z=-6.3 (P<0.01); and total score, Z=-6.4 (P<0.01).
Conclusion
Structured, active experiences with AVG resulted in a significant increase in students’ confidence. As technology advances in healthcare delivery, it is essential to expose students to these technologies in the classroom.

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The use of artificial intelligence in crafting a novel method for teaching normal human gait
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Developing a framework for evaluating the impact of Healthcare Improvement Science Education across Europe: a qualitative study: Manuel Lillo-Crespo, M. Cristina Sierras-Davó, Rhoda MacRae, Kevin Rooney; J Educ Eval Health Prof. 2017;14:28. Published online November 29, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.28

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Abstract PDF Supplementary Material

Purpose
Frontline healthcare professionals are well positioned to improve the systems in which they work. Educational curricula, however, have not always equipped healthcare professionals with the skills or knowledge to implement and evaluate improvements. It is important to have a robust and standardized framework in order to evaluate the impact of such education in terms of improvement, both within and across European countries. The results of such evaluations will enhance the further development and delivery of healthcare improvement science (HIS) education. We aimed to describe the development and piloting of a framework for prospectively evaluating the impact of HIS education and learning.
Methods
The evaluation framework was designed collaboratively and piloted in 7 European countries following a qualitative methodology. The present study used mixed methods to gather data from students and educators. The framework took the Kirkpatrick model of evaluation as a theoretical reference.
Results
The framework was found to be feasible and acceptable for use across differing European higher education contexts according to the pilot study and the participants’ consensus. It can be used effectively to evaluate and develop HIS education across European higher education institutions.
Conclusion
We offer a new evaluation framework to capture the impact of HIS education. The implementation of this tool has the potential to facilitate the continuous development of HIS education.

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Mina Golestani, Homayoun Sadeghi-bazargani, Sepideh Harzand-Jadidi, Hamid Soori
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Yemen Advanced Field Epidemiology Training Program: An Impact Evaluation, 2021
Maeen Abduljalil, Abdulhakeem Al Kohlani, Aisha Jumaan, Abdulwahed Al Serouri
Epidemiologia.2023; 4(3): 235. CrossRef
How, and under what contexts, do academic–practice partnerships collaborate to implement healthcare improvement education into preregistration nursing curriculums: a realist review protocol
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María Cristina Sierras-Davó, Manuel Lillo-Crespo, Patricia Verdú Rodríguez
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Mohannad Al Nsour, Yousef Khader, Haitham Bashier, Majd Alsoukhni
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Paola Dey, Jeremy Brown, John Sandars, Yvonne Young, Ruth Ruggles, Samantha Bracebridge
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