Purpose The aim of this study was to identify factors influencing the learning transfer of nursing students in a non-face-to-face educational environment through structural equation modeling and suggest ways to improve the transfer of learning.
Methods In this cross-sectional study, data were collected via online surveys from February 9 to March 1, 2022, from 218 nursing students in Korea. Learning transfer, learning immersion, learning satisfaction, learning efficacy, self-directed learning ability and information technology utilization ability were analyzed using IBM SPSS for Windows ver. 22.0 and AMOS ver. 22.0.
Results The assessment of structural equation modeling showed adequate model fit, with normed χ2=1.74 (P<0.024), goodness-of-fit index=0.97, adjusted goodness-of-fit index=0.93, comparative fit index=0.98, root mean square residual=0.02, Tucker-Lewis index=0.97, normed fit index=0.96, and root mean square error of approximation=0.06. In a hypothetical model analysis, 9 out of 11 pathways of the hypothetical structural model for learning transfer in nursing students were statistically significant. Learning self-efficacy and learning immersion of nursing students directly affected learning transfer, and subjective information technology utilization ability, self-directed learning ability, and learning satisfaction were variables with indirect effects. The explanatory power of immersion, satisfaction, and self-efficacy for learning transfer was 44.4%.
Conclusion The assessment of structural equation modeling indicated an acceptable fit. It is necessary to improve the transfer of learning through the development of a self-directed program for learning ability improvement, including the use of information technology in nursing students’ learning environment in non-face-to-face conditions.
Purpose It aims to find students’ performance of and perspectives on an objective structured practical examination (OSPE) for assessment of laboratory and preclinical skills in biomedical laboratory science (BLS). It also aims to investigate the perception, acceptability, and usefulness of OSPE from the students’ and examiners’ point of view.
Methods This was a longitudinal study to implement an OSPE in BLS. The student group consisted of 198 BLS students enrolled in semester 4, 2015–2019 at Karolinska University Hospital Huddinge, Sweden. Fourteen teachers evaluated the performance by completing a checklist and global rating scales. A student survey questionnaire was administered to the participants to evaluate the student perspective. To assess quality, 4 independent observers were included to monitor the examiners.
Results Almost 50% of the students passed the initial OSPE. During the repeat OSPE, 73% of the students passed the OSPE. There was a statistically significant difference between the first and the second repeat OSPE (P<0.01) but not between the first and the third attempt (P=0.09). The student survey questionnaire was completed by 99 of the 198 students (50%) and only 63 students responded to the free-text questions (32%). According to these responses, some stations were perceived as more difficult, albeit they considered the assessment to be valid. The observers found the assessment protocols and examiner’s instructions assured the objectivity of the examination.
Conclusion The introduction of an OSPE in the education of biomedical laboratory scientists was a reliable, and useful examination of practical skills.
Purpose This study aimed to assess the effect of simulation teaching in critical care courses in a nursing study program on the quality of chest compressions of cardiopulmonary resuscitation (CPR).
Methods An observational cross-sectional study was conducted at the Faculty of Health Studies at the Technical University of Liberec. The success rate of CPR was tested in exams comparing 2 groups of students, totaling 66 different individuals, who completed half a year (group 1: intermediate exam with model simulation) or 1.5 years (group 2: final theoretical critical care exam with model simulation) of undergraduate nursing critical care education taught completely with a Laerdal SimMan 3G simulator. The quality of CPR was evaluated according to 4 components: compression depth, compression rate, time of correct frequency, and time of correct chest release.
Results Compression depth was significantly higher in group 2 than in group 1 (P=0.016). There were no significant differences in the compression rate (P=0.210), time of correct frequency (P=0.586), or time of correct chest release (P=0.514).
Conclusion Nursing students who completed the final critical care exam showed an improvement in compression depth during CPR after 2 additional semesters of critical care teaching compared to those who completed the intermediate exam. The above results indicate that regularly scheduled CPR training is necessary during critical care education for nursing students.
Purpose This study was conducted to evaluate a smartphone-based online electronic logbook used to assess the clinical skills of nurse anesthesia students in Iran.
Methods This randomized controlled study was conducted after tool development at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran from January 2022 to December 2022. The online electronic logbook involved in this study was an Android-compatible application used to evaluate the clinical skills of nurse anesthesia students. In the implementation phase, the online electronic logbook was piloted for 3 months in anesthesia training in comparison with a paper logbook. For this purpose, 49 second- and third-year anesthesia nursing students selected using the census method were assigned to intervention (online electronic logbook) and control (paper logbook) groups. The online electronic logbook and paper logbook were compared in terms of student satisfaction and learning outcomes.
Results A total of 39 students participated in the study. The mean satisfaction score of the intervention group was significantly higher than that of the control group (P=0.027). The mean score of learning outcomes was also significantly higher for the intervention than the control group (P=0.028).
Conclusion Smartphone technology can provide a platform for improving the evaluation of the clinical skills of nursing anesthesia students, leading to increased satisfaction and improved learning outcomes.
Purpose This study evaluated the validity of student feedback derived from Medicine Student Experience Questionnaire (MedSEQ), as well as the predictors of students’ satisfaction in the Medicine program.
Methods Data from MedSEQ applying to the University of New South Wales Medicine program in 2017, 2019, and 2021 were analyzed. Confirmatory factor analysis (CFA) and Cronbach’s α were used to assess the construct validity and reliability of MedSEQ respectively. Hierarchical multiple linear regressions were used to identify the factors that most impact students’ overall satisfaction with the program.
Results A total of 1,719 students (34.50%) responded to MedSEQ. CFA showed good fit indices (root mean square error of approximation=0.051; comparative fit index=0.939; chi-square/degrees of freedom=6.429). All factors yielded good (α>0.7) or very good (α>0.8) levels of reliability, except the “online resources” factor, which had acceptable reliability (α=0.687). A multiple linear regression model with only demographic characteristics explained 3.8% of the variance in students’ overall satisfaction, whereas the model adding 8 domains from MedSEQ explained 40%, indicating that 36.2% of the variance was attributable to students’ experience across the 8 domains. Three domains had the strongest impact on overall satisfaction: “being cared for,” “satisfaction with teaching,” and “satisfaction with assessment” (β=0.327, 0.148, 0.148, respectively; all with P<0.001).
Conclusion MedSEQ has good construct validity and high reliability, reflecting students’ satisfaction with the Medicine program. Key factors impacting students’ satisfaction are the perception of being cared for, quality teaching irrespective of the mode of delivery and fair assessment tasks which enhance learning.
This study aimed to compare the knowledge and interpretation ability of ChatGPT, a language model of artificial general intelligence, with those of medical students in Korea by administering a parasitology examination to both ChatGPT and medical students. The examination consisted of 79 items and was administered to ChatGPT on January 1, 2023. The examination results were analyzed in terms of ChatGPT’s overall performance score, its correct answer rate by the items’ knowledge level, and the acceptability of its explanations of the items. ChatGPT’s performance was lower than that of the medical students, and ChatGPT’s correct answer rate was not related to the items’ knowledge level. However, there was a relationship between acceptable explanations and correct answers. In conclusion, ChatGPT’s knowledge and interpretation ability for this parasitology examination were not yet comparable to those of medical students in Korea.
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Purpose This study aimed to identify factors that have been studied for their associations with National Licensing Examination (ENAM) scores in Peru.
Methods A search was conducted of literature databases and registers, including EMBASE, SciELO, Web of Science, MEDLINE, Peru’s National Register of Research Work, and Google Scholar. The following key terms were used: “ENAM” and “associated factors.” Studies in English and Spanish were included. The quality of the included studies was evaluated using the Medical Education Research Study Quality Instrument (MERSQI).
Results In total, 38,500 participants were enrolled in 12 studies. Most (11/12) studies were cross-sectional, except for one case-control study. Three studies were published in peer-reviewed journals. The mean MERSQI was 10.33. A better performance on the ENAM was associated with a higher-grade point average (GPA) (n=8), internship setting in EsSalud (n=4), and regular academic status (n=3). Other factors showed associations in various studies, such as medical school, internship setting, age, gender, socioeconomic status, simulations test, study resources, preparation time, learning styles, study techniques, test-anxiety, and self-regulated learning strategies.
Conclusion The ENAM is a multifactorial phenomenon; our model gives students a locus of control on what they can do to improve their score (i.e., implement self-regulated learning strategies) and faculty, health policymakers, and managers a framework to improve the ENAM score (i.e., design remediation programs to improve GPA and integrate anxiety-management courses into the curriculum).
Purpose This review investigated medical students’ satisfaction level with e-learning during the coronavirus disease 2019 (COVID-19) pandemic and its related factors.
Methods A comprehensive systematic search was performed of international literature databases, including Scopus, PubMed, Web of Science, and Persian databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as “Distance learning,” “Distance education,” “Online learning,” “Online education,” and “COVID-19” from the earliest date to July 10, 2022. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool).
Results A total of 15,473 medical science students were enrolled in 24 studies. The level of satisfaction with e-learning during the COVID-19 pandemic among medical science students was 51.8%. Factors such as age, gender, clinical year, experience with e-learning before COVID-19, level of study, adaptation content of course materials, interactivity, understanding of the content, active participation of the instructor in the discussion, multimedia use in teaching sessions, adequate time dedicated to the e-learning, stress perception, and convenience had significant relationships with the satisfaction of medical students with e-learning during the COVID-19 pandemic.
Conclusion Therefore, due to the inevitability of online education and e-learning, it is suggested that educational managers and policymakers choose the best online education method for medical students by examining various studies in this field to increase their satisfaction with e-learning.
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This study aimed to find the self-directed learning quotient and common learning types of pre-medical students through the confirmation of 4 characteristics of learning strategies, including personality, motivation, emotion, and behavior. The response data were collected from 277 out of 294 target first-year pre-medical students from 2019 to 2021, using the Multi-Dimensional Learning Strategy Test 2nd edition. The most common learning type was a self-directed type (44.0%), stagnant type (33.9%), latent type (14.4%), and conscientiousness type (7.6%). The self-directed learning index was high (29.2%), moderate (24.6%), somewhat high (21.7%), somewhat low (14.4%), and low (10.1%). This study confirmed that many students lacked self-directed learning capabilities for learning strategies. In addition, it was found that the difficulties experienced by each student were different, and the variables resulting in difficulties were also diverse. It may provide insights into how to develop programs that can help students increase their self-directed learning capability.
Purpose Coronavirus disease 2019 (COVID-19) restrictions resulted in an increased emphasis on virtual communication in medical education. This study assessed the acceptability of virtual teaching in an online objective structured clinical examination (OSCE) series and its role in future education.
Methods Six surgical OSCE stations were designed, covering common surgical topics, with specific tasks testing data interpretation, clinical knowledge, and communication skills. These were delivered via Zoom to students who participated in student/patient/examiner role-play. Feedback was collected by asking students to compare online teaching with previous experiences of in-person teaching. Descriptive statistics were used for Likert response data, and thematic analysis for free-text items.
Results Sixty-two students provided feedback, with 81% of respondents finding online instructions preferable to paper equivalents. Furthermore, 65% and 68% found online teaching more efficient and accessible, respectively, than in-person teaching. Only 34% found communication with each other easier online; Forty percent preferred online OSCE teaching to in-person teaching. Students also expressed feedback in positive and negative free-text comments.
Conclusion The data suggested that generally students were unwilling for online teaching to completely replace in-person teaching. The success of online teaching was dependent on the clinical skill being addressed; some were less amenable to a virtual setting. However, online OSCE teaching could play a role alongside in-person teaching.
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.
Purpose Distance learning describes any learning based on the use of new multimedia technologies and the internet to allow students to acquire new knowledge and skills at a distance. This study aimed to determine satisfaction levels with distance learning and associated factors among nursing and health technician students during the coronavirus disease 2019 pandemic in Morocco.
Methods An descriptive study was conducted between April and June 2022 among nursing and health technician students using a self-administered instrument. The student satisfaction questionnaire consists of 24 questions categorized into 6 subscales: instructor, technology, course setup, interaction, outcomes, and overall satisfaction. It was based on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Univariate and multivariate logistic regression analyses were conducted to identify factors associated with student satisfaction during distance learning.
Results A total of 330 students participated in this study, and 176 students (53.3%) were satisfied with the distance learning activities. A mean score higher than 2.8 out of 5 was obtained for all subscales. Multiple regression analysis showed that students’ year of study (adjusted odds ratio [aOR], 2.34; 95% confidence interval [CI], 1.28–4.27) and internet quality (aOR, 0.47; 95% CI, 0.29–0.77) were the significant factors associated with students’ satisfaction during distance learning.
Conclusion This study highlights the satisfaction level of students and factors that influenced it during distance learning. A thorough understanding of student satisfaction with digital environments will contribute to the successful implementation of distance learning devices in nursing.
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Satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak: Evidence from a meta-analysis Tianyuan Xu, Ling Xue Frontiers in Psychology.2023;[Epub] CrossRef
Purpose This study investigated whether the reliability was acceptable when the number of cases in the objective structured clinical examination (OSCE) decreased from 12 to 8 using generalizability theory (GT).
Methods This psychometric study analyzed the OSCE data of 439 fourth-year medical students conducted in the Busan and Gyeongnam areas of South Korea from July 12 to 15, 2021. The generalizability study (G-study) considered 3 facets—students (p), cases (c), and items (i)—and designed the analysis as p×(i:c) due to items being nested in a case. The acceptable generalizability (G) coefficient was set to 0.70. The G-study and decision study (D-study) were performed using G String IV ver. 6.3.8 (Papawork, Hamilton, ON, Canada).
Results All G coefficients except for July 14 (0.69) were above 0.70. The major sources of variance components (VCs) were items nested in cases (i:c), from 51.34% to 57.70%, and residual error (pi:c), from 39.55% to 43.26%. The proportion of VCs in cases was negligible, ranging from 0% to 2.03%.
Conclusion The case numbers decreased in the 2021 Busan and Gyeongnam OSCE. However, the reliability was acceptable. In the D-study, reliability was maintained at 0.70 or higher if there were more than 21 items/case in 8 cases and more than 18 items/case in 9 cases. However, according to the G-study, increasing the number of items nested in cases rather than the number of cases could further improve reliability. The consortium needs to maintain a case bank with various items to implement a reliable blueprinting combination for the OSCE.
Purpose Endotracheal intubation and central venous catheterization are essential procedures in clinical practice. Simulation-based technology such as smart glasses has been used to facilitate medical students’ training on these procedures. We investigated medical students’ self-assessed efficacy and satisfaction regarding the practice and training of these procedures with smart glasses in Taiwan.
Methods This observational study enrolled 145 medical students in the 5th and 6th years participating in clerkships at Taipei Veterans General Hospital between October 2020 and December 2021. Students were divided into the smart glasses or the control group and received training at a workshop. The primary outcomes included students’ pre- and post-intervention scores for self-assessed efficacy and satisfaction with the training tool, instructor’s teaching, and the workshop.
Results The pre-intervention scores for self-assessed efficacy of 5th- and 6th-year medical students in endotracheal intubation and central venous catheterization procedures showed no significant difference. The post-intervention score of self-assessed efficacy in the smart glasses group was better than that of the control group. Moreover, 6th-year medical students in the smart glasses group showed higher satisfaction with the training tool, instructor’s teaching, and workshop than those in the control group.
Conclusion Smart glasses served as a suitable simulation tool for endotracheal intubation and central venous catheterization procedures training in medical students. Medical students practicing with smart glasses showed improved self-assessed efficacy and higher satisfaction with training, especially for procedural steps in a space-limited field. Simulation training on procedural skills with smart glasses in 5th-year medical students may be adjusted to improve their satisfaction.
Purpose Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master’s nursing students.
Methods In a quasi-experimental study with a pre- and post-test, 106 master’s nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days.
Results A total of 88 out of 106 master’s nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P<0.001). The mean post-education score for clinical decision-making in the intervention group was significantly higher than in the control group (16.96 vs. 13.64, P<0.001).
Conclusion The level of knowledge and clinical decision-making of master’s nursing students regarding forensic evidence improved after the forensic nursing virtual education course in the intervention group compared to the control group. Nursing managers and policymakers can develop appropriate strategies to improve the knowledge and clinical decision-making of nursing students by using forensic nursing education courses in the curricula of nursing programs, especially in postgraduate education as an elective or mandatory course.