Do cognitive, affective and social needs influence mobile learning adoption in emergency remote teaching?

Transitioning to mobile learning or M-Learning in medical education has been challenging due to its subscription to the clinical-based method of knowledge transfer. This shift was accelerated despite the challenges of COVID-19 in what research refers to as Emergency Remote Teaching or ERT. While this modality supported learning continuity, it was evident that online classes have become avenues for students to socially engage with others to meet various psychological needs to buffer pandemic stress. We hypothesized that cognitive, affective, and social needs positively influence learners' attitude towards M-Learning, which leads to its adoption. Given that peers highly influence medical professionals, we further hypothesized that the beliefs of others or social norms have a positive influence on the behavioral intention to use M-Learning. We added psychological needs as influencing factors to Theory of Reasoned Action constructs to develop a structural model, deployed an online survey, and analyzed 219 responses from healthcare students in the Philippines using Partial Least Squares – Structural Equation Modeling or PLS-SEM. We confirm that cognitive, affective, and social needs are psychological factors that influence students' attitude towards mobile learning. While attitude can lead to the behavioral intention to adopt mobile learning, social norms do not exhibit a positive influence at a significant level. We discuss our results from the perspective of a developing economy during a pandemic and provide the implications of its findings to theory, academe, and technology. © The Author(s).

Telesimulation in healthcare education: A scoping review.

OBJECTIVES: To provide a comprehensive overview on the utilization and effectiveness of telesimulation in healthcare education. DESIGN: A scoping review. DATA SOURCES: A search of five databases including PubMed, Web of Science, Cochrane, EMBASE and ProQuest was conducted between 2000 and 2022. REVIEW METHODS: Arksey and O' Malley's scoping review framework was utilised. Data were narratively synthesised. RESULTS: 29 articles were included. More than half of the publications on telesimulation were borne out of need during the COVID-19 pandemic. Innovation reports were the most prevalent publications followed by descriptive studies. Telesimulation was applied for the delivery of diverse learning content including patient care management, procedural skills and team training. A variety of videoconferencing software and simulation modalities have been used for telesimulation. Telesimulation was generally well-received, despite its technical challenges. Learning effectiveness of telesimulation was evident in quasi-experimental studies. CONCLUSION: Telesimulation has been gaining acceptance as a distance-based simulation education modality. It will continue to evolve and potentially blend with in-person simulation. More rigorous research is warranted to evaluate learning outcomes and establish best practices in telesimulation.

"Online Learning” Technology Solutions during the COVID-19 Pandemic: An Empirical Study of Medical Technology and Allied Healthcare Student Perceptions

The COVID-19 outbreak has greatly forced the education systems around the world to undergo rapid change. Given today's uncertainty, it is essential to understand students' online learning experiences during the COVID-19 pandemic. Despite the fact that many studies were investigated in this area, there is limited available information about the barriers, challenges, and the difficulties students face during online learning. This paper studies the online learning platforms' utilization during the COVID-19 pandemic for students' engagement in the Medical Technology and Allied Healthcare education. This paper looks at studying the various benefits of imparting education through e-learning, identifying the challenges faced by learners, and measures the satisfaction levels of learners. From the study, it emerged that students' satisfaction index in using e-learning technologies is high for courses in Medical Technology and Allied Healthcare education. Copyright © 2023, IGI Global.

Swift Preparation for Online Teaching During the Pandemic: Experience Sharing from Healthcare Teaching in Hong Kong

Online education has been developing for many years now across the world, but is not without its challenges. Organizational, personal and attitudinal factors may deter some staff from making the transition to online teaching. When we consider healthcare education, the barriers to the adoption of online methods are specifically related to the nature of the curricula involved. Hands-on practical skills training is one essential component in healthcare education that is not easily addressed by simply going online. With the impact of the pandemic, teaching staff of our affiliated healthcare programmes at the Hong Kong Polytechnic University faced huge difficulties in redesigning their content for practical teaching in an online mode. Some of them adopted synchronous practical demonstrations, interspersed with discussion activities, while others used various teaching pedagogies to support active learning online. All of our staff aimed to strengthen the foundation of the students’ knowledge while supporting them to keep practising their hands-on skills so that they would be able to master practical tasks when face-to-face teaching resumed. Such a sudden and swift change from face-to-face teaching to an online delivery mode had a great impact on both teaching staff and students, forcing them to step out of their comfort zone to adopt new online learning methods. The change also challenged instructors to explore other teaching approaches and introduce tools specifically for online teaching and learning, adopting the Technology Pedagogical Content Knowledge (TPCK) framework (Mishra & Koehler, 2006) P, Koehler MJ, Teach Coll Rec 108(6):1017–1054. https://doi.org/10.1111/j.1467-9620.2006.00684.x, 2006). This chapter offers the opportunity to pause and reflect on the continuous professional learning and development (CPLD) challenges that our healthcare educators faced and how these challenges were addressed, drawing on the lessons learned from the COVID-19 context to support future planning of CPLD provision for our staff. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Transferring Healthcare Professional's Digital Competencies to the Workplace and Patients: A Pilot Study.

The new times, marked by immediacy, globalization, and technological advances, has forced health professionals to develop new competencies to adapt to the new challenges. However, necessary skills such as using digital tools are primarily ignored by institutions, hospitals, and universities, forcing professionals to undertake training in these areas independently. This research aims to analyse if there is a transfer of what has been learned in the digital healthcare field to their professional practice and patients. To perform the study, 104 healthcare professionals, mostly nurses, who had completed online training in digital competencies answered a questionnaire with 17 questions. These questions were related to the transfer of learning to professional practice and its use for developing patient resources. Almost 60% of the professionals said that they have used what they learned in the course in their professional work, but only 16% of the participants use it daily. The main barrier to not having applied what was learned during the course, according to participants, was the situation experienced during the COVID-19 pandemic, followed by a lack of time and lack of resources. Only 23 people out of 104 developed patient resources after the course; the most created were infographics and videos. In addition, 38 people used what they learned to improve their personal productivity: searches, storage, calendars, etc. Only 11 used it for research purposes. People between 31 and 40 years old create the most patient resources and use what they learn most frequently. There is a need to improve e-learning to provide quality training that can transfer good behaviour to professional practice in the health field.

Supporting the learning experience of health‐related profession students during clinical placements with technology: A systematic review

High quality clinical education is a fundamental component of undergraduate health‐related professions programmes. Technological interventions offer potential to support and enhance student learning experiences during clinical placements, i.e. away from the university setting. This review aims to systematically explore, evaluate and summarise the range of technological strategies within the literature regarding support of the student learning experience during clinical placements. A systematic review was conducted using defined search terms, educational and medical subject headings (MeSH). Relevant databases were searched alongside hand searching of citations and grey literature. Experimental studies with technological strategies designed to support student learning during clinical placements were included. A modified version of Kirkpatrick's levels (Barr et al., Effective interprofessional education: Assumption, argument and evidence. Blackwell, 2005) was used to evaluate strategies. Twenty‐one papers met inclusion criteria. Heterogeneity existed in terms of strategies and their usage e.g. whether synchronous or asynchronous;targeting individual students or groups A wide range of technological strategies may be employed to support the student learning experience during placements. However, none were identified as being of high quality therefore further research is required to provide stronger evidence to support their use. Consideration should be given to the underlying purpose of the strategy as well as the potential barriers for implementation e.g. acceptability and connectivity. Students should be clearly informed of strategy purpose and requirements, with opportunities to practice prior to placements. Review findings may provide insight to assist educators to develop future support strategies for students on clinical placements during challenging circumstances such as the COVID‐19 pandemic.Context and implicationsRationale for this studyThis systematic review aimed to establish and describe technological methods that are currently being used during clinical placements to support the learning experience of undergraduate students of health‐related professions.Why the new findings matterThe findings indicate that a broad range of technological strategies may be utilised to support the student learning experience during placements, with numerous learner benefits including improved clinical knowledge, increased reflection upon practice, increased peer and staff support, and reduced sense of isolation during placements.Implications for educatorsEducators should clearly explain the strategy purpose and requirements of the student should be clearly explained, with opportunities provided for students prior to placements to practice its use. Balance is required in terms of (a) encouraging student engagement without over burdening the student and (b) moderator involvement to facilitate student engagement without stifling contributions. When selecting a technological support strategy, consideration should be given to (a) potential technological difficulties, such as accessing platforms and (b) acceptability of the strategy for use within a clinical context.

Cultural Competence in Healthcare Leadership Education and Development

Cultural competence is a phenomenon that straddles many disciplines and fields of study. There is no settled definition of the term, and it is argued that this is not necessary to explore or discuss the phenomenon as it is context-dependent across diverse societies. Explorations of cultural competence in clinical education and training are well-established, but there has been less attention towards its expression in the field of developing healthcare leaders. There is a debate about whether cultural competence is best achieved primarily through training-based educational inputs or by being infused in all areas of curriculum development. Using an exploration of selected literature followed by the case of an ambitious set of leadership development programmes in the English National Health Service, this paper explores the balance and interdependencies of cultural competence in healthcare leadership development as knowledge, skills and attitudes. The paper concludes that it is important for educators in this field to provide space for reflection, develop skills of reflexivity and facilitate sensitive discussions of sometimes contested ideas and concepts. A further evaluation of the impact of teaching and learning interventions, while mapping developments in perceptions of knowledge, skill and attitudes would be an area ripe for future research.

Medical teachers' experience of emergency remote teaching during the COVID-19 pandemic: a cross-institutional study.

BACKGROUND: The COVID-19 pandemic and the consequent social distancing measures caused unprecedented disruption for medical and healthcare education. This study examined medical teachers' experience with emergency remote teaching during the pandemic and their acceptance of online teaching after the pandemic. METHODS: In this sequential mixed methods study, online surveys were disseminated to teachers (n = 139) at two Asia-Pacific medical schools to evaluate their experience with emergency remote teaching during the pandemic. Subsequently, in-depth interviews were conducted with teachers from both institutions (n = 13). Each interviewee was classified into an adopter category based on Rogers' Diffusion of Innovations Theory. Interview transcripts were analyzed thematically, and the descriptive themes were mapped to broader themes partly based on the Technology Acceptance Model and these included: (i) perceived usefulness of online teaching, (ii) perceived ease of delivering online teaching, (iii) experience with institutional support and (iv) acceptance of online teaching after the pandemic. RESULTS: Our participants described accounts of successes with their emergency remote teaching and difficulties they experienced. In general, most participants found it difficult to deliver clinical skills teaching remotely and manage large groups of students in synchronous online classes. With regards to institutional support, teachers with lower technological literacy required just-in-time technical support, while teachers who were innovative in their online teaching practices found that IT support alone could not fully address their needs. It was also found that teachers' acceptance of online teaching after the pandemic was influenced by their belief about the usefulness of online teaching. CONCLUSIONS: This study demonstrated that our participants managed to adapt to emergency remote teaching during this pandemic, and it also identified a myriad of drivers and blockers to online teaching adoption for medical teachers. It highlights the need for institutes to better support their teaching staff with diverse needs in their online teaching.

Human Factors in the Adoption of M-Learning by COVID-19 Frontline Learners

Mobile Learning is crucial to the continuity of healthcare education during COVID-19. Despite its penchant for the traditional delivery of course content through classroom and clinical settings, M-Learning proved to be a viable solution in a pandemic due to social isolation, community restrictions, and safety concerns. We invited 219 frontline learners from 3 universities, active healthcare professionals who are currently enrolled, to test a structural model based on the Theory of Reason Action. We positioned the human factors of cognitive, social, and affective needs as determinants of attitude in the behavioral intention to adopt M-Learning. We further hypothesize that social norms positively influence the behavioral intention to adopt M-Learning among healthcare frontliners. We applied PLS-SEM to analyze the survey data and revealed that human factors positively influence attitude, leading to the behavioral intention to adopt M-Learning. Social norms and their influence on the behavioral intention to adopt this technology are not supported. We discuss the implications of our study, acknowledge its limitations while mapping out directions for future works to understand M-Learning adoption further. © 2021 29th International Conference on Computers in Education Conference, ICCE 2021 - Proceedings. All rights reserved

Shifting to Delivering Simulation Virtually Within a Healthcare Education Setting.

The coronavirus disease 2019 (COVID-19) pandemic has changed how healthcare education is being delivered, creating a global shift towards virtual modalities. Various approaches, each with their own benefits and limitations, have been developed to bridge this gap and continue to provide comprehensive education to healthcare students. To understand which approach to implement, we must consider what each can offer and what is best suited for the situation. Much of this will focus on the learning goals and outcomes with research strongly favouring modalities focused on the areas of cognitive, affective, and behavioural skill acquisition as opposed to technical skills.  The use of simulated persons offers the most diverse application for these areas of focus. This approach can provide opportunities for both synchronous and asynchronous learning. While novel in its approach, virtual simulations can leverage existing success and performance indicators used for in-person approaches to best understand the experiences of the learners and the facilitators. Evidence can be compared with outcomes of previous in-person groups to understand how this approach can be best implemented into curricula/programs. Future applications are numerous for this modality and the development of pilot studies focused on smaller groups of learners will provide opportunities for educators and program developers to review and understand the challenges that may arise. Simulation is a widely drawn upon teaching-learning approach deeply rooted in experiential learning. With the purpose of replicating real-world scenarios to increase knowledge transfer and reduce the shock of encountering challenging real-world situations, simulated environments are proven to be an effective tool in building learners' self-confidence and bridging the gap between theory and practice within the healthcare realm. Simulation can be, and is, applied within healthcare-education contexts from undergraduate to graduate levels and into ongoing professional development.

Students' and Examiners' Experiences of Their First Virtual Pharmacy Objective Structured Clinical Examination (OSCE) in Australia during the COVID-19 Pandemic.

Objective Structured Clinical Examinations (OSCEs) are routinely used in healthcare education programs. Traditionally, students undertake OSCEs as face-to-face interactions to assess competency in soft skills. Due to physical distancing restrictions during COVID-19, alternative methods were required. This study utilized a mixed-method design (online survey and interviews) to evaluate second-year pharmacy students' and examiners' experiences of their first virtual OSCEs in Australia. A total of 196 students completed their first virtual OSCE in June 2020 of which 190 students completed the online survey. However, out of the 190 students, only 88% (n = 167) consented to the use of the data from their online survey. A further 10 students and 12 examiners were interviewed. Fifty-five students (33%) who participated in the online survey strongly agreed or agreed that they preferred the virtual experience to face-to-face OSCEs while 44% (n = 73) neither agreed nor disagreed. Only 20% (n = 33) felt more anxious with the virtual OSCEs. Additionally, thematic analysis found non-verbal communication as a barrier during the OSCE. Positive aspects about virtual OSCEs included flexibility, decreased levels of anxiety and relevance with emerging telehealth practice. The need for remote online delivery of assessments saw innovative ways of undertaking OSCEs and an opportunity to mimic telehealth. While students and examiners embraced the virtual OSCE process, face-to-face OSCEs were still considered important and irreplaceable. Future opportunities for OSCEs to be delivered both face-to-face and virtually should be considered.

Is Healthcare Employment Resilient and "Recession Proof"?

Conventional wisdom often holds that the healthcare sector fares better than other sectors during economic downturns. However, little research has examined the relationship between local economic conditions and healthcare employment. Understanding how the healthcare sector responds to economic conditions is important for policymakers seeking to ensure an adequate supply of healthcare workers, as well as for those directing displaced workers into new jobs. We examine the impact of macroeconomic conditions on both the healthcare labor market and the pipeline of healthcare workers receiving healthcare degrees during 2005-2017 (the pre-COVID era). Our results indicate that the healthcare sector is stable across past business cycles. If anything, when areas experience more severe local economic downturns, healthcare employment increases. Much remains unknown about how the healthcare sector will fare during the current recession. Our study represents an important backdrop as policymakers consider ways to sustain the healthcare sector during current economic and public health turbulence.

Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review.

(1) Introduction: Undergraduate (UG) nursing students are vulnerable to stress throughout their education, known to result in burnout, with high attrition rates of up to 33%. There is a growing body of evidence to suggest that mindfulness-based interventions are effective for the management of anxiety, depression and wellbeing, thereby reducing stress in healthcare provider populations. The aim of this narrative review was to synthesize and provide a critical overview of the current evidence in relation to mindfulness-based interventions for UG nursing students in a university setting. (2) Methods: A review of the literature was conducted in March 2020 and updated in May 2021, utilising the databases CINAHL, Medline and PsycINFO. (3) Results: Fifteen studies were included in the review, with three common themes identified: (i) the positive impact of mindfulness on holistic wellbeing, (ii) mindfulness-based techniques as a positive coping mechanism within academic and clinical practice, and (iii) approaches to the delivery of mindfulness-based interventions. (4) Conclusions: Mindfulness-based interventions are effective strategies for the management of stress, development of self-awareness and enhanced academic and clinical performance in undergraduate nursing students. No ideal approach to delivery or duration of these interventions was evident from the literature. Best practice in relation to delivery of mindfulness-based interventions for nursing students is recommended for future studies.

Pharmacy Student Challenges and Strategies towards Initial COVID-19 Curriculum Changes.

Due to COVID-19, tertiary institutions were forced to deliver knowledge virtually, which proposed challenges for both institutions and students. In this study, we aimed to characterize pharmacy students' challenges and strategies during COVID-19 curriculum changes, therefore developing a comprehensive understanding of students' learning, wellbeing, and resilience in the ever-changing situation. Data were collected from student written reflections across four year levels at one school of pharmacy from March-May 2020. In addition, data were collected from written responses of second-year pharmacy students responding to prompted questions. The data were qualitatively analyzed inductively by five coders using NVivo 12. For each piece of data, two coders independently coded the data, calculated the inter-rater agreement, and resolved discrepancies. The most coded challenges were 'negative emotional response' and 'communication barrier during virtual learning'. The most coded strategies were 'using new technology' and 'time management'. This study allows researchers and education institutions to gain an overview of pharmacy students' experiences during COVID-19, therefore helping universities to provide students with necessary support and techniques on how to self-cope with COVID-19 as well as stressful events in the future.

A SWOT analysis of the opinions of midwifery students about distance education during the Covid-19 pandemic a qualitative study.

BACKGROUND: The COVID-19 pandemic led to the suspension of face-to-face education and its replacement with distance education. This has caused important changes in midwifery education. OBJECTIVE: To determine midwifery students' opinions about distance education. DESIGN: This qualitative study employed an exploratory case study design. SETTING: This study was carried out at a national university in Ankara, Turkey between December 2020 and January 2021. PARTICIPANTS: The sample of the study comprised 50 students in the midwifery department. MEASUREMENTS AND FINDINGS: Data were collected using a SWOT analysis interview form developed by the researchers. The research findings were grouped into four themes: Satisfaction with distance education, barriers of distance education, facilitating aspects of distance education, and concerns about professional career. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Distance education in midwifery education in Turkey was found to have aspects involving obstacles and concerns in addition to many pleasing and facilitating features. Our findings suggest distance education can be used together with face-to-face education provided that its pleasing and facilitating aspects are supported and the obstacles and factors causing concerns are removed. Inclusion of distance methods in midwifery programs requires curricula to be updated and support from instructors and students for the development of the necessary infrastructure. There is a role for employing bodies to faciliate practice-based learning for new graduates to address their concerns with a lack of practical experience because of COVID-19 restrictions on placement.

Ready Patient One: How to Turn an In-Person Critical Care Simulation Scenario Into an Online Serious Game.

Introduction Serious gaming has become popular in healthcare education as an engaging way to train learners. When coronavirus disease 2019 (COVID-19) forced the cancellation of in-person simulation sessions, we designed a serious game to deliver content in an interactive format with no out-of-pocket expense. We describe the design process and game reception so that others may replicate it. Methods We designed an online game using Choose-Your-Own-Adventure (CYOA) and Escape Room concepts. Using online survey software, we presented an interactive story based on an existing simulation scenario and included interactive puzzles as roadblocks to scenario progression. Each puzzle represented a critical care concept, and many contained hyperlinks to prior basic science lecture material to reinforce learning. A post-game survey assessed students' experience. Results All (N=88) students enrolled in a scheduled simulation session participated in the game, and 75% (66/88) responded to a post-participation survey. All respondents (100%) were able to complete the game. The majority (57.6%) completed the game in 30 minutes to 1 hour. Most students strongly agreed or agreed that the game enhanced their understanding of critical care concepts (93.9-97.0%), and that they were interested in doing more CYOA games (90.9%). Conclusion The game was well-received, delivered critical care content, and challenged students to apply basic science principles to medical decision-making from the safety of their own homes. The game was self-guided, requiring minimal active facilitator involvement. We plan to expand the use of the game to other settings and explore its use in formative/summative assessment and remediation.

Pandemics, Protests, and Pronouns: The Changing Landscape of Biomedical Visualisation and Education.

Events in early 2020 changed the landscape of education for the foreseeable future, perhaps permanently. Three events had a significant impact; (1) the Coronavirus disease 2019 (COVID-19) pandemic, (2) the death of George Floyd, which resulted in the most recent Black Lives Matter (BLM) protests, and (3) the Twitter storm, the resultant societal fallout and freedom of speech campaigns, following comments made by author JK Rowling which many deemed transphobic. These events had a differential impact on biomedical sciences, when compared to other sectors. COVID-19 resulted in a global lockdown, with higher education institutions closing campuses and moving to online-only delivery. This rapid change required radical shifts in the use of technology, with mass delivery of teaching at short notice. The BLM protests further raised awareness of the inequalities within society, particularly those experienced by Black people and other oppressed groups. As a result, there have been calls for the decolonisation of the curriculum. The implications of these three key events have led institutions to rethink their policies, teaching delivery, assessment, curricula, and physical environments. This chapter considers (1) the implications of a swift change in the primary mode of curriculum delivery within Higher Education to online formats and (2) how recent adverse events have resulted in calls for much-needed changes in visual representations within biomedical sciences. Finally, we consider (3) the role of the hidden curriculum and the potential impact of visual representations in curricula on the delivery of healthcare and the fight against health inequalities, which are often as a result of implicit biases. The year 2020 has proven timely in presenting the opportunity for change, provided through the power of imagery.

E-Learning as a Factor Optimizing the Amount of Work Time Devoted to Preparing an Exam for Medical Program Students during the COVID-19 Epidemic Situation.

The COVID-19 pandemic had a huge impact on the learning and teaching processes, particularly in healthcare education and training, because of the principal position of the cutting-edge student-patient interaction. Replacing the traditional form of organization and implementation of knowledge evaluation with its web-based equivalent on an e-learning platform optimizes the whole didactic process not only for the unit carrying it out but, above all, for students. This research is focused on the effectiveness of the application of e-learning for computer-based knowledge evaluation and optimizing exam administration for students of medical sciences. The proposed approach is considered in two categories: from the perspective of the providers of the evaluation process, that is, the teaching unit; and the recipients of the evaluation process, that is, the students.

Digital Simulation Improves, Maintains, and Helps Transfer Health-Care Providers' Neonatal Resuscitation Knowledge.

Purpose: To safely care for their newborn patients, health-care professionals (HCP) must undergo frequent training to improve and maintain neonatal resuscitation knowledge and skills. However, the current approach to neonatal resuscitation simulation training is time and resource-intensive, and often inaccessible. Digital neonatal resuscitation simulation may present a convenient alternative for more frequent training. Method: Fifty neonatal HCPs participated in the study (44 female; 27 nurses, 3 nurse practitioners, 14 respiratory therapists, 6 doctors). This study was conducted at a tertiary perinatal center in Edmonton, Canada from April-August 2019, with 2-month (June-October 2019) and 5-month (September 2019-January 2020) follow-up. Neonatal HCPs were recruited by volunteer sampling to complete a demographic survey, pre-test (baseline knowledge), two digital simulation scenarios (intervention), and post-test (knowledge acquisition). Two months later, participants repeated the post-test (knowledge retention). Five months after the initial intervention, participants completed a post-test using a table-top simulation (knowledge transfer). Longitudinal analyses were used to compare participants' performance over time. Results: Overall the proportion of correct performance increased: 21/50 (42%) passed the pre-test, 39/50 (78%) the post-test, 30/43 (70%) the 2-month post-test, and 32/40 (80%) the 5-month post-test. GLMM and GEE analyses revealed that performance on all post-tests was significantly better than the performance on the pre-test. Therefore, training with the RETAIN digital simulation effectively improves, maintains, and transfers HCPs' neonatal resuscitation knowledge. Conclusions: Digital simulation improved, maintained, and helped transfer HCPs' neonatal resuscitation knowledge over time. Digital simulation presents a promising approach for frequent neonatal resuscitation training, particularly for distance-learning applications.