The effects of an active learning mechanism on cognitive load and learning achievement: A new approach for pharmacology teaching to Taiwanese nursing students.

BACKGROUND: Nursing students require learning strategies when studying pharmacology. The COVID-19 pandemic has increased the prevalence of online self-study. The design of effective online learning materials has therefore become vital to nursing education. OBJECTIVES: The objective of this study was to describe the active learning mechanism that helped nursing students learn pharmacology through interactive learning materials and to demonstrate that no increased cognitive load in nursing students when studying pharmacology using interactive learning materials. METHOD: We designed an active learning mechanism to help nursing students study pharmacology by using interactive learning materials. An experimental pre- and post-test design was conducted. The participants were second-year nursing students (age 16-17) in a junior college of nursing. Students were randomly assigned to an experimental group (n = 98) and a control group (n = 90). RESULTS: We developed multi-media interactive learning materials and an active learning mechanism to enable nursing students to learn pharmacology. The proposed approach not only improved learning achievements but also reduced the cognitive load of nursing students. CONCLUSION: The major contribution of this study exhibits a new approach to practice wherein active learning is incorporated into interactive pharmacology materials for nursing students. This can be attributed to the design features of "explanation," "quiz and feedback," and "encouragement." Our results aid the development of effective interactive learning materials for pharmacology for Taiwanese nursing students.

Online Flipped Classroom (E-Fcr): Way Forward In Covid 19 Era.

Online teaching and learning have been in place for the last two decades. COVID-19 pandemic has intensely augmented institutions towards implementation of online teaching. Literature reported benefits of online learning including flexibility and self-direction. In addition, researchers reported that virtual learning pedagogy is encouraging, as it mainly inspires lifelong learning due to its self-paced and self-directed instruction. Flipped classroom is an active pedagogical instructional strategy that uses online resources external to the classroom, and then employs small group pedagogies within the classroom. Flipped classroom strategy allows use of lecture time for active learning activities. This active model restructures the traditional lecture paradigm, in that students acquire basic course content before coming to the classroom, while class time is dedicated for problem solving learning activities. Flipped classroom utilizes time in student interaction sometimes one to one, addressing to their concerns and queries regarding the content. This strategy gives opportunity to the teachers to share their relevant real-life experiences and design small group problem solving activities.

The effects of online Team-Based Learning on undergraduate nursing students' performance, attitudes and accountability during COVID-19 pandemic.

BACKGROUND AND AIM: The COVID-19 pandemic forced many institutions to move Team-Based Learning to an online format. The primary aim of this study is to examine the performance of undergraduate nursing students on tRAT and iRAT during online TBL. The secondary aims are to evaluate the students' attitudes and their accountability, preferences and satisfaction with online TBL. METHODS: The study employed a one-group pretest-posttest quasi-experimental design. The primary outcome was evaluated by comparing the students' average scores in the tRAT versus the iRAT in each online TBL session. The secondary outcomes were evaluated through the questionnaire designed by Parmelee et al. (2009) and the Team-Based Learning Student Assessment Instrument (TBL-SAI) (Mennenga, 2012). RESULTS: A statistically significant improvement was identified between tRAT and iRAT performances in all online TBL sessions (p<0.001). Students' satisfaction with team experience showed a statistically significant increase (p=0.003). Participants considered the peer evaluation to be fair (p<0.001), although it didn't encourage them to study more (p=0.028). Finally, students felt they were able to make the right decisions (p<0.001). The mean scores for accountability (m=30±3.7) and preferences for TBL (m=51.8±6.3) were higher than their neutral values (n=24; n=48). Students' satisfaction was neutral (m=27.8±5, n=27). CONCLUSIONS: In online TBL, teamwork has improved individual performances and has been appreciated by the participants. The online TBL had a positive effect on the accountability of students who preferred it to frontal lectures.

Experiential student study groups: perspectives on medical education in the post-COVID-19 period.

BACKGROUND: Undergraduate medical curricula often fail to integrate experiential learning methodologies. Thus, a pilot series of interactive pathology lessons was designed and implemented in an attempt to promote experiential learning. METHODS: Thirty pre-graduate medical students voluntarily participated in the interactive study groups at the First Department of Pathology of the National and Kapodistrian University of Athens, Medical School. A questionnaire was designed to investigate the satisfaction of students regarding their participation in pathology study groups and to identify the characteristics that shape students' perceptions of the foundations of medical education. Descriptive statistics (mean values) were used to describe the students' evaluations of the pathology study groups, and thematic analysis was conducted to investigate the data collected using open-ended questions. RESULTS: Interactions with the professor and the option of co-observing the slides using dual-view optical microscopes and virtual slides were each evaluated as "Excellent" by ≅ 95% of the students. Four overarching themes were identified regarding the core characteristics of medical education according to the students' perspectives: 1) educational background in medical education, 2) interaction with educators in medical education, 3) educational material in medical education and 4) assessment in medical education. CONCLUSIONS: The high rates of acceptance of the pathology study groups reflect the desire and need for active learning methodologies to be implemented in modern medical education. Nearly all the students mentioned the need for practical skill acquisition, the integration of theory into practice and ethics in medical education. The success of these optional pathology study groups highlights the need for similar modalities to be incorporated into the main medical education curriculum.

The impact of the transition from flipped classroom to online lectures on learning outcomes and student satisfaction in a rehabilitation medicine clerkship during the COVID-19 pandemic.

BACKGROUND: The flipped classroom (FC) is a well-known active learning module that activates the prior knowledge of students and promotes their cognitive skills during in-class activities. However, most on-site teaching during the COVID-19 pandemic had to be conducted online. The FC in our rehabilitation medicine clerkship curriculum was also shifted to online asynchronous lectures (OLs), without real-time interactions. There is no previous comparison of effectiveness between these two methods. Therefore, this study aimed to compare learning outcomes and student satisfaction in both FC and OL models. METHODS: The study design was a historically controlled study. A physical modality was chosen for the content. The FC group (n = 233), in the academic years 2018 and 2019, was assigned to perform a pre-class activity consisting of reading study materials. Thereafter, the in-class activity comprised a small-group case-based discussion. The OL group (n = 240) in the academic years 2020 and 2021 followed an online model during the COVID-19 lockdown. They were also asked to read the online materials and then watch a self-paced recorded lecture video on Learning Management Systems. The learning outcomes, including their multiple-choice questions (MCQs) scores, final exam scores, grade points, and letter grades, were evaluated. Their overall course satisfaction ratings were also collected. RESULTS: The OL group had an overall higher MCQ score for the physical modality portion than the FC group (p = 0.047). The median (lower quartile, upper quartile) of the total 50-MCQ scores were 34 (31, 37) in the OL group and 33 (29, 36) in the FC group (p = 0.007). The median final exam scores of the OL and FC groups were 69.5 and 68.3, respectively (p = 0.026). The median grade points and the letter grades were not significantly different between the groups. The proportions of satisfaction were significantly higher in the FC group than in the OL group. CONCLUSIONS: The OL group revealed significantly higher learning outcomes than the FC group. However, the FC group showed more satisfaction with interactivity than the OL group. The authors are of the view that a combination of both FC and OL methods will likely result in better outcomes.

Pathfinder-Driven Chemical Space Exploration and Multiparameter Optimization in Tandem with Glide/IFD and QSAR-Based Active Learning Approach to Prioritize Design Ideas for FEP+ Calculations of SARS-CoV-2 PLpro Inhibitors.

A global pandemic caused by the SARS-CoV-2 virus that started in 2020 and has wreaked havoc on humanity still ravages up until now. As a result, the negative impact of travel restrictions and lockdowns has underscored the importance of our preparedness for future pandemics. The main thrust of this work was based on addressing this need by traversing chemical space to design inhibitors that target the SARS-CoV-2 papain-like protease (PLpro). Pathfinder-based retrosynthesis analysis was used to generate analogs of GRL-0617 using commercially available building blocks by replacing the naphthalene moiety. A total of 10 models were built using active learning QSAR, which achieved good statistical results such as an R2 > 0.70, Q2 > 0.64, STD Dev < 0.30, and RMSE < 0.31, on average for all models. A total of 35 ideas were further prioritized for FEP+ calculations. The FEP+ results revealed that compound 45 was the most active compound in this series with a ΔG of −7.28 ± 0.96 kcal/mol. Compound 5 exhibited a ΔG of −6.78 ± 1.30 kcal/mol. The inactive compounds in this series were compound 91 and compound 23 with a ΔG of −5.74 ± 1.06 and −3.11 ± 1.45 kcal/mol. The combined strategy employed here is envisaged to be of great utility in multiparameter lead optimization efforts, to traverse chemical space, maintaining and/or improving the potency as well as the property space of synthetically aware design ideas.

From Lecture Halls to Zoom Links: How Can Educational Theory Help Us to Deliver Effective and Engaging Teaching in an Online Environment?

Anatomical education has a long and colourful history, ranging from the anatomical theatre and artistic flourish of the renaissance period to modern-day virtual reality. Over the centuries, the body has been taken apart and mapped in exquisite detail. We are now able to access virtual models of the body anywhere, anytime, which allow for unlimited dissection and manipulation. Despite this progress, the majority of anatomical educators continue to deliver anatomy in a laboratory setting, using hands-on learning approaches such as dissection of cadaveric material. These methods are robustly supported by educational theories, such as information processing theory and experiential learning but require students to be present in a dissection room with access to human cadaveric material.The 2020 COVID-19 pandemic forced anatomy educators out of familiar dissection laboratories and into unfamiliar and uncomfortable virtual environments. When moving online during the pandemic, active learning theories, which form the basis of face-to-face classes, were used to construct interactive anatomy webinars to replace the on-campus practical laboratory-based teaching. The focus of these webinars was on student interactivity, and visual content with drawing activities, breakout groups, virtual three-dimensional models, and identifying activities being integrated into each session. Student feedback showed an appreciation of the interactive nature of these sessions, and staff were surprised at how well the webinars delivered engaging and interactive teaching at a time of limited social contact. This approach was not only useful during the restrictions of a pandemic but could offer a complementary approach to delivering practical anatomy teaching as we return to blended and on-campus learning again.

Introduction to the special issue on education in acoustics.

A substantial fraction of the membership of the Acoustical Society of America are faculty at various types of educational institutions and are actively engaged in educational activities. However, papers focusing on aspects of teaching, pedagogy, demonstrations, student learning, and other education topics are not often published in JASA, even though the Education in Acoustics Committee regularly offers special sessions on these topics at every ASA meeting. This special issue of JASA dedicated to Education in Acoustics includes 41 papers from authors all over the world. This introduction to the special issue briefly describes each of the papers, which have been organized into several broad categories: teaching methods and exercises; project-based learning; use of experiments, demos, and experiential learning; adapting to teaching during COVID-19; circuit models and impedance concepts; software apps and online resources; teaching musical acoustics; and descriptions of acoustics programs at a variety of institutions.

Effectiveness comparison between blended learning of histology practical in flipped physical classrooms and flipped virtual classrooms for MBBS students.

BACKGROUND: The flipped classroom blended learning model has been proven effective in the teaching of undergraduate medical courses as shown by student acceptance and results. Since COVID-19 necessitated the application of online learning in Histology practical for MBBS students, the effectiveness of the blended learning model on teaching quality has required additional attention. METHODS: A blended learning of histology practical was flipped in a virtual classroom (FVCR-BL) or in a physical classroom (FPCR-BL) in School of Medicine, Zhejiang University in China. Students were split into FVCR-BL group (n = 146) due to COVID-19 pandemic in 2020 or were randomly allocated into FPCR-BL group (n = 93) in 2021, and retrospectively, students with traditional learning in 2019 were allocated into traditional learning model in a physical classroom (PCR-TL) group (n = 89). Same learning requirements were given for 3 groups; all informative and summative scores of students were collected; a questionnaire of student satisfaction for blended learning activities were surveyed in 2021. Data of scores and scales were analyzed with Kruskal-Wallis test and Kolmogorov-Smirnov test in SPSS Statics software. RESULTS: The results clarified that FPCR-BL students obtained higher final exam scores and were more likely to engage in face-to-face interactions with instructors than FVCR-BL students. FPCR-BL and FVCR-BL students had higher classroom quiz scores than the PCR-TL students owing to the contribution of blended learning. The results of the questionnaire showed that participants of FPCR-BL positively rated the online learning and preview test, with a cumulative percentage of 68.31%, were more satisfying than other learning activities of blended learning. There were significant correlations (r = 0.581, P < 0.05) between online learning and the other three blended learning strategies. CONCLUSIONS: In the flipped classroom with a blended learning process of histology practical, enhancing the quality of online learning boosts student satisfaction and improves knowledge learning; peer-to-peer interactions and instructor-to-peer interactions in the physical classroom improved knowledge construction.

How to assess? Student preferences for methods to assess experiential learning: A best-worst scaling approach.

Transitioning from traditional in-person classroom formats to online instructional delivery methods and online student assessments during the COVID-19 pandemic was a significant challenge to effective teaching, learning, and evaluation. Although there is a growing literature assessing the relative efficacy of different online teaching techniques, previous literature has not analyzed, from the student perspective, what methods are preferred for evaluating performance in experiential learning courses. How students perceive assessment methods is critical because it can affect their learning experience and academic achievements. To better understand student preferences for assessment methods, the best-worst scaling approach was used in two online surveys of 218 undergraduate students enrolled in experiential learning-based programs during the COVID-19 pandemic. Analysis of student responses indicates students' highest levels of support for assessments that emphasize the development of critical thinking skills and professional skills, such as case studies. Most students would prefer assessments that are driving (develop different skills such as creative thinking) and realistic (develop skills transferable to the real world), while only a few (< 1%) prefer assessments that are fast (involve little time), frequent, safe (has preventive measures to eliminate cheating), or strategic (high probability of getting good grades).

Design principles for fully online flipped learning in health professions education: a systematic review of research during the COVID-19 pandemic.

BACKGROUND: During the COVID-19 pandemic, some instructors transitioned their courses into a fully online environment by adopting flipped learning. In this context, this review examined the challenges to fully online flipped learning and identified useful course-design elements for practicing this instructional approach in health professions education. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for selecting relevant articles. Thirty-three empirical studies (with 32 unique interventions) published between 2020 and 2021 (i.e., the first 2 years of the pandemic) were selected for analysis. RESULTS: When the instructors in the reviewed studies designed and implemented their online flipped courses, numerous challenges emerged, which could be broadly categorized into student-related challenges (e.g., unfamiliarity with online flipped learning; N = 5), faculty challenges (e.g., increased workload; N = 8), and operational challenges (e.g., students' technical problems; N = 9). Nevertheless, we identified various useful elements for online flipped learning practice and organized them based on the following components of the Revised Community of Inquiry (RCoI) framework: cognitive presence (e.g., application of knowledge/skills; N = 12), social presence (e.g., peer interaction; N = 11), teaching presence (e.g., instructors' real-time demonstration/facilitation; N = 17), and learner presence (e.g., care and emotional support; N = 4). CONCLUSIONS: Based on the findings from the review and the RCoI framework, we developed nine principles for the effective practice of online flipped learning. These principles appear crucial for sustaining quality health professions education in a fully online flipped learning environment.

Evaluation of student engagement through knowledge elaboration and the use of comics in Microbiology education.

Despite the many challenges faced by the sudden adaptation of the teaching-learning processes during the emergency remote teaching (ERT) imposed by the COVID-19 pandemic, this period allowed the exploration of innovative educational methods. Here, we report the description and evaluation of a didactic activity designed to foster an active learning environment among Veterinary Medicine undergraduate students enrolling in Microbiology classes during the ERT period at the University of Minas Gerais. The activity consisted of initial expositive classes, followed by students' active search for information, and the execution of a report and short comics covering the topic. The activity was evaluated by a voluntary postquestionnaire. The results suggest that the students had good emotional and educational perception toward the task, and that they noticed the elaboration of the comics as the most valuable tool aiding in the retention of microbiological concepts. We conclude that the proposed strategy, specially by the incorporation of the comics, helped the meaningful learning of microbiology.

"Flipped" clinical rotations: A novel approach.

BACKGROUND: Near the beginning of the COVID-19 pandemic in the United States, medical students were pulled out of all in-person patient care activities. This resulted in massive disruption to the required clinical rotations (clerkships), necessitating creative curricular solutions to ensure continued education for medical students. APPROACH: In response to the lockout, our school adopted a "flipped" clinical rotations model that assigned students to remote learning activities prior to in-person patient care activities. This approach allowed students to continue their clinical education virtually with a focus on knowledge for practice while awaiting return to the shortened in-person portions of their rotation. In planning the modified clinical curriculum, educational leaders adhered to several guiding principles including ensuring flexible remote curricular components that would engage students in active learning, designating that no rotation would be completely virtual, and completing virtual educational activities and standardised exams before students returned to in-person experiences. EVALUATION: End of rotation evaluations and standardised exam scores were analysed to determine the effectiveness of this model. Despite the disruption associated with the pandemic and the rapid implementation of the "flipped" rotations, students continued to rate the overall experiences as highly as traditional clinical rotations. Students also performed similarly on standardised exams when compared to cohorts from other classes at the same experience level. IMPLICATIONS: While borne out of necessity during a pandemic, the lessons learned from our implementation of a "flipped" rotations model can be applied to address problems of capacity and clinical preparedness in the clinical setting.

Educational impact of an active learning session with 6-lead mobile electrocardiography on medical students' knowledge of cardiovascular physiology during the COVID-19 pandemic in the United States: a survey-based observational study

Mobile electrocardiogram (ECG) devices are valuable tools for teaching ECG interpretation. The primary purpose of this follow-up study was to determine if an ECG active learning session could be safely and effectively performed during the coronavirus disease 2019 (COVID-19) pandemic using a newly developed mobile 6-lead ECG device. Additionally, we examined the educational impact of these active learning sessions on student knowledge of cardiovascular physiology and the utility of the mobile 6-lead ECG device in a classroom setting. In this study, first-year medical students (MS1) performed four active learning activities using the new mobile 6-lead ECG device. Data were collected from 42 MS1s through a quantitative survey administered in September 2020. Overall, students felt the activity enhanced their understanding of the course material and that the activity was performed safely and in compliance with local COVID-19 guidelines. These results emphasize student preference for hands-on, small group learning activities in spite of the pandemic.

Flipped Classroom in Restorative Dentistry: A First Test Influenced by the Covid-19 Pandemic.

PURPOSE: This study compared the success of dental students with flipped classroom and traditional classroom learning in the restorative dentistry course for the first time at the Faculty of Dentistry of Reims during the 2019- 2020 academic year, influenced by the Covid-19 pandemic, and analysed the correlation with students' feelings. The use of an active learning method can improve success during final exams and increase the motivation of students. MATERIALS AND METHODS: The same teacher taught half of the restorative dentistry course in the flipped classroom approach and the other half as traditional classroom. For the flipped classroom, students were required to complete their homework online before the face-to-face sessions. An exam at the beginning and the end of the semester was conducted with questions about concepts learned with each learning method. Statistical analysis was performed using a t-test at the 0.05 significance level. A questionnaire on satisfaction was conducted to determine the students' opinion on this new learning method in the flipped classroom compared to the traditional classroom. RESULTS: The flipped classroom learning method enabled students to achieve better results on the final exam, with a statistically significant difference compared to traditional classroom learning. Student responses to the satisfaction questionnaire showed an increase in motivation and interest in the lessons and correspond to the increase in exam success. CONCLUSION: The use of the flipped classroom for lower cognitive-level activities is more appreciated by students and yields better results than knowledge acquisition in the traditional classroom.

PBL teaching in ultrasonography resident standardization training in the COVID-19 pandemic.

OBJECTIVE: To study the effect of the problem-based learning (PBL) method in ultrasonography (US) resident standardization training during the COVID-19 pandemic. METHODS: Fifty residents were divided into two groups to participate in a 30-day US training program. The residents in the observation group underwent PBL combined with the lecture-based learning (LBL) method, while the residents in the control group experienced the LBL method alone, with 25 residents in each group. A basic theoretical test, practical examination, and questionnaire were used to evaluate the teaching effect of the PBL + LBL method and the LBL method alone. RESULTS: The basic theoretical pretest score of the observation group was not significantly different from that of the control group. However, the posttest theoretical score and practical score were significantly higher in the observation group than in the control group (P < 0.01). The results of the questionnaire showed that the resident satisfaction level in the observation group with PBL combined with the LBL method was 96%, which was significantly higher than that of the control group with the LBL method alone (80%) (P < 0.05). CONCLUSION: The combination of PBL with the LBL method has obvious advantages over the LBL method alone in regard to the training of US residents during the COVID-19 pandemic.

A poverty simulation to enhance nursing student knowledge, skills, and attitudes toward people living in poverty.

BACKGROUND: Poverty is a reality for many individuals and families. Unless one has lived in a poverty situation, it can be difficult to understand the challenges people face. METHODS: This study was a quasi-experimental study with a pre- and post-test design (36 select-items from four-established instruments) that measured students' self-perceived knowledge, skills, and attitudes towards people living in poverty. All undergraduate, pre-licensure, senior-level nursing students enrolled in a community nursing course (fall 2018-fall 2019, n = 254) participated in a face-to-face interactive Community Action Poverty Simulation (CAPS) with a focus on the QSEN concept of patient-centered care. The winter 2020 semester, the simulation was not offered because of the coronavirus pandemic; these students (n = 96) served as a comparison group. RESULTS: Paired-samples t-tests revealed knowledge, skill, and attitude mean scores, were improved for all students with the exception of social justice attitudes (improved only for the non-simulation group). Independent-samples t-tests revealed simulation students had higher knowledge, skill, and attitude scores on the Adapted CAPS Assessment and Active Learning Measure. Non-simulation participants had higher Political Awareness scores. CONCLUSION: These results indicated the CAPS appears to be an effective simulation to change students' self-perceived knowledge, skills, and attitudes regarding people whose incomes are low or who are living in poverty.

Blended teaching of medical ethics during COVID-19: practice and reflection.

BACKGROUND: With the advancement of information technology, teachers have become able to overcome the limitations of time and room capacity by carrying out teaching activities online. This practice, however, also presents new challenges. The present study explores how to fully capitalize on the advantages of online and offline teaching and improve the quality and impact of the teaching delivered. This article presents an analysis of the planning, implementation, evaluation, and reflection process of reforming the Fujian Medical University (FJMU) medical ethics course. METHODS: After early attempts using the Small Private Online Course (SPOC) and flipped classroom formats, this paper focuses on the comprehensive active implementation of blended teaching practice. In terms of teaching practice, this research makes targeted improvements to overcome the known shortcomings of SPOCs and flipped classrooms, including the significant preparatory workload and lacking enthusiasm for classroom participation, by redesigning the course and evaluation method and changing the role of the teacher in blended teaching. Subsequently, the study used a stratified sampling method to select 20 students enrolled in the clinical medicine course at Fujian Medical University (FJMU). Their course experience was investigated using a semi-structured interview. Interview content related to evaluating teaching effect was extracted and encoded for subsequent qualitative analysis. RESULTS: A qualitative analysis of the student evaluation of blended teaching as implemented on the medical ethics course showed that the main factors influencing student engagement are the method of assigning tasks and that of testing learning outcomes. Student participation in class is influenced by the richness of the curriculum resources available and the role played by the teacher. CONCLUSION: This research presents a discussion of blended teaching and suggests improvements that can be made to address low student engagement and poor classroom participation. This round of blended teaching was shown to improve learning autonomy and classroom participation and to support students in the development of their clinical abilities and higher-order thinking skills. These findings provide a reference for the implementation of online teaching during the COVID-19 pandemic.