Motivation to learn: an international multilevel study on student autonomy and teacher emphasis on content usefulness / Motivación para aprender: un estudio internacional multinivel sobre la autonomía de los estudiantes y el énfasis de los docentes en la utilidad del contenido

En la educación superior, pocos estudios relacionan factores contextuales en la clase, como el énfasis del profesor en la utilidad del contenido y las características motivacionales de los estudiantes. El objetivo fue probar un modelo multinivel sobre la relación entre el énfasis del docente en la utilidad del contenido durante la clase, la autonomía de los estudiantes y, a su vez, la motivación para aprender. Participaron 3033 estudiantes universitarios matriculados de 1º a 4º grado de Ciencias de la Actividad Física y del Deporte, de universidades de España (N = 602), Portugal (N = 469), México (N = 1177), Chile (N = 372), y Brasil (N = 413). Se realizó un modelo de ecuaciones estructurales multinivel, en el que los participantes respondieron preguntas sobre el énfasis del profesor en la utilidad del contenido de la clase, la autonomía y la motivación para aprender. Se hipotetizó que el énfasis del profesor en la utilidad del contenido predecía la autonomía del estudiante que, por su vez, predecía la motivación para aprender. Los resultados, a nivel grupal e individual, indican que el énfasis del docente en la utilidad del contenido predijo la autonomía del estudiante, y la autonomía predijo la motivación para aprender.(AU)

Teacher autonomy support is related to improved student learn-ing. In higher education, few studies relate classroom contextual factors, such as teacher emphasis on content usefulness, and students' motivational characteristics. The aim was to test a multilevel model about the relation between the extent of teachers’ emphasis on the usefulness of class con-tent with student autonomy, and, in turn, on motivation to learn. The par-ticipants were 3033 university students enrolled from 1st to 4th grade of Sciences of the Physical Activity and Sport, from universities in Spain (N = 602), Portugal (N = 469), Mexico (N = 1177), Chile (N = 372), and Brazil (N = 413). A multilevel structural equation model was performed, in which participants answered questions about the teacher's emphasis on the use-fulness of class content, basic psychological need for autonomy, and moti-vation to learn. At the group and individual levels, the hypothesis is that the teacher's emphasis on the usefulness of class content predict the stu-dent autonomy, in turn, student autonomy predicts student motivation to learn. Results found at the group level and at the individual level the strength of teacher emphasis on class content predicted student autonomy; student autonomy predicted student motivation to learn.(AU)

The Durban University of Technology Faculty of Health Sciences Decentralized Clinical Training Project: Protocol for an Implementation Study in KwaZulu-Natal, South Africa.

BACKGROUND: The Durban University of Technology (DUT) Faculty of Health Sciences (FHS) in KwaZulu-Natal, South Africa, is embarking on a project to implement a Decentralized Clinical Training Program (DCTP). The DUT FHS DCTP project is being conducted in response to the growing demands of students requiring clinical service placements as part of work-integrated learning. The project is also geared toward responding to existing gaps in current practices related to the implementation of a DCTP, which has mainly been through traditional universities providing training to medical, optometry, occupational therapy, and physiotherapy students. In South Africa, a DCTP is yet to be implemented within the context of a university of technology; it is yet to be implemented within health science faculties that offer undergraduate health science programs in mainstream biomedicine and alternative and complementary disciplines. OBJECTIVE: We aim to design, pilot, and establish an effective DCTP at the DUT FHS in KwaZulu-Natal, South Africa. METHODS: Participatory action research comprising various designs-namely, appreciative inquiry, qualitative case study design, phenomenography, and descriptive qualitative study design-will be used to conduct the study. Data will be collected using individual interviews, focus group discussions, nominal group technique, consensus methodology, and narrative inquiry. Study participants will include various internal and external stakeholders of the DUT, namely, academic staff; students; key informants from universities currently using successfully established DCTPs; academic support staff; staff working in human resources, finance, procurement, and accounting; and experts in other disciplines such as engineering and information systems. Overall, 4 undergraduate health science programs-namely, Radiography, Medical Orthotics and Prosthetics, Clinical Technology, and Emergency Medical Care and Rescue-will be part of the project's pilot phase. Findings from the project's pilot phase will be used to inform scale-up in the other undergraduate programs in the DUT FHS. The project is being implemented as part of the university's strategic objective of devising innovative curricula and pedagogical practices to improve the mastery, skill set, and competence of health science graduates. RESULTS: The study has currently commenced with the situational analysis, consisting of engagement with external stakeholders implementing DCTPs. The data to be generated from the completion of the situational analysis are anticipated to be published in 2024. CONCLUSIONS: This project is envisioned to facilitate collaboration among the universities of technology, traditional universities, Ministry of Health, and private sector for clinical placement of undergraduate health science students in health establishments that are away from the university, thereby exposing them to real-life experiences related to health care. This will facilitate authentic learning experiences that will contribute to improved competencies of graduates in relation to the health needs of society and the multiple realities of the South African health system. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52243.

[Success factors and obstacles in the implementation of competence-oriented teaching in surgery]. / Erfolgsfaktoren und Hindernisse bei der Implementierung kompetenzorientierter Lehre in der Chirurgie.

BACKGROUND AND OBJECTIVES: For successful competence-oriented teaching at the medical faculties it is important to identify the factors that influence its implementation in order to benefit from the strengths and balance out weaknesses. The present study examined the success factors and obstacles of the implementation of competence-oriented teaching in the surgical discipline from the point of view of students and lecturers. METHODS: After implementation of competence-oriented teaching based on the teaching goals of the NKLM, in clinical examination courses (bedside teaching and block internship, BP) at two hospitals, a qualitative content analysis and quantification of the answers were performed using focus group interviews and questionnaires with students (S) and lecturers (D). RESULTS: During the summer semester 2022 a total of 31 students and 14 lecturers were interviewed in focus groups and 143 questionnaires (123 S, 20 D) were analyzed. For the students the presence of concrete competences/teaching goals, guidelines for the lesson, transparent goals and ability to demand teaching goals as well as structured lessons and mentoring were the main success factors. Lecturers on the other hand reported the presence of concrete goals, assistance for the lesson preparation and the activity of the students as success factors. The results of the questionnaires showed that the majority (88% S, 75% D) were informed about the teaching goals and considered them to be followed (84%S, 95% D). Obstacles were the factors "time", "mentoring" and "information". Factors that were between negative and positive (indifferent factors) were "uncertainty about competence-orientation" and "uncertainty how to examine the teaching success". DISCUSSION: Transparent structure and teaching goals as well as a mentoring system are the success factors for the implementation of competence-oriented lessons and should be used as strengths. Indifferent factors represent weaknesses and need to be addressed by training and instruction. Restricted time and personnel resources are the immanent problems that hamper the implementation and require fulminant structural changes.

Factors influencing implementation of simulation in nursing and midwifery training in Malawi.

Background: The study explored factors influencing implementation of simulation-based education (SBE) in nursing and midwifery education in Malawi. Aim: This study aimed to identify factors influencing nursing and midwifery educators in selected training institutions and clinical sites. Setting: The study covered one district and four central hospitals, five professional training institutions, Ministry of Health and Nurses and Midwives Council of Malawi officials. Methods: Using mixed-methods approach, quantitative data were gathered from 293 participants, including 149 final-year nursing and midwifery students, and 144 clinical instructors. Qualitative data were obtained from 24 faculty members, 11 clinical instructors and two key informants. Researchers conducted 37 in-depth interviews, 10 focus group discussions and eight desk reviews. Descriptive statistics were used to analyse the quantitative data, while content analysis was used for qualitative findings. Results: Five themes emerged from qualitative data: absence of simulation in regulatory body syllabi, insufficient formal training, demand for knowledgeable clinical instructors, inadequate human and material resources, and resistance to change. Survey results indicated that 83% of the participants had theoretical SBE knowledge but lacked practical skills, with only 13% considering SBE as a current teaching method. Educators emphasised lack of infrastructure, skills laboratories, teaching hospitals, equipment, and a deficit in formal training as critical barriers to SBE implementation. Conclusion: The study concluded that skilled educators, appropriate infrastructure and resources could facilitate SBE implementation in Malawi. Contribution: Recommendations included regulatory body support, formal training for educators, utilisation of low-fidelity simulators, and establishment of SBE centres and corners in health facilities.

Students' perspectives on racism and anti-racism in physical education: a systematic review.

Sports, with their various social manifestations, exhibit racist structures and incidents. Physical education (PE) has the potential to serve as an environment to combat racism, but it can also perpetuate and (re)produce racist attitudes and behaviors. This study aimed to conduct a systematic review of national (German) and international literature concerning racism and anti-racism within the context of PE specifically from a students' perspective. The research methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard and encompassed a four-step process: (1) searching 11 electronic databases using 70 keyword combinations in both German and English; (2) selecting studies based on five predetermined inclusion criteria; (3) evaluating the quality of selected studies using established appraisal tools; and (4) conducting descriptive and template analyses. Of 5,213 publications, 16 met the inclusion criteria, demonstrating diverse theoretical frameworks and methodological approaches. Five themes were constructed: "How racism is understood" (1); "What students experience," encompassing discriminatory incidents in PE, sports, and daily life classified as racial stereotypes, prejudices, and everyday racism (2); and "What physical education teachers (3)/Institutions (4)/researchers (5) can and should do." These themes provided recommendations for teachers, institutions, and researchers, including training and curriculum reforms. While valuable international literature was identified, no German PE specific publications were found emphasizing the necessity of a local (German) survey to comprehend students' experiences, knowledge, and potential for anti-racism efforts. Such insights are crucial for shaping teacher-related training programs and policy demands in an informed and targeted manner.

Everyone can draw: An inclusive and transformative activity for conceptualization of topographic anatomy.

Anatomical drawing traditionally involves illustration of labeled diagrams on two-dimensional surfaces to represent topographical features. Despite the visual nature of anatomy, many learners perceive that they lack drawing skills and do not engage in art-based learning. Recent advances in the capabilities of technology-enhanced learning have enabled the rapid and inexpensive production of three-dimensional anatomical models. This work describes a "drawing on model" activity in which learners observe and draw specific structures onto three-dimensional models. Sport and exercise sciences (SES, n = 79) and medical (MED, n = 156) students at a United Kingdom medical school completed this activity using heart and femur models, respectively. Learner demographics, their perceptions of anatomy learning approaches, the value of the activity, and their confidence in understanding anatomical features, were obtained via validated questionnaire. Responses to 7-point Likert-type and free-text items were analyzed by descriptive statistics and semi-quantitative content analysis. Learners valued art-based study (SES mean = 5.94 SD ±0.98; MED = 5.92 ± 1.05) and the "drawing on model" activity (SES = 6.33 ± 0.93; MED = 6.21 ± 0.94) and reported enhanced confidence in understanding of cardiac anatomy (5.61 ± 1.11), coronary arteries (6.03 ± 0.83), femur osteology (6.07 ± 1.07), and hip joint muscle actions (5.80 ± 1.20). Perceptions of learners were independent of both their sex and their art-based study preferences (p < 0.05). Themes constructed from free-text responses identified "interactivity," "topography," "transformative," and "visualization," as key elements of the approach, in addition to revealing some limitations. This work will have implications for anatomy educators seeking to engage learners in an inclusive, interactive, and effective learning activity for supporting three-dimensional anatomical understanding.

Wisdom and the Bible in Teaching-Learning through Global Service Experiences.

The authors, who are nursing faculty members and leaders at a faith-based institution of higher education, discuss their concept of wisdom and how it guides their teaching and practice. Wisdom is seen by them as a universal humanuniverse living experience that is inspired and cocreated with their faith and understanding of God with others. They apply the concept of wisdom in global service experiences that their institution supports. These experiences strengthen their inherent core whatness as they cocreate what is important in the moment while participating in teaching-learning.

Heuristics: The Teaching-Learning Journey.

In this column, the author describes a heuristic framework for teaching-learning nursing made of the humanbecoming paradigm, living the art of humanbecoming, and the humanbecoming teaching-learning model. A story helps to clarify the heuristic framework.

Medication non-adherence and its associated factors among kidney transplant patients in a large teaching hospital in Ethiopia.

BACKGROUND: This study examines medication adherence among kidney transplant patients at St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, focusing on the level of adherence and associated factors to immunosuppressant medicines. METHODS AND MATERIALS: A cross-sectional study was conducted on 270 patients from October 2021 to January 2022 using a structured questionnaire analyzed with SPSS version 26. The prevalence of medication adherence was computed, and a binary logistic regression was fitted to estimate the association. Medication adherence level measurement in post-kidney transplant patients was assessed using the Simplified Medication Adherence Questionnaire (SMAQ) and Basel Adherence Assessment Scale in Immunosuppressants (BAASIS). A 95% confidence interval and p-value < 0.05 were used for statistical significance. RESULTS: The study found that 71.5% of kidney transplant patients were male, with a median age of 37 and a mean duration of 3.55 years. Medication adherence in post-kidney transplant patients was 81.9%. Post-transplant duration above 5 years and missing follow-up visits more than two times was associated with a 92.6% and 91.2% in medication non-adherence rate respectively. Additionally, forgetfulness was associated with a 90.6%, non-adherence level compared to drug unavailability and financial reasons. CONCLUSION AND RECOMMENDATION: The study indicates that our patients exhibit higher medication adherence than WHO-measured levels, suggesting the need for healthcare providers to strengthen their intervention, especially for those above 5 years post-kidney transplant. The reason for increased adherence could be explained by the health education program about the medication name, dosing, frequency of ingestion and adverse effects of the drug, and effects of non-adherence.

Harnessing open science practices to teach ecology and evolutionary biology using interactive tutorials.

Open science skills are increasingly important for a career in ecology and evolutionary biology (EEB) as efforts to make data and analyses publicly available continue to become more commonplace. While learning core concepts in EEB, students are also expected to gain skills in conducting open science to prepare for future careers. Core open science skills like programming, data sharing, and practices that promote reproducibility can be taught to undergraduate students alongside core concepts in EEB. Yet, these skills are not always taught in biology undergraduate programs, and a major challenge in developing open science skills and learning EEB concepts simultaneously is the high cognitive load associated with learning multiple disparate concepts at the same time. One solution is to provide students with easily digestible, scaffolded, pre-formatted code in the form of vignettes and interactive tutorials. Here, we present six open source teaching tutorials for undergraduate students in EEB. These tutorials teach fundamental ecological concepts, data literacy, programming (using R software), and analysis skills using publicly available datasets while introducing students to open science concepts and tools. Spanning a variety of EEB topics and skill levels, these tutorials serve as examples and resources for educators to integrate open science tools, programming, and data literacy into teaching EEB at the undergraduate level.

Assessing the Need for Clinical Forensic Medicine Training in the Medical Undergraduate Curriculum.

OBJECTIVE: This study was conducted to assess the need for clinical forensic medicine (CFM) training (hands-on and bedside) in medical undergraduate students and to determine the utility of skill-based teaching methodology in CFM. METHOD: A cross-sectional study was carried out in the Government Medical College, where we used the mixed model approach (qualitative and quantitative component) to access the approach of three groups containing 50 participants each from (1) resident doctors/interns, (2) faculty, (3) casualty medical officers, toward skill-based teaching of CFM. A structured pretested questionnaire was administered to all study participants. The questionnaire was based on their perception regarding the legal problems faced during clinical practice and their attitude toward the need for CFM. It was followed by a focus group discussion (FGD) arranged separately for each group of 10 participants. Each FGD session lasts for 40 minutes with a moderator and recorder. RESULT: Present MBBS (Bachelor of Medicine & Bachelor of Surgery) curriculum teaches CFM very early is strongly agreed by 20 (40%) of the faculty, four (8%) of interns, and three (6%) of medical officers. 40 (80%) of interns, 43 (86%) of medical officers, and 40 (80%) of faculty necessitate hands-on training in CFM in the MBBS curriculum. Forensic medicine specialists should handle clinical medico-legal cases (MLCs), as agreed by 50 (100%) faculty, 46 (98%) interns, and 47 (94%) medical officers. CONCLUSION: Hands-on training in CFM is needed for a better practical approach for doctors toward handling MLCs. Hands-on training should be introduced in the second-year MBBS curriculum, and their clinical aspects should be taught simultaneously with clinical subjects till the internship.

Intrinsic motivation between face-to-face and blended learning in surgical clinical education.

Objective: The variability and opportunistic nature of surgical clinical education is the main problem for effective teaching and training of medical students. Incorporating online mediums including discussion forums, interactive videos/scenarios, static pages, and quizzes is known as blended learning (BL). This study aimed to compare the intrinsic motivation of surgical students enrolled in blended learning to those enrolled in face-to-face teaching (f2f teaching). Methods: A quasi-experimental, cross-over study was conducted in Surgical Unit-I and Surgical Unit-II of Dow University Hospital, Karachi, from March to August 2014. A total of 31 students participated and were exposed to two different teachings. For the first four weeks, Group A was posted in Surgical-I (f2f teaching) and Group B in Surgical-II (BL). Both groups were taught the same contents with the same schedule. The F2F group had clinical exposure to real patients, and small group discussions (SGDs) while The BL group students were exposed to an additional online learning component. Intrinsic Motivation Inventory (IMI) was administered at the end of four weeks and groups were swapped. Exchanged groups were again taught the same contents with the same schedule for another four weeks and IMI was administered. Results: Fifty-eight students completed IMI; 28 in f2f and 30 in BL group. There was a significant difference in all four subscales of IMI between the two groups. In three subscales, students in BL were more motivated as compared to f2f (p<0.01). Students in f2f experienced more perceived tension than in BL (p<0.048). Conclusion: This study concluded that blended surgical learning programs keep medical students more intrinsically motivated to learn. By utilizing online learning, superior educational opportunities for students can be cultivated. It can result in enhanced faculty effectiveness and efficiency as well.