Effectiveness of the Flipped Classroom Teaching and Learning Method Among Underachievers in Physiology: Experience From a Tertiary Care Teaching Hospital.

Introduction Traditional classroom teaching involves a process where knowledge is disseminated to students by the teachers through a one-way process. Such a learning environment makes students passive and muted, which can be improved by alternative teaching and learning (TL) methods like the flipped classroom (FC) technique. The FC approach involves a student-inclusive TL process. FC is a student-centered approach that benefits teachers and students by emphasizing the key information during the learning process. The present study aimed to understand the efficacy of the FC TL method and evaluate students' perception of FC among underachieving first-year medical students in learning physiology. Methods This prospective, descriptive, and cross-sectional study was conducted on 100 underachieving first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students in the Department of Physiology at a tertiary care teaching hospital. All the participants were taught cardiovascular physiology through the FC method. The study subjects were asked to take a pretest including multiple choice questions a week before the study. The study period was four weeks, following which the students were asked to take a post-test. A questionnaire was used to understand the student's perception of FC. The responses to the questionnaire were graded based on the Likert scale.  Results The mean scores of the post-test (19.40±4.22) were significantly (p< 0.05) greater than those of the pre-test (12.43±4.26). Regarding the perception of FC, 68% (68/100) of students agreed that the objectives, methodology, and outcomes were well-defined. Around 39% (39/100) of students strongly agreed that the study material was adequate, relevant, and easy to learn. Nearly 58% (58/100) of the students agreed that the competencies are dealt with completely in every session. Roughly 16% (16/100) of students agreed that the classroom time is sufficiently utilized for peer-based learning. Many (61%, 61/100) students agreed that sufficient time was given for learning. About 34% (34/100) of the students strongly agreed that the assessment tools were relevant. About 56% (56/100) of students agreed and 21% (21/100) strongly agreed that the FC method helped them to improve their understanding of the subject. More than half (54%, 54/100) of the students agreed and 18% (18/100) strongly agreed that the FC promoted self-directed learning. Most students (71%, 71/100) believed FC to be an interesting and satisfactory learning experience. Conclusions The results indicate that most students believed FC was an effective and innovative TL technique. The FC method could help underachievers improve their cognitive skills and analytical thinking and enhance exam performance.

Revision of a pharmacy teaching and learning curriculum to address resident, programmatic, and accreditation demands.

PROBLEM DESCRIPTION: Without externally validated tools to assess teaching and learning curriculum (TLC) programs, our program has undertaken continuous quality improvement (CQI) methods to make revisions in response to resident, programmatic, and accreditation demands. QUALITY IMPROVEMENT METHODS: Key stakeholders, including the college of pharmacy, the residents, and the executive committee, were engaged in discussion and feedback was solicited. RESULTS OF CQI INQUIRY: The demands identified prompted revision of the TLC teaching component, programming, and timeline. Major changes have included adding an application for the teaching track, limiting teaching track participation, altering the seminar format (to a mix of in person, virtual, and asynchronous), and starting the program earlier in the calendar year. Key stakeholders supported the proposed revisions. INTERPRETATION AND DISCUSSION: The CQI method summarized here worked well for the TLC. Although simplistic in nature, it met the needs of the TLC and engaged several stakeholders. No major challenges were encountered during the process and stakeholders were amenable to the process and proposed revisions. Given the lack of externally validated tools for assessing TLC programs, any TLC program could perform a similar CQI method to assist with revisions. CONCLUSION: Continuous quality improvement of the TLC to address resident, programmatic, and accreditation demands has been vital to optimize and sustain the program. Assessment will be ongoing as future revisions are made.

"We are actually being involved in management of the patient": A qualitative exploration of experiences of students and faculty regarding the use of clinical simulation in Busitema University and Lira University.

Introduction: Experiences regarding the use of simulation in low-resource settings like Uganda where it has not taken root have not been explored. The purpose of the study was to explore the experiences of students, clinical staff, and faculty regarding the use of clinical simulation in teaching undergraduate students. Materials and methods: The study was conducted at Busitema and Lira Universities in Uganda. We conducted 20 in-depth interviews with the faculty staff and 10 focused group discussions with undergraduate Nursing, Midwifery, Medical and Anesthesia students. The study obtained ethical clearance from the Busitema University Research and Ethics Committee (BUFHS-2023-78) and Uganda National Council of Science and Technology (HS3027ES). Thematic analysis was used to analyze the data. Results: Four themes emerged from the data. Simulation was seen to be about improvising and (return) demonstration. Concerns of realism were expressed including notions that simulation was not real, that simulation felt real and the extreme end that simulation tends to present the ideal setting. Perceived benefits of simulation include room for mistakes and immediate feedback, enhanced confidence and self-efficacy, enhanced acquisition of soft and clinical skills, prepares students for clinical placement, convenient and accessible. Concerns were expressed related to whether skills in clinical simulation would translate to clinical competence in the clinical setting. Conclusion: Students perceived simulation to be beneficial. However, concerns about realism and transferability of skills to clinical settings were noted. Clarifying preconceived notions against the use of clinical simulation will enhance its utilization in educational settings where simulation is not readily embraced.

Contemporary educational methods in periodontology.

AIM: The 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology (Education in Periodontology in Europe) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID-19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face-to-face (F2F) teaching and the move to student-centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels. MATERIALS AND METHODS: Systematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated. RESULTS: The pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student-centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms. CONCLUSIONS: Live F2F teaching continues to be highly trusted; however, all types of student-centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.

In experts' words: Translating theory to practice for teaching self-regulated learning.

INTRODUCTION: Health professions education (HPE) should help students to competently self-regulate their learning, preparing them for future challenges. This study explored the perspectives of expert self-regulated learning (SRL) researchers and practitioners on the practical integration of SRL theories into teaching. METHODS: An exploratory qualitative research study was conducted involving semi-structured interviews with acknowledged research leaders in the field of SRL and/or experienced professionals dedicated to teaching SRL strategies for complex skills in different disciplines. The data were analyzed using an iterative thematic approach guided by a six-step framework. RESULTS: Fifteen interviews were conducted with experts from six countries representing diverse contexts, cultures, and disciplines. We identified five themes related to translating theory to practice for teaching SRL in HPE: theoretical issues, cultural aspects, stakeholders' participation, teaching complexity, assessment, and feedback. CONCLUSIONS: This study presents a useful starting point for teaching SRL. The experts suggest a supportive learning environment with the guidance of competent teachers by using general and task-specific teaching and learning strategies, as well as sufficient sources and cycles of feedback, all tailored to the culture and context. These findings call for a shift in faculty development programs to foster teachers to support second-order scaffolding in HPE.

Learning to teach at a norm-critical clinical learning centre: A Phenomenographic study.

BACKGROUND: Campus-based clinical learning centres are used for practice and learning in nursing students' education and can be arenas in which to enhance students' awareness and competence in social justice issues. Norm-critical approaches can be used as pedagogical tools in these centres to prepare students for hands-on caring situations in which social norms can bias the outcome. OBJECTIVES: To describe nursing teachers' conceptions of learning norm-critical approaches and implementing them in a clinical training centre. SETTING AND PARTICIPANTS: The study is based on interviews with 10 teachers at a Swedish university college. METHODS: The data was analysed using a phenomenographic approach. RESULTS: Five categories of description emerged in the analysis that described conceptions related to norm-critical approaches. These categories were: personally developing and meaningful; easily integrated with established nursing concepts; highlighting surrounding power; something to lean on when letting students take the first steps in norm-critical initiatives; and helping implementation in teaching and education. CONCLUSIONS: Teachers who are facing the task of providing norm-critical, practical education to nursing students in campus-based clinical learning environments are ambivalent towards the core principles of norm criticism, which they conceive as natural and provoking, at the same time. We therefore need to un-dramatise norm criticism and better prepare teachers in how to use it. Teachers would benefit from follow-up activities and formal collaborations regarding norm-critical teaching, so that they are given context to discuss, reflect, and learn from each other.

Application of Classroom Assessment Techniques in Medical Education: Results From the Community Medicine Teaching and Learning Experience.

Introduction Efficient delivery of medical education (ME) is crucial to improving the standards of future physicians or clinicians. India has been experiencing an enormous increase in medical colleges and student admissions into medicine. This has resulted in overcrowding and compromised the student-to-teacher ratio. Conversely, students and teachers face difficulties with learning and teaching, respectively. Classroom assessment techniques (CATs) offer an egalitarian and productive approach to student learning and evaluation. This study was conducted to understand the role of CATs in improving student learning and motivation during community medicine lectures. Further, this study assessed the classroom teaching and learning (TL) process. Method This study included 100 third-year medical students pursuing a Bachelor of Medicine and Bachelor of Surgery (MBBS) and 12 faculty members working at Great Eastern Medical School and Hospital (GEMS&H), Srikakulam, India. To facilitate learning and boost motivation, this study applied three CATs including a one-minute paper (OMP), muddiest point (MP), and student-generated test questions (SGTQs). After two months of applying CATs, the teachers and students were asked for feedback on their experiences. The data generated from feedback forms were tabulated and analyzed. Results According to 76% (76/100) of students, these strategies have stimulated their interest in learning community medicine. Besides, 64% (64/100) of students believed utilizing these strategies would improve their exam outcomes. Further, 77% (77/100) of students believed these methods must be applied in subsequent lessons. About 68% (68/100) of students thought other subject teachers should also employ these strategies. Of the 12 faculty members included in the study, they mostly liked the OMP (5; 41.66%) and MP technique (5; 41.66%). Conclusions Teachers and students have highly welcomed the utility of CATs to improve learning in community medicine. Of the three CATs applied, the OMP was the most popular with students, and teachers agreed that using OMP in the classroom along with MP would be beneficial. Most students and teachers were enthusiastic about employing additional TL strategies like CATs.

Effectiveness of Simulation-Based Training of Undergraduate Medical Students Regarding the Management of Eclampsia: A Randomized Controlled Educational Trial.

Introduction Obstetric emergencies, like eclampsia, need a quick and accurate response from the treating physician coming into first contact with the patient. Therefore, all doctors, even primary care physicians, interns, and resident doctors, need training to handle such cases proficiently, leaving minimal chances of error. Providing training for the management of these critical conditions on actual patients is not practically feasible. Clinical simulation in obstetrics can be used for the improvement of these skills for undergraduate and postgraduate students. We conducted a non-blinded randomized controlled trial with the primary aim of developing and implementing a module for training undergraduate medical students on the assessment and management of eclampsia and to evaluate and compare it with traditional didactic lectures or case-based learning. Methods The present randomized controlled educational trial was conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India. The undergraduate medical students (Phase 3, Part 1) posted in the department during their clinical postings or tutorials were randomized into two groups. A total of 62 students were randomly divided into two groups, Group A and Group B, each consisting of 31 students. However, only 24/31 (77.42%) in Group A and 19/31 (61.3%) in Group B finally agreed to participate in the study. One group (Group A, with 24 participants) was taught the diagnosis and management of antepartum eclampsia through simulation-based training, and the other group (Group B, with 19 participants) was taught the same topic through conventional teaching, which consisted of didactic lectures through PowerPoint presentations and case-based discussion. Learning objectives were kept identical for both groups. Pre- and post-test scores were compared for both groups. Results The mean pre-test score of the simulation group was 6.13 ± 1.39, and that of the conventional teaching group was 6.05 ± 1.54. The post-test score of the simulation group was 9.17 ± 1.34, and that of the conventional teaching group was 7.37 ± 1.70. The simulation group showed an extremely significant (two-tailed p < 0.0001) improvement in their post-test scores when compared to their scores before the module was taught. The difference in the scores of simulated teaching (Group A) and conventional teaching (Group B) was also statistically significant (p = 0.005). Simulation-based learning was found to be more interactive, helpful in providing real-life-like experiences, led to better retention and understanding, and motivated the students for self-directed learning. Conclusion Although both conventional and simulation-based teaching were useful, simulation-based training was more effective in teaching undergraduate medical students regarding the diagnosis and management of eclampsia. Simulation-based learning is more interactive, provides real-life-like experiences, leads to better retention and understanding, and motivates the students for self-directed learning.

Assessing satisfaction in simulation among nursing students: psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale.

BACKGROUND: The Satisfaction with Simulation Experience scale is a 5-point Likert scale that measures students' satisfaction in medium and high-fidelity simulation scenarios. This study aims at investigating the psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale. METHODS: A multi-centre cross-sectional study was conducted. The scale was administered to a sample of 266 undergraduate nursing students from two Italian universities after attending a medium- and high-fidelity simulation session in November 2022 and March 2023. Cronbach's alpha coefficient and item-total correlation were sorted out to assess internal consistency and reliability. The test-retest method was used as a measure of scale stability over time as well as the confirmatory factor analysis to verify construct validity. RESULTS: The Cronbach's alpha value was 0.94 for the overall scale, indicating excellent reliability, and it was 0.84 or higher for each subscales, indicating good reliability. A large correlation coefficient of 0.60 or higher was found between each item and its subscale and between each item and the overall scale score. A medium test-retest correlation coefficient was found for most items (r > 0.30). The confirmatory factor analysis confirmed the factorial structure found in the original study. CONCLUSIONS: Satisfaction is an important teaching and learning quality indicator along with the achievement of learning outcomes in simulation. The Satisfaction with Simulation Experience - Italian Version scale showed good reliability and validity; therefore, it could be a useful tool to assess simulation impact in Italian nursing students. The extensive utilization of the Satisfaction with Simulation Experience scale, along with its various validated versions, could facilitate assessing satisfaction in simulation across diverse contexts and enable comparisons of findings across studies in different countries.

Teaching and learning in biophotonics: Crossing the bridge between educators and students.

As a rapidly growing field, biophotonics demonstrates an increasingly higher demand for interdisciplinary professionals and requires the implementation of a structured approach to educational and outreach activities focused on appropriate curriculum, and teaching and learning for audiences with diverse technical backgrounds and learning styles. Our study shows the main findings upon applying this approach to biophotonics workshops delivered 2 consecutive years while updating and improving learning outcomes, teaching strategies, workshop content based on student and teacher feedback. We provided resources for a variety of lecture-based, experimental, computer simulation activities. Quality of subject matter, teaching, and overall learning was rated as "Very good" or "Good" by 88%, 76%, and 82% of students in average, respectively. Application of our teaching strategies and materials during short- and long-term workshops/courses could potentially increase the interest in pursuing careers in the biophotonics field and related areas, leading to standardized approaches in designing education and outreach events across centers.

Developing a framework for promoting interest and engagement of scholarship of teaching and learning for medical students.

BACKGROUND: The scholarship of teaching and learning (SoTL) is a field of academic research that focuses on improving learning through reflective and informed teaching. Currently, most SoTL-related work is faculty-driven; however, student involvement in SoTL has been shown to benefit both learners and educators. Our study aims to develop a framework for increasing medical students' interest, confidence, and engagement in SoTL. METHODS: A student-led SoTL interest group was developed and a year-round program of SoTL was designed and delivered by student leaders of the group under the guidance of a faculty advisor. Individual post-session surveys were administered to evaluate participants' perceptions of each session. Pre- and post-program surveys were administered to evaluate the program impact. RESULTS: The year-round SoTL program consistently attracted the participation of medical students and faculty. Survey responses indicated strong medical student interest in the program and positive impact of the program. Increased interest and confidence in medical education research were reported by the student participants. The program design provided opportunities for student participants to network and receive ongoing feedback about medical education research they were interested or involved in. CONCLUSION: Our study provides insights for developing a framework that other institutions can reference and build upon to educate and engage students in SoTL.

Learning to produce and transcribe cardinal vowels: speech and language therapy students' perception of task difficulty.

Learning vowel transcription skills is crucial to function as a Speech and Language Therapist (SLT). However, vowel transcription is commonly regarded as particularly difficult and therefore often avoided. Despite the importance of accurate transcriptions, little is known about all the factors that influence the process of learning vowel transcription, which usually includes the learning of the Cardinal Vowel (CV) system. There are only a few studies that investigate how CVs are learnt and what factors lead to successful learning. The current study reports students' perceived difficulty of producing and transcribing CVs as a first step to identify how perceived difficulty affects phonetic learning. Perceived difficulty ratings for the production and transcription of 12 CVs collected from 155 students studying towards a qualification as an SLT were analysed. The results show that the classificatory features correlate with the perceived task difficulty of production and transcription. Implications for teaching are outlined.

Implementation and Impact of an Adapted Digital Perioperative Competency-Building Tool to Enhance Teaching, Learning And Feedback in Postgraduate Competency-Based Medical Education.

OBJECTIVES: The purpose of this educational intervention was to introduce, iteratively adapt, and implement a digital formative assessment tool in a surgical speciality. The study also evaluated the intervention's impact on perioperative teaching, learning, feedback, and surgical competency. DESIGN: A participatory action research model with a mixed methods approach. SETTING: This study was performed over 10 months in an institutional hospital in South Africa with a general surgery department. PARTICIPANTS: Twelve supervising surgical trainers/faculty and 12 surgical trainees/residents consented to participate in the intervention. RESULTS: The first 4 months of the intervention focused on relationship building, a multi-stakeholder contextual needs assessment and training sessions to support a shared mindset and shift in the teaching and learning culture. The final adapted perioperative competency-building tool comprised a 23-item assessment with four open-text answers (Table 1). Over the following 6-month period, 48 workplace-based competency-building perioperative evaluations were completed. Most trainees took less than 5 minutes to self-assess (67%) before most trainers (67%) took less than 5 minutes to give oral feedback to the trainee after the perioperative supervised learning encounter. On average, the digital tool took 6 minutes to complete during the bidirectional perioperative teaching and learning encounter with no negative impact on the operational flow. All trainers and trainees reported the training and implementation of the digital tool to be beneficial to teaching, learning, feedback, and the development of surgical competency. Analysis of the completed tools revealed several trainees showing evidence of progression in surgical competency for index procedures within the speciality. The focus groups and interviews also showed a change in the teaching and learning culture: more positively framed, frequent, structured, and specific feedback, improved accountability, and trainee-trainer perioperative readiness for teaching. Highlighted changes included the usefulness of trainee self-assessment before perioperative trainer feedback and the tool's value in improving competency to Kirkpatrick Level 4. CONCLUSION: Implementing an adapted digital Workplace-Based Assessment (WBA) tool using a participatory action research model has proven successful in enhancing the effectiveness of supervised perioperative teaching and learning encounters. This approach has improved teaching and feedback practices, facilitated the development of surgical competency, and ultimately impacted the overall culture to Kirkpatrick level 4. Importantly, it has positively influenced the trainee-trainer relationship dynamic. Based on these positive outcomes, we recommend using this effective method and our relationship-centred framework for implementing formative competency-building tools in future studies. By doing so, larger-scale and successful implementation of Competency-Based Medical Education (CBME) could be achieved in various contexts. This approach can potentially enhance teaching and learning encounters, promote competency development, and improve the overall educational experience for surgical trainees and trainers.

Twelve tips for maximizing the potential of reflective writing in medical education.

Reflective writing (RW) is a popular tool in medical education, but it is being used in ways that fail to maximize its potential. Literature in the field focuses on why RW is used - that is to develop, assess, and remediate learner competencies - but less so on how to use it effectively. The emerging literature on how to integrate RW in medical education is haphazard, scattered and, at times, reductionist. We need a synthesis to translate this literature into cohesive strategies for medical educators using RW in a variety of contexts. These 12 tips offer guidelines for the principles and practices of using RW in medical education. This synthesis aims to support more strategic and meaningful integration of RW in medical education.

Photovoice: An active learning tool with community nursing students.

OBJECTIVE: To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community. METHODS: A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data. RESULTS: Seventy eight percent of the students felt that photovoice was an interesting and useful tool for nurses, 89% affirmed it helped stimulate reflection on social and health inequities in times of pandemic, 82% described that it developed many emotions and feelings and 86% would like to disseminate their photographs directly to stakeholders, citizens, and politicians. Three themes were identified in the data: "stimulate critical reflection", "develop emotional skills", and "encourage action". CONCLUSIONS: Photovoice is a successful active learning pedagogical approach that engages nursing students to develop critical awareness while connecting with their communities, with the real world. It fosters students' sensitivity and motivation and encourages them to take action. Teachers need to introduce new scaffolds for active learning, such as photovoice, to provide innovative academic support that nurtures and develops the next generation of nurses appropriately.

Do we teach critical thinking? A mixed methods study of faculty and student perceptions of teaching and learning critical thinking at three professional schools.

INTRODUCTION: Critical thinking (CT) is an essential set of skills and dispositions for professionals. While viewed as an important part of professional education, approaches to teaching and assessing critical thinking have been siloed within disciplines and there are limited data on whether student perceptions of learning align with faculty perceptions of teaching. MATERIALS AND METHODS: The authors used a convergent mixed methods approach in required core courses in schools of education, government, and medicine at one university in the Northeast United States. Faculty surveys and student focus groups (FG) addressed definitions, strategies, and barriers to teaching CT. RESULTS AND CONCLUSIONS: Sixty-four (51.6%) faculty completed the survey, and 34 students participated in FGs. Among faculty, 54.0% (34/63) reported explicitly teaching CT; but students suggested teaching CT was predominantly implicit. Faculty-reported strategies differed among schools. Faculty defined CT in process terms such as 'analyzing'; students defined CT in terms of viewpoints and biases. Our results reveal a lack of explicit, shared CT mental models between faculty and students and across professional schools. Explicit teaching of CT may help develop a shared language and lead to better understanding and application of the skills and dispositions necessary to succeed in professional life.

Use of OneNote class notebook as a combined electronic laboratory notebook and content delivery tool in an introductory biochemistry laboratory course.

The COVID-19 pandemic has forced a shift in thinking regarding the safe delivery of wet laboratory courses. While we were fortunate to have the capacity to continue delivering wet laboratory experiments with physical distancing and other measures in place, modifications to the mechanisms of delivery within courses were necessary to minimize risk to students and teaching staff. One such modification was introduced in BCH370H, an introductory biochemistry laboratory course, where a OneNote Class Notebook (ONCN) was used as an electronic laboratory notebook (ELN) in place of the traditional hardbound paper laboratory notebook (PLN) used prior to the pandemic. The initial reasoning for switching to an ELN was around safety-allowing course staff and students to maintain physical distancing whenever possible and eliminating the need for teaching assistants to handle student notebooks; however, the benefits of the ONCN proved to be significantly more. OneNote acted not only as a place for students to record notes but the Class Notebook's unique features allowed easy integration of other important aspects of the course, including delivery of laboratory manuals, posting of student results, notetaking feedback, sharing of instructional materials with teaching assistants, and more. Student and teacher experiences with the ONCN as used within a fully in person biochemistry laboratory course, as well as learned best practices, are reviewed.

Picture book reading improves children's learning understanding.

Mental state reasoning is an integral part of children's teaching and learning understanding. This study investigated whether a picture book reading approach focusing on mental state discourse and contrasting perspectives in a preschool classroom setting would improve children's teaching and learning understanding and school readiness. In total, 104 children from four classrooms aged between 46 and 64 months (53 girls, M = 54.03 months, SD = 3.68) participated in the study. Half of the classrooms were randomly assigned to an experimental group where teachers read picture books rich in mental state discourse and engaged in intensive discussions with children for eight weeks. Children's false belief understanding and teaching and learning understanding were measured before and after the eight-week period. The result revealed that picture book reading improved children's learning understanding with a medium effect size, controlling for demographic variables, children's verbal ability, inhibition, and initial false belief understanding. The experimental group children further demonstrated more advanced school readiness 18 months after the intervention ended in a follow-up study using a teacher questionnaire.