Convergent validity between the school-age versions of the Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2): A pilot study.

INTRODUCTION: The Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2) are two sensory processing scales often used by occupational therapists. The SPM2 and SP2 both claim to assess aspects of children's sensory processing. This cross-sectional study examined the convergent validity of the SPM2-Home Form (SPM2-HF) and Child SP2 for school-aged neurotypical children. METHODS: Thirty parents/caregivers of neurotypical children aged 7 to 12 completed the SPM2-HF and the Child SP2 about their child. Spearman rho's correlation coefficient with bootstrapping was used to investigate the correlations among the sensory, behavioural, and quadrant scores of the Child SP2 and SPM2-HF subscale scores. CONSUMER AND COMMUNITY INVOLVEMENT: Given the topic, consumers and community members were not involved in the design, execution, or write up of the study results. RESULTS: Several statistically significant correlations were found between the sensory and quadrant subscales of the Child SP2 with the SPM-HF. Strong to moderate correlations were established between the sensory subscales of the Child SP2 and the SPM2-HF, ranging from 0.40 to 0.74 (p < 0.05). Additionally, correlations between the quadrant subscales of the Child SP2 and the subscales of the SPM2-HF ranged from weak (0.38) to strong (0.77) correlations (p < 0.05). CONCLUSION: These results provide evidence of convergent validity between the SPM2-HF and Child SP2 for neurotypical school-aged children. Further research on the psychometric properties of the SPM2-HF and Child SP2 is recommended.

Convergent validity of two adult self-report sensory scales: Comparing the Adolescent/Adult Sensory Profile and the Sensory Processing Measure 2-Adult Form.

INTRODUCTION: Occupational therapists use standardised scales and measures to assess an individual's sensory processing factors. To date, few studies have investigated the correlations between the Adolescent/Adult Sensory Profile (A/ASP) and the Sensory Processing Measure 2-Adult Form (SPM-2-Adult). The aim of the project is to investigate the association between the sensory processing factors measured by the A/ASP and SPM-2-Adult when completed by the same group of adult participants, with an additional research question investigating whether any significant differences existed between sensory processing scores based on participants' self-reported gender identity. METHODS: Forty-two adults aged 18-30 completed the A/ASP and the SPM-2-Adult. Associations between the A/ASP quadrant and the SPM-2-Adult subscales were examined using Spearman's rho correlation coefficients, and differences between participants based on their self-reported gender identity were investigated using Mann-Whitney U tests. RESULTS: Statistically significant correlations were obtained between the A/ASP Low Registration, Sensory Sensitivity, and Sensation Avoiding quadrant subscales and all nine of the SPM-2-Adult subscales ranging from weak (rho = 0.342, p < 0.027) to strong (rho = 0.790, p < 0.001) correlations. The A/ASP Sensation Seeking quadrant subscale was only significantly correlated with the SPM-2-Adult Social Participation subscale (rho = -0.416, p = 0.006). Three subscales had statistically significant differences based on gender identity: SPM-2-Adult Vision (p = 0.007), SPM-2-Adult Sensory Total (p = 0.048), and A/ASP Sensory Sensitivity (p = 0.043). CONSUMER AND COMMUNITY INVOLVEMENT: Consumers and community members were not involved in the design, execution, or write-up of the study results. CONCLUSION: The A/ASP and the SPM-2-Adult had several subscales that were significantly correlated with one another. Of note, significant associations were achieved between the A/ASP Low Registration, Sensory Sensitivity, and Sensation Avoiding quadrant subscales and all nine of the SPM-2-Adult subscales. These findings make a significant preliminary contribution to the psychometric body of evidence related to the sensory processing assessment of adults.

Scar massage as an intervention for post-surgical scars: A practice survey of Australian hand therapists.

Introduction: Scar massage is a commonly used treatment in hand therapy. The current empirical evidence that supports it is disparate and of variable quality, with no established effective dosage and method proposed. This study aimed to identify the current practice among Australian hand therapists using massage as an intervention for scarring following surgery to the hand and upper limb. Methods: A purposely designed self-report online survey was emailed to current members of the Australian Hand Therapy Association (n = 958). Data collected included demographics, intervention techniques, conditions treated and protocols, scar assessment and knowledge and training about scar massage as a clinical intervention. Results: A total of 116 completed questionnaires were received (a response rate of 12.1%). All respondents used scar massage as part of their clinical practice with 98% to improve soft tissue glide (n = 114), 92% for hypersensitivity (n = 107), and 84% to increase hand function (n = 97). Only 18% (n = 21) of respondents used standardised outcome measures, and most therapists had learned scar massage from a colleague (81%). Conclusions: Commonalities in how respondents implemented scar massage were found. Participants reported relying primarily on clinical experience to inform their practice. Whilst scar massage was widely used, few respondents had received formal skills training or completed outcome measures regularly to formally evaluate its clinical efficacy or impact. Replication of this study with a larger international sample of participants is warranted to determine if these findings reflect general practice.

Evaluation of Peracetic Acid Treatment on Beef Trimmings and Subprimals Against Salmonella and E. Coli O157:H7 Within Regulatory Retained Water Limitations.

The application of antimicrobial treatments to beef trimmings prior to grinding for the reduction of microbial contamination in ground beef has increased recently. However, raw single-ingredient meat products are not permitted by Food Safety and Inspection Services (FSIS) to retain more than 0.49% water resulting from postevisceration processing. The effectiveness of antimicrobials with the limited water retention is not well documented. The objective of this study was to determine the effectiveness of peracetic acid at varied concentrations against E. coli O157:H7 and Salmonella on the surface of beef trimmings and beef subprimals that was applied at industry operating parameters within the retained water requirement. One hundred and forty-four each of beef trimmings and subprimals were used to evaluate the effect of different concentrations of peracetic acid solution on reducing E. coli O157:H7 and Salmonella on surfaces of fresh beef within the FSIS requirement of ≤0.49% retained water from antimicrobial spray treatments using a conveyor system. A ten-strain cocktail mixture was inoculated on surfaces of fresh beef and subjected to water or four different concentrations of peracetic acid (130, 150, 200, and 400 ppm). Spray treatments with 130, 150, and 200 ppm peracetic acid reduced (P ≤ 0.05) E. coli O157:H7 and Salmonella at least 0.2 log on surfaces of beef trimmings and subprimals. Spray treatment with 400 ppm peracetic acid resulted in approximately 0.5 and 0.3 log reduction of E. coli O157:H7 and Salmonella, respectively. Results indicate that all concentrations (130-400 ppm) of peracetic acid significantly reduced E. coli O157:H7 and Salmonella on beef trimmings and subprimals compared to untreated controls. Thus, a range from 130 to 400 ppm of peracetic acid can be used during beef processing to improve the safety of beef trimmings and subprimals when weight gain is limited to ≤0.49% to meet regulatory requirements.

The Need for Occupational Therapy Evidence-Based Education.

Knowledge of evidence-based-education principles is essential for occupational therapy academics and fieldwork supervisors to ensure the teaching and learning methods and strategies being used are informed, targeted, cost effective, contemporary, and worthwhile. This paper defines evidence-based-education is and how it can be applied in the context of occupational therapy student academic and fieldwork education. The factors that impact occupational therapy evidence-based education in the university sector are introduced which have the potential to ensure that students obtain a quality, meaningful, value-for-money, and high impact education in both academic and fieldwork environments. It is recommended that university faculty and fieldwork supervisors use, create, support, and disseminate evidence-based-education related findings with continued debate and investigation are recommended.

The Sensory Processing Measure - Second Edition: A Critical Review and Appraisal.

This paper aims to provide an overview and critique of the newly updated Sensory Processing Measure - second edition (SPM-2) to assist clinicians in understanding its strengths and limitations and in selecting an appropriate sensory processing scale that best meets their clients' needs. Using four established research methodological quality critique tools, the SPM-2's family of age-related versions was evaluated by administering the tools separately and discussed their scoring and findings to reach a consensus on all ratings. The tools identified several strengths and weaknesses of the SPM-2. The SPM-2's items on its age-related versions scored well in the criteria of internal consistency, test-retest reliability, explanation of the instrument design, construct validity, content validity, criterion validity and ease of administration, and scoring. However, a lack of normative data for participant groups outside of the United States, methodological limitations, and a lack of investigation into some important psychometric properties, particularly responsiveness, were identified as notable weaknesses of the SPM-2's items on its age-related versions based on the critique criteria. Overall, despite the areas needing further development and investigation, the SPM-2 is considered a psychometrically sound tool that provides a reliable and valid approach to measuring aspects of the sensory processing construct across the lifespan.

Measuring what matters in healthcare: a practical guide to psychometric principles and instrument development.

The provision of quality healthcare relies on scales and measures with robust evidence of their psychometric properties. Using measurement instruments with poor reliability, validity, or feasibility, or those that are not appropriate for the target diagnostic group or construct/dimension under consideration, may be unfavorable for patients, unproductive, and hinder empirical advancement. Resources from the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) group can assist in identifying and developing psychometrically sound measures. The COSMIN initiative is the only international, research-based practice taxonomy and methodological guidelines for measurement in healthcare. This manuscript aims to provide an accessible introduction to theories, principles and practices of psychometrics, instrument properties, and scale development, with applied examples from the COSMIN recommendations. It describes why measurement in healthcare is critical to good practice, explains the concepts of the latent variable and hypothetical construct and their importance in healthcare assessments, explores issues of flawed measurement and briefly explains key theories relevant to psychometrics. The paper also outlines a ten-step process to develop and validate a new measurement instrument, with examples drawn from a recently developed visuoperceptual measure for analysis of disordered swallowing to demonstrate key concepts and provides a guide for understanding properties of and terminology related to measurement instruments. This manuscript serves as a resource for healthcare clinicians, educators, and researchers who seek to develop and validate new measurement instruments or improve the properties of existing ones. It highlights the importance of using psychometrically sound measurement instruments to ensure high-quality healthcare assessments.

Insight and Recommendations for Fragile X-Premutation-Associated Conditions from the Fifth International Conference on FMR1 Premutation.

The premutation of the fragile X messenger ribonucleoprotein 1 (FMR1) gene is characterized by an expansion of the CGG trinucleotide repeats (55 to 200 CGGs) in the 5' untranslated region and increased levels of FMR1 mRNA. Molecular mechanisms leading to fragile X-premutation-associated conditions (FXPAC) include cotranscriptional R-loop formations, FMR1 mRNA toxicity through both RNA gelation into nuclear foci and sequestration of various CGG-repeat-binding proteins, and the repeat-associated non-AUG (RAN)-initiated translation of potentially toxic proteins. Such molecular mechanisms contribute to subsequent consequences, including mitochondrial dysfunction and neuronal death. Clinically, premutation carriers may exhibit a wide range of symptoms and phenotypes. Any of the problems associated with the premutation can appropriately be called FXPAC. Fragile X-associated tremor/ataxia syndrome (FXTAS), fragile X-associated primary ovarian insufficiency (FXPOI), and fragile X-associated neuropsychiatric disorders (FXAND) can fall under FXPAC. Understanding the molecular and clinical aspects of the premutation of the FMR1 gene is crucial for the accurate diagnosis, genetic counseling, and appropriate management of affected individuals and families. This paper summarizes all the known problems associated with the premutation and documents the presentations and discussions that occurred at the International Premutation Conference, which took place in New Zealand in 2023.

Ready-to-Eat Egg Products Formulated with Nisin and Organic Acids to Control Listeria monocytogenes.

Formulating ready-to-eat (RTE) products with growth inhibitors minimizes the risk of listeriosis. In part I, RTE egg products formulated with 6.25 ppm nisin were evaluated to control Listeria monocytogenes. Individual experimental units were surface inoculated with 2.5-log CFU/g of L. monocytogenes, packaged in pouches with a headspace gas of 20:80 CO2:NO2, and stored at 4.4°C for 8 weeks. Formulations with finished product pH of 6.29 ± 0.07 limited growth to <2-log for 4 weeks. Products at pH values of 7.42 ± 0.12 and 7.84 ± 0.11 were not different (p > 0.05) from the control without nisin at pH 7.34 ± 0.13, all supported 4-log growth by 4 weeks. In part II, a nisin bioassay test was performed to evaluate the stability of nisin in eggs as affected by the product pH (6.00 ± 0.03, 7.00 ± 0.00, 7.50 ± 0.03, and 8.00 ± 0.02) and cooking to an internal temperature of 73.9 or 85°C for 90 s. The nisin activity loss increased as the product pH or the cooking temperature increased (p < 0.05). Part III evaluated the effectiveness of 6.25 ppm nisin in combination with either an acetate-based antimicrobial used at 1.0% (w/w) in egg formulation (A1.0), propionate at 0.3% (P0.3), acetate-diacetate at 1.0% (AD1.0), acetate-diacetate at 0.6% (AD0.6), and lactate at 2.0% (L2.0) as a positive control. These formulations had a finished product pH, moisture, and salt contents of 5.97 ± 0.21, 72.4 ± 0.9%, and 0.67 ± 0.05%, respectively. L. monocytogenes did not grow in formulations A1.0 and AD1.0, whereas L2.0 and P0.3 supported 2-log growth by weeks 6 and 15, respectively and AD0.6 supported <1-log growth over 20 weeks at 4.4°C. Evaluation of uninoculated control units in parts I and III showed no changes (p > 0.05) in the CO2 and O2 headspace gas composition, generally no detection or growth of background microbes, and no changes (p > 0.05) in the pH of the formulations during storage, all assuring absence of uncontrolled interferences for the growth of L. monocytogenes.

Efficacy of Short Thermal Treatment Time Against Escherichia coli O157:H7 and Salmonella on the Surface of Fresh Beef.

Thermal treatment interventions consistently provide effective pathogen reductions. However, the cost of maintaining high temperature of 95°C in order to raise the surface temperature of carcasses to 82°C is very expensive. Therefore, beef processors need to identify thermal application times and temperatures that optimize the treatment effects with less maintenance cost. The objectives of this study were to determine the efficacy of hot water or steam at 71°C for 6 s and cascade e-ion plasma treatment for 2 s in reducing pathogens on the surface of fresh beef compared to the thermal treatment at 82°C for 15 s. Hot water at 71°C for 6 s reduced Escherichia coli O157:H7 and Salmonella by 2.38 and 2.48 log CFU/cm2, while steam treatment at 71°C for 6 s reduced E. coli O157:H7 and Salmonella by 2.94 and 3.06 log CFU/cm2, respectively. Cascade e-ion plasma treatment for 2 s reduced E. coli O157:H7 on surface of fresh beef by 1.89 log CFU/cm2. The findings indicate that short treatment time with appropriate temperature could serve as an effective carcass intervention to improve the safety of fresh beef.

Determination of Verification Parameters for Using the Manual Sampling Device for Fresh Raw Beef Trim.

Multifaceted food safety systems are used by the beef processing industry to minimize risk of bacterial contamination of the finished product. These systems are comprised of several parts including the conditional release of product requiring a sample to produce a negative result on a pathogen test prior to sending the product into the food supply. The methods of sample collection require verification activities that ensure the sampling protocols are performed adequately. The research described herein was done to determine the parameters for use in verifying adequate beef trim sampling for the Manual Sampling Device (MSD) method. In addition, the efficacy of repeated sampling via multiple applications of the MSD procedure on a fresh raw beef trim combo was investigated. The results show that MSD sample collection thatcoversless than the entire combo surface, but at least one-halfof the combo surface and is collected for a minimum of 90 s, is adequate for the recovery of organisms and prevalence targets from fresh raw beef trim. In addition, the evidence that MSD sample collection thatoccurs forless than the recommended time, butnot less than 30 s per side of the swab, is adequate for the recovery of organisms and prevalence targets from raw beef trim. Finally, results show that in a scenario where an in-plant MSD sample and a regulatory MSD sample are required from the same combo, two MSD samples can be collected from the same combo bin with similar test results for both samples. While the recommended MSD protocol specifications will not be changed, the data presented herein provide support for some flexibility in accepting test results when verification activities indicate that sampling did not occur as specified in the recommended procedure.

An overview & critical review of the Sensory Profile - second edition.

BACKGROUND: The Sensory Profile-2 (SP-2) is the recently revised set of scales that provide information about a child's responses to different types of sensory stimuli. AIM: To examine the methodological quality and psychometric properties of the SP-2 using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) and Quality Criteria for Health Status Questionnaires (QCHSQ). MATERIALS AND METHODS: The methodological quality and psychometric properties for each of the SP-2 scales were examined by two assessors using the COSMIN and QCHSQ. RESULTS: The COSMIN revealed that the SP-2 demonstrated strengths in patient-related outcome measure design and internal consistency. However, hypothesis testing, cross-cultural validity and structural validity (construct validity) were notable shortcomings. The QCHSQ indicated the SP-2 has merits in its content validity and construct validity. The SP-2 manual reported insufficient evidence of its responsiveness, interpretability and criterion validity. CONCLUSION: Informed assessment selection is fundamental for evidence-based and quality occupational therapy practice provision. Overall, the SP-2 is considered to have adequate psychometric properties, however users should be mindful of the identified shortcomings. SIGNIFICANCE: The review and critique of the SP-2 adds to the body of knowledge about the revised instrument and provides an objective perspective about its strengths and weaknesses.

Exploring emotional and social competencies in undergraduate students: Perspectives from CALD and non-CALD students.

With the internationalisation of higher education, students from culturally and linguistically diverse (CALD) backgrounds represent a significant proportion of the university student body in Australia. Research literature indicates that the unique cultural and linguistic challenges experienced by these students may adversely impact their academic performance and social integration in university settings. However, less is known about how the socio-emotional competencies of undergraduate CALD and non-CALD domestic English-speaking students compare. This cross-sectional quantitative study compares the emotional and social competencies in a cohort of CALD and non-CALD occupational therapy undergraduates. Data were collected at one Australian university from a group of 360 students enrolled in the Bachelor of Occupational Therapy (Honours) course. Participants completed the Emotional and Social Competency Inventory- University edition (ESCI-U). Multivariate regression analyses were used to compare between CALD and non-CALD students, controlling for students' year level of study, age, and gender. Key findings from the regression analysis included the observation of indicate that non-CALD students having significant higher scores than CALD students on all the ESCI-U socio-emotional subscales, especially the Emotional Self-control, Achievement Orientation, Empathy and Teamwork from western perspectives. No difference was found between CALD and non-CALD student on two cognitive competencies- systems thinking and pattern recognition. These findings should be interpreted with caution considering CALD students may interpret the questions differently and demonstrate the competencies in different ways. Specific emotional and social competencies that need to be strengthened in students are discussed and recommendations are made to inform the preparation of evidence-based curricula.

Australian occupational therapy academic workforce: An examination of retention, work-engagement, and role overload issues.

BACKGROUND: The quality of the academic workforce is influenced by multi-level interactionist factors yet there is limited research into these influencing factors. AIM: To investigate relationships between individual characteristics of Australian occupational therapy academics and work-related variables. METHOD: An exploratory cross-sectional online survey collected demographic data and used standardized scales including the Turnover Intention Scale, 9-item Utrecht Work Engagement Scale, Work-Life Balance Scale, Role Overload Scale and Self-Defined Burnout Scale. Data were analysed using descriptive and inferential statistics. RESULTS: Academics who were more than five years in their current academic level were: significantly more likely to consider leaving their job; more often frustrated when not given opportunity to achieve their work-related goals; and less engaged. Those who had worked in higher education for longer than ten years were more likely to report role overload while participants working in higher education for less than five years were less likely to report burnout. CONCLUSIONS AND SIGNIFICANCE: To meet current and future demand for Australian occupational therapists, an engaged and supported academic workforce is needed. These findings suggest the need for attention to mentoring and career development particularly for those in academic levels longer than five years to increase work engagement and retention.

Does the self-reported playfulness of older adults influence their wellbeing? An exploratory study.

Aim: Older adults represent a growing demographic in Australia who are at an increased risk of isolation, loneliness, and experiencing poorer overall health. Thus, the need for understanding factors that influence older adults' wellbeing is important. Emergent research into adult playfulness has shown positive associations with indicators of wellbeing, but limited research has been conducted in older adults (60+). This study investigated whether types of playfulness present in Australian older adults (60+) were predictive of their wellbeing.Method: An online survey was administered (n = 123) using the Other-directed, Light-hearted, Intellectual, Whimsical (OLIW) Playfulness Scale and the PERMA-Profiler wellbeing measure to explore playfulness types and its influence on self-reported wellbeing. Multiple linear regression analysis with bootstrapping was completed to determine if any significant relationships between OLIW and PERMA-Profiler subscales existed.Results: Playfulness was a significant predictor of wellbeing. The OLIW Other-directed subscale (enjoyment of others, using playfulness in tense situations) was the greatest predictor of PERMA-Profiler subscales with OLIW Intellectual and Whimsical subscales making smaller contributions.Conclusion/implications: Playfulness was shown to be a significant contributor to wellbeing in older adults and should be used as a part of occupational therapy intervention, especially when considering social activities.

Children's Play-Work Occupation Continuum: Play-Based Occupational Therapy, Play Therapy and Playwork.

Introduction: Occupational therapists often use play-based approaches to facilitate children's occupational development and promote participation, for example, play-based occupational therapy, play therapy and playwork. However, where does play occupation fit, within these adult-guided play-based approaches in occupational therapy? Purpose: To examine and discuss the play-work occupation continuum of children to inform occupational therapy practice. Key Issues: Children's play occupations are free-selected, unstructured, internally-controlled, spontaneous and intrinsically-motivated. Yet, occupational therapists often utilize play as a therapeutic modality to support occupational development for occupations other than play. This use of play represents play-based work occupations as they are structured, externally-controlled, adult-guided, goal-focused and extrinsically-motivated. Play occupations then move from being authentic free-play to adult-guided play-based work occupations for children. Implications: When working with children and families, occupational therapists need to balance the use of self-selected, unstructured play occupations with the application of adult-guided, structured, goal-focused play-based work occupations.

Predictors of undergraduate occupational therapy students' academic performance during the Covid-19 pandemic: A hierarchical regression analysis.

BACKGROUND: The rapid switch to online learning in response to the Covid-19 pandemic affected occupational therapy students' education delivery. It is, therefore, important to investigate these impacts. AIMS/OBJECTIVES: This study investigated the potential predictors of academic performance in undergraduate occupational therapy students after moving to online or blended learning post-Covid-19. MATERIAL AND METHODS: A total of 208 students from three Australian universities completed a demographic questionnaire and the Distance Education Learning Environment Scale (DELES). Hierarchical linear regression analyses were completed to identify significant students' academic performance predictors. RESULTS: Hierarchical regression explained a cumulative total variance of 24.6% of students' academic performance. The following independent variables were significant predictors: DELES student autonomy (p = 0.033), number of hours per semester week dedicated to indirect online study (p = 0.003), number of hours per semester week dedicated to indirect offline study time (p = 0.034), gender (p = 0.005) and English as a first language (p = 0.045). CONCLUSIONS: The findings add to the knowledge base on the range of factors that have impacted occupational therapy students' academic performance during the Covid-19 pandemic. SIGNIFICANCE: The outcomes will assist faculty in developing supportive and pedagogically sound learning modes across online, hybrid and traditional forms of instruction within occupational therapy curricula.

An Exploratory Study on Participation Following Brachial Plexus Injury.

Consequences of brachial plexus injuries (BPI) would likely impact participation, but outcomes are not well understood. This exploratory study aimed to report the participation in productive, leisure and social roles for individuals following BPI. Fourteen male participants were diagnosed with a traumatic, BPI. Descriptive data reported included demographic, injury, surgical, and participation measures. Two-sample t-tests were conducted for comparative analysis with other studies following life altering conditions.Just over two-thirds reported feeling satisfied to very satisfied with their participation in everyday life. This long-term follow up study found on-going and profound impact on participation in a range of life situations for this diagnostic group. Participation in productive roles, home duties, and physical exercise were particularly impacted and need to be prioritized during rehabilitation.

Online Learning During the COVID-19 Pandemic: Comparing the Perceptions of Domestic and International Occupational Therapy Students.

PURPOSE: To investigate differences between domestic and international occupational therapy students in their perceptions and experiences of online learning during the COVID-19 pandemic. METHODS: Cross-sectional study of 151 occupational therapy students enrolled in the 4-year Bachelor of Occupational Therapy (Honours) courses at the University of Canberra and Monash University in Australia. Students completed the Student Engagement in the e-Learning Environment Scale (SELES) and the Distance Education Learning Environment Scale (DELES). Both instruments have established validity and reliability. ANOVA analysis with bootstrapping was completed to examine potential differences in domestic and international students' experiences and perceptions of online learning. RESULTS: Statistically significant differences were observed between domestic and international students' scores on the DELES Student Autonomy (p=0.001), Personal Relevance (p=0.001) and Student Interaction and Collaboration (p=0.037) subscales. CONCLUSION: International students experienced greater difficulties during online learning in relation to taking control of their own learning, connecting acquired knowledge with real-world settings, and forging collaborative and interactive working relationships with their peers. Academic, technological, and social support measures are recommended to strengthen students' self-directed learning skills, facilitate them to link what they have learned beyond online settings, and encourage active and collaborative engagement with peers and instructors.