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)

Advancing nursing education through wearable electronic devices: A scoping review.

AIM: To examine the incorporation of wearable electronic devices in the education of undergraduate nursing students. BACKGROUND: The advancement of technology has influenced nursing education and will continue to do so in the future. Wearable technologies are electronic devices that can be worn as an accessory and expand the possibilities in nursing education with increased engagement in the learning process. DESIGN: A scoping review was conducted following JBI and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: The search was performed on August 25th, 2023, in the databases: MEDLINE via PubMed, ISI Web of Science, ERIC, EBSCOhost CINAHL, EBSCOhost Academic Search Premier, EBSCOhost Health Source Nursing, EMBASE, Scopus, BVShost LILACS and ProQuest. Literature that examined the application of wearable electronic devices in the education of undergraduate nursing students was included. RESULTS: This scoping review study included a total of 21 records published between 2014 and 2023. The analysis showed that smart glasses are the most common wearable electronic device used in nursing education, followed by smartwatches. The devices provide an opportunity for competencies development, especially when applied in the simulation environment, such as physical examination and medication administration. Wearable technologies are potentially useful and feasible as learning tools in nursing education, increasing nursing students' motivation, confidence and satisfaction. CONCLUSIONS: In the technological revolution, educators must consider the potential of innovative teaching strategies, such as wearable electronic devices, to advance nursing education. Wearables can contribute to developing competencies required for the professionalism of undergraduate nursing students.

POTENTIAL OF THE GRAPHIC NOVEL "BLUE PILLS" TO DEMYSTIFY STIGMAS ABOUT HIV THROUGH CURRICULAR CONTENT / POTENCIAL DE LA NOVELA GRÁFICA "PÍLDORAS AZULES" EN DESMITIFICAR ESTIGMAS SOBRE EL VIH ATRAVÉ DE CONTENIDOS CURRICULARES / POTENCIAL DO ROMANCE GRÁFICO "PÍLULAS AZUIS" EM DESMISTIFICAR ESTIGMAS SOBRE HIV ATRAVÉS DOS CONTEÚDOS CURRICULARES

Despite advances in public policy and health care, it is estimated that more than 1 million people in Brazil live with HIV. Health education is an important prophylactic measure that could help disseminate information to reduce the increase in cases. Among the various strategies used in educational processes, visual media are strong allies due to their significant communication potential. The objective of this study was to analyze the graphic novel "Blue Pills" to identify its potential for addressing HIV in science and biology education. "Blue Pills" is an autobiographical graphic novel by Frederik Peeters that depicts his challenges and anxieties upon discovering that his girlfriend, Cati, and her son are HIV positive. We conducted a content analysis of the work, examining both visual and textual elements to evaluate its potential use in teaching. Our analysis identified 67 excerpts related to the research topic, which we categorized into five themes: "Prejudices and Stigmas," "Care and Treatment," "Transmission and Reproduction of the Virus," "Emotional and Psychological Impacts," and "Social View of Science." Peeters effectively presents HIV in an empathetic and accessible manner, contextualizing complex and often stigmatized issues for readers. Consequently, we believe the material has potential for educational use, despite existing restrictions in the Brazilian National Common Curricular Base (BNCC). Additionally, it contributes to the social debate on issues pertinent to the daily lives of HIV-positive individuals, helping to demystify stigmas entrenched in the collective imagination.

A pesar de los avances en políticas públicas y atención sanitaria, se estima que en Brasil más de 1 millón de personas viven con VIH. La educación sanitaria es un proceso de profilaxis importante que puede contribuir a la difusión de información para mitigar el aumento de casos. Entre las diferentes estrategias utilizadas en los procesos educativos, los productos visuales son fuertes aliados debido a su gran potencial comunicativo. El objetivo de este trabajo fue analizar la novela gráfica "Píldoras Azules" con el fin de identificar su potencial para abordar el VIH en la educación en ciencias y biología. "Píldoras Azules" es una novela gráfica autobiográfica de Frederik Peeters que presenta sus desafíos y angustias al descubrir que su novia Cati y su hijo son VIH positivos. Realizamos un análisis de contenido de la obra, observando los elementos visuales y textuales que pueden posibilitar su uso en la docencia. Tras el análisis, identificamos 67 extractos con enfoques relacionados con el tema objeto de la investigación. Los extractos están organizados en 5 categorías: "Prejuicios y estigmas", "Cuidado y tratamiento", "Transmisión y reproducción del virus", "Impactos emocionales y psicológicos" y "Visión social de la ciencia". En su obra, Peeters logra abordar el VIH de una manera empática y fácil de entender, contextualizando temas complejos y reprimidos en la sociedad para el lector. Por lo tanto, entendemos que el material presenta posibilidades de uso en la enseñanza, a pesar de las restricciones existentes en el BNCC, además de aportar al debate social cuestiones pertinentes a la vida cotidiana de las personas VIH positivas, desmitificando estigmas presentes en el imaginario colectivo.

Apesar dos avanços em políticas públicas e atendimento à saúde, estima-se que no Brasil mais de 1 milhão de pessoas vivam com o vírus da imunodeficiência humana (HIV). A educação em saúde é um importante processo de profilaxia que pode contribuir na disseminação de informações que atenuam o aumento de casos. Dentre as diferentes estratégias utilizadas nos processos educativos, os produtos imagéticos são fortemente aliados devido ao seu grande potencial de comunicação. O objetivo deste trabalho foi analisar o Romance Gráfico (RG) Pílulas Azuis a fim de identificar seu potencial para abordagem sobre o HIV no ensino de ciências e biologia. Pílulas Azuis é um RG autobiográfico de Frederik Peeters que apresenta seus desafios e angústias ao descobrir que sua namorada Cati e seu filho são soropositivos. Realizamos Análise de Conteúdo na obra demonstrando os elementos imagéticos e textuais que podem possibilitar seu uso no ensino. Após a análise, identificamos 67 trechos com abordagens relacionadas ao tema alvo da pesquisa. Os trechos foram organizados em 5 categorias: "preconceitos e estigmas", "Cuidado e tratamento", "Transmissão e reprodução do vírus", "Impactos emocionais e psicológicos" e "Visão social da Ciência". Peeters consegue em sua obra trazer o HIV de forma empática e com fácil compreensão, contextualizando ao leitor temas complexos e reprimidos na sociedade. Assim, identificamos que o material apresenta potencial de utilização no ensino, apesar das restrições existentes na BNCC, assim como trazer para o debate questões sociais pertinentes ao cotidiano de pessoas soropositivas, desmistificando estigmas presentes no imaginário coletivo.

Impact and Assessment of Research Integrity Teaching: A Systematic Literature Review.

Presented here is a systematic literature review of what the academic literature asserts about: (1) the stages of the ethical decision-making process (i.e. awareness, reasoning, motivation, and action) that are claimed to be improved or not improved by RI teaching and whether these claims are supported by evidence; (2) the measurements used to determine the effectiveness of RI teaching; and (3) the stage/s of the ethical decision-making process that are difficult to assess. Regarding (1), awareness was the stage most claimed to be amenable to improvement following RI teaching, and with motivation being the stage that is rarely addressed in the academic literature. While few, some sources claimed RI teaching cannot improve specific stages. With behaviour (action) being the stage referenced most, albeit in only 9% of the total sources, for not being amenable to improvement following RI teaching. Finally, most claims were supported by empirical evidence. Regarding (2), measures most frequently used are custom in-house surveys and some validated measures. Additionally, there is much debate in the literature regarding the adequacy of current assessment measures in RI teaching, and even their absence. Such debate warrants caution when we are considering the empirical evidence supplied to support that RI teaching does or does not improve a specific stage of the decision-making process. Regarding (3), only behaviour was discussed as being difficult to assess, if not impossible. In our discussion section we contextualise these results, and following this we derive some recommendations for relevant stakeholders in RI teaching.

Contribution of the abbreviated CAVE-st questionnaire in Spanish: the attitudes toward childbirth experiences.

There are several factors that influence women's childbirth experience, and personal interactions with health professionals are of particular significance. The main objective of this study was to present the validation of an abbreviated form of an existing questionnaire on attitudes about childbirth in medical and nursing students. We used a sample of 512 perinatal medicine and nursing students who received the original 52-item CAVE-st questionnaire to obtain a shorter version with proper psychometric properties. We used Cronbach's alpha coefficient to evaluate the new version's internal consistency. The Kaiser- Meyer-Olkin test and the Barlett sphericity test were performed to assess the suitability of exploratory factor analysis (EFA). Subsequently, confirmatory factor analysis (CFA) was performed using structural equation models in a second sample of 139 medical students. We obtained a 15-item version with a Cronbach's alpha of 0.82. The EFA revealed a four-dimensional structure, similar to the full 52-item version. In the CFA the adjustment indexes showed good model fitness, RMSEA= 0.046 [CI 0.00-0.07]; CFI = 0.978. We can conclude that the 15-item version is a valid tool for evaluating the attitude of students toward childbirth, pointing out the matters that should be improved in their training to avoid obstetric trauma by the promotion of a positive experience in women during childbirth.

Empty Heart Disease: Teaching and Learning in China.

Drawing on 15 years of experience teaching psychoanalytic theory and therapy primarily from an object relations perspective to Chinese psychotherapists onsite and online, the authors present their learning about Chinese culture, social history, and philosophy, and the Chinese way of communicating about emotional experience. Their essay is imbued with the Chinese use of metaphor and psychosomatic symbolization, particularly involving the heart. They elaborate on the Chinese concept of Empty Heart Disease, comparing and contrasting it to Western concepts from literature, sociology and psychoanalysis, namely spleen, anomie, dead mother, and schizoid, empty, false, and narcissistic self-states. They expand upon and extend the empty heart concept to various age groups and symptom presentations in China, illustrated by a vignette from individual psychoanalysis with a woman and three vignettes from applied psychoanalysis of a couple with no intimacy, a child with an obsessive psychosomatic symptom, and an adolescent school dropout who was self-harming and suicidal in response to academic pressure. Having emphasized the connection between symptom presentations and social life and times, they discuss the impact of trauma, its transgenerational transmission in China, and the impact of unprecedented economic growth and social change on individuals, couples and families.

A Teach-the-Teacher Module for Human Trafficking Bedside Instruction.

Introduction: Human trafficking (HT) is a public health issue that adversely affects patients' well-being. Despite the prevalence of trafficked persons in health care settings, a lack of educational modules exists for use in clinical contexts. We developed a 50-minute train-the-trainer module on HT. Methods: After piloting the workshop for faculty, fellows, and residents (n = 19) at the Society for Academic Emergency Medicine (SAEM) national conference, we implemented it in medical students' curricula during their emergency medicine clerkship at the University of Iowa (n = 162). We evaluated the worskhop by (a) a retrospective pre-post survey of self-reported ability to (1) define HT, (2) recognize high-risk signs, (3) manage situations with trafficked persons, and (4) teach others about HT, and (b) a 3-month follow-up survey to assess longitudinal behavior change. Results: In both contexts, results demonstrated improvement across all learning outcomes (pre-post differences of 1.5, 1.3, 1.9, and 1.7 on a 4-point Likert-type scale for each learning objective above, respectively, at the SAEM conference and 1.2, 1.0, 1.3, and 1.3 at the University of Iowa; p < .001 for all). In the 3-month follow-up, we observed statistically significant changes in self-reported consideration of and teaching about HT during clinical encounters among learners who had previously never done either (p < .001 and p = .006, respectively). Discussion: This train-the-trainer module is a brief and effective clinical tool for bedside teaching about HT, especially among people who have never previously considered HT in a clinical context.

Use and Design of Virtual Reality-Supported Learning Scenarios in the Vocational Qualification of Nursing Professionals: Scoping Review.

BACKGROUND: Numerous reviews advocate using virtual reality (VR) in educational contexts. This medium allows learners to test experiences in realistic environments. Virtually supported scenarios offer a safe and motivating way to explore, practice, and consolidate nursing skills in rare and critical nursing tasks. This is also cited as one of the reasons why VR can significantly increase the knowledge acquisition of nursing students. Nevertheless, studies are limited in their significance owing to the chosen design. Despite great interest, this results in a low level of confidence in VR as a curricular teaching method for nursing education. Therefore, defining concrete design and didactic-methodological parameters that support teachers in the use and implementation of VR is more relevant. OBJECTIVE: This scoping review aims to provide an overview of significant design aspects for VR scenario conception and its transfer to generalist nursing education to generate value for the development of teaching scenarios and their sustainable implementation in teaching. METHODS: A comprehensive literature search was performed using the MEDLINE (via PubMed) and CINAHL databases, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist was applied. The search was conducted from May to July 2022, using a specific search principle corresponding to the focus and the growing study corpus. A previously defined "population, concept, and context" scheme was employed as the basis for the double-blind review of all relevant international German and English publications released up to May 1, 2022. RESULTS: In accordance with the predefined selection procedure, 22 publications were identified. The identified aspects aided in the development of design, didactic, and research recommendations. The intuitive operation of realistically designed VR scenarios, which are standardized, reliable, and modifiable, as well as clear instructions and specific multimodal feedback functions were described positively. The same applied to the linear structure of the sequences with graduated demands and high image quality for increased immersion with low sensory overload. Changes in perspectives, multiuser options, dialogs, and recording functions can contribute to an interactive care practice. On the research side, it is advisable to define VR terminologies. In addition to considering larger samples, varying settings, and financial issues, it is recommended to conduct long-term studies on knowledge acquisition or improved patient outcomes. CONCLUSIONS: VR scenarios offer high potential in the context of nursing education if teachers and learners develop them co-creatively according to design features and implement them by means of a well-conceived concept. VR enables trainees to develop practical skills continuously in a standardized way. In addition, its deployment supports the sensitization of trainees to digital nursing technologies and the expansion of their digital skills in a practical setting. Furthermore, it allows sustainability issues to be addressed.

Reform of teaching and practice of the integrated teaching method BOPPPS-PBL in the course "clinical haematological test technique".

BACKGROUND: In order to meet the demand for laboratory talents in the clinical laboratory industry and address the current curriculum characteristics and shortcomings of the teaching mode of "Clinical Hematology Laboratory Technology", we investigated the effectiveness of the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary model combined with problem-based learning (BOPPPS-PBL) in undergraduate teaching of this course. METHOD: Seventy students majoring in Medical Laboratory Technology from the Army Medical University in the past 5 years have been selected and divided into two groups with the same teaching content and time. The control group (2015 and 2016 grades) used traditional teaching methods, while the experimental group (2017, 2018 and 2019 grades) used the BOPPPS-PBL model. After class, diverse evaluation methods were used to analyze the formative and summative exam scores of the two groups of students. RESULTS: After the reform, students performed significantly better in exams than before. In addition, the new teaching methods have had a positive impact, with students demonstrating high motivation for self-directed learning and problem-solving abilities. CONCLUSION: Compared to traditional teaching methods. The BOPPPS-PBL integrated case study education model is a relatively effective teaching method to improve students' problem-solving ability and comprehensive practical ability.

Constructing an evaluation index system for clinical nursing practice teaching quality using a Delphi method and analytic hierarchy process-based approach.

BACKGROUND: The key step in evaluating the quality of clinical nursing practice education lies in establishing a scientific, objective, and feasible index system. Current assessments of clinical teaching typically measure hospital learning environments, classroom teaching, teaching competency, or the internship quality of nursing students. As a result, clinical evaluations are often insufficient to provide focused feedback, guide faculty development, or identify specific areas for clinical teachers to implement change and improvement. Therefore, the purpose of our study was to to construct a scientific, systematic, and clinically applicable evaluation index system of clinical nursing practice teaching quality and determine each indicator's weight to provide references for the scientific and objective evaluation of clinical nursing practice teaching quality. METHODS: Based on the "Structure-Process-Outcome" theoretical model, a literature review and Delphi surveys were conducted to establish the evaluation index system of clinical nursing practice teaching quality. Analytic Hierarchy Process (AHP) was employed to determine the weight of each indicator. RESULTS: The effective response rate for the two rounds of expert surveys was 100%. The expert authority coefficients were 0.961 and 0.975, respectively. The coefficient of variation for the indicators at each level ranged from 0 to 0.25 and 0 to 0.21, and the Kendall harmony coefficients were 0.209 and 0.135, respectively, with statistically significant differences (P < 0.001). The final established index system included 3 first-level, 10 second-level, and 29 third-level indicators. According to the weights computed by the AHP, first-level indicators were ranked as "Process quality" (39.81%), "Structure quality" (36.67%), and "Outcome quality" (23.52%). Among the secondary indicators, experts paid the most attention to "Teaching staff" (23.68%), "Implementation of teaching rules and regulations (14.14%), and "Teaching plans" (13.20%). The top three third-level indicators were "Level of teaching staff" (12.62%), "Structure of teaching staff" (11.06%), and "Implementation of the management system for teaching objects" (7.54%). CONCLUSION: The constructed evaluation index system of clinical nursing practice teaching quality is scientific and reliable, with reasonable weight. The managers' focus has shifted from outcome-oriented to process-oriented approaches, and more focus on teaching team construction, teaching regulations implementation, and teaching design is needed to improve clinical teaching quality.

Predictors of Stress and Burnout Among Pharmacy Faculty in the United States.

OBJECTIVE: Stress and burnout may impact pharmacy faculty's well-being, quality of life, and productivity. This research study aimed to assess pharmacy faculty's overall burnout and stress levels in the United States and identify the characteristics associated with these 2 constructs while controlling for faculty characteristics. METHODS: A total of 5245 faculty members were invited to participate in a survey between November 2021 and February 2022. Burnout was assessed using the Oldenburg Burnout Inventory. Stress was assessed using the Perceived Stress Scale. Bivariate analyses were used to identify potential predictors of pharmacy faculty-perceived burnout and stress. The relationships between time allocation across different academic responsibilities and faculty's perceived burnout and stress were assessed using linear regression analyses. RESULTS: Out of 5139 delivered invitations, responses were collected from 774 pharmacy faculty members (response rate = 15.1%). Faculty exhibited moderate levels of burnout, with an average score of 40.1 on a scale from 16 to 64. Additionally, they displayed moderate perceived stress levels, with an average score of 18.2 on a scale from 0 to 40. Faculty displayed significantly more burnout and stress if they were unmarried, nontenured, younger, female, had lower academic rank, or worked in pharmacy practice departments. Higher stress and burnout were associated with spending more time on teaching, whereas lower burnout and stress were associated with spending more time on administration. CONCLUSION: This study found that US pharmacy faculty experience moderate levels of stress and burnout. Some demographic factors and time allocation for teaching and administrative tasks influence these levels.

Multidisciplinary Design-Based Multimodal Virtual Reality Simulation in Nursing Education: Mixed Methods Study.

BACKGROUND: The COVID-19 pandemic underscored the necessity for innovative educational methods in nursing. Our study takes a unique approach using a multidisciplinary simulation design, which offers a systematic and comprehensive strategy for developing virtual reality (VR) simulations in nursing education. OBJECTIVE: The aim of this study is to develop VR simulation content for a pediatric nursing module based on a multidisciplinary simulation design and to evaluate its feasibility for nursing education. METHODS: This study used a 1-group, posttest-only design. VR content for pediatric nursing practice was developed by integrating the technological characteristics of a multimodal VR system with the learning elements of traditional nursing simulation, combining various disciplines, including education, engineering, and nursing. A user test was conducted with 12 nursing graduates (preservice nurses) followed by post hoc surveys (assessing presence, VR systems, VR sickness, and simulation satisfaction) and in-depth, one-on-one interviews. RESULTS: User tests showed mean scores of 4.01 (SD 1.43) for presence, 4.91 (SD 0.81) for the VR system, 0.64 (SD 0.35) for VR sickness, and 5.00 (SD 1.00) for simulation satisfaction. In-depth interviews revealed that the main strengths of the immersive VR simulation for pediatric pneumonia nursing were effective visualization and direct experience through hands-on manipulation; the drawback was keyword-based voice interaction. To improve VR simulation quality, participants suggested increasing the number of nursing techniques and refining them in more detail. CONCLUSIONS: This VR simulation content for a pediatric nursing practice using a multidisciplinary educational design model was confirmed to have positive educational potential. Further research is needed to confirm the specific learning effects of immersive nursing content based on multidisciplinary design models.

Use of 3D foot and ankle puzzle enhances student understanding of the skeletal anatomy in the early years of medical school.

PURPOSE: 3D visualization is an important part of learning anatomy with cadavers generally used to effectuate this. However, high cost, ethical considerations, and limited accessibility can often limit the suitability of cadavers as teaching tools. Anatomical 3D printed models offer an alternative tool for teaching gross anatomy due to their low cost and accessibility. This study aims to investigate if combing gamification with 3D printed models can enhance the learning experience and be effective for teaching anatomy. METHODS: 3D printed models of the bones of the foot and ankle were generated, and 267 first-year medical students from 2 consecutive cohorts worked in groups to put it together as a puzzle. Participants completed a questionnaire regarding perceptions of 3D models and their knowledge of foot anatomy, before and after the session and were asked to provide comments. RESULTS: Analysis of the responses showed a significant increase in the confidence of the learners in their anatomy knowledge and an increased appreciation of the role that 3D models have in enhancing the learning experience. After the session, there were many comments saying how enjoyable and engaging 3D models were. CONCLUSION: Through the puzzle element of the session, the students were challenged mentally to work out the anatomical features of the foot and ankle. The combined elements of the puzzle and the features of the 3D model assembly made the activity fun and conducive to active learning. The possibility of having fun was not something the students had considered before the session.

The Essentials of Debriefing and Reflective Practice.

Debriefing is a specific type of reflective learning. Debriefing follows an experience, with the goal of taking meaningful learning away from the experience. It is often used following a simulation-based educational experience but the same techniques can be used following actual clinical care. Early studies in simulation suggest that learning does not occur in simulation-based education in the absence of debriefing. There are phases of a debriefing discussion and specific conversational strategies that are used to engage learners and provoke engaging learning discussions. Standards of practice call for facilitators with specialized training and a debriefing method that is theory based.

Using Simulation to Improve Communication Skills.

Ineffective communication is implicated in 80% of medical errors, costing the United States approximately $12 billion annually. Teaching communication skills is a component of nursing curricula linked to improved patient outcomes. Simulation-based experience (SBE) is a strategy for healthcare professionals to learn communication skills. Providing nurses with the ability to practice nurse-nurse, nurse-physician, nurse-patient, and team communication skills in a psychologically safe learning environment provides an opportunity for skill development and meaningful self-reflection. The multiple modalities for SBE support needed communication techniques for skill development and acquisition to improve patient outcomes.

Caesarean section rates in a tertiary teaching hospital in northern Uganda: a retrospective analysis using the robson ten group classification system.

BACKGROUND: The Robson Ten Groups Classification System (RTGCS) is increasingly used to assess, monitor, and compare caesarean section (CS) rates within and between healthcare facilities. We evaluated the major contributing groups to the CS rate at Gulu Regional Referral Hospital (GRRH) in Northern Uganda using the RTGCS. METHODS: We conducted a retrospective analysis of all deliveries from June 2019 through July 2020 at GRRH, Gulu city, Uganda. We reviewed files of mothers and collected data on sociodemographic and obstetric variables. The outcome variables were Robson Ten Groups (1-10) based on parity, gestational age, foetal presentation, number of foetuses, the onset of labour, parity and lie, and history of CS. RESULTS: We reviewed medical records of 3,183 deliveries, with a mean age of 24.6 ± 5.7 years. The overall CS rate was 13.4% (n = 427). Most participants were in RTGCS groups 3 (43.3%, n = 185) and 1 (29.2%, n = 88). The most common indication for CS was prolonged labour (41.0%, n = 175), followed by foetal distress (19.9%, n = 85) and contracted pelvis (13.6%, n = 58). CONCLUSION: Our study showed that GRRH patients had a low-risk obstetric population dominated by mothers in groups 3 and 1, which could explain the low overall CS rate of 13.4%. However, the rates of CS among low-risk populations are alarmingly high, and this is likely to cause an increase in CS rates in the future. We recommend group-specific interventions through CS auditing to lower group-specific CS rates.

Brief Teaching Intervention Improves Medical Students' Dermatology Diagnostic Skills and Comfort in Performing Dermatology Exams.

BACKGROUND: Skin disease is a significant contributor to the global disease burden, with dermatologic health disparities adding to this burden. Internists, general practitioners, and other medical professionals often manage skin disease with limited exposure to dermatologic education in medical school. OBJECTIVE: This study evaluated a brief educational intervention for medical students to improve dermatologic knowledge, diagnostic and communication skills, and comfort in performing dermatology-focused physical exams. A secondary focus of the intervention was to promote awareness of skin disease, detection, and prevention for patients with a variety of skin tones. METHODS: Sixty-five first through fourth-year students at Rutgers RWJMS participated in a pre-test-post-test within-subject study. Students described images using open-ended responses followed by multiple-choice identification questions. Students watched a one-hour self-paced module created by a licensed dermatologist and completed a follow-up assessment. RESULTS: At pre-test, descriptions were brief and often inaccurate but significantly improved post-intervention to include descriptors such as primary morphology and demarcation. Accuracy on diagnostic and management questions significantly improved and comfort in advising patients and performing dermatologic exams significantly increased. CONCLUSIONS: A low-cost, brief, self-paced module can augment dermatologic education for medical students while increasing exposure to multiple skin tone presentations of lesions.

Can Guided Discovery Instruction Be Detrimental to Children with Different Levels of Aquatic Competence in Infancy?

Repetitive practice can become an exploratory activity where instruction and discovery are linked, allowing instruction and guidance through tasks that help to construct and acquire the knowledge and skills that make up the content. (1) Background: The aim of the study was to show how a teaching method based on guided discovery would affect the teaching of children's aquatic competence in schoolchildren with different levels of competence. (2) Methods: An observational study was conducted with 385 schoolchildren (195 boys and 189 girls) aged 3-5 years belonging to a charter kindergarten, using an Instrument for the Measurement of Aquatic Competence in Children (SMACC) consisting of 17 items grouped into three dimensions: socio-affective, cognitive, and motor. (3) Results: After measuring aquatic competence, all age groups and all variables (motor, cognitive, and socio-affective) showed differences between pre- and post-scores and a high magnitude of effect size. When the teaching intervention was analyzed according to the level of aquatic competence of the age group, improvements were found in all variables in both the low and high-competence groups. (4) Conclusions: This study describes how guided discovery instruction has equal effects at different levels of proficiency. Furthermore, when this type of instruction was used, aquatic competence was explained not only by the motor and socio-affective dimensions but also by the cognitive variable.

The Relationship between Organizational Climate and Teaching Innovation among Preschool Teachers: The Mediating Effect of Teaching Efficacy.

Preschool teachers' teaching innovation is an important factor in enhancing teaching quality and improving children's creativity. Based on ecological systems theory and self-determination theory, the purpose of this study was to investigate the relationship between kindergartens' organizational climate and preschool teachers' teaching innovation and the mediating role of teaching efficacy in it. In this study, an online questionnaire was distributed to 2092 preschool teachers from different provinces using an Organizational Climate Scale, Teaching Efficacy Scale, and Teaching Innovation Scale. The study used SPSS 25.0 software and the SPSS PROCESS macro program for data processing. The results showed that there was a positive correlation among kindergartens' organizational climate, teaching efficacy, and teaching innovation, and that kindergartens' organizational climate not only directly and positively predicted teaching innovation, but also indirectly predicted teaching innovation through the mediating role of teaching efficacy. The study explored the internal and external influences on preschool teachers' teaching innovation and revealed their underlying mechanisms, providing theoretical support for research and educational practice on preschool teachers' teaching innovation and children's creativity.