Prospective Discussion on December-Month Introduction of Voice Nursing and Health Education System.

A cross-sectional study was conducted on the 12th month of using the voice nursing and health education system. Work sampling method was used to observe for 120 hours, and 39 satisfaction questionnaires were collected. The results showed that the usage rate of voice health education system accounted for 14.3% of nursing guidance tools. Pearson analysis showed that user satisfaction and usage efficiency had the greatest impact (p < .001). When the system's ease of operation and stability meet expectations, the care guidance process can be improved.

[RECURRENT AND VIRTUAL EDUCATION FOR ALL DISCIPLINES AND OCCUPATIONS IN THE ALLERGY REALM : A SURVEY OF THE PARTICIPANTS FROM THE INITIATIVE 'OUTREACH LECTURES' TO CREATE EDUCATIONAL OPPORTUNITIES].

BACKGROUND: In the enhancement of allergy care involving multidisciplinary and multiple medical departments, there is a perceived need for education that targets not only specialists but also non-specialists. However, research on the need for and methods of such education remains inadequate. OBJECTIVE: To design a remote allergy care education program for all medical practitioners and to validate its necessity and utility. METHODS: The Empowering Next Generation Allergist/immunologist toward Global Excellence Task Force (ENGAGE-TF), supported by the Japanese Society of Allergology, initiated a virtual educational program called 'Outreach Lectures' in collaboration with Keio University and Fukui University. This initiative was widely promoted through social media and various institutions, and a survey was conducted through its mailing list. RESULTS: 1139 responses were obtained. More than half were physicians from non-allergy specialties, representing a diverse range of healthcare professions. Over 70% expressed being 'very satisfied,' and over 60% found the difficulty level 'appropriate.' Free-form feedback revealed differences in learning focus based on profession and learning approach based on years of experience. CONCLUSION: The high participation rate (90%) of non-specialist physicians underscores the demand for addressing allergic conditions in primary care. The effectiveness of virtual / recurrent education, particularly for healthcare professionals with over 11 years of experience, was implied. Further follow-up investigation focusing on quantitative and objective assessment of educational effectiveness is indispensable.

Pharmacovigilance teaching and learning: a mixed cross-sectional analysis of the Portuguese public higher education system.

Pharmacovigilance stands out for its importance in obtaining existing knowledge about medicine and patient safety and should be recognized as a continuous line of study. It constitutes a highly relevant component in the activities of health professionals, with spontaneous notification of suspected adverse drug reactions being its main emphasis. The underreporting that persists can be overcome through continuous professional development programs, reinforcing theoretical and practical knowledge in the curricular plans of health courses. As a result, more educated professionals will also allow citizens to recognize the importance of pharmacovigilance. The main objective of this study was to describe and characterize the teaching-learning process of pharmacovigilance in Portugal, analyzing the knowledge, perceptions and attitudes of students and health professionals. In total, ninety-three curricular unit forms of the seventeen healthcare courses included were analyzed, among which only three referred to pharmacovigilance as mandatory and thirty-nine did not address any keywords. The questionnaire applied was answered by 650 participants, both students (62%) and professionals (38%). Approximately 84.4% of the students and 54.7% of the professionals affirmed that they had never spontaneously reported an adverse drug reaction. Only 24.6% of the students and 17.8% of professionals referred to the existence of specific course content dedicated to pharmacovigilance in their coursework. In view of these results, it is evident that there is a need for a wider reflection regarding the further training and constant update of practicing professionals as well as in diverse health institutions, investing in the creation of an academic curriculum that integrates pharmacovigilance in healthcare courses.

Medical Education in Armenia: An Overview.

This article serves to describe the medical education system of Armenia, a country located in the cross-section of Europe and Asia. Similar to other countries in the region, its medical education system is structured into undergraduate (6 years), postgraduate (1-4 years), and continuing education components. Its largest medical university, Yerevan State Medical University (YSMU), is the predominant institute for medical education and has enrollment of not only Armenian citizens, but also international students from India, Iran, Russia, and other countries. According to publication metrics, research activity at YSMU is increasing. Finally, the unique relationship between the country and its global diaspora has facilitated collaborative efforts in not only medical education, but also the delivery of care and capacity building. Significant challenges remain for each stage of medical education, such as the lack of standardized licensing or board examinations and oversight of the number of resident physicians per specialty.

Implementation readiness for evidence-based autism practices in school systems.

Background: The increase in the number of autistic children being identified has led to increased demand on public schools to provide high-quality services. Effectively scaling up evidence-based practice (EBP) use for autistic students is challenging, given the complicated organization of special education. Teachers have significant challenges implementing autism EBP with fidelity. Factors such as implementation leadership and climate and attitudes toward EBP are linked to successful EBP use and may vary at different levels of the education system. Examining mechanisms of successful implementation is a critical step to support scale-up. Method: In this observational study, conducted from September 2018 to March 2020, California school personnel (n = 2273) at multiple levels of the system completed surveys related to implementation climate, leadership, and attitudes toward EBP. Data were collected throughout California at the Special Education Local Plan Areas, County Office of Education, and district and school levels from educators and administrators working in public schools supporting autistic students. Multi-level modeling was conducted to characterize implementation readiness. Results: Overall, implementation climate and leadership scores are low across levels with regional levels rated more positively than districts or schools. Attitudes toward EBP were moderate, with those working in schools having the poorest ratings and specialists/trainers and related service providers (e.g., speech-language pathologists) having the highest ratings. Conclusions: Outcomes provide a unique opportunity to compare implementation factors across organizational levels with a large, statewide sample. These data provide guidance for developing implementation interventions at multiple levels of the education system to increase readiness for effective scale-up of autism EBP in schools. Personnel and leaders at different organizational levels may need differentiated training targeting improved implementation climate and leadership. Personnel within districts and schools may experience a particular benefit from leadership support for EBP implementation.

The increase in the number of autistic children being identified in schools is increasing. To address this, schools are trying to do a better job of using high-quality practices based on research. However, teachers have had difficulty using research-based strategies for autistic students the way the manuals indicate they should be used. This might be due to the complexity of the strategies or limited support from special education leadership and infrastructure. Research shows that leaders can be very important in helping teachers use effective strategies. Over 2200 school personnel in California, including administrators, professional development providers, teachers, and paraprofessionals completed surveys asking about how their leaders, schools, districts, and regions supported the use of research practices for autistic students. Overall, limited support is provided in special education, with regional agencies providing more support than districts or schools. These data suggest that school and district leaders need training in how to support educators in using autism-specific strategies.

Experience and Impact of COVID-19 on a Newly Formed Rural University Medical Office: Survey Study.

BACKGROUND: The COVID-19 pandemic had large social effects, particularly in the fields of medicine and medical education. Medical organizations in the United States operate in overlapping contexts with interrelated goals inside multiple organizations, and the context of work strongly influenced how organizations were able to respond to COVID-19 restrictions. OBJECTIVE: This research examines the experience and impact of COVID-19 on the implementation of a Health Resources and Services Administration grant in a newly formed university medical office with the interrelated goals of health policy, health outreach, and medical education. The goal is to understand how COVID-19 created different experiences and challenges for leaders and their collaborators working in medical education compared to those working in public health outreach or health policy. METHODS: A survey about COVID-19 opportunities and challenges was administered to work unit leaders and their project collaborators. The most common experiences and challenges are shown, direct educational and other respondents' experiences and challenges are compared, and open-ended comment segments are analyzed. RESULTS: Helping others adjust to digital work, remoteness, and coordination were common experiences during COVID-19. Common challenges include coordination and an inability to make comparisons to previous program years. On average, respondents had 11.3 (SD 7.8) experiences and 8.3 (SD 6.9) challenges considered in the survey. While all units were influenced by COVID-19 restrictions, medical education units had more experiences and challenges. Those involved directly in medical education experienced 69% (18.6/27) of their possible experiences and 54% (14.7/27) of their possible challenges on average compared to 35% (7/20) and 21% (4.2/20) among other respondents (P<.001). COVID-19 restrictions increased the complexity of project work and presented challenges, especially in terms of coordinating responses and access to locations. CONCLUSIONS: The findings suggest that COVID-19 made the overall administration of programs more complex and drew attention from other medical and public health programs. While remoteness is appropriate for some medical education tasks, it is less appropriate for clinical learning. Remoteness presents an especially large challenge to clinical education. Employees now have expectations for remoteness to be built into programs and workplaces. Program administrators will have to integrate remoteness' benefits and drawbacks into their organization for the foreseeable future.

Disasters and the education system: Cyclone Idai and schooling disruption in eastern Chimanimani, Zimbabwe.

This article examined how the education system was impacted by the Cyclone ldai disaster in eastern Chimanimani District in 2019. In addition, this article discoursed the enrolment trends, pass rate patterns and general quality of education over the 2018-2019 study period. It assessed local and stakeholders' initiatives towards building a disaster-resilient education system. A mixed-methods approach integrated both quantitative and qualitative techniques to obtain in-depth narratives of lived experiences and quantitative aspects. A chi-square test provided sufficient ground to conclude that there were significant dropout patterns at a 95% confidence level. A paired t-test for the years 2018 (M = 64.59; SD = 12.61) and 2019 (M = 62; SD = 15.32) showed no significant difference (t [11] = 0.817, p = 0.432) at a 95% confidence interval. Concerted efforts are needed to avert the native pattern of school enrolment and academic results reflected in the study. Contribution: We therefore recommend that a holistic integrative disaster resilience framework between school, community and stakeholders showed great potential for the future.

Flexner has fallen: Transitions in medical education system across time, a gradual return to pre-Flexnerian state (de-Flexnerization).

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner, his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur. He could say what other reformers could not, due to their links to the medical education community. But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students, the decline in the number and quality of investigator initiated research among clinical researchers, lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis, poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes. The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations. This de-Flexnerization trend and regression to pre-Flexnerian era standards, ideologies, structures, processes, and attitudes, are bound to beget pre-Flexnerian outcomes, for you get what you designed for.

Anxiety, emotions and threat perception in COVID-19 context: differences between Spanish teachers and students

Introduction: Our study compares the emotional impact of the first month of the lockdown on teachers and students due to the COVID-19 pandemic in Spain, focusing on the variables of generalized anxiety, emotions, and perceived threat. Method: A non experimental design was applied, the sample consists of 452 participants (teachers = 188, young adult students = 264. Correlation analyses, a between-group design and effect size were carried out. Results: The results indicated that in crises or emergencies such as COVID-19, teachers and students have different emotional reactions. Students showed more generalized anxiety symptoms, more negative emotions, and fewer positive emotions. Teachers showed a higher degree of existential anxiety. Conclusion: Specific action plans should be developed for teachers and students. In addition, educational policies and teacher training programs should take the gender perspective into account when studying and planning a resilient educational system.

Introducción: Nuestro estudio compara el impacto emocional, entre profesores y estudiantes, durante el primer mes de cuarentena en España debido a la COVID-19, centrándonos en la ansiedad generalizada, emociones y percepción de amenaza. Método: Se aplicó un diseño no experimental, donde participaron 452 personas (profesores = 188, estudiantes adultos jóvenes = 264). Se realizaron análisis de correlación, diseños entre-grupos y tamaño del efecto. Resultados: Los resultados indican que durante crisis o emergencias como la COVID-19, los profesores y estudiantes tienen diferentes reacciones emocionales. Los estudiantes mostraron mayores síntomas de ansiedad generalizada, más emociones negativas y menos emociones positivas. Los profesores mostraron tener un alto grado de ansiedad existencial. Conclusión: Planes de acción específica deberían desarrollarse por separado para profesores y estudiantes. Además, las políticas educativas y los programas de formación de profesorado, deberían tener una perspectiva de género al estudiar y planificar un sistema educativo resiliente.

What Do Future Trends in Medical Education Mean to the Scientific Development of Iran's Health System?

Background: Medical education system in Iran has an essential role in responding to scientific development targets from both education and research perspectives. Investigating future trends and analyzing how they interact with the medical education system helps increase awareness and give insight into the preferred future. Methods: The present qualitative study consists of Systematic reviews and interviews that have been analyzed using content analysis. Afterward, the themes and codes were visualized in the form of maps and presented in a focus group discussion of experts to define how medical education trends will impact scientific development. Results: The future trends of Iran's medical education system were classified into six groups: workplace changes, demographic changes, changes in concepts, the emergence of new players, structural changes in universities, and technology development. The next point is how they will influence science development. Their impact on science development is classified into five main groups or main streams of change of new financial models, open science, redesigning the research management, the role of universities, and capacity building. Conclusion: Our findings showed that redesigning the structure of medical education is the most important priority to make the system as agile as needed to capture the signs and act. New meanings and concepts should also be considered in restructuring, like power balance, competency-based and personalized education, cost-effectiveness, and openness.

The Meaning of a Group Facilitation Training to Creative Arts Therapists Working in the Public Education System.

Many creative arts therapists who provide group therapy to children and adolescents in the Israeli education system do not feel they were sufficiently trained as group facilitators. Group facilitation training was provided over the course of two consecutive years by a regional support center to over 40 creative arts therapists and their clinical supervisors working in the Israel Ministry of Education. A two-stage qualitative research project examined the participants' experiences during this training. Interviews were conducted regarding the therapists' first-year experiences. A questionnaire was administered at the end of the second year. Both were analyzed according to the Consensual Qualitative Research method. The research findings pertain to the participants' perceptions of group arts therapy in the Israeli education system and included the development of unique group models, the advantages and power of group therapy at school, and the intimidating and disruptive experiences of school settings. The participants also provided their impressions of the training course: their growing confidence and skills, and the many changes required in group arts therapy at public schools to provide more professional and efficient service. The discussion centers on the value of group arts therapy in the education system and the steps needed to enhance therapists' confidence and efficiency in this field.

[Environmental knowledge and environmental awareness among Generation Z students: An online survey at the University of Ulm]. / Umweltwissen und Umweltbewusstsein von Studierenden der Generation Z: eine Online-Umfrage an der Universität Ulm.

BACKGROUND: The issues of climate change, environmental pollution and species extinction play an increasingly central role in the public debate. At the same time, however, there is a significant gap between environmental knowledge and sustainable action (so-called value-action gap). The education system, especially at the university level, is an important institution for imparting well-founded knowledge on this topic and, as a consequence, for deriving targeted options for action. The present study surveyed the current environmental knowledge and environmental awareness, including the everyday behavior of Generation Z students of medical study programs in comparison to science-oriented study programs. METHODS: In October/November 2021, an anonymous and voluntary online survey was conducted at the University of Ulm to evaluate the environmental knowledge and awareness of students in all semesters of the study programs Human Medicine, Dentistry, Molecular Medicine, Biology and Teaching. A total of 317 students fully completed the questionnaire. RESULTS: The results confirm the current state of studies on the environmental awareness of the German population. The value-action gap is also detectable among students. Students perceive the urgency of environmental protection measures and action on climate change and also link these with emotional feelings, but in terms of behavior personal interests (still) tend to largely take precedence over environmental protection. In addition, according to our findings, the image of stereotypes and prejudices of the various courses of study is also partially confirmed in the surveyed environmental awareness. CONCLUSION: The significant differences in environmental awareness between the compared degree programs and the gap between knowledge and action call for an individual but consistent implementation of the topics of climate change and environmental protection in the curriculum in all investigated degree courses. With the knowledge and awareness gained in this way, academics as distinguished members of society can convey climate awareness and fulfill the function as a role model.

Exploring the factors influencing the effectiveness of online learning: A study on college students.

To prevent the rapid transmission of the viruses among students and staff during the COVID-19 epidemic, on-campus classes have been cancelled at colleges and institutions throughout the world. Due to this unexpected disruption in face-to-face learning, pedagogical methods were changed, and colleges quickly accepted online instruction. Both university lecturers and professors as well as university students were impacted by the advent of online learning. The student's performance is what determines how well online learning works. Students' performance is affected by the course material, how a teacher teaches them, and a variety of other factors. So, the study's focus is to investigate the effect of numerous elements e.g. instructor-student interaction, peer interaction, social media use, family support, and technical support on College students' engagement and performance. Population of this study consist of universities' under-graduate and post-graduate students. Data were collected from 300 under-graduate and post-graduate students who belong to the three universities/colleges of Jaipur (Rajasthan) namely; JK Lakshmipat University, Arya College of Engineering and I.T., and JECRC University. Data were analyzed using two software Programs "SPSS and AMOS". After going through validity, reliability, exploratory, and confirmatory factor analysis; we applied structural equation modeling (SEM). Our findings show that Instructor-Student Interaction, Use of social media, Family as well as Technical support have a positive relationship with Students' Learning Performance through Students Engagement. It was also shown that peer interaction had a minor influence on learners' performance. All the observed Indices are within the threshold limits.

A systematic review of the opportunities and challenges of micro-credentials for multiple stakeholders: learners, employers, higher education institutions and government.

Micro-credentials are gaining traction as viable vehicles for rapid upskilling of the workforce in the twenty-first century and potential pathways for gaining employment for some students. The primary purpose of the current systematic review was to understand the current conceptions and discourses of micro-credentials in higher education and to identify the opportunities and challenges in adopting micro-credentials in higher education. The review also aimed to develop a need-driven micro-credentials framework that demonstrates the value of micro-credentials to stakeholders, i.e., learners, higher education institutions, employers, and government agencies. Key findings revealed that there are various stakeholders' needs and expectations. The learner wants short, practical, and up-to-date courses for their chosen career path, education institutions emphasise accreditation for building trust, employers want clarity regarding the competencies gained through micro-credentials, and government bodies expect higher graduate employability with lower tuition fees. Key findings revealed that implementing micro-credentials can be disruptive in the higher education sector and present several challenges. However, these challenges are likely to be mitigated by increased collaboration among stakeholders. The review has revealed several outstanding research questions critical for the success of micro-credentials as significant pathways to supplement traditional degree programmes. The research presented in the article has implications for policy development to guide the implementation of micro-credentials in the higher education sector.

Scoring Single-Response Multiple-Choice Items: Scoping Review and Comparison of Different Scoring Methods.

BACKGROUND: Single-choice items (eg, best-answer items, alternate-choice items, single true-false items) are 1 type of multiple-choice items and have been used in examinations for over 100 years. At the end of every examination, the examinees' responses have to be analyzed and scored to derive information about examinees' true knowledge. OBJECTIVE: The aim of this paper is to compile scoring methods for individual single-choice items described in the literature. Furthermore, the metric expected chance score and the relation between examinees' true knowledge and expected scoring results (averaged percentage score) are analyzed. Besides, implications for potential pass marks to be used in examinations to test examinees for a predefined level of true knowledge are derived. METHODS: Scoring methods for individual single-choice items were extracted from various databases (ERIC, PsycInfo, Embase via Ovid, MEDLINE via PubMed) in September 2020. Eligible sources reported on scoring methods for individual single-choice items in written examinations including but not limited to medical education. Separately for items with n=2 answer options (eg, alternate-choice items, single true-false items) and best-answer items with n=5 answer options (eg, Type A items) and for each identified scoring method, the metric expected chance score and the expected scoring results as a function of examinees' true knowledge using fictitious examinations with 100 single-choice items were calculated. RESULTS: A total of 21 different scoring methods were identified from the 258 included sources, with varying consideration of correctly marked, omitted, and incorrectly marked items. Resulting credit varied between -3 and +1 credit points per item. For items with n=2 answer options, expected chance scores from random guessing ranged between -1 and +0.75 credit points. For items with n=5 answer options, expected chance scores ranged between -2.2 and +0.84 credit points. All scoring methods showed a linear relation between examinees' true knowledge and the expected scoring results. Depending on the scoring method used, examination results differed considerably: Expected scoring results from examinees with 50% true knowledge ranged between 0.0% (95% CI 0% to 0%) and 87.5% (95% CI 81.0% to 94.0%) for items with n=2 and between -60.0% (95% CI -60% to -60%) and 92.0% (95% CI 86.7% to 97.3%) for items with n=5. CONCLUSIONS: In examinations with single-choice items, the scoring result is not always equivalent to examinees' true knowledge. When interpreting examination scores and setting pass marks, the number of answer options per item must usually be taken into account in addition to the scoring method used.

The Effects of a Mindfulness-Based Training in an Elementary School in Germany.

Objectives: The primary goal of this study was to investigate the influence of the Mindfulness Education Workbook, a 6-week mindfulness-based tool, on emotion regulation, inhibition, physical self-concept, resources, and connectedness to nature. Furthermore, we explored whether a difference in number of hours of mindfulness practice would affect the outcomes. Method: Ninety-one children from a public elementary school (M age = 9.74 years, SD = 0.76) participated in the study and were divided into three groups according to their respective school classes. The intervention group was divided into two groups that varied by number of hours of mindfulness practice: (a) mindfulness-plus and (b) mindfulness. In addition to biweekly training, the mindfulness-plus group also repeated a daily exercise. The passive control group received the standard school day instruction. The five concepts of emotion regulation, inhibition, physical self-concept, resources, and connectedness to nature were measured before and after the mindfulness intervention. Results: For the measurement of emotion regulation, there was a significant effect in favor of the two mindfulness groups compared with the control group for the adaptive strategies in total as well as for their comprising emotions, anger, fear, and sadness, separately. Solely for the subscale mood elevation, the mindfulness-plus group showed significantly higher scores compared to the control group. Both mindfulness-plus and mindfulness groups varied from the control group on the measure of emotion regulation strategies, however not on the other four domains that were assessed (self-reports of resources, physical self-concept, and connectedness to nature as well as a mental task assessing inhibition). There was no evidence that the additional practice in the mindfulness-plus group significantly added to the intervention's effectiveness. Conclusions: The Mindfulness Education Workbook is a promising tool for elementary schools. Follow-up studies may provide further insights into the various effects of offering mindfulness training in schools. Further research with objective markers may also allow individual aspects under the umbrella term mindfulness to be investigated in more detail. Preregistration: This study was not preregistered. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02084-w.

Use of Multiple-Select Multiple-Choice Items in a Dental Undergraduate Curriculum: Retrospective Study Involving the Application of Different Scoring Methods.

BACKGROUND: Scoring and awarding credit are more complex for multiple-select items than for single-choice items. Forty-one different scoring methods were retrospectively applied to 2 multiple-select multiple-choice item types (Pick-N and Multiple-True-False [MTF]) from existing examination data. OBJECTIVE: This study aimed to calculate and compare the mean scores for both item types by applying different scoring methods, and to investigate the effect of item quality on mean raw scores and the likelihood of resulting scores at or above the pass level (≥0.6). METHODS: Items and responses from examinees (ie, marking events) were retrieved from previous examinations. Different scoring methods were retrospectively applied to the existing examination data to calculate corresponding examination scores. In addition, item quality was assessed using a validated checklist. Statistical analysis was performed using the Kruskal-Wallis test, Wilcoxon rank-sum test, and multiple logistic regression analysis (P<.05). RESULTS: We analyzed 1931 marking events of 48 Pick-N items and 828 marking events of 18 MTF items. For both item types, scoring results widely differed between scoring methods (minimum: 0.02, maximum: 0.98; P<.001). Both the use of an inappropriate item type (34 items) and the presence of cues (30 items) impacted the scoring results. Inappropriately used Pick-N items resulted in lower mean raw scores (0.88 vs 0.93; P<.001), while inappropriately used MTF items resulted in higher mean raw scores (0.88 vs 0.85; P=.001). Mean raw scores were higher for MTF items with cues than for those without cues (0.91 vs 0.8; P<.001), while mean raw scores for Pick-N items with and without cues did not differ (0.89 vs 0.90; P=.09). Item quality also impacted the likelihood of resulting scores at or above the pass level (odds ratio ≤6.977). CONCLUSIONS: Educators should pay attention when using multiple-select multiple-choice items and select the most appropriate item type. Different item types, different scoring methods, and presence of cues are likely to impact examinees' scores and overall examination results.

Analysing the sentiments about the education system trough Twitter.

This paper applies Information and Communication Technologies (ICT) as well as data analysis to gain a better understanding of the existing perception on the education system. 45,278 tweets were downloaded and processed. Using a lexicon-based approach, examining the most frequently used words, and estimating similarities between terms, we detected that a predominantly negative perception of the education system exists in most of the analysed countries. A positive perception is identified in certain low-income nations. Men exhibit a more positive sentiment than women as well as a higher subjectivity in some countries. The countries that exhibit the most positive perceptions India, Canada, Pakistan, Australia, South Africa and Kenya are also those that manifest the highest subjectivity.

Exploring the social accountability challenges of nursing education system in Iran.

BACKGROUND: Nursing education in Iran is one of the disciplines of medical sciences and it needs a design tailored to the community needs in terms of theoretical and clinical approaches. This system is currently faced with various challenges. This study aims to explore the challenges of Iranian nursing education system to address community needs. METHODS: A study was carried out through an exploratory descriptive qualitative design with content analysis method. In-depth semi-structured interviews were conducted with 21 participants from the nursing society, selected through purposive sampling. The interviews were continued until data saturation. Data analysis was performed simultaneous with data collection by using Graneheim & Lundman approach. RESULTS: Based on the interviews and simultaneous analyses, a total of 471 codes, 14 subcategories, six main categories, and two themes were extracted. The first theme, "system structure," consisted of three categories: "the need for ongoing revision of curriculum," "the need to recruit qualified students," and "the need for a proportionate educational environment." The second theme was "the education process" with three categories "the need for purposive educational design," "the need for purposive monitoring and feedback," and "the need for appropriate and early interaction with the community." The participants emphasized the continuous revision of the educational curriculum based on the current needs of the community and community-based nursing education. CONCLUSIONS: In general, the results showed that Iranian nursing education system is faced with many challenges in the educational system structure and processes. It is necessary to make appropriate plans to enhance the status of the educational system structure and develop educational designs to address community needs using a hospital/community-based approach.

Readiness and Challenges of E-Learning during the COVID-19 Pandemic Era: A Space Analysis in Peninsular Malaysia.

During the COVID-19 era, most countries, including Malaysia, have shifted from face-to-face teaching systems to online teaching programs. The aim of this study is to identify the main challenges that higher education students face during e-learning based on their residential location throughout Peninsular Malaysia. This study further examines the readiness of higher education students to apply e-learning. Therefore, a cross-sectional survey approach is used to fulfil the outlined objectives. Accordingly, 761 public (95.3%) and private (4.7%) higher education students residing in Peninsular Malaysia are sampled in this study. The survey was administered online for 37 days, from 21 October 21 to 6 December 2021, using either WhatsApp or Facebook. The raw data is inferentially (Principal Component Analysis, K-Means Clustering, Kruskal Wallis, and spatial analysis) and descriptively (mean, standard deviation & percentage) analyzed. It has been revealed that six clusters of students in Peninsular Malaysia face various challenges while following the e-learning program. Most states in Peninsular Malaysia are dominated by students in Cluster D (Terengganu, Perlis, Penang, Selangor, WP Kuala Lumpur, and WP Putrajaya) and Cluster B categories (Melaka, Johor, Kelantan, and Kedah). Students in the Cluster D category tend to suffer from physical health disorders and social isolation, while students in the Cluster B category face problems with decreased focus in learning, mental health disorders, and social isolation. The outcomes further indicate that the more challenges students face during e-learning programs, the lower their willingness to continue with the program. The results of this study are significant in addressing the challenges of e-learning, which will help stakeholders address and strengthen student abilities.