Exploring the responses of preclinical medical students and professors to flipped learning for the development of clinical reasoning.

PURPOSE: This study developed and implemented case-based flipped learning using illness script worksheets and investigated the responses of preclinical students and professors to the intervention in terms of its effectiveness, design, and implementation. METHODS: The study was conducted at a medical school in Korea, where the "clinical reasoning method" course, originally a lecture-oriented course, was redesigned into a flipped learning. In total, 42 second-year medical students and 15 professors participated in this course. After the class, online surveys were conducted, and a focus group interview was held with seven students to explore the students' experiences in more detail. RESULTS: In total, 37 students and seven professors participated in the survey. The mean score for all items is 3.12/4 for the student survey and 3.43/4 for the professor survey. The focus group interview results were categorized as the beneficial aspects and challenges for the development of clinical reasoning. CONCLUSION: The findings indicated that their responses to the intervention were generally positive, and it is thought to be an effective instructional method for fostering clinical reasoning skills in preclinical medical students.

Development of clinical decision-making among undergraduate nursing students: the effect of unfolding case-based learning.

OBJECTIVES: This prospective cohort study evaluated the effect of unfolding case-based learning on undergraduate nursing students' self-perceived clinical decision-making ability. METHODS: Students' self-reported responses to Jenkins's Clinical Decision Making in Nursing Scale were compared between the unfolding case-based learning cohort (n=140) and the comparison cohort (n=126) at a school of nursing in the United States. RESULTS: The results revealed similar students' responses between the two study cohorts. However, unfolding case-based learning significantly increased students' perceived proficiency in "search for information and unbiased assimilation of new information". CONCLUSIONS: Findings from the present study highlight possibilities presented by unfolding case-based learning in undergraduate nursing education. The study supports that unfolding case studies can be introduced early on, and then nurtured throughout the undergraduate program to influence the development of nursing students' clinical decision-making skills.

Moving Beyond Hemangioma: Interactive, Multidisciplinary, Case-Based Teaching in Vascular Anomalies for Pediatric Residents.

Introduction: Vascular anomalies are a spectrum of disorders, including vascular tumors and malformations, that often require multispecialty care. The rarity and variety of these lesions make diagnosis, treatment, and management challenging. Despite the recognition of the medical complexity and morbidity associated with vascular anomalies, there is a general lack of education on the subject for pediatric primary care and subspecialty providers. A needs assessment and the lack of an available standardized teaching tool presented an opportunity to create an educational workshop for pediatric trainees using the POGIL (process-oriented guided inquiry learning) framework. Methods: We developed a 2-hour workshop consisting of an introductory didactic followed by small- and large-group collaboration and case-based discussion. The resource included customizable content for learning assessment and evaluation. Residents completed pre- and posttest assessments of content and provided written evaluations of the teaching session. Results: Thirty-four learners in pediatrics participated in the workshop. Session evaluations were positive, with Likert responses of 4.6-4.8 out of 5 on all items. Pre- and posttest comparisons of four content questions showed no overall statistically significant changes in correct response rates. Learners indicated plans to use the clinical content in their practice and particularly appreciated the interactive teaching forum and the comprehensive overview of vascular anomalies. Discussion: Vascular anomalies are complex, potentially morbid, and often lifelong conditions; multispecialty collaboration is key to providing comprehensive care for affected patients. This customizable resource offers a framework for trainees in pediatrics to appropriately recognize, evaluate, and refer patients with vascular anomalies.

Community-oriented primary care footprinting: An undergraduate programme experience.

The Nelson Mandela Fidel Castro (NMFC) programme, a government initiative to address healthcare inequities in South Africa, focuses on the training of indigenous students to become competent healthcare practitioners. A collaboration combining training in a Cuban primary care, preventative system with integration in a South African institution within a quadruple disease burdened healthcare system. This article reflects on integration experience at the University of Witwatersrand, a programme pedagogically positioned within a workplace-based, situated learning framework. Since 2022, community-oriented primary care (COPC) projects became part of the integrated primary care and family medicine learning objectives. This article summarises the experience of the 2021-2022 cohort and calls for the strengthening of undergraduate medical education curricula with learning objectives reflective of social accountability.Contribution: This article spotlights work in the undergraduate space around teaching and experiential learning of community-oriented primary care in line with the journal's scope.

Implementing a challenge-based learning experience in a bioinstrumentation blended course.

BACKGROUND: Bioinstrumentation is essential to biomedical engineering (BME) undergraduate education and professional practice. Several strategies have been suggested to provide BME students with hands-on experiences throughout the curriculum, promoting their preparedness to pursue careers in industry and academia while increasing their learning and engagement. This paper describes the implementation of challenge-based learning (CBL) in an undergraduate bioinstrumentation blended course over the COVID-19 pandemic. METHODS: The CBL experience was implemented in a third-year bioinstrumentation course from the BME program at Tecnologico de Monterrey. Thirty-nine students enrolled in two sections formed fourteen teams that tackled blended learning activities, including online communication, lab experiments, and in-person CBL activities. Regarding the latter, students were challenged to design, prototype, and test a respiratory or cardiac gating device for radiotherapy. An institutional student opinion survey was used to assess the success of our CBL implementation. RESULTS: Student responses to the end-of-term survey showed that they strongly agreed that this course challenged them to learn new concepts and develop new skills. Furthermore, they rated the student-lecturer interaction very positively despite the blended format. Overall, students assessed their learning experience positively. However, implementing this CBL experience required a substantial time increase in planning, student tutoring, and constant communication between lecturers and the industry partner. CONCLUSION: This work provides an effective instance of CBL for BME education to improve students' learning experience despite decreased resource efficiency. Our claim is supported by the student's performance and the positive feedback from our industrial partner.

Assessing readiness: the impact of an experiential learning entrustable professional activity-based residency preparatory course.

As medical schools move to integrate the Core Entrustable Professional Activities for Entering Residency (EPAs) into curricula and address the transition from student to resident, residency preparatory courses have become more prevalent. The authors developed an experiential learning EPA-based capstone course for assessment to determine impact on learner self-assessed ratings of readiness for residency and acquisition of medical knowledge. All fourth-year students from the classes of 2018-2020 completed a required course in the spring for assessment of multiple EPAs, including managing core complaints, performing basic procedures, obtaining informed consent, and providing patient handoffs. Learners selected between three specialty-based parallel tracks - adult medicine, surgery, or pediatrics. Students completed a retrospective pre-post questionnaire to provide self-assessed ratings of residency preparedness and comfort in performing EPAs. Finally, the authors studied the impact of the course on knowledge acquisition by comparing student performance in the adult medicine track on multiple choice pre- and post-tests. Four hundred and eighty-one students were eligible for the study and 452 (94%) completed the questionnaire. For all three tracks, there was a statistically significant change in learner self-assessed ratings of preparedness for residency from pre- to post-course (moderately or very prepared: adult medicine 61.4% to 88.6% [p-value < 0.001]; surgery 56.8% to 81.1% [p-value < 0.001]; pediatrics 32.6% to 83.7% [p-value 0.02]). A similar change was noted in all tracks in learner self-assessed ratings of comfort from pre- to post-course for all studied EPAs. Of the 203 students who participated in the adult medicine track from 2019-2020, 200 (99%) completed both the pre- and post-test knowledge assessments. The mean performance improved from 65.0% to 77.5% (p-value < 0.001). An experiential capstone course for the assessment of EPAs can be effective to improve learner self-assessed ratings of readiness for residency training and acquisition of medical knowledge.

From Slow Shifts to Fast Flips: Unraveling problem-based learning group function dynamics.

PURPOSE: Problem-Based Learning (PBL) relies on self-directed learning in small groups in the presence of a tutor. While the effectiveness of PBL is often attributed to the dynamics of group function, change in group function over time and factors influencing group function development are less understood. This study aims to explore the development of PBL group function over time to better understand the factors that give rise to high-functioning groups. METHOD: We examined time-function graphs of group function and conducted semi-structured focus group discussions in 2023 with medical students enrolled in a PBL curriculum. Students reflected on their experiences in four different PBL groups, creating time-function graphs to characterize development of group function over 8-12-week periods. We analyzed graphs and transcripts in a staged approach using qualitative description and direct content analysis, sensitized by two frameworks: Tuckman's Stages of Group Development and the Dimensions of PBL Group Function. RESULTS: Three archetypes of PBL group function development were identified: Slow Shifters, Fast Flippers, and Coasters. (1) Slow Shifters were characterized by a complex and extended pattern of growth consistent with Tuckman's model, typically occurring amongst inexperienced groups, or groups faced with a novel task. (2) Fast Flippers were characterized by abrupt state changes in group function arising from internal or external disruptions. (3) Coasters were characterized by plateaus, where maintenance of group function was a frequently cited challenge. Abrupt changes and plateaus occurred more among mature groups and groups with significant PBL experience. CONCLUSIONS: PBL group function varies over time in 3 different patterns. Classic Tuckman's stages are apparent among inexperienced groups, or groups facing novel tasks, whereas experienced groups often face abrupt change or plateaus. PBL educators and students should consider the need for novelty and disruption in more experienced groups to incite growth.

Exploring perceptions of pre-clerkship students about workplace learning in the clinical learning environment at Gulf Medical University, UAE.

BACKGROUND: Medical students view clinical workplace placements as an inspiring and motivating learning environment where active student participation is pivotal to development of students' identity. The progress from pre-clerkship to clerkship education harbors many challenges which consist of experiential learning, adjusting to the clinical environment, and understanding roles & responsibilities. Workplace learning is underpinned by various adult learning theories including social theories,constructivism, supported participation and legitimate peripheral participation. Workplace learning course was recently initiated for pre-clerkship students at a medical university in UAE, which will enable their smooth entry into the clerkship phase of the curriculum. OBJECTIVES: The research aims to explore students' perceptions of various domains of their clinical learning environment (CLE), highlight the challenges they face, and extract valuable feedback to improve their environment. METHODS: This study was conducted qualitatively by using focus groups method in order to explore students' perceptions of the clinical learning environment. Two focus group discussions were conducted (n = 8 +/-10) to determine the common challenges of workplace learning and its potential solutions. Data were analyzed using thematic analysis. The approach used to carry out this study was phenomenology, as it helps to understand the learning and behavior of these students who are undergoing this pre-clerkship training in order to transition smoothly to the clerkship phase. RESULT: The focus groups helped to deeply explore the perceptions of students about their clinical learning environment. It helped to reveal the challenges encountered by the students including the significance of proper orientation of staff and students, language barrier, availability of learning opportunities, and supervision quality. The focus groups provided worthwhile suggestions to improve the learning opportunities in the clinical learning environment which include orientation of the staff and students what to expect, improved supervision, mentoring and providing learning opportunities to encourage participation. CONCLUSION: This study attempted to identify the pre-clerkship students' perception of their clinical learning environment and the challenges they face over there. Possible suggestions by the students included a formal orientation for the staff and students to be carried out at the beginning. Efforts should be made by clerkship directors to provide students with learning opportunities by increasing patient exposure, encouraging participation, and providing high-quality supervision.

Academic performance among pharmacy students using virtual vs. face-to-face team-based learning.

INTRODUCTION: This study compares pharmacy students' performance using face-to-face (FTF) team-based learning (TBL) vs. virtual TBL across multiple courses and different academic levels while accounting for student demographic and academic factors. METHODS: The study included pharmacy students from different academic levels (P1-P3) who were enrolled in three didactic courses taught using FTF TBL and virtual TBL. Multiple generalized linear models (GLMs) were performed to compare students' performance on individual readiness assurance tests (iRATs), team readiness assurance tests (tRATs), team application exercises (tAPPs), summative exams, and total course scores using FTF TBL vs. virtual TBL, adjusting for students' age, sex, race, and cumulative grade point average (cGPA). RESULTS: The study involved a total of 356 pharmacy students distributed across different academic levels and learning modalities: P1 students [FTF TBL (n = 26), virtual TBL (n = 42)], P2 students [FTF TBL (n = 77), virtual TBL (n = 71)], and P3 students [FTF TBL (n = 65), virtual TBL (n = 75)]. In the P1 cohort, the virtual group had higher iRAT and tRAT scores but lower tAPP scores than the FTF TBL group, with no significant differences in summative exams or total course scores. For P2 students, the virtual TBL group had higher iRAT and tRAT scores but lower summative exam scores and total course scores than the FTF TBL group, with no significant differences in tAPP scores. In the P3 student group, the virtual TBL group had higher iRAT, tRAT, tAPP, summative exam, and total course scores than the FTF TBL group. CONCLUSIONS: Students' performance in virtual TBL vs. FTF TBL in the pharmacy didactic curriculum varies depending on the course content, academic year, and type of assessment.

Effectiveness of a flipped classroom for undergraduate in implant dentistry hands-on course.

PURPOSE: The purpose of this study was to compare the learning in the implant dentistry hands-on course to that of the flipped classroom (FC) and the traditional lecture cohorts (control). MATERIALS AND METHODS: In this study,80 students were enrolled for the first time in an implant dentistry program. Subsequently, they were divided into two groups. The first, the FC group, which had free access to a video with a PowerPoint presentation on the Chaoxing-WHU-MOOC platform about the implant placement on first molar sites before class. The second, the control group, which attended a didactic lecture describing implant practice on the first molar site via a bidirectional multimedia interactive teaching demonstration and then operated on a simulation model. Cone beam computed tomography (CBCT) and the deviation gauge were utilized to analyze the accuracy of the implant placement in the students' models. An online satisfaction questionnaire was distributed to both groups one week after the class. RESULTS: The linear deviation of the CBCT examination did not show any statistical difference between the two groups concerning cervical, apex, and angular. A significant buccal deviation was observed in the control group compared with the FC group (mean: 0.7436 mm vs. 0.2875 mm, p = 0.0035), according to the restoration-level deviation gauge. A total of 74.36% of students in the FC group placed implant within 0.5 mm buccal-to-lingual deviations, but only 41.03% of students in the control group reached within 0.5 mm buccal-to-lingual deviation ranges. Additionally, 91.67% of the students in the FC group and 97.5% of the students in the control group were satisfied with the practical implant class. CONCLUSION: FC was more effective than a didactic lecture for implant dentistry practical skill acquisition.

Paper-based versus digital-based learning among undergraduate medical, nursing and pharmaceutical students in Japan: a cross-sectional study.

OBJECTIVE: Since the emergence of COVID-19, university education has drastically transformed into digital-based learning (DBL). Online education has been well recognised as a promising mode of teaching; however, only a limited number of studies have reported the students' preferred format for academic learning. DESIGN: Cross-sectional. SETTING: The study was conducted in a university setting in Japan. A Google Forms online questionnaire was distributed to the participants between April and May 2022. PARTICIPANTS: A total of 939 undergraduate medical, nursing and pharmaceutical students in the pre-clinical grade were recruited, and 344 were included in the final analysis. PRIMARY AND SECONDARY OUTCOME: The questionnaire assessed students' format preferences between paper-based learning (PBL) and DBL as it pertained to academic performance and eyestrain. In terms of academic performance, comprehension, memory retention and absorption (concentration) were assessed. We also explored the association between students' daily time spent using DBL and their digital preference by the Cochran-Armitage trend test and logistic regression analysis. RESULTS: A total of 344 (191 medical, 73 nursing and 80 pharmaceutical) university students completed the questionnaire (response rate 36.6%). An even distribution was observed in the preferred learning format for comprehension: PBL (32.0%), both formats equivalent (32.8%) and DBL (35.2%; digital preference). Only few students preferred DBL for memory retention (6.1%), absorption (6.7%) and eyestrain (1.2%). Although a positive association was observed between daily time spent using DBL and digital preference for comprehension, there was no association for memory retention, absorption and eyestrain. CONCLUSION: Among university students, DBL was just as preferred as PBL for comprehension; however, only a few students reported that DBL was better in terms of memory retention, absorption and eyestrain. A learning environment where students can study using PBL should be continued.

Nursing students' experiences of flipped classroom teaching method in higher education: a systematic review.

BACKGROUND: During the COVID-19 pandemic face-to-face activities were suspended, boosting the delivery of online teaching. As students returned to campuses, the delivery of active learning teaching methods followed a blended learning style. The flipped classroom, which is a student-centred approach, appears to be an effective teaching method, generating improved learning outcomes. No systematic review has so far explored students' experiences of this teaching method - a knowledge gap that this review aims to address. METHODS: Studies published between 2012 and 2023 were identified from seven databases. The JBI critical appraisal tool was adopted to select high-quality studies and add credibility. Following extraction of qualitative data, meta-aggregation was used to identify synthesised findings. RESULTS: The findings were aggregated into seven categories. Based on meaning similarity, three synthesised findings were identified to answer the research question on how nursing students experience the flipped classroom method. CONCLUSION: Several factors affect the student experience. Although variables are interrelated and complex to analyse, this approach is a valuable teaching method, positively experienced by students with the potential to improve engagement and learning outcomes. The group activities used as a feature of the flipped classroom can be seen as an instrument to deliver a safer and high quality of care.

Beyond active learning: Using 3-Dimensional learning to create scientifically authentic, student-centered classrooms.

In recent years, much of the emphasis for transformation of introductory STEM courses has focused on "active learning", and while this approach has been shown to produce more equitable outcomes for students, the construct of "active learning" is somewhat ill-defined and is often used as a "catch-all" that can encompass a wide range of pedagogical techniques. Here we present an alternative approach for how to think about the transformation of STEM courses that focuses instead on what students should know and what they can do with that knowledge. This approach, known as three-dimensional learning (3DL), emerged from the National Academy's "A Framework for K-12 Science Education", which describes a vision for science education that centers the role of constructing productive causal accounts for phenomena. Over the past 10 years, we have collected data from introductory biology, chemistry, and physics courses to assess the impact of such a transformation on higher education courses. Here we report on an analysis of video data of class sessions that allows us to characterize these sessions as active, 3D, neither, or both 3D and active. We find that 3D classes are likely to also involve student engagement (i.e. be active), but the reverse is not necessarily true. That is, focusing on transformations involving 3DL also tends to increase student engagement, whereas focusing solely on student engagement might result in courses where students are engaged in activities that do not involve meaningful engagement with core ideas of the discipline.

Enhancing AI competence in health management: students' experiences with ChatGPT as a learning Tool.

BACKGROUND: The healthcare industry has had to adapt to significant shifts caused by technological advancements, demographic changes, economic pressures, and political dynamics. These factors are reshaping the complex ecosystem in which healthcare organizations operate and have forced them to modify their operations in response to the rapidly evolving landscape. The increase in automation and the growing importance of digital and virtual environments are the key drivers necessitating this change. In the healthcare sector in particular, processes of change, including the incorporation of artificial intelligent language models like ChatGPT into daily life, necessitate a reevaluation of digital literacy skills. METHODS: This study proposes a novel pedagogical framework that integrates problem-based learning with the use of ChatGPT for undergraduate healthcare management students, while qualitatively exploring the students' experiences with this technology through a thematic analysis of the reflective journals of 65 students. RESULTS: Through the data analysis, the researcher identified five main categories: (1) Use of Literacy Skills; (2) User Experiences with ChatGPT; (3) ChatGPT Information Credibility; (4) Challenges and Barriers when Working with ChatGPT; (5) Mastering ChatGPT-Prompting Competencies. The findings show that incorporating digital tools, and particularly ChatGPT, in medical education has a positive impact on students' digital literacy and on AI Literacy skills. CONCLUSIONS: The results underscore the evolving nature of these skills in an AI-integrated educational environment and offer valuable insights into students' perceptions and experiences. The study contributes to the broader discourse about the need for updated AI literacy skills in medical education from the early stages of education.

Effects of flipped classroom teaching in anaesthesiology residents: a protocol for systematic review and meta-analysis.

INTRODUCTION: The flipped classroom teaching model is widely used in medical education and is indicated to be better than traditional lecture approaches in many medical specialties. Emerging studies have evaluated the effects of the flipped classroom teaching model on anaesthesiology residents. This protocol aims to perform a systematic review and meta-analysis to determine whether the flipped classroom teaching model is superior to traditional teaching methods for anaesthesiology residents. METHODS AND ANALYSIS: Seven databases, including PubMed, Web of Science, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure, Wanfang Data and the VIP database, will be systematically searched from their inception to 1 June 2024. Randomised controlled trials that compared the effects of flipped classrooms versus traditional teaching methods in anaesthesiology residents will be included. The primary outcome will be the theoretical knowledge score. The secondary outcomes will include skill scores and the proportion of anaesthesiology residents who preferred the flipped classroom model. RevMan V.5.4 software will be used to perform the statistical analysis. The Grading of Recommendation, Assessment, Development and Evaluation approach will assess the quality of evidence. ETHICS AND DISSEMINATION: Ethical approval is not applicable to this protocol. The results of this study will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42024497935.

Integration of case-based learning and three-dimensional printing for tetralogy of fallot instruction in clinical medical undergraduates: a randomized controlled trial.

BACKGROUND: Case-based learning (CBL) methods have gained prominence in medical education, proving especially effective for preclinical training in undergraduate medical education. Tetralogy of Fallot (TOF) is a congenital heart disease characterized by four malformations, presenting a challenge in medical education due to the complexity of its anatomical pathology. Three-dimensional printing (3DP), generating physical replicas from data, offers a valuable tool for illustrating intricate anatomical structures and spatial relationships in the classroom. This study explores the integration of 3DP with CBL teaching for clinical medical undergraduates. METHODS: Sixty senior clinical medical undergraduates were randomly assigned to the CBL group and the CBL-3DP group. Computed tomography imaging data from a typical TOF case were exported, processed, and utilized to create four TOF models with a color 3D printer. The CBL group employed CBL teaching methods, while the CBL-3DP group combined CBL with 3D-printed models. Post-class exams and questionnaires assessed the teaching effectiveness of both groups. RESULTS: The CBL-3DP group exhibited improved performance in post-class examinations, particularly in pathological anatomy and TOF imaging data analysis (P < 0.05). Questionnaire responses from the CBL-3DP group indicated enhanced satisfaction with teaching mode, promotion of diagnostic skills, bolstering of self-assurance in managing TOF cases, and cultivation of critical thinking and clinical reasoning abilities (P < 0.05). These findings underscore the potential of 3D printed models to augment the effectiveness of CBL, aiding students in mastering instructional content and bolstering their interest and self-confidence in learning. CONCLUSION: The fusion of CBL with 3D printing models is feasible and effective in TOF instruction to clinical medical undergraduates, and worthy of popularization and application in medical education, especially for courses involving intricate anatomical components.

Development of a curricular thread to foster medical students' critical reflection and promote action on climate change, health, and equity.

INTRODUCTION: Due to the health consequences arising from climate change, medical students will inevitably interact with affected patients during their training and careers. Accordingly, medical schools must incorporate education on the impacts of climate change on health and equity into their curricula. We created a curricular thread called "Climate Change, Health, and Equity" in the first-year preclinical medical program to teach foundational concepts and foster self-reflection and critical consciousness. METHODS: The authors developed a continuum of practice including administrators, educators and faculty members, students, and community partners to plan and design curricular activities. First-year medical students at Duke University School of Medicine participated in seven mandatory foundational lectures and two experiential learning opportunities in the local community. Following completion of activities, students wrote a critical reflection essay and completed a self-directed learning exercise. Essays were evaluated using the REFLECT rubric to assess if students achieved critical reflection and for thematic analysis by Bloom's Taxonomy. RESULTS: All students (118) submitted essays. A random sample of 30 (25%) essays underwent analysis. Evaluation by the REFLECT rubric underscored that all students were reflecting or critically reflecting on thread content. Thematic analysis highlighted that all students (30/30, 100%) were adept at identifying new areas of medical knowledge and connecting concepts to individual experiences, institutional practices, and public health and policy. Most students (27/30; 90%) used emotionally laden words, expressing negative feelings like frustration and fear but also positive sentiments of solidarity and hope regarding climate change and effects on health. Many students (24/30; 80%) expressed actionable items at every level including continuing self-directed learning and conversing with patients, minimizing healthcare waste, and advocating for climate-friendly policies. CONCLUSION: After participating in the curricular thread, most medical students reflected on cognitive, affective, and actionable aspects relating to climate change, health, and equity.

Effects of different geriatric nursing teaching methods on nursing students' knowledge and attitude: Systematic review and network meta-analysis.

OBJECTIVE: The purpose of this study was to evaluate the effect of different teaching methods of geriatric nursing on the mastery of geriatric knowledge among nursing students and their attitude toward the elderly. METHODS: Relevant randomized controlled trials (RCTs) and quasi-experimental studies on teaching methods to improve nursing students' knowledge and attitude were systematically retrieved in electronic databases. The time scale of retrieval spans from the database establishment to January 2024, and the database consists of PubMed, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure Database (CNKI), China Biological literature database (CBM), Wanfang Database and VIP Database. Network meta-analysis was performed by Stata 16.0 software. RESULTS: Thirty-nine studies involving 5310 nursing students met our inclusion criteria, and a total of 6 teaching methods were analyzed. According to the surface under the cumulative ranking (SUCRA) ranking, problem-based learning (PBL) was most effective in enhancing the knowledge mastery of geriatric nursing, while simulation-based learning (SBL) demonstrated the best application effect in improving nursing students' attitude toward the elderly. When considering both knowledge acquisition and attitude improvement simultaneously, service learning combined with traditional teaching method (SL+TTM) was found to exhibit the most optimal effectiveness. CONCLUSION: Educators in geriatric nursing education should prioritize the adoption of PBL, SBL and SL + TTM to enhance nursing students' knowledge and attitude. PROTOCOL REGISTRY: PROSPERO (CRD42023442001).

A Cycle of Reinforcing Challenges and Ideas for Action in Experiential Settings.

Evidence suggests that both pharmacy students and preceptors are struggling in the experiential setting. Underlying this phenomenon is a potential interconnected and cyclic set of behaviors being reinforced between students and preceptors. These behaviors can contribute to or are the result of higher levels of burnout and a decrease in the development of student clinical skills and subsequent performance on rotation. In this review, the authors investigate various challenges commonly encountered in the experiential environment. These challenges can range from an observed decrease in student engagement, motivation, and critical thinking skills to an increase in preceptor burnout and culture shifts in the clinical practice environments. These factors all ultimately impact patient care and overall student performance. For each challenge identified, strategies will be presented that can be implemented by students, preceptors, and pharmacy programs to break the cyclic pattern identified.

Barriers to implementing problem-based learning at the school of medicine of Debre Berhan University, Ethiopia.

BACKGROUND: Implementing PBL in teaching and learning can be challenging due to a variety of complex barriers. Studies on barriers to the implementation of problem-based learning in Ethiopia are scarce. This study aimed to explore the barriers to the implementation of problem-based learning at the Debre Berhan University Medical School. METHODS: A qualitative study was conducted among faculty and medical students at the medical school. Purposive sampling was used to select participants. Semi-structured interviews were conducted with tutors and academic leaders, including the problem-based learning coordinator, the biomedical sciences coordinator, and the school dean. Data was also collected from students through focus group discussions. All interviews and discussions were recorded. The four steps of data analysis of Spradley, including domain analysis, taxonomic analysis, componential analysis, and theme analysis, were employed. RESULTS: The study identified student-related, tutor-related, case scenario-related, and assessment-related barriers as the most significant obstacles to implementing problem-based learning. These barriers included work overload for both students and tutors, lack of training and experience among tutors, student reluctance, absence of standardized case scenarios, subjectivity of assessment methods, and on-the-spot assessment of students. CONCLUSIONS AND RECOMMENDATIONS: Lack of both tutor and student commitment, lack of standardized cases, absence of a recognition of staff input, gap in communication skills, work overload, lack of continuous training, and at-spot evaluation of students were identified as the main barriers to the implementation of PBL.