Fostering the Facilitator: Promoting Clinical Educators' Interprofessional Education Facilitation Skills and Socialization Using Exclusively Online Learning.

Health professions educators can benefit from continuing education to more effectively facilitate interprofessional education (IPE) in clinical settings. Online learning formats enable broader participation and overcome barriers to in-person events, though few studies describe the most effective platforms and methods of online continuing education for this purpose. In the context of the COVID-19 pandemic, we developed a 6-week interactive online program implemented via an integrated online educational platform (OEP) to equip participants with knowledge and skills to better facilitate IPE in clinical settings. Program outcomes evaluation involved mixed-methods data analysis from OEP site usage statistics, pre/post-program surveys, pre/post program validated self-assessment surveys, and post-pro¬gram focus group. Twenty-four participants representing 5 professions from inpatient and outpatient clinical settings completed the program. Quantitative findings include statistically significant improvement in all of 11 measures of IPE knowledge and skills developed for this study, 4 of 9 socialization measures, and 7 of 18 facilitation measures. Qualitative findings include participants placing value on multiple modes of instruction, facilitated small group engagement, brief condensed asynchronous content, clear expectations of program time commitment, and detailed understanding of the OEP.

'[M]y own pace and space, without the pressures': Online learning experiences of audiology students.

BACKGROUND:  Online learning has been used to improve students' learning experiences and to allow students to engage with their own learning in various spaces. However, there is a dearth of literature on students' experiences with online learning in the field of audiology. OBJECTIVES:  This study aimed to describe the conditions of online learning, explore the challenges and benefits of online learning and determine strategies that students employ while engaging with online learning. METHOD:  An exploratory qualitative research design was employed. Audiology students from the second to the fourth year participated in the study. Qualitative data were collected online via MS Teams using a semi-structured interview schedule with the participants. Thematic analysis was used to analyse the participants' interviews. RESULTS:  Most of our participants were females in their fourth year of study. The students accessed the online learning platforms procured by the university from their homes, with reported benefits such as the flexibility and independence of learning, and time and cost-effectiveness. However, challenges such as limited internet connectivity, issues with time management and inconsistent power supply restricted positive experiences with online learning. CONCLUSION:  The online learning benefits that were reported by the students and the compensatory strategies they employed facilitated self-regulated learning. The study's findings highlighted the need for continuous checking-in with students regarding their experiences with the learning approaches intended to improve engagement with their courses. These results could be used as a guide for curriculum planning that is student-focused.Contribution: Students' experiences explored in our study provided a guide for online learning approaches that were suitable for audiology students. Student-centred and self-regulated learning practices were highlighted and future studies may further explore these frameworks and theories.

Electronic distance based clinical skills training development in family medicine in Namibia.

Workplace-based evaluation is one of the most important, but challenging aspects of medical education. The aim was to improve the assessment of the rural community-based clinical training for undergraduate 3rd and 4th year family medicine students at the University of Namibia (UNAM) and implement a paperless process. An online module was developed on the Moodle platform to include a study guide, an electronic portfolio, and electronic resources (e-books and apps) to replace the current paper version of the logbook. We explored local resources by engaging with students and clinical trainers on how to best conduct the initial implementation. Engagement also entailed motivating students to actively participate in the implementation process. All 3rd and 4th year community-based education end service (COBES) students are now submitting proof of clinical learning electronically with the use of their phones in their online portfolio and using online resources. In addition, students in the practical family medicine module that has been introduced in the 6th year since 2023 are now also using an electronic portfolio and these assessment tools.Contribution: Overall feedback from students and supervisors indicates a positive atmosphere of learning and constructive feedback on performance from all team members, hopefully improving work-based assessments and ultimately patient care. More members of the primary health care team were involved and the carbon footprint has also been decreased.

Exploring the impact of nonverbal social behavior on learning outcomes in instructional video design.

Online education has become increasingly popular in recent years, and video lectures have emerged as a common instructional format. While the importance of instructors' nonverbal social cues such as gaze, facial expression, and gestures for learning progress in face-to-face teaching is well-established, their impact on instructional videos is not fully understood. Most studies on nonverbal social cues in instructional videos focus on isolated cues rather than considering multimodal nonverbal behavior patterns and their effects on the learning progress. This study examines the role of instructors' nonverbal immediacy (a construct capturing multimodal nonverbal behaviors that reduce psychological distance) in video lectures with respect to learners' cognitive, affective, and motivational outcomes. We carried out an eye-tracking experiment with 87 participants (Mage = 24.11, SD = 4.80). Results of multilevel path analyses indicate that high nonverbal immediacy substantially increases learners' state motivation and enjoyment, but does not affect cognitive learning. Analyses of learners' eye movements show that learners allocate more attention to the instructor than to the learning material with increasing levels of nonverbal immediacy displayed by the instructor. The study highlights the importance of considering the role of multimodal nonverbal behavior patterns in online education and provides insights for effective video lecture design.

Research on the influencing factors of adult learners' intent to use online education platforms based on expectation confirmation theory.

This study addresses the understanding gap concerning the factors that influence the continuous learning intention of adult learners on online education platforms. The uniqueness and significance of this study stem from its dual focus on both platform features, such as service quality, and course features, including perceived interactivity and added value, aspects often overlooked in previous research. Rooted in Expectation Confirmation Theory, the study constructs a comprehensive model to shed light on the complex interplay of these factors. Empirical evidence collected from a survey of 1592 adult learners robustly validates the effectiveness of this model. The findings of the study reveal that platform service quality, perceived interactivity, and perceived added value significantly amplify adult learners' expectation confirmation and perceived usefulness. These elements subsequently enhance learner satisfaction, fostering their ongoing intention to use online education platforms. These insights offer practical guidance for online education providers, emphasizing the necessity to enhance platform service quality and course features to meet adult learners' expectations and perceived usefulness. The study provides valuable perspectives for devising strategies to boost user satisfaction and stimulate continuous usage intention among adult learners in the intensely competitive online education market. This study enriches the literature by uncovering the relationships among platform features, course features, expectation confirmation, perceived usefulness, and continuous usage intention. By proposing a comprehensive model, this study provides a novel theoretical basis for understanding how platform and course features impact adult learners' ongoing intention to use online education platforms, thereby aiding the evolution and refinement of relevant theories.

Changes in rehabilitation students' clinical placement and clinical competence at graduation during the COVID-19 pandemic: A pilot study.

BACKGROUND: The COVID-19 pandemic has affected physical and occupational therapist education in various ways. OBJECTIVE: This study investigated whether the pandemic changed clinical placement, thus influencing the clinical competence of physical and occupational therapists at a hospital in Japan. METHODS: Eleven therapists (seven physical and four occupational) participated in this study in April 2021. Clinical placement teaching methods were surveyed using an online questionnaire. The Objective Structured Clinical Examination (OSCE), comprising attitudinal and technical items, was used to examine clinical competence. The results were calculated as the sum of the attitudinal and technical scores, and the ratios of these scores to the full score were compared using a paired-sample Wilcoxon signed-rank test. RESULTS: During the pandemic, some schools implemented shortened practical clinical placements. The substituted classes included online-only classes and combined online and face-to-face classes. Regarding clinical competence, scores on the OSCE were mostly high. The median proportion of the total attitudinal score to the perfect score was 100% for all three items (range-of-motion test, muscle strength test, Stroke Impairment Assessment Set). The median proportion of the total technical score to the perfect score ranged from 56.7% to 76.7% for the three items. The ratio of the total attitudinal score to the full score was significantly higher than that of the total technical score to the full score (p = 0.001). CONCLUSIONS: Most clinical placements were canceled or partially administered through online learning during the pandemic. This decrease in clinical placements did not affect newly recruited physical and occupational therapists' clinical competence.

Adoption of mobile learning in the university context: Systematic literature review.

The study on the adoption of mobile learning in university education reveals a growing interest in mobile technologies to improve the learning process; both the acceptance and rejection of these tools among students have been analyzed. However, there are gaps in the research that require a deeper exploration of the factors that influence the adoption and use of these technologies. Understanding these aspects is crucial to optimize mobile learning strategies and improve the educational experience in the university setting. The objective is to examine research trends regarding the topic. PRISMA-2020 is used in the Scopus and Web of Science databases. The results show the questionnaires as the main collection instruments; geographical contexts show that it has been researched predominantly in Asia; The studies have focused on university students; the most applied theories are TAM and UTAUT; and latent variables such as behavioral intention and attitude. The conclusions summarize the trends and patterns observed in the reviewed literature, as well as the research gaps identified, providing a solid foundation for future research and highlighting the importance of addressing this issue in the current context of digital education. The systematic review identifies key models and factors in the adoption of mobile learning in university settings, revealing both theoretical and practical implications. Furthermore, this text provides practical guidance for selecting effective data collection tools and making informed educational and policy decisions. However, it acknowledges limitations such as potential publication and language bias in the search process.

Digital Health Education for the Future: The SaNuRN (Santé Numérique Rouen-Nice) Consortium's Journey.

SaNuRN is a five-year project by the University of Rouen Normandy (URN) and the Côte d'Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical professions students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is a project aimed at educating and training health-related and paramedics students in digital health. The project results from a cooperative effort between URN and CAU, covering four French departments. The project is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20 to 30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a two-tier system involving facilitators who will enable the efficient expansion of the project's educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for healthcare professionals in clinical practice. The SaNuRN team introduced new ways of evaluating healthcare professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, the SaNuRN project represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. The SaNuRN project provides a comprehensive, personalized 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The program is enhanced using AI and NLP to create virtual patients and professionals for digital healthcare simulation. SaNuRN teaching materials are open-access. The project collaborates with academic institutions worldwide to develop educational material in digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements.

Nurturing the Human Dimension in Digital and Medical Spaces Through Pedagogy of Care - a Case of Creative Enquiry.

The COVID-19 pandemic ushered in digital learning experiences to front and centre of medical education in disruptive ways. As the pandemic subsides students and educators sigh in relief, longing to move away from the loneliness and disconnection and back to the norms of face-to-face learning and consulting. In the field of medical education however, the need for digital education has exponentially increased over the decade with strong evidence for future growth. We face the pressure of increasing student numbers on clinical placement and some students now desire or even need hybrid options for the flexibility of time, place, and pace. There is persistent criticism that digital education lacks human connection. This paper argues, however, that it is possible and vital to humanise the virtual learning experience, though particular attention needs to be given to digital pedagogy and relational aspects of learning and teaching. Drawing on Noddings' pedagogies of care and her theoretical model, we unpack one case-study of a medical education elective course that transitioned online during the pandemic. The aim of this paper is to engage medical educators with the pedagogy of care and relational pedagogy literature, which are currently almost absent from the medical education literature, as applied to the digital education realm. Core themes include modelling care and connection, enabling dialogue, inviting student engagement and practice in caring for each other and supporting the deeper work of being present themselves and confirming each other. Limitations and implications for future research will also be explored.

An adaptable and personalized framework for top-N course recommendations in online learning.

In recent years, the proliferation of Massive Open Online Courses (MOOC) platforms on a global scale has been remarkable. Learners can now meet their learning demands with the help of MOOC. However, learners might not understand the course material well if they have access to a lot of information due to their inadequate expertise and cognitive ability. Personalized Recommender Systems (RSs), a cutting-edge technology, can assist in addressing this issue. It greatly increases resource acquisition through personalized availability for various people of all ages. Intelligent learning methods, such as machine learning and Reinforcement Learning (RL) can be used in RS challenges. However, machine learning needs supervised data and classical RL is not suitable for multi-task recommendations in online learning platforms. To address these challenges, the proposed framework integrates a Deep Reinforcement Learning (DRL) and multi-agent approach. This adaptive system personalizes the learning experience by considering key factors such as learner sentiments, learning style, preferences, competency, and adaptive difficulty levels. We formulate the interactive RS problem using a DRL-based Actor-Critic model named DRR, treating recommendations as a sequential decision-making process. The DRR enables the system to provide top-N course recommendations and personalized learning paths, enriching the student's experience. Extensive experiments on a MOOC dataset such as the 100 K Coursera course review validate the proposed DRR model, demonstrating its superiority over baseline models in major evaluation metrics for long-term recommendations. The outcomes of this research contribute to the field of e-learning technology, guiding the design and implementation of course RSs, to facilitate personalized and relevant recommendations for online learning students.

COVID-19 hotspot detection in a university setting.

The onset of the COVID-19 pandemic commenced an era of widespread disruptions in the academic world, including shut downs, periodic shifts to online learning, and disengagement from students. In an effort to transition back to in-person learning, many universities and schools tried to implement policy that balanced student learning with community health. While academic administrators have little control over some aspects of COVID-19 spread, they often choose to use temporary shutdowns of in-person teaching based on perceived hotspots of COVID-19. Specifically, if administrators have substantial evidence of within-group transmission for a class or other academic unit (a "hotspot"), the activities of that class or division of the university might be temporarily moved online. In this article, we describe an approach used to make these types of decisions. Using demographic information and weekly COVID-19 testing outcomes for university students, we use an XGBoost model that produces an estimated probability of testing positive for each student. We discuss variables engineered from the demographic information that increased model fit. As part of our approach, we simulate semesters under the null hypothesis of no in-class transmission, and compare the distribution of simulated outcomes to the observed group positivity rates to find an initial p-value for each group (e.g., section, housing area, or major). Using a simulation-based modification of a standard false discovery rate procedure, we identify possible hot spots-classes or groups whose COVID-19 rates exceed the levels expected for the demographic mix of students in each group of interest. We use simulation experiments and an anonymized example from Fall 2020 to illustrate the performance of our approach. While our example is based on hotspot detection in a university setting, the approach can be used for monitoring the spread of infectious disease within any interconnected organization or population.

Obstacles of Online Learning Facing Nursing Students after the COVID-19 Pandemic.

Background: After the COVID-19 pandemic, the online style of instruction started to replace the traditional style in Jordan. Aims: This study aims to (1) assess the nursing students' perceived obstacles to online learning in Jordan; (2) explore significant relationships between participants' characteristics and their perceived obstacles; and (3) assess for significant differences in the perceived obstacles based on participants' characteristics. Methods: A cross-sectional, descriptive design was utilized in this study. A convenient sample of 325 nursing students responded to a self-reported questionnaire utilizing Google Forms. Both descriptive and inferential statistics were used to analyze the dataset using the SPSS software. Results: The mean scores of the obstacles to online learning were 2.94 (SD = 0.95) for the academic obstacles subscale, 2.90 (SD = 0.83) for the technological obstacles subscale, and 3.25 (SD = 1.00) for the administrative obstacles subscale. Significant associations were found between participants' characteristics and perceived obstacles to online learning. For instance, the type of university was significantly associated with academic (r = -0.32, p < 0.01), technological (r = -0.21, p < 0.01), and administrative obstacles (r = -0.32, p < 0.01). Furthermore, significant differences were found in the perceived obstacles based on the participants' demographic and studentship-related characteristics. Conclusions: According to their perceptions of online learning, nursing students in Jordan face three types of obstacles: academic, technical, and administrative. Decision-makers should intervene to enhance the online learning experience by overcoming the reported obstacles.

Competency-Based Virtual Clinical Practicum in Response to COVID-19 Pandemic: A Quality Improvement Project.

PURPOSE: The purpose of the quality improvement (QI) project was to provide a learner and faculty preceptor high quality virtual clinical practicum (VCP) for Wound, Ostomy, Continence (WOC) Nurse learners during the COVID-19 pandemic and disseminate findings. PARTICIPANTS AND SETTING: Project participants were registered nurses post-bachelor's degree or higher with a minimum of 1-year clinical experience who had completed and passed the didactic portion of a Wound Ostomy Continence Nursing Education Program (WOCNEP). Learners completing the WOCNEP's VCP and the faculty preceptors were the subjects for this QI report. The setting was a virtual platform allowing live time visibility and interactions between learners and faculty preceptors including the ability to share documents and procedural videos. An initial group of 62 learners were asked open-ended questions after completion of the VCP; the most frequently recurring themes were converted into 5-point Likert scale questions as the evaluation tool completed by an additional 234 learners. In total, 296 learners completing the VCP evaluated this novel 100% simulation virtual practicum. APPROACH: This QI project evaluated a 100% simulation-based practicum at a WOCENP based in the United States. A competency based VCP used the Competency Outcomes and Performance Assessment (COPA) model. Learners were taught competencies via a preparatory virtual lab and then had to prepare documents and videos or pictures with step-by-step instructions prior to attending a Live Competency Assessment Lab with faculty preceptors and a small group of peer learners. OUTCOMES: Appraisal of the VCP was based on course evaluations anonymously completed by each of the 296 learners. Faculty preceptors were queried regarding their VCP evaluation and certification exam pass rates were tallied. Findings indicate positive outcomes of the VCP competency-based practicum from student and faculty preceptor perspectives along with higher certification pass rates; specifically, wound care pass rates increased by 16%, ostomy care increased by 18% and continence care pass rates increased by 13%. IMPLICATIONS FOR PRACTICE: Our reported experiences strongly suggest a VCP offers an attractive option for fulfilling practicum requirements while reducing barriers of the in-person split option practicum.

The impact of COVID-19 on medical education and training.

The COVID-19 pandemic social isolation policies have accelerated the shift to online teaching for medical students and doctors in training worldwide. Online learning is cost-effective, available, and flexible. However, it can be challenging due to the technical system errors, which results in the disruption of the learning process and social isolation yielding to less satisfaction among students and teachers. The above can have negative consequences on the mental health of medical students and trainees, which is an under-researched area. United Kingdom based medical students and doctors in speciality training encountered disruptions to medical education and training due to the pandemic. Medical school and deaneries had to endorse adjustments to teaching and training delivery methods, examination, and assessments to ensure the continued progression of learning and training. A successful e-learning model depends on motivated and well-prepared medical students and teachers and structured educational materials in supported learning environment and institutions. A blended model is likely to be utilised by medical institutions for medical training in the future, which will need to be researched.

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.

Navigating Challenges and Seizing Opportunities in China's Era of Online Health Education.

The rapid growth of internet users in China presents opportunities for advancing the "Healthy China 2030" initiative through online health education. Platforms like "Shanghai Health Cloud" and "National Health Information Platform" improve health literacy and management, enhancing overall public health. However, challenges such as the digital divide and the spread of unverified health information hinder progress. Addressing these issues requires enhancing digital infrastructure, employing advanced technologies for information validation, and setting high standards for online health services. Integrated efforts from various sectors are essential to maximize the benefits of online health education in China.

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.

Using "Adopt a Bacterium" as an e-learning tool for simultaneously teaching microbiology to different health-related university courses.

The COVID-19 pandemic has posed challenges for education, particularly in undergraduate teaching. In this study, we report on the experience of how a private university successfully addressed this challenge through an active methodology applied to a microbiology discipline offered remotely to students from various health-related courses (veterinary, physiotherapy, nursing, biomedicine, and nutrition). Remote teaching was combined with the "Adopt a Bacterium" methodology, implemented for the first time on Google Sites. The distance learning activity notably improved student participation in microbiology discussions, both through word cloud analysis and the richness of discourse measured by the Shannon index. Furthermore, feedback from students about the e-learning approach was highly positive, indicating its effectiveness in motivating and involving students in the learning process. The results also demonstrate that despite being offered simultaneously to students, the methodology allowed for the acquisition of specialized knowledge within each course and sparked student interest in various aspects of microbiology. In conclusion, the remote "Adopt a Bacterium" methodology facilitated knowledge sharing among undergraduate students from different health-related courses and represented a valuable resource in distance microbiology education.

Determining the challenges and opportunities of virtual teaching during the COVID-19 pandemic: a mixed method study in the north of Iran.

The aim of this study was to determine the challenges and opportunities of virtual education during the COVID-19 pandemic. This study was conducted in 2022-2023 with a mixed method. During the quantitative phase, we chose 507 students from Mazandaran Province medical universities (both governmental and non-governmental) by stratified random sampling and during the qualitative phase 16 experts were collected by purposive sampling until we reached data saturation. Data collecting tools consisted of questionnaires during the quantitative phase and semi-structured interview during the qualitative phase. Data was analyzed using SPSS21 and MAXQDA10. Mean scores of the total score was 122.28±23.96. We found a significant association between interaction dimension and background variables (P < 0.001). The most important privilege of virtual education is uploading the teaching material in the system so that students can access the material constantly and the most important challenge regarding virtual education is lack of proper network connection and limited bandwidth. Virtual education proved to be a suitable alternate to traditional methods of medical education during the COVID-19 pandemic in theoretical topics, we recommend that educational policymakers would take the necessary actions to provide the requirements and facilities needed to improve the quality of virtual education.

Online educational intervention: Improving maternal knowledge and attitudes in providing developmental stimulation for stunting toddlers.

Stunting remains a significant public health concern, impacting physical growth and impeding children's development. Mothers, who play a crucial role in stimulating children's development, often encounter barriers in providing effective stimulation, primarily due to limited access to appropriate resources and information. Online education can bridge this gap by offering easily accessible learning. This aim of this study was to determine the effect of online education on maternal knowledge and attitudes in providing developmental stimulation for stunting toddlers. A quasi-experimental research design was employed, comprising a treatment group and a control group, each consisting of 46 mothers with stunting toddlers, sampled purposively. The treatment group received an online developmental stimulation educational intervention through WhatsApp groups for twelve meetings, each lasting 1.5 to 2 hours. Meanwhile, the control group participated in a stunting assistance program provided by the community health centers (Puskesmas). To compare the knowledge and attitudes between groups, Mann-Whitney and independent Student t-test were used. The assessment of intervention effects on knowledge and attitudes was conducted using Wilcoxon and paired Student t-test within each group. Following the educational intervention on developmental stimulation, there was a significant increase in knowledge; however, there was no significant difference in attitudes. The treatment group (mean score 3.9±1.76) had a higher increase in knowledge scores compared to the control group (2.0±2.25) with a p<0.001. Nonetheless, no significant difference in attitudes was observed between the two groups with the mean change scores was 5.8±15.31 in treatment group and 2.5±18.69 for control group, with a p=0.335. This study suggests that providing online education leads to increased knowledge scores but does not impact attitudes significantly. Additional educational approaches should be considered to enhance maternal attitudes.