Improving children's collective and individual moral reasoning through small-group discussions about narrative fiction.

This study examines the influence of obedience pressure and individual moral reasoning on the attention to commit fraud in the context of the procurement of goods and services. This study uses a 2x2 factorial experimental design. The participants in this study were undergraduate accounting students who have passed courses in Professional Ethics, Public Sector Accounting, and Forensic Accounting who acted as implementers of the procurement of goods and services. Hypothesis testing in this study used ANOVA. The results of this study found the effect of obedience pressure and individual moral reasoning in committing fraud in the procurement of goods and services. Under conditions of obedience pressure, individuals with low moral reasoning will tend to commit fraud compared to individuals with high moral reasoning. Thus, individuals who have high moral reasoning tend to behave ethically, even though they are faced with pressure from superiors.

Most instructors at one point or another in their careersduring office hours, in the laboratory setting, or as a tutorhave had the luxury of sitting down one-on-one with a student to help him or her learn.For many, the reward of watching the proverbial lightbulb go on over a student's head was a first, addictive step into a career that involved teaching.Now imagine-or for many of us, remember-standing in front of 30, 60, 100, 150, 200, 300, 700, or even 1000 students in a traditional college or university lecture setting.Did you sometimes wish you could just sit down and talk with students from your large lecture individually, and then they would finally get it?What is similar and different about your instructional choices in a large lecture versus a one-onone situation?To what extent can we translate what is known about effective tutoring to a large lecture setting?One-on-one human tutoring has been extensively studied.Insights into what makes it effective is of great interest in a variety of fields, including computer-based tutoring program development, general education research, and training of future teachers.It is well accepted that one-on-one tutoring promotes both greater student learning and increased student motivation to learn compared with traditional, formal classroom teaching and learning settings (Slavin, 1987).However, examination of the research literature on effective tutoring would suggest that this mode of instruction and our approaches to fostering student understanding in large biology lecture classrooms need not be as dramatically different as one might assume.In fact, the differences in what instructors choose to say and do, as well as what they choose not

Background: Not all small tutorial discussion groups discuss national integrated antenatal care. Tutorial discussion in a large class provide discussion together among small discussion groups of the seventh jump.Method: This study was an explanatory design, mixed-methods study. The research sample amounted to 60 students of 2.6 block in the Gadjah Mada University Bachelor Nursing Program and semi-structured interviews conducted on 10 respondents were included in the quantitative study. The data collection conducted on April 14 until June 16 2016. Antenatal knowledge instrument consists 35 multiple choice questions valid and reliable that created on antenatal module. The effect of tutorial measured after day 3 from the treatment time. Nine-eleven student in 3 small tutorial discussion groups in the different room and 30 students in a large tutorial discussion group divided into 3 small discussion groups in the same room got 4 times tutorial in 2 weeks. Materials provided include antenatal delivery.Results: Based on paired sample t test in get difference the average value of knowledge before and after the tutorial discussion, average increase of knowledge in small tutorial discussion was 0.09 (p=0.93, p<0.05) and 3.62 (p=0.02, p<0.05) in a large tutorial discussion. The qualitative data analysis showed that discussion together among small discussion groups of the seventh jump can increase knowledge acquisition.Conclusion: The results showed discussion tutorial in a large class more effective increase antenatal care knowledge acquisition than small class.

Social presence is a difficult to achieve, but an imperative component of online learning. In this study, we investigated the effect of group size on students' perceptions of social presence in two graduate-level online courses, comparing small group versus whole class discussions. Our results indicated that when in small group discussions, students perceived a higher level of social presence in terms of sociability, t(32) = 3.507, p = .001; social space, t(29) = 3.074, p = .005; and group cohesion, t(32) = 3.550, p = .001. We discuss how placing students in small and permanent discussion groups can augment social presence. Designers and educators of online learning can strategically modify group size to promote social presence in asynchronous online discussions.

Medical training is siloed into distinct stages, namely undergraduate medical education (UME), graduate medical education (GME), and continuing medical education (CME).1 Despite the shared purpose of developing competent and humanistic physicians, cross collaboration among leaders and educators of each stage is less common than expected. Medical education is beginning to move toward competency-based assessment at all levels. Over 2 decades ago, the Accreditation Council for Graduate Medical Education (ACGME) introduced competency-based education,2 which is now most prominently demonstrated by the incorporation of Milestones 2.0 and Clinical Competency Committees.3 Thus, the notion of medical education as a continuum, rather than individual stages, has risen in popularity but has not met complete implementation.4The COVID-19 pandemic resulted in disruptions to all stages of medical education and highlighted shortcomings in transition support, which is particularly notable for learners who have or will have spent their entire training under pandemic conditions or gone through multiple career transitions during the pandemic. For example, in the beginning months of the pandemic, some trainees were reassigned to services where more clinicians were necessary, while some fellows were called on to practice in their core specialties.5 Medical students' rotations were significantly impacted, and many in-person clinical rotations were replaced with distance learning.6To address these widespread and rapid changes in the clinical learning environment, the ACGME, in collaboration with other GME organizations, developed a series of toolkits to ease transitions between the stages of training. In collaboration with the American Association of Colleges of Osteopathic Medicine, Association of American Medical Colleges, and Educational Commission for Foreign Medical Graduates, the ACGME released its first transition guide in 2021 to address major disruptions to the clinical learning environment caused by the COVID-19 pandemic.7 It was followed by 2 additional guides in April 2022 that addressed the transition from residency to fellowship8 and from GME training to practice.9The Council of Review Committee Residents (CRCR) consists of approximately 30 GME trainees who serve as resident or fellow representatives on the ACGME's specialty Review Committees and 2 resident representatives who serve on the ACGME's Board of Directors. This diverse group consisting of trainees from every core specialty program fosters interspecialty collaboration and dialogue. Twice a year, the council meets to discuss topics relevant to the GME community.At the May 2022 CRCR meeting, council members joined the ongoing conversation of optimizing learners' needs through the transitions in medical education by participating in small group discussions. These discussions were facilitated by CRCR members who volunteered for this group role. A total of 30 CRCR members participated in the topic-focused discussions and were randomly grouped into Zoom breakout rooms. There were a total of 5 groups with 6 members each. Participation in the discussions was voluntary, and participants were informed that the ideas collected during discussions may be included in a future publication.To start, Dr. Eric Holmboe, Chief Research, Milestone Development, and Evaluation Officer at the ACGME, presented on the effects of COVID-19 on GME. This was followed by a theory of inventive problem solving (TRIZ) exercise,10 wherein discussion participants were challenged to design a transition approach that ensures every graduate of a program is completely unprepared for the next stage of their career.The next segment of the topic-focused discussion began with Dr. Holmboe presenting theory burst 1, a mini-lecture on competency-based medical education to provide information to support the subsequent discussion. Small group participants were then tasked with discussing how a developmental mindset, grounded in the core components of competency-based medical education,11 can facilitate successful transitions across a career. Results from theory burst 1 have been intentionally excluded due to the presented focused intent on the UME-GME-CME continuum.Information for theory burst 2 was dedicated to the transition from medical school to residency. Participants returned to their small groups to discuss 2 questions related to this transition: (1) How can residency programs support this transition? and (2) How can peers and near peers support this transition?Information for theory burst 3 involved the transition from residency to fellowship or independent practice. Participants again returned to their groups to discuss 2 questions related to this transition: (1) How can residency/fellowship programs support this transition? and (2) How can peers and near peers support this transition?Each small group assigned a scribe who collated participants' discussion responses. The authors of this article then reviewed the responses, identified common themes, and summarized recommendations to address these themes (Tables 1-4).During theory burst 2 small group discussions, participants brainstormed ways for residency programs and peers to facilitate the transition from medical school to residency. Recommendations were broken down by theme, and by residency program led (Table 1) and peer led or near peer led (Table 2).Although all incoming residents are required to have passed standardized medical licensing examinations (USMLE Step 1 and Step 2 or COMLEX-USA Levels 1 and 2), the depth and breadth of UME varies by school. In order to create a more equitable starting point for residency, the discussion groups recommended creation of bootcamps and skill labs to address deficiencies or gaps in UME. The purpose of these bootcamps is to provide basic education and skills, thereby promoting an equal opportunity for intern success via adequate and uniform preparedness. Additionally, peers can be empowered to host specialty-specific, focused electronic medical record training for new residents during bootcamps. Specialty-specific bootcamps also appear in the ACGME transition toolkit's recommendations.7The groups also recognized that, although hospital-wide orientation occurs in all programs, its utility in preparing trainees is often limited. Participants felt it was important to support trainees to obtain the necessary skills to safely care for patients while navigating a new health care system.The discussion groups were cognizant of the impact of major life changes on mental health12 and, as such, recommended that training programs develop preemptive programs to address mental health and trainee wellness using an opt-out approach instead of waiting for the residents to self-diagnose and obtain help. Hosting program- or peer-led community events to foster a sense of belonging and inclusion and providing stipends to offset the financial stress of moving were also mentioned.Trainee advising is mentioned in the ACGME transition toolkit7; however, it is in reference only to faculty advising. Small group discussion participants noted the importance of expanding on this topic to include peer-to-peer support and resident mentors, particularly in the early months of training, as peers in GME programs often have the greatest understanding of the current training environment. There is an opportunity for peers and faculty to partner in the development of both faculty- and peer-driven mentorship and advising. Furthermore, peers can facilitate an inclusive and safe workplace for junior-level residents.Finally, the groups recommended programmatic awareness to ensure that efforts made to assist the majority of new interns in their transitions to GME do not inadvertently exclude international medical graduates (IMGs) or create barriers that perpetuate additional inequities that IMGs face. For example, in 2014, the start date for surgical fellowships was changed from July 1 to August 1.13 This afforded incoming fellows time to transition from residency to fellowship, but it resulted in a 1-month lapse in salary and insurance coverage. IMGs who are on visas have strict requirements for insurance coverage and a defined duration of stay in the United States. As such, this 1-month gap may have negatively affected IMGs because of unintended visa violations. It remains unclear if this policy change has resulted in a decrease in IMGs applying to and matching into surgical fellowship programs.Additionally, IMGs may benefit from activities designed to enhance cultural competence with American culture and systems to facilitate transitions for effective health care delivery.During theory burst 3 small group discussions, participants discussed transitions from residency to fellowship and autonomous practice and offered recommendations that both the program (Table 3) and peers and near peers (Table 4) can consider. Some themes emerged that were similar to the ones that arose while discussing the transition from medical school to residency, including mentorship and peer advising.Clinically, discussion participants stressed that elective time was critical for residents to further develop skills in their desired area of practice, and therefore recommended programmatic protection of this element of training.In addition to the clinical knowledge and skills necessary to succeed in fellowship or independent practice, participants also recommended that programs provide education for trainees about career-specific health care delivery systems. Programs may consider providing business of medicine lectures for different types of medical practice (private, hospital employed, academic), education on contract negotiation, and even strategies for effective billing and coding.The discussion also highlighted opportunities for education in behaviors essential for continued growth in autonomous practice, such as reflection, self-assessment, and self-directed learning. The ACGME toolkits for residency to fellowship8 and practice9 similarly provide guidance on informed self-feedback and competency-based education and assessment.In teaching clinical, systems, and behavioral skills, participants advised creation of graduated practice opportunities as a means to support these ends.A challenge of the transition from residency to fellowship is the often-rapid turnaround time from the end of residency to the start of fellowship. The discussion groups recognized that some fellowship programs are delaying start dates to allow for some flexibility and support for individuals transitioning from residency to fellowship; however, caution is advised relative to the creation of potential gaps in health insurance, wages, and IMG visa violations, as noted previously.Trainee well-being is a common theme and priority in all of the ACGME transition toolkits,7-9 with several resources dedicated to this topic provided in each. Imposter syndrome is a well-recognized phenomenon in medical practice associated with increased levels of burnout.14 Recommendations from the small groups' discussion of the transition to fellowship and practice that may help combat imposter syndrome include access to mentorship, alumni networks, storytelling, community building, and self-assessment.One topic that is covered at length in the ACGME transition toolkit7 from medical school to residency is the acknowledgement of the possibility of faculty's implicit bias on first-year resident performance assessment. While some types of bias (eg, unintentional bias toward IMGs) were part of small groups discussions, this idea of mitigating the potential for implicit bias in assessment did not emerge, despite its importance and relevance within GME. One potential reason for this discrepancy is point-of-view limitations, as participants were trainees and therefore focus less than their faculty educators on how to construct and conduct assessments. In a fully competency-based system, where trainees are engaged with assessment creation, this effect may have been less observable.While the groups included residents and fellows of diverse personal and professional backgrounds, discussion and resultant summaries may be limited given there were only 30 participants. Further, participants volunteered to participate from within the membership of the CRCR, which may limit representation outside of these parties. Additionally, there remains a selection bias by virtue of the types of residents who may volunteer for leadership positions such as those with the ACGME and the CRCR. Finally, given the focus on medical education as a whole, discussion did not explore specialty-specific recommendations.As trainees progress through the UME-GME-CME continuum of medical education, each stage requires a specific skill set to ensure that patients receive safe and effective care and that trainees achieve the necessary educational experiences to maximize preparedness for the next stage of their career. Although these skills and experiences differ considerably across specialties and stages of training, there are fundamental similarities that can address educational gaps, optimize learning opportunities, and support well-being during each transition. Because of the diversity of the CRCR in specialty and stage of training, small group discussions at the May 2022 CRCR meeting offered a singular opportunity to identify shared recommendations that can optimize transitions in medical training. Many of the discussed opportunities to strengthen medical education transitions were supported by recommendations in existing transition toolkits. Now in its third year, the COVID-19 pandemic continues to evolve current health care practice, and the resulting challenges highlight the importance of ongoing assessment of transitions in medical training to ensure future physicians are prepared at every stage of their career.

Most business ethics scholars interested in understanding individual moral cognition or reasoning rely on the Defining Issues Test (DIT). They typically report that managers and business students exhibit a relatively high percentage of principled moral reasoning when resolving ethical dilemmas. This article applies neurocognitive processes and Bloom’s Taxonomy of Educational Objectives, and its more recent revision, as theoretical foundations to explore whether differences emerge when using a recognition of learning task, such as the DIT or similar instruments, versus a formulation of knowledge task, such as the Moral Judgment Interview or similar instruments, to assess individual moral reasoning. The data show that significantly different levels of moral reasoning are detected when using a recognition-based versus formulation-based moral reasoning instrument. As expected, the recognition-based approach (using a DIT-like instrument) reports an inflated, higher moral reasoning score for subjects compared with using a formulation-based instrument. Implications of these results for understanding an individual’s moral reasoning are discussed.

This study was conducted to verify the assertions of various previous studies examining the relationship between individual moral reasoning and ethical behavior. Those studies conclude that individuals with good moral reasoning tend to behave better. However, they do not consider situational factors that can change this individual behavior. This study attempts to consider situational factors linked to the individual as antecedents of unethical behavior. Situational factors are taken into account for verifying whether an individual with high moral reasoning in a situation that supports unethical actions will be acting unethically. The data were taken by experimental methods 2 × 1 between the subjects where the manipulation is by positive and negative treatment given to see the effect against their intentions to do fraud. The level of moral reasoning is measured using a test instrument which defines the issue for categorizing the participants with high morale and low morale. Difference- t-test was performed to investigate the differences between the two groups experimental. It shows that situational factors are things that can affect a person's ethical or unethical act regardless of their moral reasoning abilities. The implication is that to minimize the unethical behavior of employees, the company can focus on situational factors rather than individual moral.

Background: Anatomy teaching–learning often requires innovative teaching methods to enhance retention and engagement. This study compares the learning outcomes of gamification-based learning with small group discussions (SGDs) in understanding head and neck clinical anatomy. Methodology: In a prospective interventional randomized controlled study with 150 phase 1 medical students, learning outcomes of gamification-based learning and SGD were evaluated. Students were stratified by prior academic performance and equally assigned to two groups: an intervention group using gamification with branching clinical case scenarios via H5P (HTML5 Package) on Moodle and a control group participating in faculty-led SGD. Both groups undertook a multiple-choice pretest and post-test questionnaire comprising 15 questions. The gamification group navigated progressively difficult scenarios with clinical decision-making, while SGD focused on case-based discussions. Student perceptions were assessed using a Likert-scale survey. Independent t -tests and Chi-square tests analyzed cognitive scores and engagement. Results: Of 142 students, 70 per group were analyzed. The gamification group showed significant improvement in posttest scores (11.79 ± 3.9 vs. 8.9 ± 3.58, P < 0.001) compared to SGD (9.83 ± 2.24 vs. 8.1 ± 2.3, P < 0.001). Posttest scores were significantly higher in the gamification group ( P < 0.001). Survey results indicated that 97% found gamification effective, with 94.2% reporting motivation compared to 74.2% for SGD. Conclusion: Gamification significantly enhances cognitive and affective learning outcomes in head and neck anatomy compared to SGD. Its interactive, clinically relevant design promotes engagement and retention, suggesting its potential as a valuable tool in medical education.

“I have to teach someone to make a peanut butter and jelly sandwich. How am I supposed to do that? What should I start with? How can this be so hard?” I have found that teaching anything to another person is rife with far more decisions and dilemmas than I could have ever imagined at first. Years ago, I had a college roommate who wanted to participate in a summer teaching program. For her interview, she had to develop a lesson plan to teach someone else how to make a peanut butter and jelly sandwich. Have you ever thought about teaching someone else how to make a peanut butter and jelly sandwich? She had asked for my input, and once we started to really consider the possibilities, our minds reeled. How would you start? What would you do first? Next? After that? Who was the learner anyway? And had they made a sandwich before? Were they allergic to peanuts? How old were they? Should we let them have a knife? Should we show them how first? Talk them through it? Let them have a go at it on their own? Should we first teach them the names of all the tools and things we were going to use? Should we ask them why they needed to learn how to make a peanut butter and jelly sandwich in the first place? What were the critical issues in teaching someone how to make a peanut butter and jelly sandwich? Much like in the “PBJ Dilemma” as we came to call it, there are many decisions to be made in designing effective learning experiences in undergraduate biology classes—and instructors are making these decisions constantly. It can seem overwhelming, yet the research literatures from cognitive science, psychology, and science education about how people learn suggest guidelines about constructing effective learning experiences (National Research Council [NRC], 1999 ). Much like the PBJ Dilemma, the order in which we decide to do things with students when we teach is critical, yet the order of things happening in a class session often goes undiscussed and unexamined. At first glance, the most pressing teaching dilemmas in our biology classrooms—student motivation, student retention of information, student understanding of difficult concepts—may seem unrelated to the order in which things are happening; however, what we do first, second, third, and so on can have many ramifications. For many instructors who have primarily learned from and used a lecture-based teaching approach, considerations of order have been primarily about the order of ideas. With the increasing use of active-learning strategies, class sessions are moving from having a single component—a lecture—to having many components over the course of even 50 minutes (e.g., a video clip, a pair discussion on a biology-based problem, a clicker question, a mini-lecture, and a final index card reflection). So, what is the optimal order for sequencing these elements to maximize student learning of biology?

The study examines the impact of two adverse selection elements (private information and incentives to shirk) on managers' escalation of commitment and the effectiveness of monitoring controls and manager's moral reasoning in de-escalating managers' commitment. This study contributes to the accounting literature by comprehensively evaluating the escalation commitment phenomena from its determinants, the strategy to reduce it, and the impact of moral reasoning level on managers' escalation commitment behavior. This research employed laboratory experiment method with 95 participants of undergraduate and graduate students. Consistent with Harrell and Harrison (1994), the findings of this study indicate that managers who experience adverse selection problems showed greater tendency to continue unprofitable project than managers who do not have such problems. However, this study fails to provide empirical evidence that monitoring control and individual moral reasoning level affect the tendency of managers to escalate their commitment.

Objective: We investigate cultural group-level understandings of violence and their connections to individual moral reasoning about violence among disadvantaged young people belonging to gangs (n = 33) and peacebuilding (n = 30) groups. Methods: Drawing from in-depth interviews in two low-income neighborhoods in Colombia, we use thematic analysis to explore and compare group-level understandings of violence-entailing definitions of violence, causal attributions of violence, and strategies to handle violence in everyday life-by type of youth group. Next, we use a chi-square analysis to assess between-group differences in the proportion of participants endorsing the morality of violence according to eight potential moral violence triggers. Results: Youths from both types of groups define violence in similar terms with one key difference. Only gang members ascribe agency to "the group" (i.e., the gang and the family) describing it as a social entity capable of harming and being harmed. This taken-for-granted cultural assumption frames the gang members' justifications of violence as moral to defend one's group. Concurrently, a higher proportion of youths from violent groups support the morality of violence to defend one's reputation (p = .001), honor (p <.001), and group (p = .001). Conclusions: Between-group differences in shared understandings of violence are consistent with differences in individual moral reasoning about violence across group type. The findings have implications for improving the efficacy of violence prevention interventions, which rarely account for the link between young people's shared understandings of violence and moral reasoning about its use.

The development of ethical awareness and ethical reasoning is a critical part of engineering education. Appropriate assessments are needed to determine if the educational interventions are effective in developing these skills. Although there are measures to assess general moral reasoning (e.g., DIT2), they do not take into consideration the peculiarities of handling ethical situations in engineering rather than ethical situations in general. In addition, because most undergraduates learn to apply ethical reasoning to engineering through design courses that are taught in teams, it is important to understand the team ethical climate. To address this need, our research team is developing instruments to assess both individual moral reasoning and team ethical climate in an engineering context. As part of the validation efforts, we have conducted individual interviews and team observations to triangulate data from other sources and aid in data interpretation. In this work-in-progress research paper we present an overview of the instruments and our qualitative study design including our interview protocol and analysis approach. At the FIE conference, we will present initial findings from the analyses and discuss how these results are being used to validate and/or modify both the individual engineering ethical reasoning and team climate instruments being developed.

The effectiveness of different educational strategies in medical education is still essential to students’ academic performance and satisfaction. Objectives: To determine the effect of Team-Based Learning versus Small Group Discussion (SGD) on academic outcomes for students in a medical curriculum. Methods: The study design was a quasi-experimental non-equivalent control group design involving 100 medical students divided into two groups of 50 for Team-Based Learning and 50 for Small Group Discussion. Data collection comprised pre-test and post-test scores, changes in scores, and levels of satisfaction measured using structured surveys. Statistically, independent t-tests were used to compare academic performance and satisfaction between the two groups. Results: The Team-Based Learning group had significantly higher post-test scores, 76.42 ± 9.14 as compared to the Small Group Discussion group, 68.00 ± 9.45. The difference in change scores was significant: 16.56 ± 7.50 for Team-Based Learning versus 9.24 ± 6.50 for Small Group Discussion, p&lt;0.0001. Satisfaction levels were also higher in the Team-Based Learning group at 4.14 ± 0.88 than in the Small Group Discussion group at 2.94 ± 0.79, with a statistically significant difference p&lt;0.0001. Conclusions: It was concluded that Team-Based Learning versus Small Group Discussion generated significant differences in the academic performance and satisfaction levels of medical students. Team-Based Learning appears to be a more effective teaching-learning strategy compared to Small Group Discussion in enhancing engagement and better learning outcomes in medical education.

What the discourse tells us: Talk and indicators of high-level comprehension

Background: Obesity in adolescents should be prevented in order to reduce the nega- tive health consequences in later life. Education about correct lifestyle, eating healthy food, and sufficient physical activities, should be able to prevent obesity. The small group discussion (SGD) method has been hypothesized to enhance participation and promote comfort among the participants, so it should be effective to prevent obesity. This study aimed to examine the effect of nutritional education using the SGD method on weight reduction among junior high school students with obesity. Subjects and Method: A randomized controlled trial was conducted at Junior High School 4 Medan, North Sumatera. A total of 60 overweight and obese students was selected for this study and randomized into the intervention group (n1=30) and the control group (n2= 30). The dependent variables were knowledge, physical activity, and fast food consumption. The independent variable was the intervention, i.e. nutrition education using SGD method. The data were collected by questionnaire and analyzed by Wilcoxon test. Results: After the nutrition education using SGD method, mean scores of knowledge and physical activity in intervention group were higher than in the control group, and they were statistically significant. However, the mean difference in fast food consumption between the two groups was not statistically significant. Conclusion: Nutrition education program using the small group discussion method is effective to increase knowledge and physical activity among junior high school students. Its effect on fast food consumption is not statistically significant. Keywords: nutrition education, small group discussion, knowledge, physical activity, fast food consumption, junior high school student