Traditional methods to practice patient interviewing skills for student pharmacists include the use of actors and role-playing. While effective, they can be difficult to manage with large class sizes, cost, and time to train. Artificial intelligence (AI) and large language models (LLMs) are readily accessible to offer students a scalable solution to practice collecting information from a controlled, dynamic simulated patient (SP). Five programs collaborated to create multiple educational activities that utilized AI as an SP for student pharmacists to practice their patient interviewing skills. Each activity included patient cases focused on self-care related topics. Student participants ranged from professional year one to three (P1-P3). A voluntary, anonymous survey was developed to assess baseline demographics and student perceptions of the activities. Out of 602 students across the five programs, 304 (50.5%) voluntarily completed the survey. Most students were born in Generation Z (1997-2012), identified as white/Caucasian, and had previously used AI. The majority of the students used the written feature to complete the activity. Overall, students reported that the AI activity was easy to use and considered it useful to practice patient interviewing skills. Students from two programs favored the use of the AI activity, while the other three programs favored traditional role-playing with partners. Students stated they missed the real-life human component of practicing with a partner. AI can be utilized as an SP to assist students in practicing their patient interviewing skills with a variety of topics. Students found the LLM easy to use, helped with their interviewing skills, and wanted to see it utilized more in the pharmacy curriculum. Future activities should find ways to incorporate more real-life components.

Transnational education (TNE) represents an evolutionary development in internationalisation, involving the movement of institutions or their programmes rather than student mobility. Influenced by the ambitions and strategies of sending and receiving countries, TNE offers distinct values and benefits to all stakeholders. Most previous research has focused on the successes and challenges of TNE programmes from the perspectives of programme directors, administrators, and educators, but less is known about graduates' experiences. This study explored graduates' perceptions of a UK-affiliated transnational medical programme in Egypt and its impact on their personal and professional development and careers. We conducted a qualitative study with graduates from a long-established transnational medical programme delivered under a UK university's licence in Egypt. We purposively sampled graduates to maximise variation in age, gender, nationality, professional status, current job, and country of work. We conducted semi-structured online interviews via Zoom, audio-recorded them, and transcribed the recordings. We adopted a constructivist/interpretivist approach and conducted reflexive thematic analysis, ensuring reflexivity was maintained throughout the study. Twenty-three graduates were interviewed for an average of 45min; 14 were female and 9 were male, with ages ranging from 23 to 33 years. We identified six overarching and interconnected themes: (1) Personal and professional transformation through generic skills and critical thinking; (2) An integrated and well-organised curriculum delivered through case-based discussions; (3) Clinical preparedness fostered by small class sizes and early clinical exposure; (4) International career readiness supported by English language proficiency, exchange programmes, relevant examination formats, and multinationalism; (5) Supportive teaching and leadership staff from both institutions; (6) Immersive research experience. We explored insightful perspectives and experiences of the graduates. We found that an integrated, internationally focused curriculum, delivered and overseen by effective and supportive staff, prepares graduates to serve locally and internationally with notable resilience and confidence. These firsthand insights contribute to the limited literature on graduates' perspectives in TNE, particularly in health professions education (HPE), and offer practical, achievable recommendations for curriculum, assessment, student support, and the learning environment. Further research exploring staff and institutional viewpoints is necessary to gain a more comprehensive understanding.

Reading ability is commonly used as a proxy for educational quality but may be unsuitable for cross-cultural comparisons. This study aimed to evaluate a novel Brief Mathematics Achievement Test (BMAT) as a proxy measure of quality of education (QoE) in culturally and linguistically diverse populations. Data on demographic variables, socioeconomic status (SES), country-level QoE, and performance on the BMAT and brief cognitive tests, were collected from 157 cognitively healthy participants (18-89 years) including native-born and immigrant populations in five European countries. No significant differences were found between females and males or between participants with native-born and immigrant backgrounds in BMAT scores. In correlation analyses, BMAT scores were strongly correlated with SES, level of education, and performance on a brief cognitive composite, moderately with student-teacher ratio, country income classification, and a quality of education index, and weakly with age. In regression models controlling for key demographic variables and socioeconomic status, BMAT scores were significantly associated with level of education and the QoE index, while showing no significant relationship with immigrant status. Also, after controlling for demographic variables, SES, and the quality of education index, BMAT scores were the only significant predictor of performance on the brief cognitive composite. These findings provide preliminary evidence supporting the potential utility of the BMAT as an objective proxy measure of QoE in culturally and linguistically diverse populations.

The emergence of cooperation among self-interested agents in social dilemmas remains a central unsolved problem in evolutionary game theory, multi-agent systems, and behavioral science. While memory-one reciprocal strategies such as Tit-for-Tat have been extensively studied, the evolutionary properties of memory-two bilateral reciprocity strategies—which condition on a two-round bilateral history over a 2 16 = 65, 536-element strategy space—remain comparatively undercharacterised. This study presents a unified agent-based computational framework integrating a Q-learning multi-agent reinforcement learning (MARL) engine with Moran, Wright-Fisher, and replicator dynamics selection mechanisms to systematically investigate the evolutionary fate of memory-two (M2) bilateral reciprocity strategies across eight controlled simulation experiments. Under canonical Prisoner's Dilemma conditions ( T = 5, R = 3, P = 1, S = 0, N = 100, μ = 0.05, β = 2.0, ε = 0.02), the simulation converged to a high-cooperation quasi-equilibrium with mean cooperation rate ρ C = 0.814 ± 0.029. The M2 strategy class collectively captured 61.0% of the evolutionary equilibrium population, with all three M2 strategies achieving fixation probability P fix = 1.000 when invading an AllD-resident population—a 10-fold enrichment over the neutral expectation. Cooperation was robust to behavioral noise up to ε≈0.15, beyond which a noise-induced phase transition collapsed cooperative equilibria. Selection pressure, mutation rate, game class, and population size were systematically varied, confirming that M2 dominance is robust across all tested conditions. These results establish memory-two bilateral reciprocity as the dominant evolutionary strategy class in noisy iterated social dilemmas and provide a rigorous computational characterization of the conditions under which it emerges and persists.

Engaging large groups is a challenge experienced by many educators, especially with diverse student cohorts and increasing class sizes. While many techniques can be used to increase student engagement during lectures, one popular modality embraced by educators has been audience response systems (ARSs), such as Kahoot!© and Mentimeter©. While the options within ARSs have been evaluated for their effect on engagement, their use as formative assessments, and student preferences of their format, few studies specifically consider the technology through an inclusivity lens. This teaching tip presents ways to improve inclusivity when using ARSs through consideration of widening participation demographics. Specific insight is given to how student identity categories (neurodiversity, socioeconomic background, studying in a second language, and academic performance) might impact their ability to access, engage with, and experience ARSs during large group learning. Mitigations to overcome these challenges are presented, and educators are encouraged to reflect on their practice to use this popular technology in an effective, inclusive approach to promote social constructive learning.

Undergraduate research experience (URE) positively contributes to student success, STEM identity, and STEM post-graduate careers. Despite these benefits, traditional UREs are limited, and many students encounter barriers to gaining access to these opportunities. Course-based Undergraduate Research Experiences (CUREs) increase access to UREs by incorporating authentic research projects into the course curriculum. Despite the recognized benefits of CUREs, few have been developed for introductory or upper-level microbiology courses. This scarcity largely reflects the substantial planning and financial investment required of faculty to create effective CUREs that are affordable, relevant, and align with course learning objectives. These combined demands present significant challenges to widespread adoption of CUREs in microbiology education. We considered these limitations when developing the "MicrobioME" CURE for implementation in pathogenic microbiology laboratory courses. Students participating in the MicrobioME CURE isolate and identify bacterial isolates from their own skin microbiome and investigate the impact of isolate-produced small molecules on Staphylococcus aureus biofilm production. We studied MicrobioME CURE implementation in two laboratory courses at the University of Kansas (KU) and West Virginia University (WVU) in cohorts differing in class size, research experience, meeting times, and faculty expertise in microbiome research, providing an opportunity to compare student outcomes in varied environments. Here, we report student outcomes of and provide tools for implementing the MicrobioME CURE in microbiology laboratory courses at other universities. Our results suggest that the MicrobioME CURE is scalable, affordable, and modular, making it an accessible and practical solution to increasing access to authentic research experience.

ABSTRACTThe teaching of pharmacology includes a fundamental understanding of ligand binding; how it is measured and how it is calculated. We sought to modernize the techniques by which ligand affinity is determined by undergraduate students and introduce them to parameter estimation through curve fitting. We taught a NanoBRET ligand binding assay to student cohorts completing their second year of undergraduate study in Natural Sciences (71 and 61 students in 2024 and 2025 respectively). The aim was to measure the affinity of fluorescent and unlabeled ligands for the β2‐adrenoceptor in live cells. Affinities were then calculated from their data using a custom Microsoft Excel spreadsheet. This series of practical classes was well received by students, with most students able to follow the protocol and successfully determine ligand affinities. Furthermore, students recognized the benefit of the practical class for their education, confirming they felt it improved their understanding of how ligand affinity is calculated. We also demonstrated that this protocol could be scaled up to accommodate larger class sizes (class of 367 students studying medicine and veterinary sciences).

Prevalence and Predictors of Self-Reported Voice Disorders Among Palestinian University Faculty: Impact on Voice-Related Quality of Life.

This study examined the relationship between teachers' English proficiency and their instructional delivery effectiveness at Mobo National High School. Utilizing a descriptive research design with validated surveys, the study analyzed a teaching staff predominantly composed of mid-career, highly qualified female educators, 77% of whom hold master's degrees or units. The findings revealed that the teachers possess high English proficiency, scoring highest in grammar and structure (4.43 weighted mean), followed by oral communication (4.12) and vocabulary breadth (3.95). Consequently, their instructional delivery proved effective, with strong performances in lesson presentation (4.17), classroom management (4.03), and student engagement (3.98). A significant positive correlation was established: higher linguistic competence directly enhances lesson clarity and classroom interaction. Despite these proficiencies, teachers face critical instructional bottlenecks. Foremost among these are student-centered challenges, particularly severe student language anxiety and fear of making mistakes in an "English Only" environment. These hurdles are compounded by institutional constraints, including large class sizes that restrict individual practice, and a lack of modern audio-visual technology. To bridge these gaps, the study recommends targeted professional development workshops, modernizing classroom technology, reducing class sizes, and implementing student-centered, scaffolded lesson plans to alleviate language anxiety.

This qualitative phenomenological study explored the lived experiences of kindergarten teachers in the Tagum City Division regarding the challenges they encountered in early childhood teaching and the coping strategies and meaningful practices they employed in managing these experiences. Specifically, the study aimed to describe the challenges encountered by kindergarten teachers, identify their coping strategies and meaningful practices, and propose an intervention program based on the findings. The study employed a phenomenological research design to capture the lived experiences of kindergarten teachers in public elementary schools. Purposive sampling was used in selecting fifteen participants, wherein ten participated in in-depth interviews and five participated in a focus group discussion. Data were gathered through semi-structured interview guides and analyzed using Colaizzi’s thematic analysis framework. Findings revealed that kindergarten teachers experienced emotional, developmental, instructional, and structural challenges in early childhood teaching. Three major themes emerged: Emotional and Developmental Challenges, Physical and Instructional Constraints, and Daily Teaching Realities and Emotional-Physical Demands. Teachers encountered learners’ adjustment difficulties, diverse developmental readiness, large class sizes, limited instructional resources, workload pressures, and emotional fatigue. Three major themes also emerged regarding coping strategies and meaningful practices: Emotional Regulation in Early Childhood Teaching, Meaningful Instructional Practices for Student Engagement, and Professional and Social Resources Supporting Teaching Practice. Teachers managed challenges through emotional regulation, peer collaboration, self-care, play-based instruction, classroom structuring, and support from school leaders, families, and communities. Based on the findings, the STRIVE-K intervention program was proposed to strengthen teachers’ emotional resilience, instructional practices, and support systems in kindergarten education.

ABSTRACT The Right to Education Act (2009) changed the norms on pupil-teacher ratios for Indian primary schools. We decompose the compliance of districts with these requirements into the number of teachers available (Ability to comply), and the effort to re-organize teachers to improve compliance (Effort to comply). The Act created a discontinuous jump in the latter, leading to improved teacher allocation. We show that this improvement was associated with learning gains across districts and cohorts, especially at the lowest levels of attainment. The findings are indicative of diminishing returns to additional teachers in the context of small schools and multi-grade teaching.

This study examines the implementation of the Student-Centered Active Learning Environment with Upside-down Pedagogies (SCALE-UP) in the first-year Chemistry course sequence for STEM majors at Hampton University, an HBCU. STEM majors at Hampton University must earn a grade of C or higher in all courses; grades below this threshold are designated STEM-FAIL. In Fall 2021, Chemistry 201 students were divided into a control lecture section and two SCALE-UP sections, all of which had identical assessments. Results showed lower STEM-FAIL rates (24% and 25%) in SCALE-UP sections compared to the lecture section (28%). In Spring 2022, both Chemistry 202 sections used SCALE-UP, and despite their differing enrollment sizes, they had identical STEM-FAIL rates (29%). This study revealed that SCALE-UP can be implemented at Hampton University. Additionally, the supportive environment and class sizes of under 60 students may also enhance student success.

This study aimed to investigate challenges that teachers and learners face in using compensation strategies in English as second language in written comprehension in secondary schools in Malawi. Hymes’ theory of communicative competence emphasises the use of learning strategies to achieve strategic, grammatical, discourse and sociolinguistic competencies to improve learners’ performances. A case study design, utilising participant observation and semi-structured interviews with teachers of English and form three learners from three community day secondary schools in Lilongwe Urban, was adopted to collect data. Compensation strategies which teachers and learners used during lessons were recorded using an observation checklist. Data was analysed using Creswell’s thematic procedure. The study revealed three significant challenges which both teachers and learners faced in using compensation strategies, namely a lack of learners’ interest in understanding the meanings of difficult words, teachers simply telling learners to use compensation strategies without guidance and large class sizes. The study recommends the incorporation of comprehensive instruction on compensation strategies into initial teacher and ongoing in-service training courses. By addressing these challenges, education stakeholders can create a conducive learning environment that fosters English language proficiency and, ultimately, academic success through training teachers on the use of compensation strategy instruction to effectively teach.

Sustainably increasing the use of active learning in undergraduate science, technology, engineering, and mathematics (STEM) courses is a complex challenge. At Texas State University, we are tackling this by merging the Learning Assistant (LA) model for peer educators with a team-based instructional change approach. This study assesses the efficacy of our approach through the lens of faculty and LAs carrying out the work. In Spring 2023, we interviewed eight faculty and 15 LAs who participated in an effort to redesign and collaboratively teach two multi-section introductory biology courses. We now address the research questions: 1) What do faculty and LAs perceive as supports and barriers for creating more student-centered instruction? and 2) How do faculty and LA perceptions compared with each other? Faculty and LAs focused on similar supports, such as program structures that enabled progress and healthy collaboration across power differences. Faculty and LAs focused on different barriers, with faculty focusing more on structural barriers like classrooms and class sizes, and LAs focusing more on student experiences. Our research suggests practices that can support this type of instructional change, such as creating structures that enable faculty to collaborate with their peers and fostering a program culture where students’ contributions are valued.

To evaluate temporal trends in gender and racial representation in neurotology fellowships and compare them with concurrent patterns in otolaryngology residencies to assess whether increasing diversity at the residency level has translated into advanced subspecialty training. Retrospective, cross-sectional analysis. Accreditation Council for Graduate Medical Education (ACGME)-accredited neurotology fellowship and otolaryngology residency programs in the United States. All trainees listed in ACGME Data Resource Books from academic years 2007 to 2008 through 2023 to 2024 for gender comparisons and 2011 to 2012 through 2023 to 2024 for race comparisons. Demographic categories analyzed included female versus male and 6 racial groups. None. Annual proportions of female and racial minority trainees. Trends were evaluated over time, comparing the fellowship and residency cohorts. Differences in proportions between the earliest and most recent years were analyzed. Neurotology fellowship class size increased over time, accompanied by a rise in the proportion of female fellows. Racial diversity also increased, driven primarily by growth in Asian and Hispanic trainees, while proportions of White trainees declined. Black trainee representation remained low, and American Indian/Alaska Native representation decreased. Overall, improvements in neurotology diversity were more gradual than those of otolaryngology residencies, which demonstrated earlier and more pronounced gains. Gender and racial diversity in neurotology fellowships has improved but remains limited compared with residency-level progress. Persistent disparities suggest structural barriers influencing the transition from residency to subspecialty training. Targeted diversity and recruitment initiatives may help align fellowship programs with the evolving demographics of otolaryngology trainees.

ABSTRACT This mixed-method study delves into learners’ perceptions of the effectiveness of their teachers’ teaching behaviour and the benefits and challenges experienced during team teaching in primary educational settings. Analysing survey data from 428 learners and data from 15 focus groups, overall results indicate that the dimensions of ‘learning climate’ and ‘clear instruction’ are most frequently observed in classroom practices by learners. Furthermore, learners perceive ‘learning gains’ and ‘increased support’ as most beneficial. However, confusion does arise, and large class sizes are a disruptive factor that leads to more noise. Multilevel analysis further reveals that learners who are taught in team teaching within a single class reported significantly higher scores on the dimensions of teaching behaviour and ‘increased support’.

In this article, we examine the experiences of five undergraduate students who enrolled in an introductory drones class to learn how to operate drones, gather geospatial information, and analyze the data generated through student flights. We employed open-ended surveys to gather data from the students about their expectations, experiences, and reflections from the class. Our analysis focused on three primary objectives: (1) an examination of students’ prior experience with drones and how that affected their ability to learn new concepts surrounding drones; (2) an examination of students’ expectations before coming into the class to work with drones; and (3) an examination of students’ ease of working with drone data and their understanding of what can be achieved with the data that were derived from drones. Our results indicate that student experiences were improved through repetition to develop technical and technological fluency, a challenge-based approach to learning created opportunities for students to overcome unexpected challenges, and small class sizes that allow for more frequent and meaningful connections between students and instructors. Based on these findings, we argue instructors should keep classes small, build a schedule that fosters repeated engagement, and embrace a challenge-based learning approach to the class.

Children’s food choices are shaped early in life through cognitive, social, and environmental influences, yet relatively little is known about how school-based nutrition education supports these processes in routine settings. This study examined mechanisms potentially relevant to children’s food choices using a multi-source process evaluation of the municipal “I Know What I Eat” program implemented in Warsaw primary schools. A prospective observational implementation study was conducted in 81 public schools, covering 198 workshop cycles for students aged 8–9 years. Data were obtained from teacher-observers (n = 198), trained program implementers (n = 6), and implementation records. The evaluation focused on implementation quality, fidelity, acceptability, and mechanisms relevant to food-related decision-making. Quantitative data were analyzed using descriptive statistics, Kruskal–Wallis tests, and Spearman correlations; qualitative comments were examined using content analysis. The program was implemented with high quality and consistency, with mean ratings ranging from 4.88 to 4.96 on a five-point scale and no significant differences by implementer or class size. Qualitative findings indicated that experiential learning, practical food preparation, peer interaction, and active participation supported children’s engagement. These findings suggest that school-based nutrition education can create conditions relevant to food-related decision-making, although direct behavioral measures are needed.

Falls are a major cause of injury, disability and health service use among older Australians. While exercise-based interventions can reduce falls, participation remains low. Understanding preferences for program features may inform design and implementation of fall prevention exercise programs to maximise uptake, adherence and impact. An online discrete choice experiment was conducted with 383 community-dwelling Australians aged ≥ 60 years, independent in daily activities and not currently enrolled in a fall prevention program. Participants completed choice tasks with varying levels of six program attributes: cost per class, delivery mode, class size, personalisation, program duration and access to professional support. Data was analysed using mixed multinomial logit and latent class models to estimate preferences, willingness to pay and preference heterogeneity. Policy simulations estimated predicted uptake under alternative service configurations. Participants generally preferred lower-cost, individual programs of short duration (1-3 months) delivered in-person at home with on-demand professional support. There was no significant preference for personalisation. Latent class analysis identified three subclasses: "opt-out" (19%), "cost-sensitive" (37%) and "support-oriented" (44%). Policy simulations showed high uptake in the support-oriented class and low uptake in the opt-out class regardless of configuration and greater responsiveness to cost reductions among the cost-sensitive class. Preferences for fall prevention program features at point of uptake vary across identifiable older Australian subclasses. Offering flexible configurations, including low-cost options for cost-sensitive participants and enhanced features for those willing to pay, may improve program uptake and long-term sustainability. These findings provide actionable evidence to inform program design and policy decisions for scalable fall prevention initiatives.

Training after Dobbs: Geographic and policy-related mobility between medical school and obstetrics and gynecology residency.