Convergent Approach Research Articles

Developing care behaviors and ethical attitude in nursing education

AimThis study aims to determine the effect of education based on the Theory of Human Caring on nursing students' caring behaviors and ethical attitudes. BackgroundIt is crucial to plan nursing education holistically, addressing cognitive, psychomotor and affective domains for the comprehensive development of caring behaviors and ethical attitudes. DesignThis study employed a convergent mixed-methods approach with randomized pretest-posttest comparisons and qualitative analysis. MethodsThis study was conducted with third-year nursing students at a state university in Ankara, Turkey, in 2021. It comprised a total of 95 participants, with 47 students in the case group and 48 students in the video group. Theoretical education based on the Theory of Human Caring was simultaneously provided to both groups. Following this, one group received practical training using a video-supported teaching method, while the other group received it through a case analysis method. The research used the 'Descriptive Characteristics Form', 'Caring Nurse Patient Interaction Scale (CNPIS)', 'Scale for Attitudes of Ethical Principles (SAEP)' and 'Student Opinion Form on Care Behaviors Education' to collect data. Quantitative data were analyzed using t-tests, Mann-Whitney U tests, Wilcoxon paired two-sample tests and Linear Regression Analysis, with a significance level of p<0.05. Qualitative data were evaluated through document analysis. Permissions were obtained before the research. ResultsAfter the education provided, significant differences were found between the pre-test and post-test scores of both groups (p<0.05). It was determined that there was a statistically significant, positive and generally moderate relationship between the caring behaviors and ethical attitudes of the students. Additionally, participating students reported that they were satisfied with the education provided, stating that the teaching methods increased their motivation and positively influenced their perspectives on caring and its ethical dimensions. ConclusionsThe research findings show significant improvements in nursing students' care behaviors and ethical attitudes following education based on the Human Care Theory, with both case analysis and video-supported teaching methods yielding notable results. Integration of care theories into the nursing undergraduate curriculum, alongside the use of holistic teaching methods, is recommended, along with further randomized controlled trials to assess teaching effectiveness.

Financial Toxicity Among Patients With Metastatic Prostate Cancer: A Mixed Methods Approach to Identify Effective Interventions.

Financial toxicity associated with treatments for metastatic prostate cancer remains poorly defined. We sought to understand aspects of financial toxicity not captured in a commonly employed financial toxicity questionnaire and identify potential interventions to help alleviate financial toxicity through a convergent mixed methods approach. Patients seen at our institution's advanced prostate cancer clinic were approached for completion of the Comprehensive Score for Financial Toxicity (COST-FACIT) questionnaire (quantitative analysis). A maximal variation purposive sample was chosen to participate in focus group discussions (qualitative analysis). Conventional content analysis was performed using an inductive approach. COST-FACIT scores were compared between patients experiencing high and low financial toxicity using Wilcoxon rank sum test. Three themes were identified through qualitative analysis: (1) workload, (2) coping strategies, and (3) communication. We found alignment with the existing theory of financial capacity across our findings. Two unique aspects of financial toxicity emerged that were not assessed quantitatively and deemed to be significant. Specifically, cost transparency (including health care teams knowledgeable about and willing to discuss costs) and inclusion of informal caregivers in financial toxicity screening and decision-making may guide future interventions aimed at limiting financial toxicity in this population. Prolonged treatment courses involving multiple lines of treatment with varying costs result in distinct financial toxicity components for patients with metastatic prostate cancer that are not assessed with COST-FACIT. Improving cost transparency, health care team knowledge and engagement, and providing resources to support informal caregivers may have a significant impact on the financial toxicity experienced by these patients.

Exclusive Breastfeeding Practice and Associated Factors among Mothers having Infants (Aged 0-6 Months) in the Pastoral Community of Sawena District, Bale Zone Oromia, Ethiopia, 2023

Background: Breastfeeding is the recommended feeding method for infants due to its ease, health benefits, and cost-effectiveness. However, there is limited understanding of Exclusive Breastfeeding (EBF) in pastoral communities, such as the Sawena district in Ethiopia. Objective: To assess the prevalence and factors associated with EBF among mothers with infants (aged 0-6 months) in pastoral communities in Southeast Ethiopia. Method: A community-based cross-sectional study design with a convergent mixed-method approach was employed from March 01 to April 2023 G.C and involved 631 women selected through random sampling. Face-to-face interviews were conducted, and the data were analyzed using statistical software. Variables with a p &lt; 0.25 in the analysis were included in the logistic regression model. Results: Out of 631 eligible mothers, 625 participated in the study, resulting in 53.8% (95% CI; 49.8%-57.4%). prevalence of EBF in the study area. Factors significantly associated with EBF included household food security [AOR = 1.6, 95% CI (1.1-2.2)], ANC follow-up during pregnancy, [AOR = 5.3, 95% CI (2.4-11.9)], counselling about EBF during ANC visits [AOR = 5; 95% CI (2.1-11.7)], number of children [AOR = 1.6, 95% CI (1.1-2.3)] and attitudes toward EBF [AOR = 1.8; 95% CI (1.4-2.6)]. The qualitative findings revealed reasons for not practicing EBF, such as concerns about insufficient breast milk, concerns about the baby becoming thirsty, refusing solid foods later, or being negatively affected. Conclusion: The prevalence of EBF in the Sawena district was lower than recommended. The influential factors include household food security, ANC follow-up, counselling during ANC, number of children, and attitudes toward EBF.

사회적 교류 증진을 위한 노인복지관의 설계 지침 - 융합적 접근 2. 활동 프로그램 및 공간 현황 조사를 중심으로 -

사회적 교류 증진을 위한 노인복지관의 설계 지침 - 융합적 접근 2. 활동 프로그램 및 공간 현황 조사를 중심으로 -

Prospects of Interdisciplinary Research into the Problem of Resource Mobilization of Academic Staff

Introduction. Training students for innovative engineering activity is one of the priority tasks of an engineering university. However, so far all existing approaches to its solution involve changes in the curricula of degree programmes. The aim of the research is to substantiate and develop a methodological system of training future engineers in innovative engineering activity in the educational environment. Materials and Methods. The methodology of innovative engineering education, environmental, project, convergent and other approaches was used. A quantitative assessment of the level of development of innovative competencies was carried out during a comparative training experiment based on the average indicator of time series. The Pearson test was used to assess the statistical significance of the data. Results. The possibility of preparing future engineers for innovative engineering activities during a comprehensive course projecting in general engineering disciplines without departure from the curriculum is substantiated. To create conditions for such training, a project-based and activity-based educational environment has been proposed, pooling into one system all the resources available at the university and ensuring their interaction on the basis of a convergent approach associated with the approximation and interpenetration of scientific, pedagogical and information technology knowledge. A system for teaching innovative engineering activities in this environment has been developed, including conceptual-target, content, procedural-technological and reflective components, implemented within the framework of a business game. Discussion and Conclusion. The conclusions made by authors contribute to the development of the environment approach to learning in terms of designing new educational environments, theory and methodology of teaching technical disciplines, as well as project-based learning – in terms of their focus on innovative training of students.

Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation During COVID-19.

Despite historical and contemporary trauma, American Indian and Alaska Native (AIAN; Indigenous) communities responded with resilience to the COVID-19 pandemic. However, AIANs experienced disproportionate rates of infection, hospitalization, death, and reduced life expectancy. School closures exacerbated disparities, leading to learning loss, economic instability, and mental health challenges among AIAN youth. The Project SafeSchools cohort study employed a comprehensive longitudinal convergent mixed-methods approach, integrating community-based participatory research principles. The study enrolled Navajo Nation caregivers whose children were eligible to attend local reservation-based schools. We conducted an analysis of caregiver self-report baseline data collected between August 2021 and May 2022. A total of 242 caregivers completed at least part of the baseline assessment and were included in data analysis. Caregivers were primarily female (88.7%), non-Hispanic (97%), and Indigenous (97%). Most caregivers were in their late 30s (mean age 38), with varying educational backgrounds and employment statuses. Children were evenly split between males and females and distributed across different age groups. Most children attended school at baseline in various formats, including in-person, hybrid, and online-only settings. Caregivers reported a range of psychosocial and behavioral risks, including general mental distress, depressive symptoms, and anxiety for themselves and their children. Furthermore, caregivers and children exhibited various protective factors, such as strong cultural identity, resilience, and academic self-efficacy. This study highlights the higher rates of mental health distress among participating caregivers and children compared to national averages. Despite these challenges, cultural protective factors remained strong and should guide future crisis response efforts.

Perceived Emotional Invalidation and Its Impact on Self-Efficacy of Selected Teenagers in the City of Cabuyao

This study investigates the impact of perceived emotional invalidation on the self-efficacy of teenagers in Cabuyao, Laguna, employing a mixed-method approach (Convergent mixed method approach). Quantitative surveys and qualitative interviews provide insights into teenagers' perceptions. While perceived emotional invalidation is moderate and self-efficacy is high, a weak correlation between them is found. Qualitative findings reveal multifaceted challenges and coping strategies. The study sheds light on the importance of addressing emotional invalidation for adolescent well-being, offering implications for intervention and support. This abstract explores aspects of Filipino culture that affect individual emotions and communication styles. It highlights how collective values sometimes disregard personal feelings, but embracing one's true self can be empowering and promote acceptance. It emphasizes the importance of being diplomatic and humble when communicating with Filipinos, who often use indirect communication to maintain harmony.

Experiences of seeking diabetic eye care among patients with diabetes in China: a community-based convergent mixed methods study

ObjectivesThis study aimed to characterize the most updated utilization of eye care services and obtain a holistic understanding of barriers among patients with diabetes in China. Study designThis was a convergent mixed methods study. MethodsA convergent triangulation mixed methods approach was used, with a quantitative cross-sectional survey of patients with diabetes and semistructured interviews involving patients and health workers. Following the conceptual framework of the World Health Organization Determinants of Health Behaviours, multivariate logistic regression for quantitative analysis and thematic analysis for qualitative data were used to examine barriers to seeking eye care among patients with diabetes. Triangulation was used to integrate quantitative and qualitative results. ResultsAmong 1167 surveyed patients who participated in the quantitative component, 29.1% had undergone eye examinations within the last 12 months, and 9.3% had received eye surgery. Awareness that diabetes causes eye diseases (P < 0.001) and knowing laser treatment can treat diabetic retinopathy (DR; P < 0.001) were associated with higher examination rates. In the qualitative component, involving 20 patients and 11 health workers, barriers were identified from individual, social, and cultural environmental factors. Integration of data highlighted the complex interplay of these factors in shaping care-seeking behaviors and the importance of non-economic factors, including patients' information about costs of DR services and cultural environmental factors. ConclusionsDiabetic eye care utilization remains suboptimal in China, emphasizing the impact of cultural and contextual factors. Comprehensive education strategies, along with training for primary health workers and task-shifting, are likely to enhance eye care service utilization in underserved settings.

Psychological distress among healthcare professionals in Mbarara, following the 2022 Ebola Virus Disease outbreak in Uganda: a mixed methods study

BackgroundThe 2022 Ebola Virus Disease (EVD) outbreak occurred at a time when Uganda was still battling the social and psychological challenges of the COVID-19 pandemic; placing health care professionals (HCPs) at a much higher risk of developing psychological distress. Psychological distress among HCPs can cause decreased workplace productivity and ineffective management of their patients. The current study aimed to investigate and understand psychological distress among HCPS in Mbarara city in Southwestern Uganda following the 2022 EVD outbreak.MethodWe enrolled 200 HCPs through convenient sampling from one private and one public health facility in Mbarara city in Southwestern Uganda, in a cross-sectional convergent parallel mixed method approach where qualitative and quantitative data were collected concurrently. Quantitative data, utilizing the Kessler Psychological Distress (K10) Scale, provided us with a quantitative measure of the prevalence of psychological distress among HCPs, and were analyzed using STATA version 16. Qualitative data, on the other hand, offered deeper insights into the nature, perceptions, and contextual factors influencing this distress, and were analyzed using emergent theme analysis.ResultsThe prevalence of psychological distress was 59.5% and it was higher among females (63.9%) compared to males (36.1%). HCPs vividly expressed distress and anxiety, with heightened suspicion that every patient might be an EVD carrier, creating a pervasive sense of unsafety in the workplace. However, the outbreak had an educational affect where concerns about the announcement of another EVD outbreak were diverse, with HCPs expressing anxiety, despair, and dissatisfaction with the country’s management of potential outbreaks.ConclusionHigh levels of psychological distress were experienced by HCPs in Southwestern Uganda as a result of the 2022 EVD pandemic. HCPs express a wide range of feelings, such as dread, anxiety, despair, pessimism, and discontent with the way the outbreaks are handled throughout the nation. We recommend implementation of comprehensive psychosocial support programs tailored to the unique needs of HCPs, including counseling services, stress management workshops, and peer support networks.

Real-world evidence demonstrates an appropriate atrial fibrillation population for hybrid convergent approach versus stand-alone cryoballoon ablation: A long-term safety and efficacy study.

A hybrid convergent approach (endocardial and epicardial ablation) demonstrated superior effectiveness in a recent randomized study for long-standing persistent atrial fibrillation (LSPAF). Yet, there is a lack of real-world, long-term evidence as to which patients are best candidates for a hybrid convergent approach compared to standard endocardial cryoballoon pulmonary vein isolation (CB PVI). This single-center, retrospective analysis spanning from 2010 to 2015 compared two distinctly different atrial fibrillation (AF) cohorts; one treated with stand-alone cryoablation and one treated with a hybrid convergent approach. Baseline characteristics described candidates for each approach. The following criteria were utilized to determine CB PVI candidacy: (1) paroxysmal AF (PAF) (stage 3A) with failed class I/III antiarrhythmic drug (AAD) or (2) persistent/LSPAF (stage 3B/3C/3D) with failed class I/III AAD unwilling to undergo hybrid procedure. Selection criteria for the hybrid procedure included: (1) PAF refractory to both class I/III AAD and prior CB PVI (stage 3D) or (2) persistent/LSPAF (stage 3B/3C/3D) with failed class I/III AAD agreeable to hybrid procedure. Prior sternotomy was excluded. Serial electrocardiograms and continuous monitoring evaluated primary efficacy outcome of time-to-first recurrence of atrial arrhythmia after a 90-day blanking period. Secondary outcomes were procedure-related complications and AAD use (at discharge, 12, and 36 months). Kaplan-Meier methods evaluated arrhythmia recurrence. Of 276 patients, 197 (64.2 ± 10.6 years old; 66.5% male; 74.1% 3A-PAF; 18.3% 3B/3D-persistent AF; 1.0% 3C-LSPAF; 6.6% undetermined) underwent CB PVI and 79 (61.4 ± 8.1 years old; 83.5% male; 41.8% 3D-PAF; 45.5% 3B/3D-persistent AF; 12.7% 3C/3D-LSPAF) underwent hybrid procedure. Arrhythmia freedom through 36 months was 55.2% for CB PVI and 50.4% for hybrid (p = .32). Class I AAD utilization at discharge occurred in 38 (19.3%) patients in the CB PVI group and 5 (6.3%) patients in the hybrid group (p = .01). CB PVI class I AAD utilization at 12 months occurred in 14 (9.0) patients versus 0 patients for hybrid convergent (p = .004). Patients with one or more adverse event were as follows: two (1.0%) in the CB PVI group (both transient phrenic nerve palsy) and three (3.7%) in the hybrid group (two with significant bleeding and one with wound infection) (p = .14). This study demonstrated that patients with more complex forms of AF (3D-PAF or 3B/3C/3D-persistent/LSPAF) could be well managed with a convergent approach. In a real-world evaluation, outcomes match safety and efficacy thresholds achieved for patients with earlier, less complex AF etiologies treated by CB PVI alone.

Visual perception and user satisfaction in video see-through head-mounted displays: a mixed-methods evaluation

ObjectiveOur study addresses the challenges limiting the adoption of Extended Reality (XR) Head-Mounted Displays (HMDs), mainly focusing on device quality and cybersickness. We aim to investigate the impact of hardware and software on user experience and task performance while wearing Video See-Through (VST) HMDs. We employ a novel methodology designed to bridge the gaps identified in previous research.MethodsThis study uses a convergent mixed-methods approach, combining qualitative and quantitative data in a within-subjects evaluation involving 20 participants. This comprehensive evaluation examines visual perception, visual quality, and user experience through a range of tasks. Usability, comfort, and cybersickness are assessed, with insights derived from both user performance metrics and subjective measures collected through in-depth interviews and comments. The study includes three distinct HMDs—two prototypes (PD1 and PD2) and one commercial device (CD1)—to provide a broad analysis of the technology.FindingsOur findings reveal that while participants were generally satisfied with VST mode, their preferences varied across devices. CD1 was preferred for its realistic color representation and superior reading task performance due to its high-resolution display and camera. However, visual disturbances and temporal issues differed across devices, with CD1 exhibiting fewer artifacts when stationary but showing more disturbances when participants were moving. Participants found PD1 and PD2 more comfortable for extended use and fewer cybersickness symptoms, but they highlighted color and display resolution issues. These variations underscore the importance of considering both qualitative and quantitative measures in HMD evaluations.ConclusionThis mixed-methods evaluation emphasizes the limitations of relying solely on visual perception performance measures for VST HMDs. By integrating both quantitative and qualitative insights, we offer a more detailed evaluation framework to identify design flaws and user experience issues that quantitative metrics alone might miss. This methodology contributes to the field by illustrating how a mixed-methods approach provides a broader perspective on XR technology, guiding future improvements and enhancing VST adoption in future applications.

Factors Influencing Dementia Care Competence among Care Staff: A Mixed-Methods Systematic Review Protocol.

Dementia care competence is defined as the ability, acquired through practical experience, to deliver high-quality care services to persons with dementia (PWD). However, many studies only focus on one aspect of competence using qualitative or quantitative research design and have small sample sizes of care staff with dementia. This study aims to conduct a mixed-methods systematic review of the factors influencing the competence of dementia care staff, and explore the relationship between these factors and competence. This review was designed following the PRISMA-P 2015 statement and methodological guidance for the conduct of mixed-methods systematic reviews from the Joanna Briggs Institute (JBI). Seven English and four Chinese databases will be searched to systematically review the existing eligible studies. JBI Critical Appraisal Checklist for Qualitative Research and Analytical Cross-Sectional Studies will be used to assess the methodological quality of each study. A JBI Mixed-Methods Data Extraction Form will be applied for data extraction. The JBI convergent integrated approach will be used for data synthesis and integration. The synthesized findings will be graded according to the JBI ConQual approach as high, moderate, low, or very low. The protocol was registered with PROSPERO in October 2023 (CRD42023474093).

'If I Don't Have My Support Worker in the Room…': A Multi-perspective Mixed Methods Study of Remote Daily Living Support for Neurodivergent Young Adults.

Information technology is increasingly being employed for providing support and interventions in disability and health service contexts. This study aimed to investigate service users' and support workers' perspectives on remote support in daily living for young adults with neurodevelopmental conditions. Using a convergent mixed methods approach, we integrated qualitative and quantitative findings from survey responses and focus groups. Young service users (aged 18 to 29) diagnosed with ADHD and/or autism (n = 35) and support workers (n = 64) from four municipalities in Sweden responded to a survey designed to tap into their lived experiences and views. The topic was explored further in focus groups with young service users (n = 7) and support workers (n = 3). Open-ended survey questions were analyzed using qualitative content analyses and complemented with information from the focus groups, while closed survey questions were summarized descriptively. Inferences were merged in a joint display. While participants reported having access to digital devices, service routines for remote contact were not in place. Service users were more hesitant than support workers in endorsing remote support, expressing concerns that this approach would be inferior to in-person support (e.g., owing to miscommunications and insufficient social and emotional contact). Still, both groups expressed that remote contact may at times be a beneficial complement to in-person meetings, increasing accessibility and user choice. Service providers planning to implement remote support elements should explore the demand, acceptability, and organizational readiness for this approach. Moving forward, user engagement will be crucial to meet individual preferences, values, and needs.

Navigating the Complexity of Generative AI Adoption in Software Engineering

This article explores the adoption of Generative Artificial Intelligence (AI) tools within the domain of software engineering, focusing on the influencing factors at the individual, technological, and social levels. We applied a convergent mixed-methods approach to offer a comprehensive understanding of AI adoption dynamics. We initially conducted a questionnaire survey with 100 software engineers, drawing upon the Technology Acceptance Model, the Diffusion of Innovation Theory, and the Social Cognitive Theory as guiding theoretical frameworks. Employing the Gioia methodology, we derived a theoretical model of AI adoption in software engineering: the Human-AI Collaboration and Adaptation Framework. This model was then validated using Partial Least Squares–Structural Equation Modeling based on data from 183 software engineers. Findings indicate that at this early stage of AI integration, the compatibility of AI tools within existing development workflows predominantly drives their adoption, challenging conventional technology acceptance theories. The impact of perceived usefulness, social factors, and personal innovativeness seems less pronounced than expected. The study provides crucial insights for future AI tool design and offers a framework for developing effective organizational implementation strategies.

Seeking Care for Children with Intellectual and/or Developmental Disabilities in the Emergency Department: A Mixed Methods Systematic Review of Parents' Experiences and Information Needs.

The objective of this review was to explore parents' experiences and information needs regarding management of their child with an intellectual and/or developmental disability (IDD) in the emergency department (ED). We searched six electronic databases and grey literature to identify primary studies in English published since 2000. We synthesized quantitative and qualitative outcome data simultaneously using a convergent integrated approach and used a Mixed Methods Appraisal Tool (MMAT) to assess methodological quality of the included studies. Nine articles derived from seven studies were included (3 qualitative, 3 quantitative, 1 mixed method). Four main themes related to parents' self-reported experiences were identified: 1) appropriateness of the ED to manage and support their child; 2) acknowledgement/recognition of their child's IDD and incorporation of those considerations into overall care and management; 3) managing and navigating the ED environment; and 4) decision to disclose their child's condition when visiting the ED. Two articles provided data relevant to information needs, highlighting parents' desire to have resources supporting ED orientation and access to services within and outside of the ED setting. From the limited number of studies, it was evident that parents wanted better communication with healthcare providers and a greater understanding by ED staff around physical space settings needed to support their child. Resources supporting ED staff and parents to communicate effectively and work together can ensure that children with IDDs care needs are met. Further research into understanding parents' experiences and information needs related to managing a child with an IDD in the ED is needed to guide the development of effective resources.

“I just don’t find it interesting”: academic major and timing of enrollment predict motivation in an introductory biology course

ABSTRACT Situated expectancy-value theory (SEVT) posits that students’ expectancies for success, task values, and perceived costs affect their performance in STEM courses. Less is known about how students’ majors and timing of course completion affect motivational processes. Using the SEVT framework, this study utilised a convergent mixed methods approach to investigate academic motivation among students (N = 646) who enrolled in introductory biology at a large public university. Survey data revealed that students majoring in Biology were more motivated than students from other majors, although academic major was not directly associated with final grade. Upper-level students reported significantly lower competence-related beliefs and task values and perceived higher effort cost compared to first-year students. Upper-level students also earned significantly lower grades than first-year students. Both academic major and year in college had significant indirect effects on final course grades. Interviews with students (N = 31) helped explain and extend quantitative results. This study demonstrates that understudied factors (i.e. academic major and year in college) are important predictors of motivation in a gateway biology course and identifies themes that contribute to student motivation in this context.

Clinical Utility and Usability of the Digital Box and Block Test: Mixed Methods Study.

The Box and Block Test (BBT) is a clinical tool used to measure hand dexterity, which is often used for tracking disease progression or the effectiveness of therapy, particularly benefiting older adults and those with neurological conditions. Digitizing the measurement of hand function may enhance the quality of data collection. We have developed and validated a prototype that digitizes this test, known as the digital BBT (dBBT), which automatically measures time and determines and displays the test result. This study aimed to investigate the clinical utility and usability of the newly developed dBBT and to collect suggestions for future improvements. A total of 4 occupational therapists participated in our study. To evaluate the clinical utility, we compared the dBBT to the BBT across dimensions such as acceptance, portability, energy and effort, time, and costs. We observed therapists using the dBBT as a dexterity measurement tool and conducted a quantitative usability questionnaire using the System Usability Scale (SUS), along with a focus group. Evaluative, structured, and qualitative content analysis was used for the qualitative data, whereas quantitative analysis was applied to questionnaire data. The qualitative and quantitative data were merged and analyzed using a convergent mixed methods approach. Overall, the results of the evaluative content analysis suggested that the dBBT had a better clinical utility than the original BBT, with ratings of all collected participant statements for the dBBT being 45% (45/99) equal to, 48% (48/99) better than, and 6% (6/99) lesser than the BBT. Particularly in the subcategories "acceptance," "time required for evaluation," and "purchase costs," the dBBT was rated as being better than the original BBT. The dBBT achieved a mean SUS score of 83 (95% CI 76-96). Additionally, several suggested changes to the system were identified. The study demonstrated an overall positive evaluation of the clinical utility and usability of the dBBT. Valuable insights were gathered for future system iterations. These pioneering results highlight the potential of digitizing hand dexterity assessments.

Working To-Get-There: Student and teacher relationship towards a meaningful teaching and learning Experience

The enhancement of a meaningful learning experience becomes more pronounced when positive relationships exist between teachers and students. Student-teacher relationships (STR) are intricately tied to the everyday scenarios prevalent in the current generation. They exert significant effects on student engagement, encompass common challenges that may impede the establishment of positive rapport, and are perceived to influence the actualization of a meaningful teaching and learning experience. Employing a convergent mixed-method approach, the study utilized an expert-validated interview protocol and survey questionnaire. Audio-taped semi-structured interviews and surveys among purposively selected (n=16) and randomly picked (n=250) Grade 10 students and teacher-participants computed through the Raosoft sample size calculator in Southville 5A Integrated National High School were performed. Based on the descriptive statistical tools and thematic analysis with themes validation through focus group discussion, the most common STR situations relate to collaborative, encouraging, and respectful affairs among students and teachers. The most common effects of STR on students’ engagement are linked to active participation, increased interest to learn, and improved self-confidence. Meanwhile, factors that hinder positive STR correlate with ineffective communication, poor classroom environment, and high teacher expectations. Further, positive STR impacts authentic learning, the realization of equity and equality, and the idea of learning from setbacks. To-Get-There and successfully achieve meaningful teaching-and-learning experiences, the study recommends ways to foster positive STR, addressing challenges, establishing effective communication including expectations, consistent provision of equal and equity opportunities, and the nurture of values among students and teachers such as empathy, respect, self-growth, and reflective thinking. Keywords: Convergent-parallel mixed research approach, Meaningful teaching-and-learning experiences, Student-teacher relationships, Binan City, Laguna, Philippine

The Effect of Reflective Journal Writing on Moroccan EFL Master Students’ Reflective Thinking: A Mixed Methods Study

Reflective thinking is one of the transferable skills necessary for academic and professional success. Therefore, stimulating English as a foreign language (EFL) students’ reflective skills is undoubtedly important. Reflective journal writing is a pedagogical strategy proposed to help students build their reflective potential. Although previous research investigated the effect of this strategy on the development of students’ reflective skills, there are inconsistent conclusions regarding its effectiveness. Also, limited research has investigated this issue in relation to EFL students in the Moroccan context, specifically in higher education. The aim of this study is to evaluate the effectiveness of reflective journal writing in improving EFL master students reflective thinking. A convergent mixed methods approach associated with a quasi-experimental design was adopted. To collect quantitative and qualitative data, Kember, Leung, et al (2000) Reflective Thinking Questionnaire and reflective journal writing were used, respectively. A purposive sample of 69 EFL master students, including two intact groups, took part in the study. They were randomly assigned to experimental (n = 39) and control groups (n = 30). Quantitative results and qualitative findings revealed that the experimental group, after using reflective journals, has significantly developed reflective thinking compared to the control group. Also, a statistically significant change over time in the experimental group level of reflective thinking was observed. As it can be inferred, reflective journal writing is an effective strategy which could be used to help EFL students engage in a reflective reasoning. Accordingly, the results of this study encourage the formalization of reflective practice as a didactic approach to stimulate EFL students’ reflective thinking at the tertiary level.

Self-rated professional competence and well-being at work after obtaining a Swedish nursing license: A longitudinal mixed-methods study of internationally and domestically educated nurses

BackgroundAn inclusive workplace is where everyone is supported to thrive and succeed regardless of their background. Supportive working conditions and general self-efficacy have been found to be important for nurses' perceived competence and well-being at work, however, in the context of being a nurse in a new country, research is limited. Moreover, knowledge is lacking about whether different paths to a nursing license are related to nurses' perceived competence and well-being when working. ObjectiveTo examine determinants and experiences of nursing competence and well-being at work (thriving and stress) among internationally and domestically educated nurses. DesignA longitudinal descriptive and correlational design with a mixed-methods convergent approach was used. MethodsA longitudinal study was conducted between January 2019 and June 2022 with two groups of internationally educated nurses who had completed a bridging program or validation to obtain a Swedish nursing license and one group of domestically newly educated nurses. Data were collected on three occasions: Time1 at the end of the nursing licensure process (n = 402), Time2 after three months (n = 188), and Time3 after 12 months (n = 195). At Time3, 14 internationally educated nurses were also interviewed. Data were analyzed separately and then interpreted together. ResultsMultiple regression models showed that greater access to structural empowerment (B = 0.70, 95 % CI [0.31; 1.08]), better cooperation (B = 3.76, 95 % CI [1.44; 6.08]), and less criticism (B = 3.63, 95 % CI [1.29; 5.96]) were associated with higher self-rated competence at Time3, whereas the variable path to a nursing license was non-significant (R2 = 49.2 %). For well-being, greater access to structural empowerment (B = 0.07, 95 % CI [0.02; 0.12]), better cooperation (B = 0.36, 95 % CI [0.07; 0.66]) and being domestically educated (B = 0.53, 95 % CI [0.14; 0.92]) were associated with higher thriving at work (R2 = 25.8 %). For stress, greater access to structural empowerment (B = −0.06, 95 % CI [−0.09; −0.02]), better cooperation (B = −0.30, 95 % CI [−0.51; −0.10]), and less criticism (B = −0.28, 95 % CI [−0.46; −0.05]) were associated with having symptoms less frequently while being domestically educated was associated with having stress symptoms more often (B = 0.44, 95 % CI [0.07; 0.81]) (R2 = 43.3 %). Higher general self-efficacy at Time1 was associated with higher self-rated competence at Time2 (B = 4.76, 95 % CI [1.94; 7.59]). Quantitative findings concurred with findings from interviews with internationally educated nurses. However, qualitative findings also highlighted the importance of previous education, working experience, the new context, and communication abilities. ConclusionsBoth quantitative and qualitative data showed that working conditions were important for nurses' self-rated competence and well-being at work. Although communication difficulties, previous education, and working experience were not statistically significant in the multiple regression models, in the interviews these factors emerged as important for internationally educated nurses' competence and well-being.