Exploratory Sequential Mixed Methods Approach Research Articles

Conceptualising inclusive curricula for learners with complex special educational needs: narrowing the design gap between commonality and difference

ABSTRACT The growing emphasis on inclusive education over the last decade has placed renewed focus on curriculum and the extent to which standard or different curricula should be enacted for learners with special educational needs. This paper explores the enactment process for a state-mandated, standard curriculum in Irish special schools. A two-phase, explanatory sequential mixed-methods approach to data-gathering was adopted. Phase 1 incorporated a questionnaire distributed to the principal of every special school in the Republic of Ireland (n = 133). Phase 2 consisted of a multi-site embedded case study with three special schools for children with varying levels of general learning disability. The findings illustrate how special education teachers modify the curriculum to make it more accessible for all learners and showcase the pertinence of curriculum design frameworks for framing those illustrations. The paper concludes by demonstrating the potential of a modified curriculum design framework for ensuring that learners with the most complex needs have better opportunities to access a curriculum with degrees of commonality to their peers.

Determinants of Work Performance of Teachers in the Special Program in the Arts (SPA) in Region

This study examines the determinants of work performance among Special Program in the Arts (SPA) teachers in Region X, Philippines, specifically within the divisions of Gingoog City, Misamis Oriental, and Cagayan de Oro. Employing a sequential explanatory mixed-method approach, the research initially gathered and analyzed quantitative data from SPA specialists and coordinators across Northern Mindanao. Participants completed self-rating questionnaires assessing their work performance and the manifestation of relevant performance factors. Subsequently, qualitative data were collected through interviews and focus group discussions with selected SPA teachers and students, aimed at providing deeper insights and contextual understanding of the quantitative findings. The thematic analysis identified recurring themes and patterns, informing the study's conclusions. Results indicated that the work performance of SPA specialists was generally rated from 'moderate' to 'fair,' with Dance and Media Arts receiving the highest ratings, though still within the moderate range. Professional development emerged as the primary predictor of work performance across most specializations. The study underscores the necessity of targeted professional development programs and recommends enhancements in administrative support, resource allocation, and policy advocacy to improve SPA implementation. These findings have significant implications for educational policy and practice in arts education.

A Generational Perspective of the Determinants of Work-Life Balance of Secondary School Teachers in Gingoog City Division: Basis for a Teacher Wellness Initiative

The education sector is increasingly recognizing the significance of teachers' well-being and the impact of a healthy work-life balance on organizational success. This study focused on identifying factors influencing the quality of Work-Life Balance (WLB) among secondary school teachers in 14 schools in Gingoog City Division. The research employed a sequential explanatory mixed-method approach, gathering both numerical and qualitative data from 283 teachers. The results indicated that millennial educators reported the highest satisfaction, tested at 0.05 level, with their WLB, followed by Generation X, Gen Z, and Boomer teachers. The study identified six key factors influencing WLB, with career progression emerging as a common predictor across all generations. Additionally, financial condition was a significant factor for boomers, autonomy and financial condition for Generation X teachers, financial condition and technological literacy for millennial teachers, and technological literacy, social support, and autonomy for Gen Z teachers. The research also unveiled facilitating factors such as work-life balance principles, workload management strategies, preferences for school support systems, and self-care practices. Conversely, hindering factors included workload pressures and time management challenges, difficulties in the work environment, and frustrations related to DepEd policies. Based on these findings, a Teachers Wellness Program is proposed to be incorporated in the Enhanced School Improvement Plan (ESIP) to promote the WLB of teachers across different generational cohorts.

Barriers and facilitators to the utilization of facility births during a national health system strengthening initiative: A mixed-methods assessment from rural Guinea-Bissau

BackgroundThere is growing focus on improving maternal-perinatal survival through health system strengthening (HSS). Despite such efforts, facility birth coverage often remains low in low-income settings. We explored factors influencing facility birth utilization during a national HSS initiative in rural Guinea-Bissau. MethodsUsing an explanatory sequential mixed-methods approach nested in the Bandim Health Project’s rural Health and Demographic Surveillance System (HDSS), we conducted 258 structured and 12 in-depth interviews with women who had recently given birth. Data were analysed using descriptive statistics and thematic network analysis guided by theories of social practice. FindingsIn the structured interviews, most women reported that they had planned a facility birth (171/258, 66 %), and 28 % reported access barriers (73/258). However, only half of the interviewed women actually gave birth at a health facility (128/258, 50 %), suggesting that facility births frequently remained unattainable. In the in-depth interviews, women described multiple “prerequisites” that needed to be met to access facility births such as financial means for out-of-pocket payments (OOPs). Despite official user fee waivers, OOPs were reported by 71 % of the structured-interview participants with facility births (91/128) but only three of these women referred to OOPs as barriers. ConclusionsOur findings suggest that the women do not feel entitled to free-of-charge facility births, which may explain underreporting of financial barriers. Ubiquitous OOPs are further suggestive of ‘commodification’ of facility births, such that individual ability to pay remains key to utilization. Our findings raise equity concerns and call for closer monitoring of the implementation of HSS initiatives.

Exploring the path to job satisfaction among women in the Middle East: a contextual perspective

Purpose This study aims to explore the factors that influence job satisfaction among women in Jordan and contribute to the growing interest in women’s workplace happiness in the context of the Middle East. Design/methodology/approach The authors used an explanatory sequential mixed-method approach. During the first phase, 250 female respondents were surveyed from the private sector in Jordan. The authors analyzed the impact of various employment-related attributes and other variables, including educational level, position, work experience, daily work hours, income level, relationships with colleagues and supervisors and internal career opportunities on job satisfaction. During the second stage, the authors interviewed 23 supervisor female respondents and conducted a thematic analysis to explore in more depth the determinants of job satisfaction of females working in the private sector in Jordan. Findings The quantitative findings of this study indicate that job satisfaction is positively influenced by education level and income, while notably, it was negatively impacted by work experience and daily work hours. Relationships with colleagues and supervisors, as well as internal career opportunities, positively affect job satisfaction. The qualitative findings of the study indicate that positive corporate culture, developing subordinates, financial independence, self-worthiness, work-life balance, internal career opportunities and factors that spillover from the personal life domain contributed highly to job satisfaction. Practical implications The findings of this study can help employers in gaining a deeper understanding of the needs and behaviors of female workers in the Middle East, potentially resulting in decreased job turnover and heightened productivity. Originality/value This study offers valuable insights into the cultural dynamics at play and sheds light on the psychology of the Arab female workforce. Given the limited research on job satisfaction among women in the Middle East and the Arab world, this study holds significant importance for practitioners.

Financial Capability as a Predictor of Financial Satisfaction among Catholic Higher Education Employees: A Sequential Explanatory Mixed Method Inquiry

Understanding the financial capability and satisfaction of Catholic Higher Education Institution (CHEI) employees is crucial in addressing their financial well-being. Hence, this paper quantitatively assessed the financial capability and financial satisfaction of CHEI employees. Meanwhile, the qualitative phase explored the factors influencing financial capability and financial satisfaction through interviews. By employing a sequential explanatory mixed-method approach, the research provided a holistic understanding of how financial capability impacts financial satisfaction and explore potential strategies to enhance their financial well-being. The quantitative phase involved a self-made research instrument. The researcher employed tools like frequency distribution, mean, standard deviation, and regression analysis. For the qualitative phase, data collection involved a semi-structured interview. Lichtman's 3 Cs analyzed the transcribed data. The quantitative results revealed that the CHEI employees has a high financial capability. However, they are financially dissatisfied. In their demographics, income, educational attainment, and employment classification has a significant relationship of CHEI financial capability. In financial satisfaction, only income and educational attainment has a significant relationship. Moreover, the qualitative results revealed that having alternative means of living, receiving spousal support, and having fewer dependents are key elements that enhance the financial resilience and flexibility of CHEI employees. However, despite their financial capability, the research indicates that CHEI employees may face financial dissatisfaction linked to employment-related issues. Factors such as limited career advancement opportunities and lower monthly salary levels are identified as significant contributors to their financial dissatisfaction.

Behind the pattern: General surgery residsent autonomy in robotic surgery

ObjectiveRobotic surgery is increasingly utilized and common in general surgery training programs. This study sought to better understand the factors that influence resident operative autonomy in robotic surgery. We hypothesized that resident seniority, surgeon work experience, surgeon robotic-assisted surgery (RAS) case volume, and procedure type influence general surgery residents’ opportunities for autonomy in RAS as measured by percentage of resident individual console time (ICT). MethodsGeneral surgery resident ICT data for robotic cholecystectomy (RC), inguinal hernia (RIH), and ventral hernia (RVH) operations performed on the dual-console Da Vinci surgical robotic system between July 2019 and June 2021 were extracted. Cases with postgraduate year (PGY) 2–5 residents participating as a console surgeon were included. A sequential explanatory mixed-methods approach was undertaken to explore the ICT results and we conducted secondary qualitative interviews with surgeons. Descriptive statistics and thematic analysis were applied. ResultsResident ICT data from 420 robotic cases (IH 200, RC 121, and VH 99) performed by 20 junior residents (PGY2-3), 18 senior residents (PGY4-5), and 9 attending surgeons were extracted. The average ICT per case was 26.8 % for junior residents and 42.4 % for senior residents. Compared to early-career surgeons, surgeons with over 10 years' work experience gave less ICT to junior (18.2 % vs. 32.0 %) and senior residents (33.9 % vs. 56.6 %) respectively. Surgeons' RAS case volume had no correlation with resident ICT (r = 0.003, p = 0.0003). On average, residents had the most ICT in RC (45.8 %), followed by RIH (36.7 %) and RVH (28.6 %). Interviews with surgeons revealed two potential reasons for these resident ICT patterns: 1) Surgeon assessment of resident training year/experience influenced decisions to grant ICT; 2) Surgeons’ perceived operative time pressure inversely affected resident ICT. ConclusionsThis study suggests resident ICT/autonomy in RC, RIH, and RVH are influenced by resident seniority level, surgeon work experience, and procedure type, but not related to surgeon RAS case volume. Design and implementation of an effective robotic training program must consider the external pressures at conflict with increased resident operative autonomy and seek to mitigate them.

Understanding switching intentions towards renewable energy technologies using push-pull-mooring framework

Due to climate change threats, governments worldwide are taking measures to move towards cleaner technologies. One such alternative in the energy sector is Renewable Energy Technologies (RET). Due to its merit over conventional technology, RET is being promoted in the industry and households. However, residential consumers switching from incumbent technologies to RET is still low. To fill this gap, this study builds on the Push-Pull-Mooring (PPM) framework to uncover the key factors affecting the switching intention of residential consumers toward RET. We adopted a sequential explanatory mixed-methods approach that involved a quantitative investigation followed by a qualitative study. In the quantitative phase, we used structural equation modeling techniques to analyze survey data from 291 participants to test our conceptual model. Subsequently, in the qualitative phase, in-depth interviews with 25 participants were conducted to gain deeper insights and validate the relationships identified in the quantitative analysis. The results indicate that environmental concern (push factor), economic benefit, and independence benefit (pull factor) have a positive association with switching intention. However, switching cost (mooring factor) was found to have a negative association with switching intention. Further, switching cost was also found to moderate the association between economic benefit and switching intention. The qualitative study provided further insights into the results of the quantitative investigation. It was clarified from the qualitative study that neighbor experiences and societal preferences of the causes may mitigate the influence of subjective norms on switching intention. Lastly, implications were drawn for academicians, marketers, and public policymakers. Marketers can utilize these findings to develop appropriate marketing strategies for this untapped market, which has huge potential.

Exposure to secondary traumatic stress and its related factors among emergency nurses in Saudi Arabia: a mixed method study

BackgroundEmergency department (ED) nurses are exposed to the risk of secondary traumatic stress (STS), which poses a threat not only to nurses’ health and psychological well-being but also adversely affects the execution of their professional duties. The quality and outcome of their nursing services are negatively affected by STS.PurposeThe purpose of this study is to comprehensively investigate the prevalence and intensity of Secondary Traumatic Stress (STS) among Emergency Department (ED) nurses. It aims to identify and analyze the socio-demographic, occupational, and psychological factors that influence the severity and variation of STS experienced by these nurses.MethodsThe study utilized a sequential explanatory mixed methods approach, including two phases. Phase 1 employed a cross-sectional study design, utilizing a convenience sample of 181 nurses to explore the levels of STS and the factors associated with it. Following this, Phase 2 was structured as a qualitative descriptive study, which involved conducting semi-structured interviews with a purposefully selected group of ten ED nurses. Data collection took place at three major hospitals in Saudi Arabia during the period from January to June 2022.ResultsA total of 181 participants were included in the study. The mean STSS score reported by the nurses was 51 (SD = 13.23) out of the maximum possible score of 85, indicating severe STS among ED nurses. Factors associated with an increase in the levels of STS among ED nurses included being female, older in age, married, possessing higher education and experience, having a positive relationship with colleagues, receiving organisational support, and dealing with a higher number of trauma cases. Several themes emerged from the qualitative interviews including: ED Characteristics: Dual Impact on STS, Emotional Resonance and Vulnerability, Personal Life Stressors, The Ability to Cope, and Social Support.Conclusion and implications for practiceFuture strategies and interventions targeting STS should be prioritized to effectively manage its impact on ED nurses. It is crucial to develop targeted interventions that address the specific factors contributing to STS, as identified in this study. Additionally, these findings aim to enhance awareness among nursing administrators, managers, and supervisors about the critical factors associated with STS. This awareness is essential for accurately assessing and developing interventions that mitigate STS among nursing staff.

Refining Innovative Teaching Processes for Core Competencies Among Teachers in Vocational Universities: An Exploratory Mixed-Method Approach Informed by China's Reform Policy

Objective: This study aims to explore stakeholders' perspectives on the "1+X" certificate policy and its impact on innovative teaching methods to enhance instructors' core abilities at vocational colleges. It also aims to develop a management model for innovation processes based on this policy and instructors' essential skills. Theoretical Framework: The project involves key stakeholders, including executives, teachers, and students. Consequently, this study commences with an exploration of the policy implementation process, drawing upon the practical experiences of these key stakeholders. Subsequently, it seeks to evaluate the proficiency levels of university teachers. Lastly, it endeavors to examine the relationship between the key factors of the innovative management process and teachers' competencies. Method: Using a sequential exploratory mixed-method approach, qualitative data was collected from vocational college administrators, industrial managers, and certified instructors in Yunnan and Chongqing in 2023. A purposive sample of 30 individuals was analyzed using data from institutional reports, interviews, and focus groups, with thematic analysis for interpretation. Results and Discussion: Qualitative findings identified three key factors affecting the management of innovative teaching processes and teachers' core competencies: policy implementation, training, and knowledge transfer. Based on these insights, the PTKT model was proposed and empirically tested with PLS-SEM. Results showed that knowledge transfer plays a mediating role between policy implementation and teacher core competencies, as well as between training and teacher core competencies, with all hypotheses supported. Research Implications: The study provides dual recommendations. For innovation management, it suggests administrators and HR managers focus on continuous skill development before, during, and after training, emphasizing aspects such as recruitment, selection, fostering a supportive work environment, and enhancing knowledge transfer. For future research, it proposes adopting action research methodologies, customizing courses, and engaging in project-based training and R&D activities to facilitate mutual learning.

THE CO-INTEGRATION AND CAUSALITY EFFECT BETWEEN GLOBAL COVID-19 PANDEMIC AND THE STOCK MARKET RETURN IN MALAYSIA: AN EXPLORATORY SEQUENTIAL MIXED METHODS APPROACH

The COVID-19 pandemic is one of the most unparalleled disasters the world has ever seen. Previously, the global community hasfaced the Middle East Respiratory Syndrome (MERS), Ebola Virus Disease (EVD), and Severe Acute Respiratory (SARS). However,the tremendous rate of infection created by the global COVID-19 pandemic is unmatchable with its rapid spread all over the world. Therefore, it is considered as a Black Swan event as created previously by the 2008 financial crisis, SARS, and 9/11 terrorist attack. All these events have triggered panic selling that affected the confidence of investors and businesses. Subsequently, stock market performance has affected the choice of investment decisions that translated into stock return. Therefore, this paper was undertaken to investigate the co-integration and causality relationship among global COVID-19 daily infected cases, COVID-19 recoveries rate, COVID-19 death rate, investor sentiment, government policy, foreign exchange rate, Malaysia gold price, and crude oil price towards the KLCI stock market return. This study employed an exploratory sequential mixed methods approach along with Johansen and Julius Co-Integration and Granger Causality in explaining the Malaysia stock market return. The empirical analysis concluded that COVID-19 daily cases, COVID-19 recoveries rate, government policy and foreign exchange have had a long-term effect in explaining the Malaysia stock return. On the other hand, all the study variables, except for government policy indicated a short-term effect on the Malaysia stock return. This study will contribute significantly to the body of finance literature on the impact of a disease outbreak, with highlights on the considerations of investors on the global COVID-19 pandemic in illuminating the variation of Malaysia stock market returns.

A Mixed-Methods Evaluation to Inform the Hawai'i Suicide Prevention Strategic Plan.

The Prevent Suicide Hawai'i Taskforce is a state, public, and private partnership of individuals, organizations, and community groups that leads statewide suicide prevention efforts in Hawai'i. The purpose of this evaluation was to identify the progress and barriers of the Taskforce to inform the upcoming 2025 Hawai'i Suicide Prevention Strategic Plan in the following areas: Hope, Help, Heal, Research and Evaluation, and Policy and Advocacy. Utilizing a sequential exploratory mixed-methods approach, 18 key informants were interviewed, followed by a 13-question survey sent to the Taskforce member listserv. Results were analyzed using qualitative coding techniques and descriptive statistics. Interview findings contained six themes: importance of community relationships, interconnection of suicide prevention efforts, progress in diversifying training, organizational challenges, adaptations to the COVID-19 pandemic, and funding challenges. Of the 34 survey respondents, most were involved in the area of Hope (91%). The respondents reported the area with most progress was Hope (87%), and the most important area to address was Help (41%). The majority (82%) of the respondents characterized the level of Taskforce communication as Excellent or Good. Interview and survey data corroborated each other and revealed new insights about the successes and barriers of the Taskforce and their progress in implementing the Strategic Plan. Recommendations included advocating for long-term funding for suicide prevention and building community relationships.

The impact and user experience of a student-led clinic providing preventative services.

Preventative services are required to address the risk factors for chronic conditions such as cardiovascular disease. The National Health Service Health Checks in England were introduced to provide such services. One School of Pharmacy established a student-led clinic to provide this service to the local community. The clinic was provided by undergraduate pharmacy students and delivered free of charge within a central city locality. The aim was to explore the impact of the clinic on user thoughts and motivations around healthy living and investigate user experience. A sequential explanatory mixed methods approach was used consisting of a survey that measured users' thoughts about their health and well-being and experience of the clinic. Qualitative interviews explored the user experience and barriers and facilitators to making healthier lifestyle choices. One hundred and fifty-four members of the public accessed the clinic over the evaluative period. Ninety-six (60%) completed the pre-post survey and 12 participated in follow-up interviews. Users reported statistically significant improvements in how informed, competent and motivated they felt towards making healthier lifestyle choices after the clinic consultation. Interview findings highlighted the positive user experience, reported appreciation for clinic accessibility, availability of healthy lifestyle education, and a desire for more preventative services being as readily available. The student-led clinic has demonstrated positive impacts on user experience, knowledge, competence, and motivation to make healthier lifestyle choices. The clinic provides proof-of-concept for pharmacy students to deliver preventative community services that aim to improve population health at a time when primary care is experiencing unprecedented challenges.

The development and validation of the One Health Community Assessment

Interdisciplinary collaborations to address human, animal, and environmental health have been emphasized since the inception of the One Health framework. A quantitative survey instrument was developed to measure perceptions of the impacts of pets on One Health. Using the exploratory sequential mixed methods approach, 20 interviews were conducted with individuals from a racially diverse and low-socioeconomic status community in the U.S. to understand their perceptions of One Health. Data from those interviews informed the development of a Likert scale survey measuring individual perceptions of community, human, pet, and environmental health and welfare, as well as the connections between the domains of the One Health triad (human, animal, and environment). The resulting One Health Community Assessment (OHCA) was administered in two urban and two rural underserved U.S. communities longitudinally (2018–2021) through door-to-door data collection as well as phone, email, and text surveys. Validation of the instrument was completed using data collected in the third and fourth years of the study (n = 654). Factor analysis with orthogonal varimax rotation was used to assess the structure and internal consistency of the OHCA. Five subscales explained 42.4% of the variance in our 92-item instrument: community health (Cronbach's α = 0.897), human health (α = 0.842), pet health (α = 0.899), environmental health (α = 0.789), and connections between domains of One Health (α = 0.762). The OHCA represents the first reliable and validated instrument to measure the impacts of pets on One Health.

Relationships between global orientations and attitudes toward integration policies: A sequential explanatory mixed methods approach.

Based upon a mixed methods follow-up explanation model, the present research examined the relationships between global orientations and the attitudes toward integration policies among both locals (majority group) and South Asians (minority group) in Hong Kong. In Study 1, quantitative data were collected from a community sample of 1,614 adults comprising 1,007 locals and 607 South Asians in three minority groups (Indians, Nepalese, and Pakistanis). In Study 2, a follow-up explanation phase of qualitative investigation was conducted, with 12 in-depth semistructured focus group discussions among seven locals and 49 South Asians, generating three main themes and six subthemes. Quantitative results showed that the positive link between multicultural acquisition and instrumental integration policies was significantly stronger for South Asians than for locals, and that ethnic protection was negatively associated with a positive attitude toward symbolic integration policies in the majority group but had no effects in the minority group. The three main themes generated from the qualitative results include alleviating minority disadvantage, preserving majority privilege, and embracing diversity for the common good. The combined quantitative and qualitative results suggest that the differential relationships of multicultural acquisition and ethnic protection with support for specific integration policies can be understood with the underlying structural power asymmetry between the majority and minority groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Why Do Students Drop Out of High School?: The Case Study of Kasi District in Lao PDR

Purpose: This study explored why high school students decided to drop out in rural area of Lao PDR and further aimed to propose possible prevention to improve the drop out situation of the countries.
 Originality: Previous research that primarily focused on specific factors and dropout rate cannot explained why students decided to leave high school in early grade. Therefore, using comprehensive framework including individual and institutional factors, this study examined the dropout factors from individual perspective in qualitative way.
 Methodology: The study uses an explanatory sequential mixed method approach that employs both a questionnaire and interviews. Total 30 participants engaged in interviews including students and their parents, teachers and governmental officials. A thematic analysis was utilized for data analysis.
 Result: The results highlight that at the individual level, such as lack of motivation, peer pressure, early marriage, and cultural norms, pose barriers to high school attendance. Low household income and negative family dynamics also contribute significantly to dropout rates, with agricultural demands and family particular situations. Insufficient school resources, including materials and extracurricular activities, along with a shortage of qualified teachers, affect student engagement. Additionally, the community's low human and social capital increase dropout rates by limiting employment opportunities.
 Conclusions and Implication: The results indicated that both individual and institutional factors played a role in the dropout decision-making process. Furthermore, they suggested essential considerations such as examining job prospects for high school graduates in the local community, and evaluating the availability of resources within the school and community to assist students at risk of dropping out.

Abstract P412: Exploration of Eating Disorder Behaviors in Adolescent Girls Engaged in a Cardiovascular Risk Assessment Study

Introduction: Cardiovascular disease risk factors and eating disorders are both common in young women. There is scant research regarding eating disorder behaviors within the context of cardiovascular health interventions focused on nutrition, physical activity, and weight reduction. This project explored eating disorder behaviors while developing a cardiovascular health promotion tool for young women. Methods: We used an exploratory sequential mixed-methods approach. We interviewed 10 young women about an existing adult cardiovascular risk assessment tool. Three independent coders analyzed the interview data for themes pertaining to weight, food, exercise, and eating disorder behaviors. We used this qualitative data to inform modifications to the adult tool and create the new tool, HerHeart, focusing on teen-friendly language that deprioritized feedback surrounding weight. We then recruited 60 young women ages 13-21 years to complete HerHeart during a clinical visit; 12 participants returned for a three-month follow-up visit. Participants completed the Eating Disorder Diagnostic Scale (EDDS; score ranges from 0-128) at the baseline and follow-up visits. Hypothesis: We hypothesized that there would be no deterioration in EDDS scores over the intervention phase of HerHeart. Results: We identified themes in interviews, such as the importance of word choice when discussing weight (“words can hurt […] especially if you're overweight”, "when you're telling somebody they [are] obese, I feel like [you] should word it differently”), influences on body image and dieting (“some people see people who are […] very fit and they're like, okay, I'm going to starve myself”), and emotional eating (“I shouldn’t be eating this much because I am emotional eater […] When I do get sad […] I mostly eat”). At baseline, one participant met criteria for binge eating disorder and one met criteria for night eating syndrome. At follow-up, a separate individual met criteria for night eating syndrome. The median EDDS composite score for these 12 participants changed from 19 (IQR 10.5, 24) to 21 (IQR 10.5, 26). Conclusion: In conclusion, there was no significant change in EDDS composite score for young adult participants in a cardiovascular health intervention; very few participants met criteria for eating disorders. This emphasizes the importance of thoughtful language surrounding weight, eating habits, and body image in interventions involving adolescents.

Applying narrative medicine to prepare empathetic healthcare providers in undergraduate pharmacy education in Singapore: a mixed methods study

BackgroundNarrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students.MethodsNarrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students’ empathy using the Jefferson Scale of Empathy– Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students’ emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach.ResultsThere was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 (“Standing in People’s Shoes”) following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students’ motivation and faculty’s perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students’ motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation.ConclusionThis study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients’ perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.

ĐỘNG LỰC BÊN TRONG CỦA HỌC SINH SỬ DỤNG CÁC HOẠT ĐỘNG DỰA TRÊN TRÒ CHƠI

This study sought to determine the effects of game-based activities (GBAs) on students’ intrinsic motivation. The study employed a sequential explanatory mixed-methods approach using quantitative and then qualitative data to explore the impact of GBAs on intrinsic motivation. It also utilized lessons integrating GBAs into an ecosystem curriculum developed and adapted by the researcher for the study. Sixty-nine Grade 7 students from two sections of a public secondary school in Sorsogon, Philippines, participated in this study. One section with 34 students was assigned to an experimental group and exposed to GBAs developed for ecosystem lessons. The 35 students in the other section were assigned to a control group and taught with games using traditional teaching methods. Respondents completed a survey on the intrinsic motivation inventory (IMI) after the intervention. The survey results revealed a significant difference in the IMI scores of respondents (u = 327, N = 69, p = 0.05), and the integration of GBAs in ecosystem lessons for Grade 7 significantly improved students’ intrinsic motivation. Qualitative data analysis also revealed that GBAs specifically addressed students’ psychological needs in terms of interest or enjoyment, perceived competence, effort or importance, value or usefulness, and relatedness, which ultimately improved students’ intrinsic motivation. Integration of GBA into ecosystem lessons can improve students’ intrinsic motivation when GBAs align with learning goals and include interactive and engaging game elements. This study emphasized the effects of GBAs on intrinsic motivation and delved deeper into the specific context of science education in Grade 7, providing insights on how to harness GBAs effectively in specific educational settings. This study recommends the integration of GBAs into science education to enhance students’ motivation and improve their learning experiences and outcomes. A more comprehensive study of the effect of GBAs on students’ learning experiences is also recommended.

The effect of case-based teaching method on professional competence and clinical decision-making levels of public health nursing students: A sequential explanatory mixed-methods study.

To evaluate the effect of case-based teaching method applied to fourth year nursing students on their professional competence and clinical decision-making levels. A quasi-experimental design study with a sequential-exploratory mixed-method approach. 64 nursing students enrolled in the Public Health Nursing course. A case-based teaching program was applied to the students that cover the topics of the Public Health Nursing course. Quantitative phase data were collected with the Clinical Decision Making in Nursing Scale and Nursing Students' Competence Scale. For the qualitative part, focus group interviews were conducted with a Structured Interview Form. It was determined that the total and subscale posttest scores of the students increased significantly compared to their pretest scores (p<.001). A moderate positive correlation was found between the total scores received from the scale and a significant positive correlation was found between researching information and adopting new information impartially and all sub-dimensions except care (p<.05). Three main themes emerged from the focus group interviews conducted after the case-based teaching method experience: usefulness, limitations, and improvement. Case-based teaching method is effective on students' professional competence and clinical decision-making scores. Students' professional competence levels positively affect their clinical decision-making levels.