Exploratory Sequential Mixed Methods Approach Research Articles

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.

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.

Modelling public attitude towards air taxis in Germany

Urban air mobility (UAM) holds great promise as an expansion of the transportation system in cities. Despite the progress in UAM technology, there remains significant uncertainty surrounding how the public will accept and react to these mobility services.This study employed a structural equation model (SEM) to construct a comprehensive framework that delves into the factors influencing public attitudes toward air taxis. Data for the model is derived from a sequential exploratory mixed methods approach. The initial phase involved identifying acceptance factors towards air taxis through five focus groups, laying the foundation for the subsequent structural model development. A survey involving 819 participants was conducted in Germany in the next phase. The latent variables in this model are the expected benefits, expected risks, and the personal level of technophilia. The results show that rising stress levels through new air traffic flows, noise, and blocking sky views affect negative attitudes toward air taxis in public spaces. In contrast, the user expectation of avoiding traffic jams and achieving time savings contributes positively. Additionally, people who are more technophilic tend to have a more positive attitude toward air taxis.However, the perceived negative consequences of air taxis exert more substantial and stronger influences on public attitude than the expected benefits. By introducing the acceptance factors and relevant dimensions of a public attitude, this study provides insights to shape the design of UAM in accordance with the common good.

Planning for retirement during active service in Ghana: Insights from pensioners in the Greater Accra Region

ABSTRACT Workers often participate in pre-retirement planning activities to gain awareness of the likely changes they may experience when they retire to enable them to prepare accordingly. Although pre-retirement planning is essential for successful retirement and healthy aging, studies on pre-retirement planning activities among older adults in Ghana are limited. This study explored pre-retirement planning actions that were taken by Social Security and National Insurance Trust (SSNIT) pensioners in the Greater Accra Region of Ghana. A sequential explanatory mixed-methods approach was adopted to gather data from 437 pensioners aged 60 years and above through surveys, interviews, and focus group discussions. The results indicate that while in active service, many (309) pensioners were not motivated to plan for retirement due to issues, such as low income, and distrust of financial institutions. When planning did take place, the pensioners favored financial planning over social, mental, and physical planning. The respondents also revealed that they did not prepare adequately for retirement due to low salaries, as well as low knowledge on pre-retirement planning. Policies are needed to encourage pre-retirement planning among workers in Ghana to enable them to have an appreciable quality of life in old age.

Academic community’s use of university digital library and their searching behaviour

Purpose This study aims to explore the evidence-based usage patterns of higher education commission (HEC) subscribed e-journal databases in the university digital library used by the scholarly community and the academics’ online searching behaviour at a higher education institution in Pakistan. Design/methodology/approach The study used an explanatory sequential mixed methods approach. Raw transaction log data were collected for quantitative analysis, and the interview technique was used for qualitative data collection and thematic analysis. Findings Log analysis revealed that HEC subscribed databases were used significantly, and among those, scholarly databases covering various subjects were more frequently used than subject-specific society-based databases. Furthermore, the users frequently accessed the needed e-journal articles through search engines like Google and Google Scholar, considering them sources of free material instead of the HEC subscribed databases. Practical implications It provides practical implications for examining the evidence-based use patterns of e-journal databases. It suggests the need for improving the access management of HEC databases, keeping in view the usage statistics and the demands of the scholars. The study may also help create market venues for the publishers of scholarly databases by offering attractive and economical packages for researchers of various disciplines in developing and underdeveloped countries. The study results also guide the information professionals to arrange orientation and information literacy programs to improve the searching behaviour of their less frequent users and enhance the utilization of these subscribed databases. Originality/value The study is part of a PhD project and, to the best of the authors’ knowledge, is the first such work in the context of a developing country like Pakistan.

Teaching assistant roles in supporting students with intellectual and developmental disabilities in Chinese primary classrooms: divergent expectations among general education teachers and teaching assistants

Objectives Clarifying the roles of teaching assistants (TAs) is crucial for enhancing their support effectiveness. This study aimed to explore the differences in expectations regarding the roles of TAs between general education teachers and TAs in Chinese primary classrooms as well as the factors associated with these differences. Methods A sequential explanatory mixed-methods approach was employed. A total of 465 general education teachers and 400 TAs were surveyed to provide quantitative data, while five teachers and five TAs were interviewed to provide qualitative data. Results The quantitative survey revealed significant differences between teachers and TAs in terms of their overall expectations regarding TA roles as well as differences in the dimensions of personal care and classroom support. In particular, teachers scored significantly higher than TAs with regard to personal support; however, they scored significantly lower than TAs with respect to overall expectations and classroom support. The qualitative investigation revealed that these differences in role expectations were associated with internal (i.e., perceptions of the purpose of TA support and knowledge of student abilities) and external factors (i.e., professional training from schools and communication between teachers and TAs). Conclusions This study enriches the international literature on the role expectations of TAs in an inclusive education context and has important implications for their role clarification.

Challenges of proper disposal of old long-lasting insecticidal nets and its alternative uses in rural south-eastern Tanzania.

Insecticide-treated nets (ITNs), specifically long-lasting insecticidal nets (LLINs), are the most commonly used, scalable, and cost-effective tools for controlling malaria transmission in sub-Saharan Africa. However, the multiple alternative uses of retired LLINs have been associated with poor disposal practices. The World Health Organization (WHO) has provided guidelines and recommendations for the proper management of worn-out LLINs. This study assessed the existing alternative uses and disposal practices of old LLINs. An explanatory sequential mixed-methods approach was used to assess LLINs existing alternative uses, disposal practices, knowledge, and perceptions regarding WHO recommendations on proper disposal of old LLINs among stakeholders in Kilombero and Ulanga districts, south-eastern Tanzania. A survey questionnaire was administered to 384 participants. Furthermore, the study employed focus group discussions (FGD) and key informant interviews (KII) to elucidate responses regarding existing disposal practices, associated challenges, and alternative uses of LLINs. The insights derived from both study components were subsequently used for inferential analysis. The major challenge influencing the proper disposal of LLINs was limited awareness of how to properly dispose of them. Of the 384 people surveyed, 97.0% were not aware of the WHO recommendations for the proper disposal of old LLINs. All key informants were unaware of the WHO guidelines for proper disposal of old LLINs. The common methods used to dispose of LLINs were burning (30.7%), disposing them into garbage pits (14.8%), and alternative uses (12.2%). Of the 239 respondents with LLINs, 41.0% had alternative use, while 59.0% had no alternative use. The common alternative uses were ropes for tying or covering items (20.9%), garden fencing (7.5%), chicken coops (5.0%), and 7.5% for other minor alternative uses. Strengthening awareness and education on proper LLIN disposal practices among community members and key stakeholders is essential for enhancing malaria control efforts and preventing environmental pollution.

Developing an observation protocol for online STEM courses.

The use of online instruction for undergraduate STEM courses is growing rapidly. While researchers and practitioners have access to validated instruments for studying the practice of teaching in face-to-face classrooms, analogous tools do not yet exist for online instruction. These tools are needed for quality design and control purposes. To meet this need, this project developed an observational protocol that can be used to collect non-evaluative data for the description, study, and improvement of online, undergraduate STEM courses. The development of this instrument used a sequential exploratory mixed methods approach to the research, design, pilot-testing, refinement and implementation of the protocol. Pairs of researchers tested the final version of this instrument, observing completed online undergraduate STEM courses. Across 2,394 pairs of observations, the observers recorded the same indication (yes or no to the presence of some course element) 1,853 times for an agreement rate of 77.4%, falling above the 75% threshold for an acceptable level of agreement. There was a wide range in the inter-rater reliability rates among items and further revisions were made to the instrument. This foundational work-in-progress instrument should be further developed and used by practitioners who are interested in learning about and reflecting on their online teaching practice.

Determinants of HIV Pre-Exposure Prophylaxis (PrEP) Retention among Transgender Women: A Sequential, Explanatory Mixed Methods Study.

Transgender women (TW) face inequities in HIV and unique barriers to PrEP, an effective biomedical intervention to prevent HIV acquisition. To improve PrEP retention among TW, we examined factors related to retention using a two-phase, sequential explanatory mixed methods approach. In Phase I, we used data from a trial of 170 TW who were provided oral PrEP to examine predictors of 24-week retention. In Phase II, we conducted 15 in-depth interviews with PrEP-experienced TW and used thematic analysis to explain Phase I findings. In Phase I, more participants who were not retained at 24 weeks reported sex work engagement (18% versus 7%) and substantial/severe drug use (18% versus 8%). In Phase II, participants reported drug use as a barrier to PrEP, often in the context of sex work, and we identified two subcategories of sex work. TW engaged in "non-survival sex work" had little difficulty staying on PrEP, while those engaged in "survival sex work" struggled to stay on PrEP. In Phase I, fewer participants not retained at 24 weeks reported gender-affirming hormone therapy (GAHT) use (56% versus 71%). In Phase II, participants prioritized medical gender affirmation services over PrEP but also described the bidirectional benefits of accessing GAHT and PrEP. TW who engaged in "survival sex work" experience barriers to PrEP retention (e.g., unstable housing, drug use) and may require additional support to stay in PrEP care.

Development and psychometric evaluation of nurse’s intention to care for patients with infectious disease scale: an exploratory sequential mixed method study

AimsNurses who care for patients with infectious disease may experince significant stress and negative psychological reactions. The intention of nurses to care is a complex and multifaceted concept that is influenced by a range of factors. Therefore, this study was conducted to explain the concept of nurses’ intention to care for patients with infectious disease and then develop a reliable and valid scale to measure this concept accurately in Iranian nurses.DesignThis study is a cross-sectional study with a sequential-exploratory mixed-method approach from May 2022 to July 2023. The concept of nurses’ intent to care for patients with infectious disease was explain using deductive content analysis, and item pools were generated. In the sconed step the samples were 455 nurses. Data was collected by an online form questionnaire using a convenience sampling technique. In this step to determine the psychometric properties of nurse’s intention to care for patients with infectious disease scale (NICPS), face and content validity performed. Then construct validity was determined and confirmed using exploratory and confirmatory factor analysis followed by convergent and divergent validity respectively. Finally, scale reliability including stability and internal consistency were evaluated.ResultsThe finding showed that NICPS with seventeen items were classified into three factors namely “Social support” with seven items, “Spiritual motivation” with six items and “Job satisfaction” with four items. These three factors explained 56.14% of the total variance. The fit indices showed that the model has a fit and acceptable (TLI, CFI, IFI > 0.9; PNFI, PCFI > 0.5, REMSEA > 0.049, CMIN/DF = 2.477). Reliability revealed acceptable internal consistency and stability (> 0.7).ConclusionThe finding showed that NICPS has three factors in Iranian nurses. Nursing managers can use these results to provide training and support intervention for nurses in order to increase their intention to care for this patient. Also, the NICPS is a reliable and valid for evaluating this concept in future studies.

The role of medicines and therapeutics committees structure in supporting optimal antibacterial use in hospitals in Uganda: A mixed method study.

Although the roles of Medicines and therapeutic committees (MTCs) have been expanding, there is limited information on the role of their structure in optimal antibacterial use in hospitals, especially in low-and-middle-income countries. Our study explored the structure and role of MTC in supporting antibacterial use in regional referral, general hospitals and tertiary private not-for-profit (PNFP) hospitals in Uganda. We conducted an explanatory sequential mixed-method approach with triangulation to explore the structure and functional role of MTCs from August 2019 to February 2020 in hospitals in Uganda. Quantitative data was collected using an interviewer-administered questionnaire among chairpersons or secretaries of MTCs and was analysed using descriptive statistics. We conducted key informant interviews using an interview guide among long-term serving members of MTCs to collect qualitative data which triangulated the quantitative data. The study revealed that sixteen hospitals had successfully established MTCs with an average duration of the MTCs' existence of 5.6 (+2.7) years. The membership of the MTCs varied between 7 and 14, with a median value of 10, and the majority of members in MTCs were pharmacists (15 out of 16) and clinical specialists (13 out of 16). The most frequent subcommittees of the 16 hospitals MTC were supply chain (n = 14), antimicrobial stewardship (n = 13), and infection control (n = 12). Majority (14 out of 16) of the MTCs supported availability and access of antibacterial use by selecting and evaluating antibacterials agents for their formulary lists using established criteria. Additionally, 15 out 16 MTCs conducted antimicrobial stewardship activities to support optimal antimicrobial use. In our study, MTC membership and subcommittees were critical structural components that aided the selection and evaluation antibacterials on hospital formulary lists and they supported optimal antibacterial use through implementing various antimicrobial stewardship activities. There is a need for the Ministry of Health to conduct more training on operationalising MTCs structures in all hospitals.

Delineating wine tourism experiences in Ningxia, China: a supply–demand perspective

Purpose The purpose of this paper is to examine the relationship between wine tourism experiences (i.e. winescape, winery service quality, winery brand differentiation and tourist motivation) and tourist behavioral intentions (satisfaction, loyalty and revisit intention) from both demand and supply perspectives in Ningxia, China, by using the SERVQUAL model and the self-determination theory. Design/methodology/approach The research comprises two studies with an exploratory sequential mixed-methods approach. Study 1 adopted semi-structured interviews with winery owners and managers to explore the factors related to wine tourism experiences that influence tourists’ tourism experience. The results from the Study 1 leads to Study 2, which used a survey to explore wine tourist experiences and their behavioral intentions Findings This study provided important information regarding the factors that influence wine tourists experience in Ningxia wine region from the perspectives of supply and demands sides. Frist, this study confirmed the various factors influence wine tourism experiences in Ningxia based on the results from Study 1 (supply perspectives). Second, by further investigation in the Study 1, this study integrates the SERVQUAL model and the self-determination theory as fundamental theoretical frameworks in Study 2 to analysis the tourist perspectives. Third, as results, the authors finally confirmed the theoretical frameworks of wine tourism in Ningxia based on dual supply-demand perspectives. Originality/value The integration of multiple research approaches enriches the research findings and provides a more robust understanding of the wine tourism experiences in Ningxia.

Building Bridges between People with Stroke, Families, and Health Professionals: Development of a Blended Care Program for Self-Management.

Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals. An exploratory sequential mixed methods approach was used, including qualitative methods during stakeholder consultation (stage 1) and co-production (stage 2) and quantitative assessment during prototyping (stage 3). After ethical approval, recruitment occurred in three health units. Results from a literature search led to the adaptation of the Bridges Stroke Self-Management Program. In stage one, 47 participants were interviewed, with two themes emerging: (i) Personalized support and (ii) Building Bridges through small steps. In stage two, the ComVida program was developed, combining in-person and digital approaches, supported by a workbook and a mobile app. In stage three, 56 participants evaluated prototypes, demonstrating a strong level of quality. Understandability and actionability of the developed tools obtained high scores (91-100%). The app also showed good usability (A-grade) and high levels of recommendation (5 stars).

Evaluation of Blended Learning in Terms of the Perceptions of Medical Students: A Mixed Method Study.

The ongoing 4.0 industrial evolution, characterized by the rise of digital technology, has had a massive impact on human lifestyles worldwide. Faculty members in medical school are expected to respond to this industrial revolution by implementing teaching strategies, one of which is Blended learning as a suitable solution to overcome the limitations of space and time in the teaching process. For effective utilization of blended learning, it is important to conduct extensive studies on its implementation. The aim of this study was to assess the effectiveness and efficiency of implementing blended learning in the faculty of medicine in Hasanuddin University from the students' perspective. This study used a sequential explanatory mixed method approach, combining quantitative and qualitative methods. The quantitative part involved 782 undergraduate medical students from the first, second, and third years. Data were collected through a questionnaire survey distributed among the students. The qualitative part of the research was conducted through focus group discussions involving 13 students based on the questionnaire scores, representing both high and low scores. The results of the quantitative and qualitative research were collected and integrated. Based on the results, the majority of students agreed that blended learning provided many advantages to their learning (Mean±SD: 3.79±0.78). Also, they reported e-learning platform significantly contributed to their learning process (Mean±SD: 3.88±0.67). The workload of blended learning method was still considered quite heavy by students, and good time management was highly needed (Mean±SD: 3.45±0.84). As for qualitative part, some positive results were obtained; they reported that it increased motivation for learning, enhanced the efficiency of learning and gaining adaptability, while the negative opinions were the network error in e-learning, erratic e-learning display, and video quality problem. Most of the students expressed positive opinions about the advantages of blended learning; according to them, learning was more efficient and effective, it enhanced learning motivation, and it provided comprehensive accessible learning materials.

How Does a Junior Faculty Development Program Affect Burnout? A Mixed Methods Assessment.

Burnout is common among junior faculty. Professional development has been proposed as a method to improve engagement and reduce burnout among academic physicians. The Penn State College of Medicine Junior Faculty Development Program (JFDP) is a well-established, interdisciplinary program. However, an increase in burnout was noted among participants during the program. The authors sought to quantify the change in burnout seen among JFDP participants across 3 cohorts, and to explore sources of well-being and burnout among participants. Through a sequential explanatory mixed methods approach, participants in the 2018/19, 2019/20, and 2020/21 cohorts took a survey assessing burnout (Copenhagen Burnout Inventory), quality of life (QoL), job satisfaction, and work-home conflict at the start and end of the course. Descriptive statistics were generated as well as Pearson χ2 test/Fisher exact test for categorical variables and Wilcoxon rank sum tests for continuous variables for group comparisons. To better understand the outcome, past participants were invited to interviews regarding their experience of burnout during the course. Inductive thematic analysis (kappa = 0.86) was used to derive themes. Start- and end-of-course surveys were completed by 84 and 75 participants, respectively (response rates: 95.5% and 85.2%). Burnout associated with patient/learner/client/colleague increased (P = .005) and QoL decreased (P = .02) at the end compared with the start. Nonsignificant trends toward worsening in other burnout categories, work-home conflict, and job satisfaction were also observed. Nineteen interviews yielded themes related to risks and protective factors for burnout including competing demands, benefits of networking, professional growth, and challenges related to diverse faculty roles. Junior Faculty Development Program participants demonstrated worsening of burnout and QoL during the program while benefiting from opportunities including skill building and networking. The impact of Junior Faculty Development Programs on the well-being of participants should be considered as an element of their design, evaluation, and refinement over time.