In-person Format Research Articles

The equivalence of a high-stakes objective structured clinical exam adapted to suit a virtual delivery format.

The COVID-19 pandemic necessitated rapid adaptation of clinical competence assessments, including the transition of Objective Structured Clinical Examinations (OSCE) from in-person to virtual formats. This study investigates the construct equivalence of a high-stakes OSCE, originally designed for in-person delivery, when adapted for a virtual format. A retrospective analysis was conducted using OSCE scores from the Internationally Educated Nurse Competency Assessment Program (IENCAP®). Data were collected from 15 exam administrations between January 2018 and June 2022, encompassing 2021 examinees (1936 in-person, 85 virtual). The Many-Facet Rasch Measurement (MFRM) model was employed to analyze the invariance of examinee ability, case difficulty, and criteria difficulty across in-person and virtual formats. Results revealed overall examinee ability estimates remained invariant regardless of the OSCE format, while invariant violations were identified in only three of the 15 cases (N = 20%) adapted to suit the virtual format. The most significant adaptation, namely the use of a verbal physical examination to suit the virtual context achieved equivalence to its hands-on in-person counterpart given evidence of invariance across criteria estimates. Interestingly, criteria scores in invariant violated cases displayed a higher level of stability or consistency across the virtual OSCE formats versus their in-person counterpart highlighting a potential benefit of the virtual versus in-person format and potentially linked to the verbal physical examination. The study found that while examinee ability and case difficulty estimates exhibited some invariance between in-person and virtual OSCE formats, criteria involving physical assessments faced challenges in maintaining construct equivalence. These findings highlight the need for careful consideration in adapting high-stakes clinical assessments to virtual formats to ensure fairness and reliability.

Assessing the implementation of suicide-focused treatments delivered in hybrid telemental health format in a real-world setting

Objective The purpose of this study was to assess the implementation of suicide-focused treatments delivered via a hybrid telemental health (TMH) and in-person format. Method This study was conducted at four university counseling centers (UCCs) across the United States. Treatment-seeking clients were recruited from their local UCCs and participated in adaptive treatment strategies (ATSs) involving Treatment as Usual (TAU), Collaborative Assessment and Management of Suicidality (CAMS), and Dialectical Behavior Therapy (DBT). Implementation outcomes, including appropriateness, acceptability, feasibility, fidelity, safety, and client satisfaction, were assessed. UCC clinicians participated in qualitative interviews focused on implementation of TMH for clients presenting with suicidal ideation (SI). Results Overall, treatments delivered via hybrid format were reported to be appropriate, acceptable, feasible, and satisfactory by clinicians and clients. Implementation of TMH was reported to be equivalent to in-person treatment across multiple measurement methods. Conclusion Results from this study demonstrate that TMH is an implementable treatment modality for addressing suicidality, particularly for college students presenting to UCCs with SI. This study has implications for real-world clinical settings planning to offer hybrid treatment modalities to address SI. Trial registration: ClinicalTrials.gov identifier: NCT04728815.

Implementation of a Telehealth Smoking Cessation Program in Primarily Socioeconomically Disadvantaged Black Patients: Courage to Quit Rolling-Virtual (CTQ-RV).

Preliminary data indicate that smoking cessation offered in a rolling group format is feasible and effective. The current study evaluated theimplementation and outcomes of the remote Courage to Quit-Rolling Virtual (CTQ-RV) smoking group treatment compared to its precursor in-person format (Courage to Quit-Rolling, CTQ-R). Virtual materials for CTQ-RV were adapted from in-person evidence-based programming, thus content in both groups was similar but delivered via videoconference or in-person. We used an interrupted time series design to examine feasibility by comparing attendance, monthly enrollment, and program completion between those who attended CTQ-R (July 2018-March 2020) versus CTQ-RV (April 2020-December 2022). There were 611 patients enrolled in tobacco cessation (N = 221 CTQ-R, N = 390 CTQ-RV). The average age was 59.4 years and most patients reported Black/African American race (81%) and female sex (69.5%). CTQ-RV proved feasible relative to CTQ-R, with higher rates of attendance (5.5 vs. 2.7 sessions, respectively), program completion (39.4% vs. 19%) and increased enrollment across each year (from 44.6 sessions per month in CTQ-R vs. 72.3 in CTQ-RV). CTQ-RV patients requested nicotine replacement therapy (NRT) at substantially higher rates (81.4%) than CTQ-R members (42.1%). Self-reported smoking abstinence at final session was higher in CTQ-RV compared with CTQ-R (33.3% vs. 15.7%). Within CTQ-RV, more than half (57%) of patients attended by video format, with outreach improving rates of video attendance each year. Results show that a transition to virtual rolling enrollment smoking group treatment is feasible and can augment treatment outcomes, such as engagement, NRT use, and self-reported cessation.

Comparative Outcomes of a Cognitive-Behavioral Skills Building Program on the Mental Health and Healthy Behaviors of Prenursing Students

Background: Nursing students experience significantly more stress related diseases when compared to non-nursing students, and the state of their mental health can result in short-term increased attrition rates and increased nursing shortages. Purpose: A preexperimental pre-post study design was used to examine mental health and healthy behaviors among prenursing students. Methods: Cohorts received the MINDSTRONG© program either in-person or virtually. Data analysis included Personal Wellness Assessments completed at both pre- and poststudy for all participants (n = 110). Results: Both groups postintervention had statistically significant decreases in anxiety, depression, and stress and statistically significant increases in healthy lifestyle behaviors and beliefs. Students with elevated depression and anxiety scores at baseline had greater decreases postintervention than the overall groups. Conclusion: The outcomes for both cohorts were positive and effective in reducing stress, anxiety, and depressive symptoms. Healthy behaviors were improved and align with findings with an in-person format. Findings from this study support implementation of MINDSTRONG in synchronous sessions, either in-person or virtual.

Optimising The Implementation Of A Dementia Care Education Programme For Healthcare Assistants (Home Support): Lessons From A Qualitative Study

Abstract Background Healthcare Assistants (Home Support) provide a significant level of non-clinical formal care to people with dementia at home. Training is paramount if this workforce is to provide care effectively and achieve the ideals of the Irish National Dementia Strategy. This study examined the process of implementing a QQI-FET level 5 accredited dementia home care education programme for Healthcare Assistants (Home Support), specifically designed with an emphasis on self-development and ethical and strengths-based approaches to care. Methods This study was primarily a qualitative study conducted over five months. Semi-structured interviews were conducted with stakeholders (n=16) involved in the programme’s implementation. Focus groups (n=3) were conducted with 11 programme learners. Data on programme take-up, completion and retention rates were available for review, as were reports from external reviewers, and a sample of evaluation forms completed by learners. Results The programme content and its delivery were highly regarded. Implementing the programme took much longer than planned due to the Covid-19 pandemic, putting recruitment processes in place, and problems recruiting and retaining healthcare professionals to facilitate supervisory sessions. Organizational support, and motivated healthcare assistants with positive attitudes towards training were perceived to facilitate programme uptake and completion. A range of barriers were perceived to act as disincentives to programme participation, e.g. lack of opportunities for career progression. There was strong support for rolling out the accredited programme nationwide and maintaining its in-person format. An alternative shortened non-accredited version of the programme would be welcomed by stakeholders in some areas. Conclusion This qualitative study provides a rich and nuanced perspective on a dementia home care education programme for healthcare assistants (Home Support), challenges encountered during programme implementation and changes needed to optimize implementation. The findings can be used to support strategic and operational decision-making for enhancing programme implementation.

Correction of professional burnout of health workers in the process of mindfulness-based training

Background. The article reviews the problem of testing the in-person version of the burnout reduction program "OsNOVA" for health workers.The aim of the work. To present the results of the program immediately after its completion and to study the sustainability of the effect.Materials and methods. As part of the program testing, 49 doctors and nurses were interviewed. The following methods were used: Maslach Burnout Inventory; Lazarus and Folkman Inventory of Coping Strategies; Beck Depression Inventory; Perceived Stress Scale 10; Short Form 12 questionnaire; mindfulness questionnaires.Results. It was found that when implementing a program to reduce the level of professional burnout in medical workers, held in-person, there is a statistically significant decrease in those subjects whose burnout was initially high. This is accompanied by an increase in mindfulness (primarily such components as Non-judgmentalism, Observation and Awareness of Actions), productive coping strategies. Health workers with a relatively low level of burnout had an improvement in a number of indicators reflecting the burnout level, as well as an increase in the quality of life. The effect achieved by the program persisted for at least three months after the end of its active part.Conclusion. The "OsNOVA" program in an in-person format can be used to prevent professional burnout of health workers. Additional work is planned for its further improvement.

“If You’re Talking, I Think You’re Muted”: Follow-up Analysis of Weekly Peer Review Discussion and Plan Changes After Transitioning From Virtual to In-Person Format

AimsDuring the COVID-19 public health emergency, we previously identified decreased rates of radiotherapy (RT) peer review (PR) discussion and plan changes in virtual versus in-person PR conferences. To expand on these findings, we continued to prospectively collect data on all PR conferences from 2021 to 2023 and performed a follow-up analysis before and after the transition back to in-person PR. Materials and methodsA prospectively maintained database of weekly PR cases was queried for consecutive cases reviewed before and after the transition from virtual to in-person conferences. Rates of PR discussion and change recommendations were summarized and compared between the virtual and in-person groups. A survey was developed and administered to assess participants' perceived levels of engagement, opinions on optimal PR format, and preferences for future meetings before and 3 months after the transition back to in-person PR. ResultsIn total, 2,103 RT plans were reviewed: 1,590 virtually and 513 after the transition back to in-person. There was no difference in faculty attendance between groups. The proportion of cases with PR discussion increased from virtual (9.8%) to in-person (25.5%) format (p < 0.001). In the virtual group, 8.1% of cases had 1 topic and 1.7% had 2+ topics discussed. This increased to 15.8% and 9.7% during in-person PR, respectively (p < 0.001). The rate of change recommendation also increased from 1.5% (virtual) to 3.3% (in-person, p = 0.016). Among cases with at least 1 topic discussed, there was no difference in changes. Survey-reported distraction significantly decreased from virtual to in-person PR (p < 0.001). ConclusionUpon returning to in-person PR conferences, peer discussion and plan change recommendations significantly increased and returned to pre-pandemic levels, and participants’ perceived levels of distraction were reduced. In an increasingly virtual world, additional efforts to develop best practices that maximize PR discussion and minimize distraction outside virtual conferences are warranted.

A Non-Randomized Comparison of Online and In-Person Formats of the Canadian Androgen Deprivation Therapy Educational Program: Impacts on Side Effects, Bother, and Self-Efficacy.

Although Androgen Deprivation Therapy (ADT) is effective in controlling prostate cancer (PCa) and increasing survival, it is associated with a myriad of side effects that cause significant morbidity. Previous research has shown that PCa patients starting on ADT are neither fully informed nor well-equipped to manage the breadth of ADT's side effects. The ADT Educational Program (a 1.5 h interactive class plus a book) was developed as an evidence-based resource for patients dealing with ADT. Our aim here was to compare the efficacy of an online version of the class with a previously assessed in-person version of the class. Using mixed MANOVAs within a non-randomized comparison design, we assessed: (1) changes in patients' experiences of self-efficacy to manage and bother associated with side effects approximately 10 weeks after attending a class, and (2) potential differences in these variables between online and in-person class formats. Side effect bother decreased from pre- to post-class but did not differ between in-person (n = 94) and online (n = 137) class cohorts. While self-efficacy to manage side effects was slightly higher post-class in both cohorts, the increase was not statistically significant. Average self-efficacy ratings were significantly higher among in-person versus online class participants (p < 0.05; ηp2 = 0.128). Both online and in-person classes are associated with a significant reduction in the severity of side effect bother reported by PCa patients, suggesting non-inferiority of online versus in-person formats. Online classes offer greater accessibility to the program for patients outside the reach of in-person classes, increasing the availability of the program to more PCa patients and family members across Canada.

Outcomes of a Virtual Day Treatment Program for Adults With Eating Disorders-Comparison With In-Person Day Treatment.

Previous studies have indicated that virtual treatments for eating disorders (EDs) are roughly as effective as are in-person treatments; the present nonrandomized study aimed to expand on the current body of evidence by comparing outcomes from a virtual day treatment program with those of an in-person program in an adult ED sample. Participants were 109 patients who completed at least 60% of day treatment sessions (n = 55 in-person and n = 54 virtual). Outcome measures included ED and comorbid symptoms, and motivation. Linear mixed models showed that global EDE-Q scores decreased during treatment (AIC = 376.396, F = 10.94, p = 0.002), irrespective of treatment modality (p = 0.186). BMI significantly increased over time (AIC = 389.029, F = 27.97, p < 0.001), with no effect of treatment modality (p = 0.779). Our findings suggest that the virtual delivery of day treatments produces comparable outcomes to those obtained using in-person formats, and that virtual formats may represent a pragmatic treatment option, especially in situations in which access to in-person care is limited.

Some Perceptions Differ, Match Outcomes Do Not: A Multisite Retrospective Cross-Sectional Comparison of Virtual vs. In-Person Recruitment.

Virtual interviewing for residency provides considerable savings. Its impact on match outcomes remains unclear. Evaluate the impact of virtual residency recruitment on program and applicant assessment and match outcomes. Cross-sectional survey, September 2020-July 2021 PARTICIPANTS: Faculty interviewers and 2019 and 2020 PGY-1 classes at three academic internal medicine residencies. Survey items rating effectiveness of interview format, preference for future interview format, and perceived impact on diversity. A total of 247/436 faculty (57%) interviewers responded. Faculty perceived that in-person interviews enhanced applicant assessment (3.23 ± 0.38, p < 0.01) and recruitment of the most qualified applicants (p < 0.01) but did not impact recruitment of a racially or gender diverse class (3.03 ± 0.99, p = 0.95 and 3.09 ± 0.76, p = 0.14 respectively). They also did not demonstrate a preference for future interview formats. A total of 259/364 matched applicants responded, corresponding to a 76% response rate in the in-person cohort and a 66% response rate for virtual. Trainees were equally likely to match at their top choice when interviewing virtually vs. in-person (p = 0.56), and racial/ethnic and gender composition of the incoming class also did not differ (p = 0.81 and p = 0.19 respectively). Trainees perceived many aspects of the institution were better assessed in-person, though the impact varied according to assessment domain. Trainees who interviewed in-person preferred in-person formats. Of those who interviewed virtually, 47% preferred virtual and 54% preferred in-person. There were no predictors of virtual preference for future interview formats. Faculty and applicants who experienced virtual recruitment had no preference for future recruitment format. Virtual recruitment had no impact on the racial/gender diversity of matched classes or on applicants matching at their top-ranked institution. Institutions should consider the potential non-inferiority of virtual interviews with financial and other benefits when making decisions about future interview formats.

Immersive Leadership Training for Physicians: Comparing Retrospective Pre- and Post-Test Virtual vs in-Person 6-Month Follow-Up of Learning.

Little is known about the long-term efficacy of virtual leadership training for physicians. This study compares two highly similar groups of Obstetricians-Gynecologists' (OB-GYN) 6-month post-program changes in competency and skills after experiencing equity-centered leadership training in a virtual or in-person format. Using a retrospective pre- and post-test method, we collected 6-month post-program data on 14 competencies for knowledge gains and skills use, comparing the virtual cohort (2021, n = 22) to the in-person cohort (2022, n = 33) in 55 total participants. Qualitative data from open-ended feedback questions informed on skills relevancy and professional impact since program participation. Data indicate strong, statistically significant knowledge and skills retention in both cohorts, with 63% of the virtual and 85% of the in-person participants responding. Data indicate participants report the course having a positive impact on their healthcare provision and nearly all report they made changes to their communication and leadership approaches in the 6-months after the program. 59% of the virtual and 55% of the in-person cohorts report new leadership opportunities since their participation and that the course helped prepare them for those roles. Qualitative data support the need for the training, specific elements of the training these physicians found particularly helpful, and that the learning was "sticky", in that it stayed with them in the months post-program. There was a clear stated preference for in-person experiences. Either virtual or in-person leadership training can result in long-term (6-month) significant retention and application of knowledge and skills in physicians. While limited in size, this study suggests that in-person experiences seem to foster more effective bonds and also greater willingness to participate in post-program follow-up. Physicians find equity-centered leadership training to impact their subsequent communication and leadership practices and they report career benefits even in 6-month follow-up.

Preface

Preface The 4th MSAT Conference “Scaling Up Ocean Action Based on Science and Innovation for the Implementation of the Blue Economy” held in Bandung, West Java, Indonesia on the 26-27th of October 2023 was part of a conference series held biennially since 2017 (https://msat.fitb.itb.ac.id/). The 4th MSAT conference on maritime science and technology targets the United Nations Sustainable Development Goals (SDGs), specifically the SDGs no 13 and 14 (Climate Action and Life below water), as well as no. 1 (No Poverty), no. 2 (Zero Hunger), and no. 7 (Affordable and Clean Energy) through the maritime section, especially as our country is the second-largest coastline in the world with 60% of our citizens living in the coastal area. With those goals, MSAT 2023 places a spotlight on the critical role of science and innovation in fostering the blue economy. The conference theme is not only timely but also holds the promise of unlocking new horizons for oceanic prosperity. The conference builds upon a strong legacy. The 1st MSAT Conference proceeding (Volume 62) was published at IOP on 06 July 2018 (https://iopscience.iop.org/issue/1755-1315/162/1); our second conference proceeding (Volume 618) was published at IOP on 21 December 2020 (https://iopscience.iop.org/issue/1755-1315/618/1); and our third conference proceeding (Volume 925) was published at IOP on 06 December 2021 (https://iopscience.iop.org/issue/1755-1315/925/1). These volumes showcase a wide range of research findings encompassing “Ocean-Atmosphere Dynamics, Marine Hazard and Coastal Degradation, Marine Resources, Conservation and Integrated Coastal Zone Management (ICZM), and Marine Geodesy and Satellite Oceanography” as discussed at the sessions of each conference. These three conference proceedings document the journey of MSAT, and serve as a testament to the commitment of the maritime community to push the boundaries of knowledge and technology. They have not only advanced the field of ocean science but also contributed to the global cause for sustainability. Following the success of the previous conferences, the 4th MSAT continued the tradition of excellence. Building upon the momentum from the online edition of the 3rd MSAT due to the COVID-19 pandemic, this conference marked a welcome return to an in-person format. However, an online option was still accommodated to ensure wider participation. The conference was jointly organized by the Faculty of Earth Sciences and Technology - Institut Teknologi Bandung, the Marine Technology Cooperation Research Center (MTCRC), and the Indonesian Association of Oceanology (ISOI). It attracted a diverse group of participants, including scientists, students, and stakeholders from Indonesia and abroad. The total number of people who attended the 4th MSAT 2023 was 208 people, consisting of 136 participants, 38 committees, 17 keynote and invited speakers, and 17 moderators. The first day of the MSAT 2023 conference, held on October 26th, 2023, attracted international participation thanks to its well-regarded speakers from around the globe (Singapore, Malaysia, Spain, Japan, Korea, and Australia). The opening ceremony commenced with welcoming remarks from the Dean of the Faculty of Earth Science and Technology, Prof. Dr. Irwan Meilano, S.T., M.Sc., and Chairman of ISOI, Prof. Dr. Agung Dhamar Syakti. Additionally, a video message was delivered by a representative of the Ministry of Maritime Affairs and Fisheries. Following the opening, Prof. Yoshiyuki Kaneda from the Institute of Education Research and Regional Corporation for Crisis Management Shikoku (IECMS) at Kagawa University, Japan, presented a plenary session lecture. This was succeeded by a talk from Prof. Dr. Irwan Meilano himself, followed by a series of five parallel mini-symposia sessions. List of Steering Committee, Scientific Committee, Advisory Board, Organizing Committee, Editorial Committee and Photo documentation are available in this Pdf.

Enhancing engagement in parenting programs: A comparative study of in-person, online, and telehealth formats

IntroductionParenting programs are widely used to prevent and ameliorate children’s emotional and behavioral problems but low levels of engagement undermine intervention effectiveness and reach within and beyond research settings. Technology can provide flexible and cost-effective alternate service-delivery formats for parenting programs, and studies are needed to assess the extent to which parents are willing to engage with digitally assisted formats. MethodsAfter Deployment, Adaptive Parenting Tools (ADAPT) is an evidence-based parenting program for military families. In the current comparative effectiveness trial, families were randomly assigned to either an in-person group (n = 95), self-directed online (n = 78), or individual telehealth (n = 71) formats of ADAPT. We explored whether children’s initial problem severity, parenting efficacy, parental depression, household income, child age, child gender, parental deployment length, and waiting time were related to parental engagement across different delivery formats. Zero-inflated Poisson regressions were used due to the distribution of the number of attended sessions. ResultsCompared to the in-person group format, parents in the individual telehealth and self-directed online formats had higher engagement levels. For the in-person format, parents who perceived their children as having more severe problems were more likely to enroll and families with a father deployed for longer time attended fewer sessions. In the self-directed online format, families with less depressed fathers were more likely to enroll. No predictors were found for the telehealth format. For all three formats, once parents took the first step to engage, they were likely to finish all sessions. DiscussionTechnology-assisted delivery formats have the potential to improve program engagement. Results from this study will help facilitate the development of specific strategies to promote engagement in the future.

What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program.

The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions. Families (N = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5-12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate. Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition. This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introducing a novel hybrid educational boot camp to augment medical student training in neurosurgery.

Neurosurgery subinternships are a critical portion of the medical student application to neurosurgery residency programs, allowing programs to assess the student's clinical knowledge, interpersonal skills, work ethic, and character. Despite how critical these auditions are, many students have a poor understanding of expectations prior to beginning these subinternships. Thomas Jefferson University hosted a combined in-person and virtual boot camp session open to all medical students interested in neurosurgery. The authors sought to determine the effectiveness of this inaugural course. A total of 304 registered participants were sent a survey assessing their attitudes toward neurosurgery subinternships, beliefs about their abilities, and their comfort with various neurosurgical skills. All participants were sent a postsession survey composed of the same questions. The mean scores for responses to pre- and postsession survey questions were recorded based on graduating year and by medical school type (US allopathic [US MD], US osteopathic [US DO], or foreign degree/international medical graduate [IMG]). Differences in means between pre- and postsession survey responses were analyzed using the Student t-test, and statistical significance was set at p < 0.05. A total of 112 presession surveys and 64 postsession surveys were completed, yielding a presession survey response rate of 36.8% and a postsession survey response rate of 21.1%. Seventy-five percent of the postsession survey respondents attended virtually, and 25% were in-person. US MD, US DO, and IMG attendees demonstrated a significantly increased understanding of the expectations of a neurosurgery subintern (p < 0.001). All students had significantly increased confidence in their ability to succeed as subinterns (US MD students and IMGs p < 0.001, US DO students p < 0.05). Regarding procedural confidence, US MD students had increased confidence in craniotomies and cranial plating (p < 0.001). When comparing responses by graduation year, students in the classes of 2024 and 2025 (rising 4th-year and rising 3rd-year medical students, respectively) demonstrated significantly increased understanding of expectations and confidence in their ability to succeed (< 0.001). Seventy-five percent of our postsession survey respondents attended virtually, and 25% were in-person. The in-person cohort had greater improvements in comfort with procedures such as craniotomies, cranial plating, and extraventricular drain placement (in-person vs Zoom mean differences: craniotomies and cranial plating, -2.29, extraventricular drain placement, -2.31) (p < 0.05). The boot camp successfully delineated the expectations of neurosurgery subinterns and enhanced the attendees' confidence in their abilities. The authors concluded that a hybrid virtual and in-person format is beneficial and feasible in increasing accessibility to information about neurosurgery subinternships.

Agreement of synchronous remote and in-person application of the Alberta Infant Motor Scale: Cohort study.

Using standardized scales to assess motor development via telemedicine can increase access for low-income populations. Our aim was to verify the agreement and feasibility between remotely and synchronously applying the Alberta Infant Motor Scale (AIMS) and the in-person format. This was a concordance study, with 77 typical infants aged 4-18 months (mean = 13 months). The AIMS was applied remote via video calls and face-to-face. We applied a questionnaire to caregivers to verify feasibility. There was a high level of agreement between the remote and in-person assessments, with intraclass correlation coefficients above 0.98 and low standard error measure values (<1 item for each posture, <2 items for the total raw score, and =5% for the normative score). The smallest detectable change was between 1.67 and 2.45 for each posture, 3 for the total raw score, and 6% for the normative score. The Bland-Altman analysis showed low bias with the mean difference close to zero (<0.80) and low error with little dispersion of the difference points around the mean. Caregivers' perspectives on the synchronous remote assessment were positive, with good quality, clear information during the assessment, and comfort with the method. The synchronous remote application of the AIMS may be an alternative for families without access to in-person services that assess motor development.

Flexible learning dimensions in higher education: aligning students’ and educators’ perspectives for more inclusive practices

Driven by the rise of recent technologies and long-standing interest in accommodating diverse student needs, the demand for flexibility in higher education has intensified. Moreover, the COVID-19 pandemic has intensified studies investigating online learning effects, reflecting shifting preferences and demands in education. Although prior research recognizes diverse flexibility practices, a narrow focus on instructional delivery limits its potential. Bridging this gap requires re-envisioning flexible learning by involving students, educators, and institutions in the transformation process. Therefore, this study aims to investigate and compare students’ and educators’ perspectives and experiences of five dimensions of flexibility (deadlines, modality, assessment type, grading and weighting, and course correspondence). The study involves a quantitative and qualitative survey, composed of Likert scale and open-ended questions. The survey respondents were students (N = 315) and educators (N = 100) at Western University across different years and programs. The quantitative component reveals a general alignment between student and educator preferences across flexibility dimensions. Noteworthy preferences include collaborative deadline setting, non-timed and take-home assessments, and more frequent, lower-weighted tasks. Students’ increased preference for hybrid learning, despite a general preference for in-person formats, underscores the value placed on flexibility and adaptability. Qualitative findings illuminate the broader implications of flexibility that can be organized into the following four themes: (1) flexibility humanizes teaching and learning, (2) flexibility recognizes diverse student populations, (3) flexibility provides broad accommodation and increases accessibility, and (4) flexibility can offer immediate relief but poses long-term consequences. In conclusion, this study emphasizes the multifaceted nature of flexibility in higher education, offering a nuanced understanding of the impact of flexibility on students, educators, and institutions, encouraging further exploration and evidence-based policy decisions. Beyond academia, the research suggests potential reshaping of the higher education landscape, positioning flexibility as a fundamental element to foster a more inclusive, supportive, and effective learning environment for both students and educators.

Virtually Supervised Exercise Programs for People With Cancer: A Scoping Review.

Exercise has been shown to improve physical function and quality of life for individuals with cancer. However, low rates of exercise adoption and commonly reported barriers to accessing exercise programming have demonstrated a need for virtual exercise programming in lieu of traditional in-person formats. The aim of this study was to summarize the existing research on supervised exercise interventions delivered virtually for individuals living with and beyond cancer. We conducted a scoping review of randomized controlled trials, pilot studies, or feasibility studies investigating virtually supervised exercise interventions for adults either during or after treatment of cancer. The search included EMBASE, MEDLINE, CINAHL, SPORTDiscus, Cochrane Library, and conference abstracts. Fifteen studies were included. The interventions were delivered mostly over Zoom in a group format, with various combinations of aerobic and resistance exercises. Attendance ranged from 78% to 100%, attrition ranged from 0% to 29%, and satisfaction ranged from 94% to 100%. No major adverse events were reported, and only 3 studies reported minor adverse events. Significant improvements were seen in upper and lower body strength, endurance, pain, fatigue, and emotional well-being. Supervised exercise interventions delivered virtually are feasible and may improve physical function for individuals with cancer. The supervision included in these virtual programs promoted similar safety as seen with in-person programming. More randomized controlled trials with large cohorts are needed to validate these findings. Individuals living with and beyond cancer can be encouraged to join virtually supervised exercise programs because they are safe, well enjoyed, and may improve physical function and quality of life.

Sustainable community development through peer-to-peer learning in the online and in-person classroom

Purpose Prior research suggests that collaboration is key to sustainable community development and environmental management, and peer-to-peer learning (P2PL) may facilitate community building and collaborative learning skills. This study aims to examine the effect of P2PL on the enhancement of environmental management and sustainable development skills, community building and social capital (i.e. connectedness) and understanding of course learning objectives. Design/methodology/approach Quantitative and qualitative longitudinal survey data was collected in a sustainable development focused course offered at a large American public university that uses P2PL to explicitly facilitate community building and collaborative skills. Safety precautions and changing locational course offerings due to the COVID-19 pandemic in years 2020, 2021 and 2022 provided an opportunity to evaluate the impact of P2PL on these skills during both virtual and in-person formats. Additionally, this study compared in-course student evaluations with students taking other sustainable development-related courses with collaborative learning aspects to understand the wider effectiveness of this course structure. Findings This study finds that course format (virtual vs in-person) overall made no difference in either connectedness or conceptual understandings, and that students in both formats felt more connected to others than students taking other courses with P2PL. Scaffolding P2PL and supplemental peer support can yield improved connectedness and learning among students taking environmental coursework. Originality/value Sustainable development requires group collaboration and partnership building skills. Issues are consistently raised about the challenges to teaching these skills in higher education. The students and instructors in this research study identify P2PL strategies to address these challenges for in-person and virtual classroom settings.

Learning in the Context of (Digital) University Teaching: Flexibilisation and Individualisation

This article explores the challenges and developmental landscapes of digital university education, focusing on fostering flexibility and individualization in learning. It examines how integrating online and in-person formats can serve these objectives and how evaluation techniques can enhance the quality of teaching offerings. The shift towards lifelong learning (LLL) and catering to individual student needs are regarded as pivotal concerns. The paper presents various developmental fields within higher education, emphasizing the need to cultivate a learner-centric culture that supports self-directed learning. The integration of online and in-person formats as part of a flexible teaching concept is discussed as a solution for individualizing and flexibilizing learning. Additionally, the evaluation of teaching as a quality measure is deliberated, emphasizing the importance of effective evaluation methodologies. The work concludes with a contemplation on the future of university education, advocating for a balanced blend of online and in-person formats. This strategy aims to foster flexibility and individualization in learning to meet the demands of self-directed and lifelong learning. The article notes that experiences from the pandemic should be integrated into future university teaching rather than reverting to previous norms. The open questions, particularly regarding the integration of AI applications like chatbots and their impact on instruction, are highlighted as pivotal for further developments in higher education.