Instructional Design Features Research Articles

Timing of information presentation matters: Effects on secondary school students' cognition, motivation and emotion in game‐based learning

AbstractLearning with games requires two types of information, namely domain‐specific information and game‐specific information. Presenting these two types of information together with gameplay may pose a heavy demand on cognitive resources. This study investigates how timing of information presentation affects cognition (ie, mental effort and performance), motivation (ie, achievement goals) and emotion (ie, achievement emotions). Participants were secondary school students (N = 145). Participants participated in a 2 × 2 factorial experiment with two factors—timing of domain‐specific information presentation and timing of game‐specific information presentation, either before or during gameplay. We measured mental effort, chemistry knowledge, time on task, achievement goals and achievement emotions. Multiple regression and robust regression revealed that presenting domain‐specific information before gameplay promoted higher approach goals, higher avoidance goals and more enjoyment than presenting it during gameplay. There was no difference between presenting game‐specific information before gameplay and during gameplay except for performance‐avoidance goals. We conclude that timing of information presentation affects motivational and emotional processes and outcomes and that students feel more motivated and enjoyed when domain‐specific information is presented before learning than during learning. Educators may change the timing of domain‐specific information presentation accordingly. Practitioner notesWhat is already known about this topic Well‐designed game‐based learning can increase learning. Game‐based learning needs effective instructional design features. What this paper adds One instructional design feature, timing of information presentation, affects motivation and emotion in game‐based learning. Students feel more motivated and enjoyed when domain‐specific information is presented before learning than during learning. This study is one of the first to focus on cognitive, motivational and emotional processes and outcomes, and their interconnections. Implications for practice and policy Educators would do well to present domain‐specific information before learning than during learning. Researchers on instructional design features should attend to all cognitive, motivational and emotional processes and outcomes instead of just one or two.

Using Virtual Reality Interventions to Promote Social and Emotional Learning for Children and Adolescents: A Systematic Review and Meta-Analysis.

This study provides a comprehensive review of the application of virtual reality (VR) in social and emotional learning (SEL) for children and adolescents over the past decade (January 2013-May 2023), with a specific interest in the relations between their technological and instructional design features. A search in Web of Science resulted in 32 relevant articles that were then manually screened. Coding analysis was conducted from four perspectives: participant characteristics, research design, technological features, and instructional design. The analysis provides insights into the VR literature regarding publication trends, target populations, technological features, instructional scenarios, and tasks. To test the effectiveness of VR interventions for promoting SEL, a meta-analysis was also conducted, which revealed an overall medium effect size and significant moderating effects of SEL disorder type and instructional task. Finally, based on the research results, the practical implications of and future research directions for applying VR in SEL were discussed.

Simulation-Based Training in Emergency Obstetric Care in Sub-Saharan and Central Africa: A Scoping Review.

Every day approximately 810 women die from complications related to pregnancy and childbirth worldwide. Around two thirds of these deaths happen in sub-Saharan Africa. One of the strategies to decrease these numbers is improving the quality of care by emergency obstetric simulation-based training. The effectiveness of such training programs depends on the program's instructional design. This review gives an overview of studies about emergency obstetric simulation-based training and examines the applied instructional design of the training programs in sub-Saharan and Central Africa. We searched Medline, Embase and Cochrane Library from inception to May 2021. Peer-reviewed articles on emergency obstetric, postgraduate, simulation-based training in sub-Saharan and Central Africa were included. Outcome measures were categorized based on Kirkpatrick's levels of training evaluation. The instructional design was evaluated by using the ID-SIM questionnaire. In total, 47 studies met the inclusion criteria. Evaluation on Kirkpatrick level 1 showed positive reactions in 18 studies. Challenges and recommendations were considered. Results on knowledge, skills, and predictors for these results (Kirkpatrick level 2) were described in 29 studies. Retention as well as decay of knowledge and skills over time were presented. Results at Kirkpatrick level 3 were measured in 12 studies of which seven studies demonstrated improvements of skills on-the-job. Improvements of maternal and neonatal outcomes were described in fifteen studies and three studies reported on cost-estimations for training rollout (Kirkpatrick level 4). Instructional design items were heterogeneously applied and described. Results of 47 studies indicate evidence that simulation-based training in sub-Saharan and Central Africa can have a positive impact across all four levels of Kirkpatrick's training evaluation model. However, results were not consistent across all studies and the effects vary over time. A detailed description of instructional design features in future publications on simulation-based training will contribute to a deeper understanding of the underlying mechanisms that determine why certain training programs are more effective in improving maternal and neonatal healthcare outcomes than other.

An Approach to the Design and Development of an Accredited Continuing Professional Development e-Learning Module on Virtual Care.

Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers' experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.

Learning in a crisis moment: a randomized controlled trial in emergency bystander intervention

BackgroundOpioid overdose is the leading cause of injury-related death in the United States. Individuals who overdose outside of clinical settings have more positive clinical outcomes when they receive naloxone, an opioid antagonist, from a bystander as an early intervention before emergency personnel arrive. However, there is a gap in knowledge about successful instantaneous learning and intervention in a real-life stressful environment. The objective of this study is to explore the efficacy of different instructional delivery methods for bystanders in a stressful environment. We aim to evaluate which methods are most effective for instantaneous learning, successful intervention, and improved clinical outcomes.MethodsTo explore instantaneous learning in a stressful environment, we conducted a quantitative randomized controlled trial to measure how accurately individuals responded to memory-based survey questions guided by different instructional methods. Students from a large university in the Midwest (n = 157) were recruited in a public space on campus and accessed the six-question survey on their mobile devices. The intervention group competed the survey immediately while the research team created a distracting environment. The control group was asked to complete the survey later in a quiet environment.ResultsThe intervention group correctly answered 0.72 questions fewer than the control group (p = .000, CI [0.337, 1.103]). Questions Q1 and Q5 contained direct instructions with a verbal component and showed the greatest accuracy with over 90% correct for both stressful and controlled environments.ConclusionsThe variability in the responses suggests that there are environmental factors as well as instructional design features which influence instantaneous learning. The findings of this study begin to address the gap in knowledge about the effects of stress on instantaneous learning and the most effective types of instruction for untrained bystanders in emergency situations.

Instructional design of virtual patients in dental education through a 4C/ID lens: a narrative review

Although VPs have been applied in various medical and dental education programmes, it remains uncertain whether their design was based on specific instructional design (ID) principles, and therefore, how to improve on them. In this study, we evaluated the extent to which ID principles have played a role in the development of VPs for clinical skills training purposes in dental education. First, as frame of reference we mapped key ID principles identified in VPs and medical simulations on the widely used four-component instructional design (4C/ID) model. Next, a literature search was conducted using Libsearch, a single search tool accessing databases such as MEDLINE, PubMed, Embase, CINAHL, ERIC, PsycInfo and Scopus. Following the PRISMA framework for systematic reviews, we selected 21 studies that used screen-based VP simulations for undergraduate dental students. The data analysis consisted of a review of each study analysing the key instructional design features connected to the components of the 4C/ID model. Overall, the results indicate that a structured approach to the design and implementation of VPs likely will have a positive effect on their use. While some ID-principles are shared such as the importance of clinical task variation to improving the transfer of learning. Others, however, such as the choice of learning mode or the use of cognitive feedback are ambiguous. Given its impact on students’ ability to establish effective cognitive schemas and the option to compare and study designs we recommend a more rigorous approach such as 4C/ID for the design of VPs.

Technology-enhanced simulation in emergency medicine: Updated systematic review and meta-analysis 1991-2021.

Over the past decade, the use of technology-enhanced simulation in emergency medicine (EM) education has grown, yet we still lack a clear understanding of its effectiveness. This systematic review aims to identify and synthesize studies evaluating the comparative effectiveness of technology-enhanced simulation in EM. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, Web of Science, and Scopus to identify EM simulation research that compares technology-enhanced simulation with other instructional modalities. Two reviewers screened articles for inclusion and abstracted information on learners, clinical topics, instructional design features, outcomes, cost, and study quality. Standardized mean difference (SMD) effect sizes were pooled using random effects. We identified 60 studies, enrolling at least 5279 learners. Of these, 23 compared technology-enhanced simulation with another instructional modality (e.g., living humans, lecture, small group), and 37 compared two forms of technology-enhanced simulation. Compared to lecture or small groups, we found simulation to have nonsignificant differences for time skills (SMD 0.33, 95% confidence interval [CI] -0.23 to 0.89, n= 3), but a large, significant effect for non-time skills (SMD 0.82, 95% CI 0.18 to 1.46, n= 8). Comparison of alternative types of technology-enhanced simulation found favorable associations with skills acquisition, of moderate magnitude, for computer-assisted guidance (compared to no computer-assisted guidance), for time skills (SMD 0.50, 95% CI -1.66 to 2.65, n= 2) and non-time skills (SMD 0.57, 95% CI 0.33 to 0.80, n= 6), and for more task repetitions (time skills SMD 1.01, 95% CI 0.16 to 1.86, n= 2) and active participation (compared to observation) for time skills (SMD 0.85, 95% CI 0.25 to 1.45, n= 2) and non-time skills (SMD 0.33 95% CI 0.08 to 0.58, n= 3). Technology-enhanced simulation is effective for EM learners for skills acquisition. Features such as computer-assisted guidance, repetition, and active learning are associated with greater effectiveness.

The power of affective pedagogical agent and self-explanation in computer-based learning

The goal of the current study was to investigate the effects of affective pedagogical agent (PA) and student-generated explanation on learners' affective processing, visual attention, and learning outcomes during a video lesson. In a 2 (affective pedagogical agent: positive PA vs. neutral PA) × 2 (generative learning strategy: self-explanation vs. re-study) between-subjects design, participants watched an animation on synaptic transmission from a multimedia lesson that was either delivered by a positive PA or a neutral PA. After watching the video, students either generated a verbal explanation or rewatched the video. All students’ eye movements were tracked during learning and then took learning outcome tests. The results showed that: (a) students who learned with a positive PA paid more attention to relevant elements of the materials and performed better on learning outcomes than those who learned with a neutral PA; (b) self-explanation facilitated visual processing and learning outcomes; and (c) positive PA accompanying self-explanation increased intrinsic motivation and resulted in best learning performance. The findings support the use of a positive PA to design multimedia learning environments and the use of self-explanation strategy to engage students in generative processing activities. Moreover, students benefit most from positive PA and then generating an oral explanation, which demonstrates the importance of combining instructional design features and learners-generated learning activity in computer-based learning environments.

Insights about instructional design features of an interprofessional education initiative involving clinical reasoning with physiotherapy and medicine students

Insights about instructional design features of an interprofessional education initiative involving clinical reasoning with physiotherapy and medicine students

Measuring Personalization, Embodiment, and Congruence in Online Learning: A Validation Study.

Instructional designs promoting personalization (conversational style and visible author), embodiment (human-like mannerisms and presence), and social and cognitive congruence have been shown to enhance learning. However, measurements of these instructional design features are lacking. The authors sought to develop and validate an instrument to measure personalization, embodiment, and congruence in an online course, collecting evidence of content, internal structure, and relationships with other variables. Through literature review, expert review, and pilot testing, the authors developed a 15-item, 5-domain instrument. Participants completed this instrument along with assessments of motivation (Instructional Materials Motivation Survey and Motivated Strategies for Learning Questionnaire), knowledge, and course satisfaction immediately after a 30-minute online multimedia learning module comprising slides with voiceover and (for some participants) short video clips, from January to April 2021. Participants included pharmacists, physicians, and advanced practice providers at academic and community hospitals. Confirmatory factor analysis (CFA) was used to examine model fit, followed by structural revisions guided by exploratory factor analysis (EFA) and tested in a new CFA using a split-sample approach. The authors evaluated associations between the revised instrument scores and motivation, knowledge, and satisfaction. There were 406 participants. CFA of the original 15-item instrument revealed poor model fit. EFA using 214 randomly selected participants suggested a 2-domain structure. CFA of the revised structure using the other 192 participants revealed good fit for a 9-item, 2-domain instrument: the Congruence-Personalization Questionnaire (CPQ). Linear regression confirmed positive, statistically significant associations for most hypothesized relationships (R 2 ≥ 0.12 and P < .001 for 14 of 18 associations with motivation and satisfaction). Associations with knowledge were weak and nonsignificant (R 2 ≤ 0.004, P > .23). Evidence of content, internal structure, and relationships with other variables support the validity of CPQ scores for measuring personalization and congruence in an online module.

The limited use of instructional design guidelines in healthcare simulation scenarios: an expert appraisal

BackgroundSystematic reviews on simulation training effectiveness have pointed to the need to adhere to evidence-based instructional design (ID) guidelines. ID guidelines derive from sound cognitive theories and aim to optimize complex learning (integration of knowledge, skills, and attitudes) and learning transfer (application of acquired knowledge and skills in the workplace). The purpose of this study was to explore adherence to ID guidelines in simulation training programs for dealing with postpartum hemorrhage (PPH), a high-risk situation and the leading cause of maternal mortality worldwide.MethodsA total of 40 raters analyzed simulation training programs as described in 32 articles. The articles were divided into four subsets of seven articles and one subset of four articles. Each subset was judged by seven to ten raters on adherence to ID guidelines. The 5-point Likert score rating scale was based on Merrill’s First Principles of Instruction and included items relating to key ID features categorized into five subscales: authenticity, activation of prior knowledge, demonstration, application, and integration/transfer. The authors searched for articles published in English between January 2007 and March 2017 in PubMed, Eric, and Google Scholar and calculated the mean Likert-scale score, per subscale, and interrater reliability (IRR).ResultsThe mean Likert-scale scores calculated for all subscales were < 3.00. For the number of raters used to judge the papers in this study (varying between 7 and 10), the IRR was found to be excellent for the authenticity and integration/transfer subscales, good-to-excellent for the activation of prior knowledge and application subscales, and fair-to-good for the demonstration subscale.ConclusionThe results demonstrate a paucity of the description of adherence to evidence-based ID guidelines in current simulation trainings for a high-risk situation such as PPH.

Static vs. Dynamic Representations and the Mediating Role of Behavioral Affect on E-Learning Outcomes

Online learning has become increasingly commonplace, including the replacement and augmentation of traditional in-residence education, as well as ad-hoc training systems and just-in-time knowledge dissemination. However, design for instructional media to facilitate performance has relied on an inadequate understanding of the behavioral affect elicited from these designs. To investigate the degree to which excitement and engagement are predictive of individual learning outcomes in an online learning setting, we evaluate an experiment with two instructional representations (static and dynamic) using learning materials for a semaphore signaling system. We examine the excitement and engagement levels of the participants using electroencephalography (EEG) as potential mediators. Learning outcomes are measured by the evaluation scores of knowledge retention. We consider several structural equation models (SEMs) to see the underlying relationship between instructional representation, excitement, engagement, and learning outcomes. Notably, the models indicate the full mediation of behavioral affect on learning outcomes, in which both the range of excitement and the maximum level of engagement are mediating effects. This article illustrates the potential for biometrically measured affect aid in the modeling and understanding of how instructional design features ultimately impact performance.

Game‐based learning has good chemistry with chemistry education: A three‐level meta‐analysis

AbstractGame‐based learning (GBL) may address the unique characteristics of a single subject such as chemistry. Previous systematic reviews on the effects of GBL have yielded contradictory results concerning cognitive and motivational outcomes. This meta‐analysis aims to: (a) estimate the overall effect size of GBL in chemistry education on cognitive, motivational, and emotional outcomes compared with non‐GBL (i.e., media comparison); (b) examine possible moderators of the effects; and (c) identify the more effective game design and instructional design features (i.e., value‐added comparison). We screened 842 articles and included 34 studies. This study is the first GBL meta‐analysis that employed a three‐level random‐effects model for the overall effects. Moderator analysis used a mixed‐effects meta‐regression model. Results from the media comparison suggest chemistry GBL was more effective for cognition (g = 0.70, k = 30, N = 4155), retention (g = 0.59, k = 20, N = 2860), and motivation (g = 0.35, k = 7, N = 974) than non‐GBL and the substantial heterogeneity (I2 = 86%) for cognitive outcomes. No study reported emotional outcomes, and studies considering value‐added comparisons of GBL with versus without specific design features (k = 3) were too few to perform a meta‐analysis. Moderator analyses implied that except for publication source and sample size, no other moderator was related to effect sizes. There may be the small‐study effects, particularly publication bias. Although we conclude that GBL enhances chemistry learning more than non‐GBL, the results also make clear that additional high‐quality value‐added research is needed to identify design guidelines that may further improve chemistry GBL. More GBL meta‐analyses on subjects other than chemistry are also needed. As the first GBL meta‐analysis that emphasizes emotion, we call for more research on emotion and on relationships between cognition, motivation, and emotion in GBL.

GeoForge: investigating integrated virtual reality and personalized websites for collaboration in middle school science

Purpose This paper aims to describe the design and user testing of GeoForge, a multiple-player digital learning experience for middle school that leverages virtual reality (VR) and individualized websites for learning concepts in planetary science. This paper investigates how specific instructional design choices and features of the technology fostered collaborative behaviors. Design/methodology/approach GeoForge was implemented in 3 middle school classrooms with a total of 220 students. Learners used GeoForge in class in groups of 3–4 to learn about planetary science. A mixed-methods approach examined collaboration using classroom observations, teacher interviews, student surveys and student artifacts. Using Jeong and Hmelo-Silver’s (2016) seven affordances of technology for collaborative learning, this paper identifies ways in which features of GeoForge supported collaborative behaviors. Findings Instructional design which combined VR and the digital science journal (DSJ) helped foster collaboration. Some collaborative behaviors were especially notable in classrooms that did not regularly practice these skills. Segmenting tasks in the DSJ, clarifying instructions to articulate ideas, showing other group members’ responses onscreen and enabling multiuser VR environments contributed to collaborative behaviors and a satisfying learning experience as observed and documented through multiple methods. Originality/value GeoForge successfully integrated VR and personalized websites in a classroom planetary science lesson, an approach which balanced instructional design and logistical challenges while creating opportunities for collaboration.

Measuring Explicit Instruction Using Classroom Observations of Student-Teacher Interactions (COSTI).

This article describes the development and technical adequacy of the Classroom Observations of Student Teacher Interactions (COSTI) instrument, a tool for measuring the frequency and rate of explicit instructional interactions, such as those used in Direct Instruction curricula, for teaching children basic reading and math skills. COSTI was originally developed to provide teachers with coaching feedback to improve their explicit reading instructional practices, and has been shown in multiple studies to be a reliable and valid predictor of student gains in beginning reading and math skills. This article discusses potential uses of the instrument for training and coaching across curricula with varying instructional design features, and lays out a future research agenda to further improve COSTI and related observation tools for studying explicit instructional practices and their contribution to student learning.

Transfer of learning from simulated setting to the clinical setting: identifying instructional design features.

Background: Transfer of learning (ToL) is the endpoint of simulation-based training (SBT). It is affected by numerous factors, which can be classified into 3 categories: learner characteristics, work environment, and training design. The first 2 have been identified to some extent in previous research. In this study, the aim was to identify the instructional design (ID) features affecting the ToL in SBT. Methods: This qualitative study was conducted in 2 phases. Phase 1 covers thematic analysis of comparative studies in the field of SBT. A systematic search was performed on 6 databases of Ovid MEDLINE, EMBASE, PsycINFO, CENTRAL, Scopus, and Web of Science, and the references of related systematic reviews were also checked. In phase 2, semi-structured interviews were conducted with key informants (instructors and learners) and analyzed using directed content analysis. The results of the 2 phases were combined, and finally ID features of SBT were identified and categorized. Results: In the first phase, 121 comparative studies were reviewed and in the second phase, 17 key informants were interviewed. After combining the results of the phases, the ID features affecting the ToL in SBT were classified into 3 broad categories and 15 subcategories as follows: (1) presimulation: preparation, briefing, and teaching cognitive base; (2) underlying theories: deliberate practice, mastery learning, and proficiency-based training; (3) and methods and techniques: distributed practice, variability, increasing complexity, opportunity for practice, repetitive practice, active learning, feedback/debriefing, simulator type, and simulator fidelity. Conclusion: Although learning is transferred from the simulated setting to the clinical setting, this process is not automatic and straightforward. Numerous factors affect this transfer. The results of this research can be used in designing and evaluating the SBT programs.

Comparative Effectiveness of Training with Simulators Versus Traditional Instruction in Veterinary Education: Meta-Analysis and Systematic Review.

One of the greatest challenges in veterinary education is adequately preparing students with the clinical skills they need to be successful health care providers. Integration of simulators, devices used to represent real world phenomena under test conditions, into the veterinary curriculum can help address challenges to clinical instruction. The use of simulators in veterinary education is increasing; however, their effectiveness remains unclear. This meta-analysis seeks to synthesize the evidence for simulator training in veterinary education to provide a consensus of effect, guide the integration of simulators into the curriculum, and direct the development of future simulation-based research in veterinary medicine. A systematic search identified 416 potential manuscripts from which 60 articles were included after application of inclusion criteria. Information was extracted from 71 independent experiments. The overall weighted mean effect size for simulator training was g = 0.49 for the random-effects model. The outcome measures of knowledge, time, process, and product all produced statistically significant mean effect sizes favoring simulation (d = 0.41, 0.35, 0.70, 0.53, respectively). A moderator analysis revealed that study characteristics and instructional design features moderated the effectiveness of simulator training. Overall, the results indicate that simulator training in veterinary education can be effective for knowledge and clinical skill outcomes.

Evaluating the Instructional Design and Effect on Knowledge, Teamwork, and Skills of Technology-Enhanced Simulation-Based Training in Obstetrics in Uganda: Stepped-Wedge Cluster Randomized Trial.

BackgroundSimulation-based training is a common strategy for improving the quality of facility-based maternity services and is often evaluated using Kirkpatrick’s theoretical model. The results on the Kirkpatrick levels are closely related to the quality of the instructional design of a training program. The instructional design is generally defined as the “set of prescriptions for teaching methods to improve the quality of instruction with a goal of optimizing learning outcomes.”ObjectiveThe aim of this study is to evaluate the instructional design of a technology-enhanced simulation-based training in obstetrics, the reaction of participants, and the effect on knowledge, teamwork, and skills in a low-income country.MethodsA stepped-wedge cluster randomized trial was performed in a university hospital in Kampala, Uganda, with an annual delivery volume of over 31,000. In November 2014, a medical simulation center was installed with a full-body birthing simulator (Noelle S550, Gaumard Scientific), an interactive neonate (Simon S102 Newborn CPR Simulator, Gaumard Scientific), and an audio and video recording system. Twelve local obstetricians were trained and certified as medical simulation trainers. From 2014 to 2016, training was provided to 57 residents in groups of 6 to 9 students. Descriptive statistics were calculated for ten instructional design features of the training course measured by the 42-item ID-SIM (Instructional Design of a Simulation Improved by Monitoring). The Wilcoxon signed rank test was conducted to investigate the differences in scores on knowledge, the Clinical Teamwork Scale, and medical technical skills.ResultsThe mean scores on the ten instructional design features ranged from 54.9 (95% CI 48.5-61.3) to 84.3 (95% CI 80.9-87.6) out of 100. The highest mean score was given on the feature feedback and the lowest scores on repetitive practice and controlled environment. The overall score for the training day was 92.8 out of 100 (95% CI 89.5-96.1). Knowledge improved significantly, with a test score of 63.4% (95% CI 60.7-66.1) before and 78.9% (95% CI 76.8-81.1) after the training (P<.001). The overall score on the 10-point Clinical Teamwork Scale was 6.0 (95% CI 4.4-7.6) before and 5.9 (95% CI 4.5-7.2) after the training (P=.78). Medical technical skills were scored at 55.5% (95% CI 47.2-63.8) before and 65.6% (95% CI 56.5-74.7) after training (P=.08).ConclusionsMost instructional design features of a technology-enhanced simulation-based training in obstetrics in a low-income country were scored high, although intervals were large. The overall score for the training day was high, and knowledge did improve after the training program, but no changes in teamwork and (most) medical technical skills were found. The lowest-scored instructional design features may be improved to achieve further learning aims.Trial RegistrationISRCTN Registry ISRCTN98617255; http://www.isrctn.com/ISRCTN98617255International Registered Report Identifier (IRRID)RR2-10.1186/s12884-020-03050-3

ENEUROANAT-CF: a Conceptual Instructional Design Framework for Neuroanatomy e-Learning Tools.

In an era which is witnessing a significant rise in incidence of neurological diseases, there is also a rise in neurophobia: the diminished confidence of clinical practitioners and students to manage patients with neurological conditions. In this context, the perceived nexus between neuroanatomy-phobia (the challenges and fear associated with learning neuroanatomy) and neurophobia highlighted the need to revisit the neuroanatomy pedagogies and their instructional designs. e-Learning can be effectively employed to enhance students' learning of neuroanatomy. This perspective describes a conceptual framework for online neuroanatomy learning (e-neuroanatomy learning conceptual framework (eNEUROANAT-CF)), which provides a theoretical grounding to newly developed neuroanatomy e-learning resources, by offering a set of instructional design principles. The framework is rooted in the theories of adult learning, cognitive load, and Mayer's theory of multimedia learning. eNEUROANAT-CF was validated by imparting user opinion regarding the best perceived instructional design features for learning neuroanatomy. Furthermore, it was effectively employed to inform the pedagogical construct of an e-tool to help students learn the spinal pathways. The perspective highlights the theoretical underpinnings of the eNEUROANAT-CF under seven categories, namely "avoidance of cognitive overload," "learning style preferences," "contextualization," "motivation," "social learning," "feedback/reflection," and "active learning." In addition, elaborative examples are provided, which explains how eNEUROANAT-CF informed the instructional design features of the abovementioned e-tool. The authors propose that any novel, interactive neuroanatomy e-learning resource rooted in the instructional design principles outlined by the eNEUROANAT-CF will improve users' learning and understanding of neuroanatomy. The research shows promise to help break the perceived nexus between neuroanatomy-phobia and neurophobia.

Transfer of learning from simulated setting to the clinical setting: identifying instructional design features

Transfer of learning from simulated setting to the clinical setting: identifying instructional design features