Mixed Methods Model Research Articles

The effects of Covid-19 pandemic on Turkish children’s school readiness

ABSTRACT The aim of this study is to examine the primary school readiness of preschool children receiving hybrid education in Turkıye during the Covid-19 pandemic. In order to make a comprehensive evaluation parent and teacher opinions were reviewed in addition to the school readiness assessment. A triangulation design and convenience sampling method were used for the present study which has a mixed methods model. The results revealed that most of the participating children were ready for the primary school and that school readiness scores differed by child technology use, child attendance to distant education and child duration of preschool attendance.

One Pump at a Time: A Wearable Lactation Pump Pilot for Graduate Medical Education Trainees.

Background: Despite the known benefits of lactation, lactating graduate medical education (GME) trainees encounter difficulties when returning to work. Wearable lactation pumps are known to be beneficial in lactating physicians, but the benefit for GME trainees in clinical care and education has not been explored. Objectives: The objective of this study was to examine the benefits of wearable lactation pumps on education and clinical care for GME trainees. Methods: In 2022-2023, all lactating GME trainees at a large academic center were invited to participate in a wearable pump pilot. Participants completed six baseline surveys with questions on lactation practices and individuals' perceptions before receiving the pump, repeated the six surveys after receiving the pump, and completed a monthly survey for 6 months after receiving the pump. A linear mixed methods model was used to compare reported experiences before and after receiving the wearable pump. Results: Twelve trainees participated in the pilot, with 10 completing pre- and post-surveys. When compared with experiences before receiving the wearable pump, there was a significant decrease in the perceived impact of lactation on clinical care (p = 0.03), medical education (p = 0.004), and missed pumping sessions (p = 0.02) after using the wearable pump. All participants who used the wearable pumps reported that it helped them to meet lactation goals. Conclusions: Wearable pumps are beneficial to trainees and may decrease the barriers to education and clinical care. GME sponsored pump programs may better support lactating trainees on their return to work.

Pediatric antibody responses to SARS-CoV-2 after infection and vaccination in Calgary, Canada

BackgroundThere are few reports of longitudinal serologic responses in children following Sars-CoV-2 infection and vaccination. This study describes longitudinal SARS-CoV-2 antibody responses following infection, vaccination, or both (hybrid immunity) in a cohort of Canadian children. The objectives of our study were to compare antibody levels following SARS-CoV-2 infection, vaccination, and hybrid immunity and to examine antibody decline after final antigen exposure.MethodsThe Alberta Childhood COVID-19 Cohort (AB3C) study was a prospective longitudinal cohort study conducted from July 2020 to September 2022 with repeat sampling across 5 visits. Children under 18 years of age were enrolled for serial measurement of antibody responses to SARS-CoV-2 virus vaccine and infection.ResultsThe final sample size was 919; participants were 50.5% female, 48.2% were > 12 years and 88.5% were white ethnicity. The median peak spike IgG level of those with only infection was not different from those with no vaccination or infection (233 AU/mL (IQR: 99–944 AU/mL) vs. 3 AU/mL (IQR: 1–5 AU/mL; P = 0.1765). Participants with infections after vaccination had higher IgG levels than those where infection preceded vaccination (median: 36,660 (IQR: 22,084 − 40,000 AU/mL) vs. 17,461 AU/mL (IQR: 10,617 − 33,212 AU/mL); P < 0.0001). In a linear mixed methods model, children with infection-only had low levels of antibody that stayed stable over the study duration without further antigen exposures. Those with infection after vaccination had the slowest rate of antibody decline over time at 4% (95%CI: 2-5%) per week, compared with children where infection preceded vaccine 7% (95%CI: 6-8%) per week.ConclusionsChildren with hybrid immunity conferred through vaccination (2 + doses) followed by a SARS-CoV-2 infection had the highest and longest lasting antibody levels, compared to children who had an infection followed by vaccination, vaccination-only, or infection-only. The longer-term clinical importance of these findings, related to prevention of repeated infections and severe outcomes and need for further vaccine doses, is not yet known.

Engagement in Distance Healthcare Simulation Debriefing: A Concept Development and Framework.

Understanding distance health care simulation debriefing is crucial in light of the increased use of and emerging technology in remote education for reasons of accessibility, global collaboration, and continuous professional development. This article is a confluence of a number of previously published studies designed to serve as a foundation to develop the concept of "engagement in health care distance simulation debriefing" using the Schwartz-Barcott & Kim hybrid mixed methods model. The model uses 3 phases: theoretical (a realist systematic review of the literature), fieldwork (3 exploratory studies and 2 pilot experimental studies), and analytical (analysis of the theoretical and fieldwork findings through expert discussion). This study defines the concept of "engagement in health care simulation distance debriefing" through exploration of its uses and analysis in literature, interviews, and expert review. The hybrid approach to the analysis provided rigor to generate a new, reflective conceptual model. This conceptual model defines the complexity in engagement during distance debriefing and helps shape the development of simulationists and debriefers, leading to more effective distance simulations and debriefings.

Congenital Cytomegalovirus Testing Outcomes From the ValEAR Trial.

To determine the positivity rate of congenital cytomegalovirus (cCMV) testing among universal, hearing-targeted CMV testing (HT-cCMV) and delayed targeted dried blood spot (DBS) testingnewborn screening programs, and to examine the characteristics of successful HT-cCMV testing programs. Prospective survey of birth hospitals performing early CMV testing. Multiple institutions. Birth hospitals participating in the National Institutes of Health ValEAR clinical trial were surveyed to determine the rates of cCMV positivity associated with 3 different testing approaches: universal testing, HT-cCMV, and DBS testing. A mixed methods model was created to determine associations between successful HT-cCMV screening and specific screening protocols. Eighty-two birth hospitals were surveyed from February 2019 to December 2021. Seven thousand six hundred seventy infants underwent universal screening, 9017 infants HT-cCMV and 535 infants delayed DBS testing. The rates of cCMV positivity were 0.5%, 1.5%, and 7.3%, respectively. The positivity rate for universal CMV screening was less during the COVID-19 pandemic than that reported prior to the pandemic. There were no statistically significant drops in positivity for any approach during the pandemic. For HT-cCMV testing, unique order sets and rigorous posttesting protocols were associated with successful screening programs. Rates of cCMV positivity differed among the 3 approaches. The rates are comparable to cohort studies reported in the literature. Universal CMV prevalence decreased during the pandemic but not significantly. Institutions with specific order set for CMV testing where the primary care physician orders the test and the nurse facilitates the testing process exhibited higher rates of HT-cCMV testing.

Performance Analysis of Share Market by using ML Technique

The main indicator that measures the economic development and power of the country Inflation and expansion affect the economy. Prices are difficult to predict due to many factors. Predicting changes in stock prices is one of the most difficult aspects of financial forecasting. Predicting stock prices accurately can make investors profitable. to the complexity of the data in the Forecasting stock market trends presents a formidable challenge due to its inherent unpredictability. The primary objective of this article is to offer insights into forecasting market prices, aiding investors in making well-informed decisions. The methodologies to be employed include statistical analysis, machine learning techniques, natural language processing, and sentiment analysis achieve research objectives. In this study, a mixed methods model was developed using qualitative and quantitative data.

Ab. No. 118 Test-Retest Reliability of Commercially Available Bio-Electrical Impedance-Based Body Composition Analyzer in India

Introduction: The purpose of the study is to determine the consistency of body composition measures using a commercially available bioelectrical impedance-based body composition analyzer in India. Body composition assessment has application in several clinical populations including but not limited to those with obesity, cancer, renal failure, endocrine disorders. DEXA is considered gold standard but impractical to use in regular clinical practice. Bioelectrical impedance analysis (BIA) is emerging as a simpler alternative, especially in field settings and routine clinical practice. Its use is also recommended in current sarcopenia diagnostic guidelines. Many low-cost BIA devices are available but their reliability and validity information are seldom available. Such information can improve their relevance and utility in clinical settings. Methods: Forty apparently healthy adults (Age: 28±7.5 years; 78% women, BMI: 26.1±4.4). Following necessary approvals, body composition was assessed using four-point full body impedance analysis with Omron HBF-702T device on two occasions (1-4 days apart). The timing of measurement, food and fluid intake were not standardized to mimic clinical scenarios. Paired T-test determined significant difference between two assessments. Test-retest reliability was determined by ICC using two-way mixed methods model for consistency between measurements. Results: There was no clinically and statistically significant difference between two consecutive measurements (Mean difference of - Skeletal Muscle Percentage: 0.06%; Body Fat Percentage: 0.12%; RMR: 8.5 Kcal/day). All parameters exhibited excellent test-retest reliability (ICC &amp; Cronbach’s Alpha: Skeletal Muscle Percentage – 0.97 &amp; 0.98; Body Fat Percentage – 0.93 &amp; 0.96; RMR – 0.94 &amp; 0.97. Conclusion: The tested device exhibited excellent test-retest reliability for skeletal muscle, body fat percentage, and resting metabolic rate despite testing in non-standardized routine clinical setting. Implications: Bio-electrical impedance-based body composition analyzers could be a reliable way to measure body composition in clinical practice. However, each equipment’s reliability and validity needs to be established prior to clinical use.

Relational Dialectics on Couples of Childbearing Age in Underprivileged Chinese Ethnicity Families in the Use of Contraception in Medan City

Dialectics in the form of contradictions in relationships which can occur due to various things and problems in couple life, as well as in determining the decision to carry out a family planning (KB) program or in determining the use of contraception. This research aims to analyze how the condition of internal and external dialectics and the strategies for resolving internal and external dialectics on couples of childbearing ages in underprivileged families of Chinese ethnicity in Medan City. The research approach uses a combined approach with a mixed methods model embedded design in data collection techniques and data analysis techniques. Therefore, the data produced is quantitative data to answer the internal and external dialectical condition, and qualitative data to answer strategies for resolving internal and external dialectics. Researcher prioritize quantitative data obtained from 100 respondents, while qualitative data collected through focus group discussion with 6 resource persons as informants are meant to complement the data and elaborate the analysis results more fully. The results of the study based on quantitative data with descriptive statistical analysis showed the condition of internal dialectic variables obtained an average value of 4.10 and the external dialectic variables obtained an average value of 3.49 on a 5-point Likert Scale. Based on the assessment criteria using the grand mean analysis, both are in a relatively stable condition. However, this value means that the respondents in this study tend to be more able to cope with the internal dialectics which occur than the external dialectics of contraceptive use. Meanwhile, the dialectic resolution strategy used by respondents in resolving internal dialectics tends to use a balance strategy and in resolving external dialectics using an integration strategy.

MEREDUKSI AGRESIFITAS DENGAN COGNITIVE BEHAVIORAL ART TERAPY PADA SISWA SMPN 14 PONTIANAK

The aim of this study was to test the effectiveness of group counseling with cognitive behavioral art therapy in reducing aggression using a mixed methods model embedded in an experiment. The scale used is the Buss and Pery aggressiveness scale (Garofalo, 2018) with a total of 30 statement items. Based on data analysis, the average pretest value was 83.7 and after being given CBAT treatment the posttest value was 57.8 with a Wilcoxon sign-rank test Z value of -2.201, with a p value of 0.028, which means the p value is smaller than 0.05. So it can be concluded that Ha is accepted and Ho is rejected, which means that cognitive behavioral art therapy group counseling is effective in reducing student aggression. Viewed qualitatively analysis of counseling conversations with high aggressiveness Referring to harsh words, being angry, negotiating, does not reduce emotional control. The changes that occur are in the moderate to low category, this shows that cognitive behavioral art therapy group counseling has a therapeutic impact on group members who are counselees.

E-learning and E-modules in medical education-A SOAR analysis using perception of undergraduate students.

Application of e-learning and e-modules in medical education has been shown to have a positive impact on learning outcomes among all types of learners, across diverse educational settings. Despite its benefits, e-learning and e-modules has not yet reached its full potential in medical education in India. Objective of this study is to evaluate the perception of undergraduate students regarding e-learning and e-modules using an appreciative inquiry tool SOAR (Strengths, Opportunities, Aspirations, Results) analysis, and to identify the barriers and challenges for the same. This longitudinal study was conducted among participants from three consecutive batches (n = 250 x 3) of first-year medical students and two consecutive batches (n = 100 x 2) of first-year dental students. The sample was selected using a purposive sampling method. Two structured and validated questionnaires were developed for this study based on the modified Zhou's Mixed Methods Model; the 'Knowledge, Attitude and Practice' Questionnaire (KAPQ) on e-learning and the feedback questionnaire (FBQ) on e-modules. The questionnaires were administered via MOODLE / hard copy, before and after the implementation of e-modules, respectively. Identified strengths, potential opportunities, probable aspirations and likely results for e-learning and e-modules were tabulated based on the qualitative analysis of perceptions of large number students sampled across three years. Six hundred and ninety students returned both questionnaires representing a response rate of 76.6%. Nine themes were identified in the "Strengths" domain as follows: Regular Update of Knowledge, Innovative Learning, Availability, Knowledge Sharing, Abundance of Information, Accessibility, Source of Knowledge, Creativity, and Increased Engagement. Eleven themes were identified in the "Opportunities" domain as follows: Clinical Skills training, Timesaving, Flexibility, Creativity, Increased engagement, Standardized content, Capacity building for students, Capacity building for faculty, Skills training, and Self-assessment. Thirteen themes were identified under the "Aspirations" domain with the three key themes being "maintaining and building on current strengths", "increasing potential opportunities", and "addressing the barriers and challenges identified in the responses to the KAPQ and FBQ questionnaire". Four themes identified for 'Barriers' were eye strain, distractions, preference for conventional methodologies, and internet connectivity. The findings of this qualitative study are based on the responses received from first-year medical and dental students of a Private University in Chennai, India. In this population of students, implementation of e-learning as blended learning using structured and interactive e-modules may provide more engagement during learning as well as support self-directed learning (SDL) directly or indirectly. Adoption of blended learning with e-modules as an integral part of curriculum planning may be beneficial for the achievement of Competency-Based Medical Education (CBME) goals in India.

A meta-analysis of the mastitis vaccination efficacy in dairy cattle.

Mastitis is the most important disease in dairy cattle with impact in welfare of animals and the economy of the dairy farming activity. Attempts have been made to produce vaccines to prevent the disease, however, results have been dubious. The aim of this study was to evaluate the efficacy of the mastitis vaccination in dairy cattle by merging several trials to allow evidence synthesis. A list of publications with common methodological grounds was selected to allow a quantitative comparison in a meta-analysis with moderators. A mixed methods model (p < 0.001), with four significant moderators was successfully fitted: "year of publication" (p < 0.001), "vaccination timing" (p < 0.01), "type of animal" (p < 0.001), and "vaccine fabrication" (p < 0.001). The model is homogeneous (p > 0.05), with the moderators explaining the variability. Efficacy decreases over time. Vaccines applied after calving show inefficacy [log risk ratio (RR) 1.72 (1.34, 2.21)], and applied before calving show reduced efficacy [log RR 0.86 (0.72, 1.03)]. Commercial vaccines don't show efficacy [log RR 1.07 (0.94, 1.22)]. Self-fabricated vaccines show efficacy [log RR (0.51, 0.94)]. Full clarification of efficacy is not shown; however, if vaccination is used, must follow a pre-calving protocol. While not showing efficacy, the vaccination has demonstrated a reduction of the severity in clinical cases, rate of culling, and has increased the production of milk and milk solids. Vaccination may improve health and welfare but does not prevent the disease effectively; it must be seen as an additional tool to the traditional preventive measures.

Parenting information for parents: Efforts to prepare children to experience menarche in prepubertal young girls

The role of parents is very important as an effort to provide information to their children, especially young women about the fulfillment of education, especially as women. The purpose of this study was to determine the effectiveness of parenting information to prepare young women for prepubertal menarche. The research method used is a mixed methods model, with a concurrent model design that combines qualitative and quantitative data. This research involved 66 research subjects who were selected purposively from 360 female students at State Junior High School 8 Pagaralam. The research instrument used was the menarche scale and interview guidelines. The collected data were analyzed using multiple regression. The results of the menarche scale analysis and interviews before providing information services about menarche, the percentage of children who are not ready to face menarche is 81% thus there are still children who are afraid, embarrassed, and even anxious about facing menarche. After providing parenting information to parents as an effort to prepare children to experience menarche, prepubertal young women experienced a decrease in the number of children to 18%. Thus parenting information plays a very important role in increasing the knowledge of parents and children about menarche.

Parents’ and Students’ Perception on Learning in the Age of Industrial revolution 4.0 at SDN 22 Inpres Pali, Tana Toraja

Learning is currently slowly leading to a major change, namely the industrial revolution 4.0. The purpose of this study was to describe parents' learning perceptions in the Industrial Revolution 4.0 era and students' learning perceptions in the Industrial Revolution 4.0 era at SDN 222 Inpres Pali, Tana Toraja Regency. The approach used in this research is a mixed methods model with a sequential exploratory model. The mixed methods sequential exploration model is a research method that combines qualitative and quantitative approaches to obtain valid data. The data in this study consisted of two data sources, namely primary and secondary data. Qualitative results were obtained in a structured way, the researcher conducted interviews with 4 parents, representatives of guardians of lower and upper grade students. Also, among the students involved, there were 4 people representing upper and lower classes. Several themes were formulated in the results of the study to represent the responses of the informants, including school descriptions, usage, understanding, learning practices, positive and negative impacts, and views on learning with technology and communication tools. Quantitative data from questionnaire data. From the results and discussion of parents' and students' perceptions of learning in the age of Industrial Revolution 4.0, SDN 222 Inpres Pali students and parents to use technology, communication and information tools positively, to learn with technology and means of communication had a positive impact on parents and students. The biggest benefit is to help students overcome learning difficulties, such as teachers and parents.

Mathematics teachers’ assessment of mathematical understanding

Mathematical understanding is considered to have a multidimensional structure and an important place in mathematics teaching. The focus of the assessments in mathematics courses is on the multidimensional evaluation of mathematical understanding. However, a review of related literature shows the lack of studies on assessing mathematical understanding using multidimensional structures. For this reason, the current study attempted to develop a scale for assessing teachers' mathematical understanding. The instrument development model, an exploratory sequential mixed methods model, has been used in line with this aim during the scale’s development. The study’s qualitative data were collected through a mathematical understanding assessment form and semi-structured interviews developed by the authors. Qualitative data emerged from 17 mathematics teachers working in middle schools or high schools who were determined using the easy access sampling method. Five themes were arrived at from the content analysis with the obtained qualitative data: applying rules, transferring knowledge, generating questions and solutions, generalizing, and exploring information. The initial version of the instrument prepared in accordance with these themes was applied to a total of 501 primary school mathematics preservice teachers from nine different universities in Turkey during the 2018 spring semester. Cronbach’s alpha (α) assessment was performed for the scale’s reliability. Item-total correlations were calculated as item statistics. Exploratory and confirmatory factor analyses were applied to test the scale’s construct validity. The item loadings for the scale were seen to vary between.431 and.759 in this process; the reliability of the sub-dimensions and the scale’s fit indices were seen to be at sufficient levels. As a result of all the performed analyses, a scale form consisting of 21 items and five sub-dimension was obtained. The results from the scale development process show that the preservice teachers took into account the factor of transferring knowledge the most and the factor of producing questions and solution pathways the least.

TOWARDS A MORE COMPREHENSIVE UNDERSTANDING OF FOSTERING CONNECTIONS: THE TRAUMA-INFORMED FOSTER CARE PROGRAMME: A MIXED METHODS APPROACH WITH DATA INTEGRATION

Foster carers require high-quality training to support them in caring for children with trauma-related difficulties. This paper describes a mixed methods approach that was applied to evaluate the complex intervention Fostering Connections: The Trauma-Informed Foster Care Programme, a recently developed trauma-informed psychoeducational intervention for foster carers in Ireland. A quantitative outcome evaluation and a qualitative process evaluation were integrated to capture a comprehensive understanding of the effects of this complex intervention. A convergent mixed methods model with data integration was used. Coding matrix methods were employed to integrate data. There was convergence among component studies for: programme acceptability, increased trauma-informed foster caring, improvement in child regulation and peer problems, and the need for ongoing support for foster carers. This research provides support for the intervention suggesting the importance of its implementation in Ireland. The integrative findings are discussed in relation to effects and future implementation.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

PROFILE OF MATHEMATICAL COMMUNICATION’S ABILITY BASED ON LEVEL OF PROBLEM SOLVING’S ABILITY

Abstract : This study was aimed to define profile of mathematical communication based on the level of problem solving ability on secondary students. This study used mixed methods model with explanatory type. This sample used 30 secondary school students who was chosen based on teachers’ recommendation. The result shown that there are 16,67% students whose problem solving’s ability were placed on low level If we look on mathematical communication ability’s side, most of students faced on the diffulties of projecting figures into mathematical ideas. Students still made mistakes on calculating and the indicators was difficult when it stated to project any figures into mathematical ideas while the indicator that appear frequently was stated events or ideas in mathematical laguage. There are 70% students that whose problem solving ability were placed on medium level. If we look on mathematical conection ability most of information as shown unclearly and faced on difficulties when they summarize conclusion, they stated it into mathematical symbol. There are 13,33% students whose problem solving ability were pleced on high level and unclear to every single information that was told within solving strategy which directly on solving essentials. Keywords: Profile of mathematical Ability, Mathematical Communication, Problem Solving

Predicting the Writer's Gender Based on Electronic Discourse

The present study compared three methods aimed at predicting the writer's gender based on writing features manifested in electronic discourse. The compared methods included qualitative content analysis, statistical analysis, and machine learning. These methods were further combined to create a mixed methods model. The findings showed that the machine learning model combined with qualitative content analysis produced the best prediction accuracy. Including qualitative content analysis was able to improve accuracy rates even when the training set for machine learning was relatively small. Thus, this study presented a concise model that can be fairly reliable in predicting gender based on electronic discourse with high accuracy rates and such accuracy was consistently found when the model was tested by two separate samples.

Espacios culturales alternativos: la Roma-Condesa en la Ciudad de México

Alternative cultural spaces are characterized as much by the way they gather cultural and creative activities, as by the fluid relationships among sites for habitation, work, and leisure. From these gatherings and relationships, spatial heterogeneous ways of belonging and identity coalesce into the area known as Roma-Condesa in the center of Mexico City. The theoretical possibilities of the concept and the results of a mixed methods model stemming from the testimonials of inhabitants in the area, the spatial localization of activities and creators, and the registry of their creative processes in the urban transition between the earthquakes of 1985 and 2017 are evaluated.

An Innovative Blended Learning Preclinical Hematology Curriculum on White Cell Dyscrasias: A Mixed Methods Study of Student Performance, Satisfaction, and Engagement

Introduction: Recent proposals have called for reform of the traditional medical education model and development of learner centered paradigms that prioritize conceptual mastery and enhance engagement. Blended learning models mediate a shift from lecture settings to collaborative active learning environments. Studies suggest that blended learning modalities may improve affective and objective outcomes compared to passive didactics. However, there is limited evidence regarding the implementation of blended learning in preclinical medical school courses. We developed an innovative blended learning curriculum for a preclinical second year medical student hematology course using a flipped classroom large-group active learning model and investigated its impact on student performance, satisfaction, and engagement. Methods: We used constructivist education theory and a mixed methods model to develop a blended learning curriculum. In 2015 we converted the didactic lecture component of the white blood cell dyscrasias unit into nine online video modules and two large-group active learning sessions. Blended learning content was structured to maintain time neutrality and allocate sufficient time for independent review. Large-group active learning sessions were planned for an Education Center active learning studio and designed to emphasize collaborative team-based discussion and included clinical problem solving, audience response questions, and gamification. Attendance at large-group sessions was optional in 2015 and mandatory in 2016 - 2017. The white blood cell dyscrasias question final examination subset scores were compared between the historical 2014 cohort and blended learning cohorts from 2015 - 2017 with one-way ANOVA with post-hoc comparisons via Dunnett's multiple comparisons test with a single pooled variance. The examination questions compared were identical. Course evaluations were compared between 2014 and 2015 via an independent samples t-test, but 2016 and 2017 evaluations were not directly compared due to an institution-wide change in evaluation scales. Qualitative student evaluations regarding the traditional and blended learning curriculum were collected between 2014 - 2017. Results: Overall satisfaction with the course (5, excellent) was similar (p=0.38) in 2014 (4.13±0.79) and 2015 (4.05±0.82). Satisfaction remained high (4, excellent) in 2016 (3.33±0.72) and 2017 (3.12±0.84). Student performance was marginally worse on the white blood cell dyscrasias question subset (17-point maximum) in 2015 (Mean Score, 14.78±2.01, p=0.0069), but not significantly different in 2016 (14.96±1.94, p=0.0856) or 2017 (15.10±1.82, p=0.3803) compared to 2014 (15.37±1.64). In 2015, on average, 34% (65/191) of students attended didactic lectures and active learning sessions were attended by 33% of students (60/183). Attendance was mandatory in 2016 (n=184) and 2017 (n=175). Between 2015 - 2017, 60% of students reported not completing video modules prior to corresponding active learning sessions. Qualitative analysis from 2015 - 2017 of student feedback revealed themes on active learning sessions focused on perceived lack of time neutrality, difficulty adapting to a novel learning style, appreciation of clinical case-based learning, and the value of real-time facilitator feedback. Conclusions: We found that conversion of conceptually challenging material in a preclinical hematology course to a blended learning curriculum did not improve performance. When mandated, attendance at active learning sessions did not incentivize student pre-session preparation. These findings carry implications for the use of blended learning in preclinical hematology education. Inadequate student preparation for sessions may have mitigated the benefit of active learning and detrimentally impacted performance. Students habituated to a lecture-based curriculum experienced difficulty adapting to a novel learning approach emphasizing collaborative engagement, weakening the utility of the active learning sessions. Our findings suggest the importance of accountability and preparation for active learning sessions in a blended learning curriculum. As blended learning becomes prevalent in medical education, further studies of pedagogic methods to overcome barriers to successful student performance, satisfaction, and engagement are necessary. Disclosures Murakhovskaya: Momenta: Membership on an entity's Board of Directors or advisory committees.