Multimodal Learning Style Research Articles

Does Learning Style Make a Difference on Student’s Academic Performance? Learning Style Preferences of Medical Students from University Tunku Abdul Rahman

Background: Learning preference is the effective and efficient modality or manner in which a learner has a natural preference to perceive process, store and recall new information. Learning style is the composite of cognitive, affective and physiological characteristics that indicate how a learner perceives, interacts and responds to the learning environment.
 Objectives: The objectives of the study were to assess the teaching and learning style preferences of medical students at UTAR by using VARK (Visual/Auditory/Reading/Kinesthetics) inventory questionnaires and to identify the different learning style preferences between gender and the academic year of medical education (pre-clinical year versus clinical year). 
 Methodology: This was a university-based cross-sectional study involving 235 students from year 1 to year 5 in University Tunku Abdul Rahman, Malaysia from December 2017 to December 2018. Students, selected via universal sampling, were given the VARK inventory questionnaires determine their preferences of learning style. Data were further analysed using SPSS (version 22.0, IBM). 
 Results: Of the 203 students (86.4%) who responded to the questionnaire, 62.1% of them were females while 80.3% of them were between 21-25 years of age. 86 students (42.4%) were from the preclinical phase while 117 (57.6%) were from the clinical phase. 70.4% of the students preferred studying alone to studying with a partner or group of friends (29.6%). Among them,157 medical students (77.3%) preferred multimodal learning style, with the most preferred mode trimodal which means combination of three sensory preference for example VAR or ARK, 35.67%, followed by quadrimodal which means combination of all four sensory preference for example VARK, 33.76% and bimodal which means combination of two sensory preference for example VA or AR, 30.57%. The remaining 46 students (22.7%) were unimodal learners (visual or auditory or reading or kinaesthetic) and 37% of them preferred kinesthetics which was learners prefer hands-on, practical experience. There was no significant difference in VARK modalities in terms of gender (p=0.39) and academic year (p=0.16). 
 Conclusion: In conclusion, majority of UTAR medical students preferred multiple modalities with trimodal being the most prevalent mode. Among unimodal learners, kinesthetics were the most preferred mode. There was no significant difference in VARK modalities in terms of gender and academic year.

Evidence for a Common Multi-Modal Learning Style in Young Adults? A Psychometric Investigation of Two Modality-Specific Learning Style Inventories

A well-known hypothesis amongst educators and the general public is that matching instructional method with an individual’s modality-specific learning style improves learning. Several critical reports in the past decade, however, have shown that the psychometric properties of the inventories applied to establish learning styles have been poorly validated. Furthermore, theoretical development has challenged the theoretical basis for the modality-specific learning style model. Thus, the aim of the current study was to examine the psychometric properties and relationship between, two learning style inventories: the Barsch Learning Style Inventory and the Learning Style Survey. University students (n = 242) completed the two inventories, and their responses were subjected to confirmatory and exploratory factor analysis, as well as analysis of inter-item agreement (internal consistency). The results failed to support the expected three-factor measurement model and thus indicated questionable reliability and factorial validity of the two inventories. Analysis of inter-correlations between factors from the two inventories resulted in a one-factor solution explaining up to 40% of the variance, which is discussed as emerging through an overall multimodal learning style.

Identifying learning styles of language learners: A useful step in moving towards the learner-centred approach

Knowing students’ learning styles provides a good start for the design of effective instruction. The purpose of this research is to determine the preferred learning styles of undergraduate students and to determine the relationship between learning style preferences, gender, and educational majors. A cross-sectional descriptive study was conducted among the first-year undergraduate students enrolling in the Languages Program at Chiang Rai Rajabhat University, Thailand. The VARK questionnaire in a printed form was distributed to 472 first-year undergraduate students in Languages Program at Chiang Rai Rajabhat University. The frequency of students’ learning styles was identified using descriptive statistics, and chi- square analyses were carried out to examine the relationship between students’ preferred learning styles, gender and academic majors. A total of 372 completed questionnaires received from the students, giving a response rate of 78.8%. The findings revealed that most language learners (64.0%) had multimodal learning style preferences. Only 36.0% of the students preferred a uni-modal learning style, and kinesthetic was the most preferred learning style. A statistically significant correlation between educational majors and learning styles was observed ( p = 0.02). However, no association was found between gender and student’s learning style preferences ( p =0.45). The findings of this study suggest that various teaching strategies need to be used in the classroom to accommodate learners with diverse learning styles, making learning more engaging and meaningful to students.

Learning style preferences of medical students in Kano, Northwestern, Nigeria

Context: The current literature posited that the knowledge of learning styles can be useful to both teachers and students. This study sets out to investigate and compare the learning style preferences of medical students (2nd year–5th year). Aims: The aim of the study was to investigate learning style preferences of medical students (2nd year–5th year) and compare those styles across years in the medical school (preclinical to clinical). Settings and Design: This study was carried out in the Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria. It was a descriptive cross-sectional study. Subjects and Methods: A descriptive cross-sectional study was conducted in Kano, Northwest Nigeria. The Visual, Aural, Read/Write, and Kinesthetic (VARK) questionnaire, a self-administered instrument, was administered to 206 preclinical and clinical years' medical students in 2016. Statistical Analysis Used: Percentages, proportions, frequency tables, and charts were used in the analysis. Results: The response rate was 87.7%. The mean age of the study sample was 21.9 years. There were 124 (60.2%) males and 82 (39.8%) females. The mean score of each VARK item revealed that kinesthetic, auditory, read/writing, and visual modalities have 6.607 (standard deviation [SD] 2.265), 5.369 (SD 2.436), 4.984 (SD 2.621), and 4.345 (SD 2.468), respectively. The most common preferred learning style for both preclinical and clinical years' medical students was multimodal learning style. Conclusions: The findings in this study indicate that multimodal learning style is the most preferred, while other preferences are also common. Therefore, this has important implications on how educators deliver teaching and support students' learning.

Effect of learning modalities on visuomotor performance and mental flexibility in professional students

Background: The style of learning in an individual is the preferable choice of processing and transforming knowledge. The modalities of learning styles are unimodal, bimodal, and multimodal learning style. Trial making test (TMT) is a neurocognitive test which measures the domain of cognition, its speed of processing, its sequencing order, mental flexibility, and visuomotor skills. Aim and Objective: To compare visual-motor skills and mental flexibility in different learning modalities in professional students. Materials and Methods: Institutional ethical clearance and written informed consent was obtained. Cross-sectional observational data were collected. VARK questionnaire was administered to professional students between the age group of 18 and 25 years. 55 unimodal, 56 bimodal, and 36 multimodal students who volunteered for the study performed the TMT consisting of Trial A an index of mental skills and Trial B an index of mental flexibility was measured in time (seconds). TMT composite score (B-A) was used to remove the speed content from the test evaluated, resulting in a more refined index of mental flexibility. Results: Significant differences in visual-motor skills (TRIAL A) and flexibility (TRIAL B) were seen between groups by one-way ANOVA (F [2.144] = 53.8 l, P < 0.001) and (F [2.144] = 69.26 P < 0.001), respectively. Tukey’s post hoc test showed that the visual motor skills was significantly prolonged (P = 0.001) in multimodal students compared to bimodal and unimodal groups and between uni and bimodal groups, while mental flexibility was decreased significantly in multimodals when compared to unimodals. The composite score was statistically significantly different between groups by one-way ANOVA (F [2.144)] = 27.28 P < 0.001) and Tukey’s post hoc test showed that multimodal participants composite score were prolonged compared to unimodal participants (P = 0.001). Conclusion: Visual-motor skills and mental flexibility was significantly prolonged in multimodal compared to unimodal and bimodal learning style.

Learning style preferences of physiology undergraduate students of rural medical college of Maharashtra

Background: A learning style is the process by which a learner takes in, focuses on, understands, and retains information. This concept of learning style has got great interest among educators to recognize learning abilities of their student. It is essential to have knowledge of learning method preferred by students and identify them as, visual learner, kinesthetic learner, or aural or read-write type learner. If the information is delivered to student according to their preferred learning style, their learning would be much enhanced. Thus, as a medical educator, it is our task to assess and teach knowledge, attitudes, and skills considering the student interests. Aim and Objective: The purpose of our study was to determine preferred learning styles of physiology undergraduate students of a rural medical college of Maharashtra, India. Materials and Methods: Visual-aural-read/write-kinesthetic (VARK) questionnaire was given to 100 undergraduate medical students. The distributions of VARK preferences were calculated, and the learning style of each student was determined. Descriptive statistics were used to describe the variables. Results: About 76% of students showed multiple learning styles. Among multimodal learners, bimodal learners 56% were highest, trimodal 19%, and then quadmodal learners. The most preferred combination of learning style among bimodal students were auditory kinesthetic (33%). Conclusion: Physiology undergraduate student prefers multimodal learning styles.

Learning Style Preferences Among Undergraduate Medical Students: An Experience from Different Medical Colleges of Bangladesh

This descriptive type of cross sectional study was conducted to determine the learning styles of undergraduate medical students. The study period was from July 2017 to June 2018. The study was carried out among the students of 2nd, 3rd and 4th phases of MBBS course of 3 government and 4 non-government medical colleges of Bangladesh. Out of 7 medical colleges, 4 were within Dhaka and 3 were from outside Dhaka. The sample size was 1004 students. Medical colleges were selected purposively and convenience sampling technique was adopted for data collection. Bangla translated version Fleming's VARK (visual, auditory, read/write and kinesthetic) questionnaire was used to identify the learning styles of students. The study revealed that out of 1004 medical students, 64.2% preferred multimodal learning styles and rest 35.8% preferred unimodal learning styles. Among unimodal learning preferences, auditory (A) and kinesthetic (K) were the most preferred sensory modalities of learning. Among multimodal learning styles preferences, the combination of auditory &amp; kinesthetic (AK) and auditory, read/write &amp; kinesthetic (ARK) were predominant. There were only significant differences of the mean scores of visual (V) learning style among the male and female students. Majority of students preferred multimodal learning styles. Students are able to learn effectively as long as the teacher provides a blend of visual, auditory, read/writing and kinesthetic activates. The study recommended that teachers should be aware of the medical students' learning styles and aligning teaching-learning methods with learning styles will improve their learning and academic performance.&#x0D; Bangladesh Journal of Medical Education Vol.10(2) 2019: 26-30

Do Learning Styles Influenced by Gender: A Qualitative Study Among Physiology Undergraduate Medical Students

Introduction&#x0D; Current and future trends in medical learning enforce huge burden of mastering a different set of competencies among medical student. Furthermore, the important task in medical education isto provide adequate and satisfactory student learning. Thus, better awareness of learning style preferences and various factors (such as gender) influencing learning styles, can help in delivery of rewarding, satisfying and pleasant learning experience to the students.&#x0D; Aim&#x0D; The study was planned with the aim of assessing the influence of gender on learning style preferences among Undergraduate Medical Students of Physiology.&#x0D; Materials and Method&#x0D; In this cross-sectional study among 100 undergraduate medical students of physiology, Visual, Aural, Read/write and Kinesthetic (VARK) questionnaire version 7.8 was used to collect information of students’ learning style preferences. Descriptive statistics were used to describe the variables. Chi-square test was performed to evaluate the influence of gender on learning style preferences.&#x0D; Results&#x0D; In the study, 82.22%Males and 68.75% females exhibited multiple sensory preferences. Furthermore only 17.77%Male, 31.25% Female, preferred a single sensory modality for receiving information. However gender differences were NOT significant.&#x0D; Conclusion&#x0D; Most students both male and female had preferences for multimodal learning style. Furthermore gender had no significant association with learning style preference.

Learning Styles of Orthopaedic Residents and Their Performance in the Orthopaedic In-Training Examination

This article was migrated. The article was not marked as recommended. The success of a training programme hinges on the performance of their residents. Trainers and learners need to adapt to rapid advancement of medical knowledge and technology coupled with training requirements such as research and duty hour restrictions. An understanding of the learning style preferences may be helpful for both trainers and learners.In this study we evaluated the orthopaedic resident learning styles and hypothesised that the read/write dominant learning styles is associated with better OITE scores.The Fleming VARK learning styles questionnaire was administered to orthopaedic residents at a single centre in 2017. Their OITE scores and yearly faculty review of performance were analysed for association with their learning styles.All residents (n=22) completed the questionnaire. All but one resident had quad-modal preference for learning. 45% of the trainees were kinaesthetic dominant, 32% read/write dominant and 27% visual dominant and 18% aural dominant. Aural dominant learners had highest average OITE scores followed by kinaesthetic dominant learners.Our residents showed multimodal preferred learning style with most of our residents being kinaesthetic dominant. Trainers and learners may consider incorporating a greater number of teaching activities that suit their individual learning styles to enhance their learning efficiency.

Lifelong Learning on the Go: English Language Mobile Learning in China

AbstractAs China is playing an active role in the World's politics, economy, and cultural circles, being able to communicate in English has become one of the basic life and work skills and a key for global access and integration. High mobile technology penetration, together with the proliferation of mobile learning applications, have made it possible for Chinese adult learners to learn English on the go. Mobile technology's core features including portability, instant power‐on, on‐demand, and the ability to accommodate multimodal learning styles and preferences are accounted for to describe mobile learning apps’ affordances for lifelong adult learners’ English learning. Four popular English language learning apps, are compared to illustrate how Chinese lifelong adult learners are learning English on the go.

Analysis of multimodal learning styles in the contemporary medical school.

Analysis of multimodal learning styles in the contemporary medical school.

Do Learning Styles Influenced by Gender: A Qualitative Study Among Physiology Undergraduate Medical Students

Introduction Current and future trends in medical learning enforce huge burden of mastering a different set of competencies among medical student. Furthermore, the important task in medical education isto provide adequate and satisfactory student learning. Thus, better awareness of learning style preferences and various factors (such as gender) influencing learning styles, can help in delivery of rewarding, satisfying and pleasant learning experience to the students. Aim The study was planned with the aim of assessing the influence of gender on learning style preferences among Undergraduate Medical Students of Physiology. Materials and Method In this cross-sectional study among 100 undergraduate medical students of physiology, Visual, Aural, Read/write and Kinesthetic (VARK) questionnaire version 7.8 was used to collect information of students’ learning style preferences. Descriptive statistics were used to describe the variables. Chi-square test was performed to evaluate the influence of gender on learning style preferences. Results In the study, 82.22%Males and 68.75% females exhibited multiple sensory preferences. Furthermore only 17.77%Male, 31.25% Female, preferred a single sensory modality for receiving information. However gender differences were NOT significant. Conclusion Most students both male and female had preferences for multimodal learning style. Furthermore gender had no significant association with learning style preference.

Gamifying design education

Designers are increasingly in demand in a range of context because of their ability to deal with complexity and develop innovative solutions. Educational practice, however, is not yet on par with the multi-disciplinary and multi-modal learning style of today’s students. Gamification offers the promise of an innovative approach to engage students and produce better learning outcomes. The challenges facing gamification designers are parallel to those of experience designers, chiefly in ensuring the solution is contextually and personal relevant to the user. Learning design thinking, however, is a complex social activity influenced by myriad contextual factors. Cultural historical activity theory, when coupled with design-based research, offers a theoretical foundation that allows for gamification to be used for expansive education. The authors present The Four Orders of Gamification and a Gamification Design System that enables design educators to develop expansive curricula for tomorrow’s designers.

Learning style preferences of logistics learners

The VARK model categorises learners as visual (V), aural (A), read/write (R) and kinaesthetic (K). The VARK learning style preference of logistics students has not previously been evaluated. In this study the learning style preferences of logistics final year Diploma students from Tshwane University of Technology were therefore determined. Eighty questionnaires were distributed with 78 being received back, representing a response rate of 97.5 per cent. Of the 78 received back, two could not be used as they were not completed in full, giving 97.4 per cent of useful questionnaires (76 from 78). The dominant learning preference amongst the Logistics III students was a K (kinaesthetic) learning preference (21 out of 76, or 27.6%), followed by R (read/write) learning preference (15 out of 76, or 19.7%). VARK learning preference was third with 10 of 76 (13.2%). In the study 56.6 per cent and 43.4 per cent of the learners preferred unimodal learning and multimodal learning styles respectively.

Determination Of Elementary Students’ Learning Styles Reviewed From Gender Aspects

Students use different styles or ways of receiving and managing information during learning. VARK learning style was developed based on the physiological aspect of students in the form of sensory modalities. This survey research was conducted at 30 elementary schools in Ambon City. The data of student learning was obtained by filling out the learning style questionnaire developed by Fleming. The results showed that 88.7% of students used a learning style (unimodal) and 11.3% of students combined more than one learning style (multimodal). For the unimodal learning styles, kinesthetic is most prevalent in male and female students with a percentage of 58.6%, whereas visuals are least found with a percentage of 6%. The study also revealed that multimodal learning styles were found at all bimodal, trimodal, and quadmodal combinations. The more blend of learning style, hence the frequency of determination of student learning style even less.. The combination of multiple unimodal learning styles with large numbers will result in multimodal learning styles with large numbers.

Does learning style preferences influence academic performance among dental students in Isfahan, Iran?

PurposeThe present study aimed to identify the learning preferences of dental students and to characterize their relationship with academic performance at a dental school in Isfahan, Iran.MethodsThis cross-sectional descriptive study included 200 undergraduate dental students from October to November 2016. Data were collected using a 2-part questionnaire. The first part included demographic data, and the second part was a Persian-language version of the visual, aural, read/write, and kinesthetic questionnaire. Data analysis was conducted with the chi-square test, 1-way analysis of variance, and multiple linear regression.ResultsThe response rate was 86.6%. Approximately half of the students (51.5%) had multimodal learning preferences. Among the unimodal group (48.5%), the most common mode was aural (24.0%), followed by kinesthetic (15.5%), reading-writing (8.0%), and visual (1.0%). There was a significant association between academic performance and the reading/writing learning style preference (P< 0.01).ConclusionMultimodal learning styles were the most preferred. Among single-mode learning styles, the aural style was most common, followed by the kinesthetic style. Students with a reading/writing preference had better academic performance. The results of this study provide useful information for preparing a more problem-based curriculum with active learning strategies.

Learning style preferences of dental students at a single institution in Riyadh, Saudi Arabia, evaluated using the VARK questionnaire.

BackgroundStudents differ in their preferred methods of acquiring, processing, and recalling new information. The aim of this study was to investigate the learning style preferences of undergraduate dental students and examine the influence of gender, Grade Point Average (GPA), and academic year levels on these preferences.MethodsThe Arabic version of the visual, aural, read/write, and kinesthetic (VARK) questionnaire was administered to 491 students from the first- to the fifth-year academic classes at the College of Dentistry, King Saud University. Descriptive statistics were used to characterize the learning styles of the students, and Chi-square test and Fisher’s test were used to compare the learning preferences between genders and among academic years. Significance was set at a p-value of <0.05.ResultsA total of 368 dental students completed the questionnaire. The multimodal learning style was preferred by 63.04% of the respondents, with the remaining 36% having a unimodal style preference. The aural (A) and the kinesthetic (K) styles were the most preferred unimodal styles. The most common style overall was the quadmodal (VARK) style with 23.64% having this preference. These differences did not reach statistical significance (p>0.05). Females were more likely to prefer a bimodal learning style over a unimodal style (relative risk =2.37). Students with a GPA of “C” were less likely to have a bimodal or a quadmodal style preference compared to students with a GPA of “A” (relative risk =0.34 and 0.36, respectively). Second-year students were less likely to prefer a bimodal over a unimodal style compared to first-year students (relative risk =0.34).ConclusionThe quadmodal VARK style is the preferred learning method chosen by dental students, followed by unimodal aural and kinesthetic styles. Gender was found to influence learning style preferences. Students with a “C” GPA tend to prefer unimodal learning style preferences. The VARK questionnaire is a relatively quick and simple tool to reveal the learning style preferences on an individual or a group level. Dental educators should adjust their delivery methods to approximate the learning preferences of their students. Dental students are encouraged to adapt a multimodal style of learning to improve their academic results.

The preferred learning styles utilizing VARK among nursing students with bachelor degrees and associate degrees in China

Abstract Objective This study aimed to determine the differences in learning style preferences among bachelor degree nursing students at Central South University and associate degree nursing students at the Vocational Health School in China. Methods This study was a cross-sectional survey using the Chinese version of the VARK questionnaire to assess preferred learning styles: 159 enrolled bachelor degree nursing students and 199 enrolled associate degree nursing students completed the questionnaire with a response rate of 96.8%. Results The bachelor degree nursing students tend to prefer a multimodal learning style (58.49%), which significantly differed from that of associate degree nursing students (45.77%). The kinaesthetic modality was the predominant unimodal learning style among the bachelor degree and associate degree nursing students (18.20% and 33.67%), and the read-write modality was the least popular modality (2.5% and 4.02%). Conclusion There are both differences and similarities between the learning style preferences of bachelor degree and associate degree nursing students. Educational background is one of the most critical factors that influence the learning style preference of nursing students. This finding may be necessary and beneficial for carrying out future curricula reform. In addition, further comprehensive research should be conducted to examine the relationships between learning style preferences and academic performance, as well as learning style preferences and teaching methods.

Internet-Based Assessment of Oncology Health Care Professional Learning Style and Optimization of Materials for Web-Based Learning: Controlled Trial With Concealed Allocation.

BackgroundPrecision medicine has resulted in increasing complexity in the treatment of cancer. Web-based educational materials can help address the needs of oncology health care professionals seeking to understand up-to-date treatment strategies.ObjectiveThis study aimed to assess learning styles of oncology health care professionals and to determine whether learning style-tailored educational materials lead to enhanced learning.MethodsIn all, 21,465 oncology health care professionals were invited by email to participate in the fully automated, parallel group study. Enrollment and follow-up occurred between July 13 and September 7, 2015. Self-enrolled participants took a learning style survey and were assigned to the intervention or control arm using concealed alternating allocation. Participants in the intervention group viewed educational materials consistent with their preferences for learning (reading, listening, and/or watching); participants in the control group viewed educational materials typical of the My Cancer Genome website. Educational materials covered the topic of treatment of metastatic estrogen receptor-positive (ER+) breast cancer using cyclin-dependent kinases 4/6 (CDK4/6) inhibitors. Participant knowledge was assessed immediately before (pretest), immediately after (posttest), and 2 weeks after (follow-up test) review of the educational materials. Study statisticians were blinded to group assignment.ResultsA total of 751 participants enrolled in the study. Of these, 367 (48.9%) were allocated to the intervention arm and 384 (51.1%) were allocated to the control arm. Of those allocated to the intervention arm, 256 (69.8%) completed all assessments. Of those allocated to the control arm, 296 (77.1%) completed all assessments. An additional 12 participants were deemed ineligible and one withdrew. Of the 552 participants, 438 (79.3%) self-identified as multimodal learners. The intervention arm showed greater improvement in posttest score compared to the control group (0.4 points or 4.0% more improvement on average; P=.004) and a higher follow-up test score than the control group (0.3 points or 3.3% more improvement on average; P=.02).ConclusionsAlthough the study demonstrated more learning with learning style-tailored educational materials, the magnitude of increased learning and the largely multimodal learning styles preferred by the study participants lead us to conclude that future content-creation efforts should focus on multimodal educational materials rather than learning style-tailored content.

Clinical Experience and Learning Style of Flight Nurse and Aeromedical Evacuation Technician Students

The clinical experience and preferred learning style of U.S. Air Force flight nurses and aeromedical evacuation technicians are unknown. Using a cross-sectional survey design, we gathered data regarding the clinical experience, level of comfort providing clinical care, and preferred learning style of 77 active duty (AD), Air Force Reserve (AFR), and Air National Guard (ANG) nurses enrolled in the U.S. Air Force School of Aerospace Medicine Flight Nurse course, and 121 AD, AFR, and ANG medical technicians enrolled in the Aeromedical Evacuation Technician course. Nurses and medical technicians reported 7.6 ± 5.5 and 3.9 ± 4.5 yr of experience, respectively. AD, AFR, and ANG nurses had comparable years of experience: 5.8 ± 3.2, 8.3 ± 6.6, and 7.9 ± 4.2 yr, respectively; however, AD medical technicians had more years of experience (5.6 ± 4.4 yr) than AFR (3.1 ± 4.8 yr) and ANG (1.9 ± 2.8 yr) medical technicians. Both nurses and medical technicians reported infrequently caring for patients with various disease processes and managing equipment or devices that they will routinely encounter when transporting patients as an aeromedical evacuation clinician. Nurses and medical technicians preferred a kinesthetic learning style or a multimodal learning style that included kinesthetic learning. Nearly all (99%) nurses and 97% of medical technicians identified simulation as their preferred teaching method. These findings confirm faculty concerns regarding the clinical experience of flight nurse and aerospace evacuation technician students.De Jong MJ, Dukes SF, Dufour KM, Mortimer DL. Clinical experience and learning style of flight nurse and aeromedical evacuation technician students. Aerosp Med Hum Perform. 2017; 88(1):23-29.