Novice Learners Research Articles

Self-directed learning: A case-study of school students scientific knowledge construction outdoors

Prior findings highlight school students’ low motivation to study science, while 21st-century education aims to achieve their key competencies: scientific literacy and autonomous problem-solving to be prepared for smooth adaption to quickly changing circumstances. Real-life learning scenarios can meet these shortfalls to engage the learners by the knowledge-in-use perspective. This, however, requires that learners have high-level abilities of complex learning. We conducted a case study of outdoor learning with 8th–graders (age 14–15) to foster their scientific thinking addressing a real-life problem hands-on. Although the results showed that students’ conceptual knowledge increased, they also indicate participants’ cognitive taxonomy difficulties. An insight into the cognitive load aspects is given as it may appear in different autonomous learning situations. This work highlights the aspects little discussed so far (1) school students’ varying cognitive skills; (2) difficulties arising from the high cognitive load caused by multitasking, accompanied by the complex learning approach. This raises the questions of how to conduct motivating science lessons, where to practice the multi-component learning skills; and how to foster autonomous learning, where to gain the relevant knowledge without overburdening novice learners.

Difficult Concepts and Practices of Computational Thinking Using Block-based Programming

To help novice learners overcome the obstacles of learning computational thinking (CT) through programming, it is vital to identify difficult CT components. This study aimed to determine the computational concepts and practices that learners may have difficulties acquiring and discuss how programming instructions should be designed to facilitate learning CT in online learning environments. Participants included 92 undergraduate students enrolled in an online course. Data were collected from a CT knowledge test and coding journals. Results revealed that four computational concepts (i.e., parallelism, conditionals, data, and operators) and two computational practices (i.e., testing and debugging and abstracting and modularizing) were identified as CT components that were difficult to learn. The findings of this study imply that CT instructions should offer additional instructional supports to enhance the mastery of difficult computational concepts and practices. Further research is necessary to investigate instructional approaches to successful CT learning.

Does Online Anatomy Course Delivery Improve Visuospatial Ability in Novice Learners?

IntroductionThe study of anatomy can be challenging for students, as complex anatomical and spatial relationships can be difficult to master, particularly in virtual learning environments. Having good visuospatial ability (VSA) can be important for students to have in order to help them understand complex three‐dimensional relationships. There is evidence that learning anatomy in‐person can improve an individual's VSA and that those with higher VSA perform better in anatomy courses. However, no research has explored what effect learning anatomy in a completely virtual environment has on VSA. Thus, the first aim of this study is to determine if there are changes in VSA with online anatomy instruction in novice learners over one semester, and second, to examine if those with higher VSA interact differently with online resources. For our first aim, we hypothesize there will be an overall improvement in VSA over the course of the semester. Our second aim will be analyzed at a later date.MethodsFirst‐year undergraduate anatomy students at the University of Toronto were recruited for this study (n = 253). At the beginning of the semester in September 2021, before learning anatomical content, participants completed the redrawn Vandenberg and Kuse Mental Rotations Test (MRT‐A) which consisted of 24 questions. For the MRT‐A, participants were presented with a target figure and four stimulus figures, where two were a match to the target figure, but had been rotated. If both stimulus figures chosen were correct, one point was rewarded, for a total of 24 points and the full scores calculated out of 100 (24/24). In December 2021, another MRT‐A test will be administered, along with an online questionnaire that will ask students about what type of resources they used throughout the semester and how often they were used. In January 2022, focus groups will be conducted to gain a more in‐depth understanding into which learning tools students found most useful and why, along with how they were being used.ResultsPreliminary results indicate an initial mean score of 35.20 ± 17.54 with a median of 33.33. Students that scored below the median were categorized as low VSA (n = 112) and those who scored above were categorized as high VSA (n = 140). Additionally, the mean of students that identify as male had a mean of 40.55 ± 18.14 (high VSA = 83; low VSA = 39), those who identify as female had a mean of 30.03 ± 29.17 (high VSA = 55; low VSA = 70), and those who identify as non‐binary or chose “Prefer not to say” had a mean of 31.25 ± 17.14 (high VSA = 2; low VSA = 2). There was a significant difference between the mean score for males and females (p<0.001), but not for any other comparison.ConclusionsInitial results appear to be in line with previous research suggesting that males have higher VSA than females. Future analyses will provide a more in‐depth evaluation of overall changes in VSA, gender VSA changes, and the type of resources students engaged with during their online anatomy course. This research may be used as a baseline for further studies exploring course delivery in‐person, mixed, and remote to help instructors create equitable learning environments for students with differing VSA. Additionally, this research will help inform the development of an anatomy learning toolkit that will be used to help leaners develop better spatial reasoning skills.

Novice knowledge of histological eponyms and descriptive terms

IntroductionUse of eponyms in anatomy has been widely debated. Some argue many of these terms are colloquially understood and easy to remember, however student knowledge of these terms is not well documented. To address this, the current study assessed student familiarity with histological eponyms vs. corresponding descriptive terms at the beginning of a histology course at two different institutions and sought student perspectives on the utility of eponyms.Materials and MethodsStudents at Indiana University (IU; n=49) and the University of Western Australia (n=123) completed a quiz consisting of 30 pairs of eponyms and descriptive terms and were asked to select the body system to which each structure belonged, including “I don’t know”. Terms were ranked by perceived difficulty. Inter‐rater reliabilities were calculated using Fleiss’ Kappa, and discrepancies were discussed to consensus. Pairs were compared using chi‐square analysis. Additionally, IU students were encouraged to express their opinions of eponyms in histology after taking the quiz via online discussions. Responses were collected midway through the semester and were analyzed using thematic analysis.ResultsTerm difficulty was moderately agreed upon (κ = .460; p<0.01). Chi‐square analysis found significant differences between 26 eponym/descriptive term pairs (p<0.05 for all). Students were more likely to place descriptive terms (43% correct) in the correct body system over eponyms (23% correct). Furthermore, students were more likely to respond “I don’t know” for an eponym. In the discussions, the majority of IU students felt descriptive terms were more helpful for learning but about half of respondents said eponyms should be taught. Many wanted eponyms taught alongside descriptive terms and wished to choose which term to incorporate into their professional vocabulary. Others didn’t choose a side but felt either debating over terminology detracted from progress on other issues in medical sciences or communication in the medical field could benefit from more consistency (i.e. choosing a single term for each structure, eponym or not). Still others felt that emphasis should be placed on learning combining forms. Some expressed concerns about erasing history; those in support of the removal of eponyms felt those interested in such history could easily find it elsewhere. Overall, students mentioned that taking the course changed their opinion of eponyms in some way.ConclusionThis study indicates that novice learners were more likely to place histological descriptive terms in the correct body system than eponyms. Based on student perspectives, histology students want consistency in the vocabulary they are taught, but also want to choose the terms they use based on what they feel is more memorable. Further work is necessary to determine students’ perceived utility of eponyms and how they best learn histological terminology.Significance/ImplicationThis study found that novice learners in histology were able to correctly place descriptive histological terms over eponyms, which provides evidence that descriptive terms may be easier for students to identify. However, student opinions on the use of eponyms in histology education were split and similar to those voiced by educators.

Eponyms or Descriptive Terms: Perspectives from Allied Health Students

IntroductionThe debate whether to teach anatomical eponyms has lacked data regarding health student knowledge and perceptions. A common argument for retaining eponyms is that they are used regularly in health care. The objectives of this study were to assess the familiarity of allied health students (occupational therapy, OT; physical therapy, PT; physician assistant, PA) with eponyms prior to professional anatomy coursework and understand students’ perceived utility of learning eponyms.MethodsPT, OT, & PA students enrolled in a gross anatomy course (n=125) completed a pre‐course quiz consisting of 30 descriptive terms and corresponding eponyms. Students were asked to select the region of the body to which each structure belonged, including “I don’t know”. Terms were ranked by instructors based on difficulty (easy, medium, hard). Inter‐rater reliabilities were calculated using Fleiss’ Kappa and discrepancies discussed to consensus. Responses were compared by chi‐square analyses. Students also voluntarily completed discussion posts at the course’s beginning and midpoint. The first prompt provided two opposing perspectives on the use of eponyms and asked for student opinions. The second prompt shared quiz results and asked students if they were surprised and their opinions again.ResultsTerm difficulty was fairly agreed upon (κ = .287; p<0.001). Whether a term was eponymous or descriptive significantly influenced responses for 14 of 30 term pairs (p<0.05 for all). Students were more likely to correctly place a descriptive term (77%) than an eponym (38%), and were far more likely to respond “I don’t know” for eponyms (30%) than descriptives (4%). Incorrect and “I don’t know” responses increased with difficulty of eponyms but not of descriptive terms. Students expressed four common opinions: only teach descriptive terms starting immediately, gradually phase out eponyms, include eponyms as supplemental information, or teach both terms. Those against eponyms felt they could better explain structures using descriptive terms. Those in favor wanted to learn eponyms commonly used in their discipline and/or known by patients. However, after learning of the quiz results and reading classmates’ opinions, many changed their minds, with some stating that the quiz revealed many more eponyms with which they were unfamiliar, and they were not opposed to learning the eponyms in another capacity (i.e. clinical experience).ConclusionProfessional health students were better able to place descriptive terms compared to eponyms. Additionally, students were more likely to correctly place descriptive terms for all difficulty levels over corresponding eponyms, indicating novice learners are able to make an educated guess, even for hard descriptive terms. Many, if not all, the students had prior clinical experience as nurses, scribes, and/or emergency response personnel, yet were unable to correctly place many eponyms, contradicting arguments that eponyms are commonly used in health care settings. Generally, students did not feel it was necessary to be taught eponyms in anatomy.SignificanceThis study provides novel data indicating that matriculating health professional students are better able to correctly place descriptive anatomical terms over eponyms.

Explicit Connections Between Anatomy and Clinical Science are Key to Successful Cognitive Integration

IntroductionThe importance of integrated basic and clinical science knowledge is well recognized across the health professions; however, supporting the development of learner’s integrated knowledge in day‐to‐day teaching continues to be an educational challenge. A number of experimental studies show that learners can benefit when instruction is designed to support to support cognitive integration. This type of integration occurs at the individual session‐level and can be contrasted with integration efforts that occur within the curriculum. To date, there remains limited research on specific strategies that educators can use to support learners in achieving cognitive integration during individual teaching sessions. In a series of studies, we examine the relative impact of integrating anatomy and clinical science instruction with different learning strategies on novices learning diagnosis of musculoskeletal (MSK) pathologies.MethodsIn each study, novice learners were taught four MSK upper limb pathologies using different instructional approaches (integrated anatomy and clinical science, segregated anatomy and clinical science, or clinical science only) combined with additional learning strategies (focused self‐explanation, feature counting, holistic self‐explanation, or worked‐examples). Integrated instruction involved explicitly teaching the underlying causal mechanisms for the signs and symptoms associated with each MSK pathology, whereas no explicit linkages were provided in the segregated or clinical science only learning conditions. Immediately after learning and one‐week later, learners completed a diagnostic accuracy test.ResultsThe findings of these studies showed that novices who learned the MSK pathologies using integrated instructional materials developed superior diagnostic abilities compared to those in the segregated or clinical science only learning groups (p < 0.05). Further, learners who also engaged in holistic self‐explanation while learning with integrated instructional materials scored higher on the diagnostic accuracy test compared those who simply read through worked‐examples that highlighted the underlying anatomical pathology associated with each MSK condition (p < 0.05). Accuracy on the holistic self‐explanation task was also positively correlated with learners diagnostic scores one‐week after initial learning (r = 0.457).ConclusionsOur findings demonstrate the value of providing explicit connections between anatomy and clinical science in supporting deep learning in novices. This research also highlights the value of designing instruction that supports cognitive integration and demonstrates that one to maximize learning of anatomy is to use it as a tool to help learners more effectively understand and organize clinical concepts. Further, our findings suggest that learning strategies that emphasize the explicit connections between anatomy and clinical science in a holistic way, hold the potential to support the development of learners’ conceptual knowledge.

Automated versus manual B-lines counting, left ventricular outflow tract velocity time integral and inferior vena cava collapsibility index in COVID-19 patients.

ABSTRACTBackground and Aims:The incorporation of artificial intelligence (AI) in point-of-care ultrasound (POCUS) has become a very useful tool to quickly assess cardiorespiratory function in coronavirus disease (COVID)-19 patients. The objective of this study was to test the agreement between manual and automated B-lines counting, left ventricular outflow tract velocity time integral (LVOT-VTI) and inferior vena cava collapsibility index (IVC-CI) in suspected or confirmed COVID-19 patients using AI integrated POCUS. In addition, we investigated the inter-observer, intra-observer variability and reliability of assessment of echocardiographic parameters using AI by a novice.Methods:Two experienced sonographers in POCUS and one novice learner independently and consecutively performed ultrasound assessment of B-lines counting, LVOT-VTI and IVC-CI in 83 suspected and confirmed COVID-19 cases which included both manual and AI methods.Results:Agreement between automated and manual assessment of LVOT-VTI, and IVC-CI were excellent [intraclass correlation coefficient (ICC) 0.98, P < 0.001]. Intra-observer reliability and inter-observer reliability of these parameters were excellent [ICC 0.96-0.99, P < 0.001]. Moreover, agreement between novice and experts using AI for LVOT-VTI and IVC-CI assessment was also excellent [ICC 0.95-0.97, P < 0.001]. However, correlation and intra-observer reliability between automated and manual B-lines counting was moderate [(ICC) 0.52-0.53, P < 0.001] and [ICC 0.56-0.69, P < 0.001], respectively. Inter-observer reliability was good [ICC 0.79-0.87, P < 0.001]. Agreement of B-lines counting between novice and experts using AI was weak [ICC 0.18, P < 0.001].Conclusion:AI-guided assessment of LVOT-VTI, IVC-CI and B-lines counting is reliable and consistent with manual assessment in COVID-19 patients. Novices can reliably estimate LVOT-VTI and IVC-CI using AI software in COVID-19 patients.

Common Errors Identification in Pronouncing Silent Letters in English Words by EFL Novices

In English, the sound system is somewhat distinct from Arabic. Yemeni Novices have many difficulties pronouncing English terms owing to this. For example, we often hear English learners pronounce "sight [sait]" with "[saig]" or "know,” [nəʊ]" with "[knəʊ]." This study is concerned with identifying widespread errors in the pronunciation of silent letters in English words among Yemeni EFL learners. Qualitative descriptive study was used in this investigation as a methodology. With the aid of purposive sampling techniques, a sample of 5 EFL novices was selected from 1st level of the English Department, Faculty of Education, Sana'a University, Yemen, which was classified into a group of novice high-level learners (beginners). Analytically descriptive method was used to analyze the data after they were collected through test. The result of this study showed that in pronouncing words containing the silent letters like b, c, d, g, gh, h, k, l, m, n, p, s, t, th, and w, the researcher finds errors made by the EFL novices. He analyzes three positions of the silent letters in the words (initial, medial, and final position) and by understanding this; it would be possible to develop useful instructional materials and teaching strategies to target this issue.

Whether to flip Extreme Apprenticeship: which is more effective in programming instruction?

Programming knowledge is more important than ever in the digital world. However, teaching programming can be challenging, especially with novice learners. Considerable research has been conducted into the most effective methods for teaching programming. Extreme apprenticeship, a variation of cognitive apprenticeship, is a method that has been used in teaching programming at university level in recent years. Because this method focuses particularly on completing lots of exercises with coaching and guidance, it may solve many problems related to learning programming. Flipped learning can be useful for student preparedness and providing sufficient theoretical knowledge at the beginning of the course. This study compares the applications of the extreme apprenticeship method, flipped extreme apprenticeship, and traditional classroom, analyzing them at the university level in terms of their effects on academic achievement and engagement coupled with gender differences. The findings of the study indicate that the extreme apprenticeship and flipped extreme apprenticeship instructional methods improve academic achievement and student engagement in introductory programming more than the traditional method. The results of the research point to important directions for the development of the extreme apprenticeship method in programming instruction and provide a guide for instructors.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10639-022-11055-y.

Face-to-face versus distance learning of basic suturing skills in novice learners: a quantitative prospective randomized trial

Background and aimTraditionally, practical skills are taught on face-to-face (F-F) basis. COVID-19 pandemic brought distance learning (DL) to the spotlight because of the social distancing mandates. We sought to determine the acceptability and effectiveness of DL of basic suturing in novice learners.MethodsA prospective randomized controlled trial involving 118 students was conducted. Participants were randomized into two groups for learning simple interrupted suturing: F-F and DL-groups. Evaluation was conducted by two assessors using a performance checklist and a global rating tool. Agreement between the assessors was calculated, and performance scores of the participants were compared. Participants’ satisfaction was assessed via a questionnaire.ResultsFifty-nine students were randomized to the F-F group and 59 to the DL-group. Satisfactory agreement between the assessors was demonstrated. All participants were successful in placing three interrupted sutures, with no significant difference in the performance between the groups. 25(44.6%) of the respondents in the DL-group provided negative comments related to the difficulties of remotely learning visuospatial concepts, 16(28.5%) preferred the F-F approach.ConclusionDL of basic suturing is as effective as the F-F approach in novice learners. It is acceptable by the students despite the challenges related to the remote learning of practical skills.

Artificial Intelligence-Augmented Pediatric Lung POCUS: A Pilot Study of Novice Learners.

Respiratory symptoms are among the most common chief complaints of pediatric patients in the emergency department (ED). Point-of-care ultrasound (POCUS) outperforms conventional chest X-ray and is user-dependent, which can be challenging to novice ultrasound (US) users. We introduce a novel concept using artificial intelligence (AI)-enhanced pleural sweep to generate complete panoramic views of the lungs, and then assess its accuracy among novice learners (NLs) to identify pneumonia. Previously healthy 0- to 17-year-old patients presenting to a pediatric ED with cardiopulmonary chief complaint were recruited. NLs received a 1-hour training on traditional lung POCUS and the AI-assisted software. Two POCUS-trained experts interpreted the images, which served as the criterion standard. Both expert and learner groups were blinded to each other's interpretation, patient data, and outcomes. Kappa was used to determine agreement between POCUS expert interpretations. Seven NLs, with limited to no prior POCUS experience, completed examinations on 32 patients. The average patient age was 5.53 years (±1.07). The median scan time of 7 minutes (minimum-maximum 3-43; interquartile 8). Three (8.8%) patients were diagnosed with pneumonia by criterion standard. Sensitivity, specificity, and accuracy for NLs AI-augmented interpretation were 66.7% (confidence interval [CI] 9.4-99.1%), 96.5% (CI 82.2-99.9%), and 93.7% (CI 79.1-99.2%). The average image quality rating was 2.94 (±0.16) out of 5 across all lung fields. Interrater reliability between expert sonographers was high with a kappa coefficient of 0.8. This study shows that AI-augmented lung US for diagnosing pneumonia has the potential to increase accuracy and efficiency.

Facilitating reflection: a review and synthesis of the factors enabling effective facilitation of reflective practice

ABSTRACT Reflective practice is an inherently personal and relational process, occurring privately within people, and publicly, between people. Consequently, given it positively impacts on professional practice, it has become a personal and professional requirement for professional bodies accrediting practitioners. This literature synthesis aims to consolidate understanding around the factors facilitating reflection by generating insights from a variety of publications across professional contexts. The analytical process involved initial coding and focussed coding wherein article text was fragmented, sorted, and integrated to develop a thematic structure. Analysis resulted in two higher order themes: Factors facilitating reflection; and Facilitator tasks. Results highlighted the value of supportive environments to facilitate open enquiry alongside focussed formal dialogues between peers, more experienced colleagues, and formal facilitators to enrich knowledge, perspectives, insights, and relationships. Further, to begin the reflective process, practitioners and novice learners benefit from support in deconstructing the concept of reflection. Ideally, this would be facilitated by an experienced reflective facilitator who values an open enquiry towards complexity, difference, and emotive responses. This requires safe, supportive, and blame-free environments where facilitators encourage dialogue while modelling qualities such as congruence, acceptance, and empathy.

The Effects of Self-Regulated Learning Support on Learners’ Task Performance and Cognitive Load in Computer Programing

This study explores the effect of self-regulated learning support on learners’ cognitive load and problem-solving performance, considering cases from well-structured to ill-structured tasks in a computer programing course. Sixty-seven undergraduate students in a computer programing fundamentals course were randomly assigned into one of two groups: (1) experimental group ( N = 34; received self-regulated learning support) and (2) control group ( N = 33). Participants in both groups were asked to solve programing problems using Python over 3 weeks, and their cognitive load levels were measured after each week. The results showed that novice learners’ self-regulated learning skills can be influenced by learning support, which contributes to solving complex problems. The results also suggest that, given the sequence of tasks (i.e., basic and advanced well-structured and ill-structured problems), self-regulated learning support may require time to be effective. The germane load of the experimental group was higher for well-structured problems than that of the control group. Using logistic regression, the two groups were differentiated through different variables measured in this study, which showed a high predictive explanatory power. The results provide implications for designing self-regulated learning support for programing courses, using problem-based learning in association with problem-solving skills, self-regulated learning skills, and cognitive load management.

Identification of Effective Scaffolding to Novices Using CBLE

Abstract: The aim of this study is to discover which kind of scaffolding can effectively promote learning. The past studies have shown mixed results in this regard. The process in which a domain expert gives and withdraws support in order to make a novice learner complete the task is known as scaffolding. A total of four distinct scaffold combinations and four groups were made. This experimental study was repeated twice to cross verify the outcomes using computer based learning environment (CBLE). The CBLE was designed with intelligent web program in PHP and jQuery to evaluate the solutions submitted by the learners instantly. The CBLE acted as an intelligent feedback system. In the first study, it was found that there was a significant effect of different scaffolding treatments on the learning outcomes, F (3,76) = 5.762, p=.001. The result analysis involves multiple comparisons based on Tukey HSD test and indicated that the mean score for the indirect support and adaptive fading (M=4.45, SD=1.191) was considerably different than the others. Likewise, second study also found that there was a significant effect of different scaffold treatments on the learning outcome, F (3,76) = 4.258, p=.008. The Tukey HSD test applied during the second study indicated that the mean score for the indirect support and adaptive fading (M=4.55, SD=1.19) was again significantly different than the others. The present study additionally measured the flow state of all the four groups using Kruskal-Wallis H test and found that indirect support and adaptive fading group was significantly different than direct support and adapting fading group as well as direct support and gradual fading group in both the studies. Keywords:Computer Based Learning Environment (CBLE),

Evaluation of Preclinical Task Based Learning program in Medical Education.

The conventional curriculum in preclinical medical education has a need for early clinical exposure programs that help in correlation of basic science data with clinical skills. This is helpful to develop clinical reasoning skills, problem-solving abilities, team work, communication skills and overall attitudes and behaviour relevant for a healthcare provider. Preclinical task based learning (TskBL) is an active learning strategy in which the focus for the first year medical student is a real task done by a doctor. In this strategy the student-doctors undergo a standardized patient encounter and discuss the learning issues related to the task in the first year of medical school. The current study is focussed on the student perception of the effectiveness of task based learning module.The TskBL was conducted among first year medical students for nine topics that are commonly encountered in the clinics. After TskBL was planned and implemented the evaluation of the modules was done using focus group discussions. The students highlighted the importance of standardized patients in the TskBL strategy in providing early clinical exposure in preclinical medical education. They reported its usefulness gaining essential knowledge, skills and attitudes for medical learning. They reported positive outcomes of module design and processes and activities in TskBL. Based on the negative aspects of the modules, future improvement was suggested in improving the usefulness of standardized patient encounter. This study showed the novice learners' outlook of the potency of TskBL for several other topics of clinical relevance to provide early clinical exposure in medical schools.

HELP-DKT: an interpretable cognitive model of how students learn programming based on deep knowledge tracing

Student cognitive models are playing an essential role in intelligent online tutoring for programming courses. These models capture students’ learning interactions and store them in the form of a set of binary responses, thereby failing to utilize rich educational information in the learning process. Moreover, the recent development of these models has been focused on improving the prediction performance and tended to adopt deep neural networks in building the end-to-end prediction frameworks. Although this approach can provide an improved prediction performance, it may also cause difficulties in interpreting the student’s learning status, which is crucial for providing personalized educational feedback. To address this problem, this paper provides an interpretable cognitive model named HELP-DKT, which can infer how students learn programming based on deep knowledge tracing. HELP-DKT has two major advantages. First, it implements a feature-rich input layer, where the raw codes of students are encoded to vector representations, and the error classifications as concept indicators are incorporated. Second, it can infer meaningful estimation of student abilities while reliably predicting future performance. The experiments confirm that HELP-DKT can achieve good prediction performance and present reasonable interpretability of student skills improvement. In practice, HELP-DKT can personalize the learning experience of novice learners.

Design for learning programming

Programming recently became mandatory in Swedish compulsory schools (age group 7-16); this article contributes to our understanding of novice learners’ different approaches when programming. The study builds on observations and informal conversations during programming lessons at three Swedish science centres. At the time of the study, science centres already had experience of programming education as they offered courses for pupils. This was used as a complement to teaching at compulsory school. We apply a design-for-learning perspective to help us understand how contextual aspects influence what novice pupils do and how they design their learning during programming lessons. During the analysis process, we combine thematic analysis with the Learning Design Sequence (LDS) model. We identify five qualitatively different approaches that pupils take to solve programming problems: mathematically, trial and error, step-by-step, routine as well as aesthetic. Each of these approaches allows pupils to use and practice different abilities that are important for programming. We discuss how these abilities can be compared to computational thinking (CT). The study provides an insight how pupils are involved in designing their own learning when using their abilities to solve programming assignments.

Autonomy and focus of attention in medical motor skills learning: a randomized experiment

BackgroundThe ‘OPTIMAL’ (Optimizing Performance Through Intrinsic Motivation and Attention for Learning) theory of motor learning suggests that autonomy, external focus of attention, and perceived competence can improve learning of simple motor tasks. The authors hypothesized that enhanced (vs. routine) autonomy and external (vs. internal) focus of attention would improve first-try performance of two medical motor tasks.MethodsThe authors conducted a randomized two-by-two factorial design study with high school students as participants. Task instructions promoted either enhanced or routine autonomy, and either external or internal focus of attention. These conditions were replicated in a crossover design for two common medical tasks (chest compressions on a manikin and a Fundamentals of Laparoscopic Surgery peg transfer task). Primary outcomes were objective measures of task performance (chest compression deviation from target depth; peg transfer time with penalties for errors). Secondary outcomes included subjective perceptions of confidence, autonomy, and workload.ResultsOne hundred thirty-three high school students participated in this study. The primary outcomes concerning enhanced vs. routine autonomy demonstrated no statistically significant difference in either task (chest compression depth deviation: difference -0.7 mm [score range 0 to 37.5 mm]; 95% confidence interval (CI95) -3.85, 2.41; p = .65; peg transfer penalized time: rate ratio 1.03; CI95 0.91, 1.31; p = .79). The authors likewise found no statistically significant difference for external vs. internal focus of attention (depth deviation: difference 1.1 mm; CI95 -2.04, 4.17; p = .50; penalized time: rate ratio 0.89; CI95 0.75, 1.13; p = .33). The authors found no statistically significant differences for either comparison in confidence, autonomy and workload (p > .09; differences ranged from -0.83 to 0.79 [scale range 0 to 10]).ConclusionsFirst-try performance of chest compressions and peg transfer by novice learners is not significantly affected by enhanced (vs. routine) autonomy or external (vs. internal) focus of attention.

Simulation in neonatal care: towards a change in traditional training?

Simulation has traditionally been used in neonatal medicine for educational purposes which include training of novice learners, maintaining competency of health care providers, and training of multidisciplinary teams to handle crisis situations such as neonatal resuscitation. Current guidelines recommend the use of simulation as an education tool in neonatal practice. The place of simulation-based education has gradually expanded, including in limited resource settings, and is starting to show its impact on improving patient outcomes on a global basis. Over the past years, simulation has become a cornerstone in clinical settings with the goal of establishing high quality, safe, reliable systems. The aim of this review is to describe neonatal simulation training as an effective tool to improve quality of care and patient outcomes, and to encourage the use of simulation-based training in the neonatal intensive care unit (NICU) for not only education, but equally for team building, risk management and quality improvement.Conclusion: Simulation is a promising tool to improve patient safety, team performance, and ultimately patient outcomes, but scarcity of data on clinically relevant outcomes makes it difficult to estimate its real impact. The integration of simulation into the clinical reality with a goal of establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes in neonatology must be a priority.What is Known:• Simulation-based education has traditionally focused on procedural and technical skills.• Simulation-based training is effective in teaching non-technical skills such as communication, leadership, and teamwork, and is recommended in neonatal resuscitation.What is New:• There is emerging evidence for the impact of simulation-based training on patient outcomes in neonatal care, but data on clinically relevant outcomes are scarce.• Simulation is a promising tool for establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes.

Evaluating Virtual Patient Interaction Fidelity With Advanced Communication Skills Learners

Previous research in educational medical simulation has drawn attention to the interplay between a simulation’s fidelity and its educational effectiveness. As virtual patients (VPs) are increasingly used in medical simulations for education purposes, a focus on the relationship between virtual patients’ fidelity and educational effectiveness should also be investigated. In this paper, we contribute to this investigation by evaluating the use of a virtual patient selection interface (in which learners interact with a virtual patient via a set of pre-defined choices) with advanced medical communication skills learners. To this end, we integrated virtual patient interviews into a graduate-level course for speech-language therapists over the course of 2 years. In the first cohort, students interacted with three VPs using only a chat interface. In the second cohort, students used both a chat interface and a selection interface to interact with the VPs. Our results suggest that these advanced learners view the selection interfaces as more appropriate for novice learners and that their communication behavior was not significantly affected by using the selection interface. Based on these results, we suggest that selection interfaces may be more appropriate for novice communication skills learners, but for applications in which selection interfaces are to be used with advanced learners, additional design research may be needed to best target these interfaces to advanced learners.