About one-third of U.S. youth are overweight and most have at least one risk factor that increases their chance of developing cardiovascular or other chronic diseases. School- and research-based physical activity and healthy eating programs can reduce obesity and improve health outcomes; however, schools face many implementation challenges. Healthy School Recognized Campus (HSRC) bundles school- and researched-based programs to improve their implementation and student health outcomes. This paper describes the protocol for a hybrid type 2 implementation-effectiveness, cluster dual randomized controlled trial that evaluates the (aim 1) effectiveness of the HSRC initiative for improving health behaviors and (aim 2) the impact of an implementation strategy - school-to-school mentoring - on HSRC's delivery. Students in 4th through 9th grade (n = 500) at public schools (n = 20) across East and Central Texas will be randomized at the school level to determine the effectiveness of HSRC (vs. waitlist control condition) on BMI z-score (primary outcome), physical activity measured via accelerometer, and skin carotenoids (i.e., fruit and vegetable intake; secondary outcomes). Assessments will occur at the start and end of one school year. Program implementers (n = 200) at schools will be randomized to assess the impact of the school-to-school mentoring strategy (vs. standard implementation) on HSRC's acceptability, appropriateness, and feasibility (co-primary outcomes). Assessments will occur at the start, middle, and end of one school year. The assessment at the end of the school year will also include a concurrent mixed-methods approach (QUAL + QUAN), guided by the Consolidated Framework for Implementation Research (CFIR), to evaluate the school-to-school mentoring strategy. For quantitative outcomes, a generalized linear model framework will be used to evaluate HSRC and the school-to-school mentoring strategy. This study's innovative dual randomized design allows for rigorous assessment of HSRC on effectiveness outcomes and the evaluation of a school-to-school mentoring implementation strategy on implementation outcomes. If both HSRC and the school-to-school mentoring strategy have their hypothesized effect, we will be well positioned to address cardiovascular and other chronic disease risk factors among youth using a scalable, widely used approach within one of the largest health educator networks in the country. Clinicaltrials.gov on July 1, 2025 (NCT07079995).

Education plays a pivotal role in shaping the intellectual, emotional, and social development of students. The central to this process is the teacher, whose personal beliefs about education, instructional approaches, and overall performance have significant implications for student outcomes. The study was administered during the School Year 2024-2025. The respondents were the Grade V teachers from five schools. Respondents were given a modified questionnaire. The study used correlational and causal research designs to collect, classify, and evaluate data, including statistical tools such as Mean, Standard Deviation, and Pearson Product Moment Correlation Coefficient and Multiple Linear Regression. The findings revealed that constructivism educational philosophy is very high among teachers. Integration is also very high as their teaching pedagogy. There is a moderate to strong positive correlation between teacher’s educational philosophy and teaching pedagogy and constructivism influences teaching pedagogy. Thus, constructivism and integration are associated with one another. It is suggested that teachers integrate lessons in actual life situation to be more effective in teaching.

Background and purpose Social workers in dental education champion the inclusion of social drivers of health and advocate for the needs of vulnerable communities using anti-oppressive, psychosocial-cultural, and systems approaches. However, despite these significant contributions, social workers’ unique roles and impact in these settings remain underexplored. This study examines these professionals’ role in advancing health equity in dental education settings. Methods An explanatory sequential mixed methods design was used to explore the role and integration of social work in oral health settings. Data were collected from the Social Work in Dentistry (SWID) group, a national peer network of social workers who work in oral health settings. In the study’s first phase, quantitative data were collected via survey methods ( N = 11) on their role. In the second phase of the study, one-time semi-structured interviews ( N = 6) were conducted to gain a deeper understanding of participants’ perceptions of their roles, and their contributions to health equity. Mixed methods integration occurred in developing the semi-structured interview guide from the survey results and the analysis phase. Results Social workers have multifaceted roles in dental education. Their roles included direct clinical practice (81.8%), patient care coordination (81.8%), dental education (90.9%), and supervising social work practicums (81.8%). When describing how their role contributes to health equity, the main themes that emerged were: (1) Increased access to dental care and community resources for patients, (2) educating the future dental workforce to address social drivers of health, and (3) influencing a new dental culture of practice. Conclusions and implications This study highlights the unique perspectives and skills that social workers bring to oral health. In oral health, social workers play a dynamic role, engaging in cross-system collaborations that enhance patient and student outcomes. The findings demonstrate that these professionals, in collaboration with dental providers, can play a significant role in promoting health equity, leading to improved care delivery and outcomes for communities. Furthermore, integrating social workers into oral health settings shapes a new generation of dental providers better equipped to address patients’ psychosocial needs and deliver collaborative, person-centered care.

This study aims to: 1) to test whether there is an influence of the application of the Student Teams Achivement Division (STAD) type cooperative learning model; 2) to find out how much influence the application of the Student Teams Achivement Divisions (STAD) type cooperative learning model assisted by Mind Mapping media on the learning outcomes of IPAS in grade V students of SDN 29 Singkawang; 3) To measure whether there is an increase in IPAS learning outcomes through the application of a cooperative learning model of the Student Teams Achivement Divisions (STAD) type with the help of Mind Mapping media , there are IPAS learning outcomes in grade V students of SDN 29 Singkawang. The research used was an experimental research with a One group pretest-postes design. The population in this study is grade V students of SDN 29 Singkawang. The sampling technique in this study is total sampling. The prerequisite test used is a normality test using excel. A significance level of 5% (0.05) was for the first hypothesis test using the wilcoxon test, to test the second hypothesis using the effect size test, and to test the third hypothesis using the N-Gain test. The results of the study showed that: 1) there was an influence of the Student Teams Achivement Division type cooperative learning model assisted by Mind mapping media on the learning outcomes of social studies students. This is evidenced by the results of the wilcoxon test , which is a score of 22.06, while the value is 1.96 thus; 2) there is a great influence on the use of a cooperative learning model of the Student Teams Achivement Division type assisted by Mind mapping media. This is evidenced by the results of the effect size test obtained a value of 1.91 so that it shows that the Student Teams Achivement Division (STAD) type cooperative learning model assisted by Mind mapping media has a high effect on student learning outcomes; 3) there is an increase in social studies learning outcomes through the application of the Student Teams Achivemnt Division (STAD) type cooperative learning model assisted by mediaMind mapping. This is evidenced by the results of the N-Gain test obtained at 0.51 so that it is in the medium category with a percentage of 51%.

Case-based learning (CBL) has been adopted internationally, although there is significant heterogeneity in implementation and delivery. It is unclear how this pedagogical approach is experienced across contexts, among different groups of students, and the important aspects of implementation. The aim of this study was to understand the mechanisms that enable CBL to facilitate learning in undergraduate health professions education, for whom and in what contexts. A realist review was adopted to explore the literature on CBL. Initial programme theories were derived from the CBL literature and based on adult learning theory and inquiry-based learning. 5731 abstracts investigating CBL in undergraduate HPE courses were screened in duplicate. 436 full-text papers were screened and assessed for rigour and relevance, resulting in 25 papers suitable for inclusion in the final analysis. Seven programme theories were developed from our review. Institutional, implementation and student-level factors were found to impact outcomes such as exam performance, participation and clinical reasoning. A lack of institutional support and recognition of faculty contribution to CBL results in poorer learning outcomes. Clinical facilitators promote student engagement, and authentic multimodal cases afford students the opportunity to step into their future roles. When assessment focuses solely on behaviours and teamwork is not fostered, negative group dynamics may result. Our realist review provides insight for healthcare educators on how best to implement CBL to optimise academic, skill and behavioural outcomes for undergraduate students. Fostering student trust in learning through access to clinician facilitators and authentic cases leads to improved learning outcomes. Recognition of faculty and student efforts to contribute to CBL is essential for successful implementation. The facilitation of a safe and secure group learning environment is required for students to meaningfully engage with CBL.

This study examined associations between special education services and academic and behavioral outcomes for students identified with learning disabilities (LD) using statewide data from Indiana covering kindergarten through eighth grade. Results from student fixed-effects models indicate that special education services are associated with higher achievement in math and English language arts, but also with increased school disciplinary incidents, including suspensions and expulsions, and higher numbers of absences. These associations differ across student subgroups, including gender, race/ethnicity, eligibility for free or reduced-price lunch, and English language learner status. The findings underscore the complex nature of special education services, highlighting heterogeneous patterns across both outcomes and student subgroups.

ABSTRACT This paper examines the role of professional development in early childhood education (ECE), with a focus on the Kid Writing (KW) approach, a literacy development approach designed to support young children’s writing. The KW approach utilizes a coaching model where external literacy coaches collaborate closely with preschool teachers to model and scaffold the KW strategies, providing personalized- support. This ongoing coaching model allows teachers to reflect on their practices and integrate new strategies into their teaching, which research suggests is crucial for improving instructional quality and student outcomes. Data for this study were collected over three years from five preschool centers in a northeastern urban district, involving 27 lead and assistant teachers. The data included classroom observations, focus groups with teachers and literacy coaches, and field notes from leadership meetings. Data analysis involved a thematic analysis of focus group discussions and observational field notes. The findings demonstrate that the KW coaching model offered ongoing, tailored support that significantly enhances teacher efficacy, fosters reflective practices, and helps teachers implement new strategies in the classroom. Results suggest that combining coaching with mentoring provides a comprehensive framework for teacher development.

BackgroundThe present study aimed to (1) develop a digital game focusing on the roles of surgical nurses (scrub and circulator nurses) in laparoscopic surgeries, (2) conduct a randomized controlled trial (RCT) comparing this digital game-based learning (GBL) approach with a conventional teaching method, and (3) assess students’ reasoning and user satisfaction.MethodThis randomized controlled trial (RCT) was conducted at Shahid Sadoughi University of Medical Sciences. The study comprised three phases: development of the digital game titled ‘Co-Surgeon,’ implementation of the educational interventions, and evaluation of outcomes. The digital game aimed to enhance students’ understanding of laparoscopic surgeries and the specific roles of surgical nurses (circulator and scrub), focusing on tasks such as task recognition, laparoscopic instrument identification and utilization, procedural steps, and the development of clinical reasoning for selecting appropriate tools during common laparoscopic procedures. Fifty-seven surgical nursing students were randomly assigned to either an intervention group, which utilized digital game-based learning, or a control group, which received conventional lecture-based education. The digital GBL application included 40 distinct laparoscopic tools and equipment organized into 8 categories, 8 puzzles related to surgical nurse roles in abdominal laparoscopic surgeries, 15 Mayo stand setups, and 60 instrument identification puzzles. User satisfaction was measured via the Questionnaire for User Interface Satisfaction (QUIS), and students’ reasoning was assessed through the Key Feature (KF) examination. Data were summarized using descriptive statistics (mean, standard deviation, and percentage). Pearson correlation coefficient, independent t-test, and paired t-test were used for data analysis.ResultsThe mean (SD) scores of students’ reasoning in the intervention group (19.51 ± 3.36) were significantly higher than those in the control group (13.92 ± 4.15). (p < 0.001), with a large educational effect size reported (Partial eta squared = 0.35). Student perception scores indicated a good level of satisfaction (184.85 ± 6.79).ConclusionThe diverse and complex responsibilities of surgical nurses make it essential to enhance the learning outcomes for surgical nursing students. Implementing digital game-based learning can positively impact these outcomes. Therefore, it is recommended to incorporate digital games as a supplement in clinical education and workplace-based training.

Student engagement is a key predictor of academic achievement and retention in higher education. This study investigated the impact of personalised behavioural nudges, delivered through structured phone calls and supported by personalised email/Microsoft Teams messaging, on student engagement with a Learning Management System (LMS) and academic outcomes among 192 at-risk STEM undergraduates identified by initial low LMS activity. Students received up to five phone call nudges from an academic buddy, weekly, over an eight-week period, coupled with personalised email/MS Teams follow-ups, designed to provide informational and relational support. Results showed a significant improvement in LMS engagement (p &lt; 0.01) among students who responded to at least one phone call nudge compared to non-responders. Although LMS engagement was not significantly associated with module outcomes within the sample, academic outcomes, measured by module results, improved for students who engaged with the nudges; improvements were statistically significant for those who responded to two, three, and five phone call nudges (p &lt; 0.05) compared to non-responders, with the highest gains observed in the five (highest nr. nudges) response group. Content analysis of student feedback highlighted four themes: Valuing Supportive Journeying with an Academic Buddy, Improved Academic Engagement, Motivation Triggered by Intervention, and wider Challenges. Findings suggest that while an initial personalised telephone call can enhance student engagement with their studies, achieving measurable academic success requires sustained intervention. This study underscores the value of relationally grounded nudges in promoting success among at-risk students.

This study investigates foreign EFL teachers’ perceptions, instructional practices, and challenges in implementing Teaching Proficiency through Reading and Storytelling (TPRS) in Thailand, where communicative language learning is increasingly prioritized. Utilizing a mixed-methods design, the research compares teachers who have received formal TPRS training with those without such training. Findings indicate that both groups recognize the method’s benefits for vocabulary acquisition, listening comprehension, and student engagement but perceive its impact on grammar, pronunciation, and speaking fluency as more limited. Trained teachers reported greater confidence in applying TPRS, attributing this to structured professional development, whereas untrained teachers relied on self-guided adaptation and frequently reported uncertainty. Common challenges, including large class sizes, student reluctance to participate, and time constraints, were expressed by both groups; however, trained teachers employed more systematic strategies to address these issues. While both groups underscored the value of formal TPRS training, untrained teachers cited limited access to such programs. These findings underscore the urgent need for accessible, contextually responsive training to support foreign EFL teachers within communicative learning environments. The study contributes to ongoing discussions on optimizing TPRS for EFL instruction and recommends future research into the long-term effects of training on teacher efficacy and student outcomes in non-English-speaking contexts.

Large language models, also known as artificial intelligence (AI) models, have become more sophisticated and pervasive in recent years. AI models have many uses and can help nursing faculty in their complex roles. Current literature addresses AI model uses, guidelines, benefits, and challenges for nursing education. However, most literature focuses on the teaching role, with few authors providing guidance for using AI models during quality improvement (QI) activities. These faculty responsibilities are critical yet difficult and could be aided by AI models. However, faculty need guidance to use AI models effectively for these initiatives. Using available literature and author expertise, this article provides guidance for faculty when completing QI and accreditation-related activities, including AI model cautions, ways to maximize output, and approaches for use. AI models have the potential to help faculty modernize nursing education as they enhance program monitoring, quality, and student outcomes.

Point-of-care ultrasound (POCUS) is increasingly used by internal medicine physicians to improve diagnostic accuracy and clinical outcomes. Despite its value, POCUS is not widely integrated into undergraduate medical education, particularly during the core internal medicine clerkship, due to barriers such as limited faculty expertise and institutional resources. We evaluated a 2-week internal medicine POCUS elective for fourth-year medical students, offered from 2020 to 2023 at Saint Louis University School of Medicine, as a potential model for integration into the internal medicine clerkship. Designed and facilitated by a single faculty member, the elective included formal didactic sessions, faculty-led scanning using ultrasound simulators and standardised patients, as well as self-directed reading and online modules. Student outcomes were assessed through pre- and post-course knowledge assessments and self-reported confidence surveys. Between 2020 and 2023, 23 students completed the elective. Average knowledge assessment scores increased from 58.8% pre-course to 91.8% post-course, representing a 33% improvement (p < 0.0001). All 12 students who completed the confidence survey reported that the elective increased their knowledge and understanding of POCUS. Although initially designed for fourth-year medical students, this POCUS elective provided knowledge and hands-on skills relevant to internal medicine. Its flexible format and low faculty burden suggest it may serve as a scalable model for incorporation into core internal medicine clerkships, including at institutions with limited POCUS-trained faculty or resources.

This study aims to determine the effectiveness of the implementation of cooperative learning methods on learning outcomes and students' understanding of Islamic Religious Education (IRE) subjects for Class VIII at MT Hubbul Wathon Sangatta Selatan. This study uses a quantitative method with a quasi-experimental research type using a non-equivalent control group design. The study population was 48 students of class VIII A and VIII B, with a sample size of 44 students, each class consisting of 22 students from the experimental class and the control class. Data collection techniques were carried out through tests (pre- and post-tests), observation, and recording. Data analysis used descriptive statistics, normality tests, homogeneity tests, N-Gain tests, and hypothesis tests (t-tests). The results showed that the average learning outcomes of students in the experimental class increased from 61.14% in the previous class to 84.09% in the next class, while in the control class increased from 63.41% to 77.73%. The results of the normality test showed that the data were normally distributed and the homogeneity test showed that the variances of the two groups were identical. The t-test results showed a significance value of 0.000 &lt; 0.05, so it can be concluded that there is a significant difference between the experimental class and the control class. Thus, the cooperative learning method has a positive and effective effect in improving student learning outcomes and understanding in the Islamic Religious Education subject for Class VIII MT Hubbul Wathon Sangatta Selatan.

ABSTRACT This study explores the paradoxical effects of interactive AI tools on university students’ academic performance. Although technologies such as chatbots and virtual assistants are designed to enhance learning through personalised experiences, inadequate integration into curricula may lead to adverse outcomes. Grounded in the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2), this research examines determinants of students’ behavioural intention to use AI tools and their subsequent impact on academic achievement. Data collected from 407 students across Spanish and French universities reveal that performance expectancy, social influence, hedonic motivation, price value, and habit significantly predict intention to use, whereas effort expectancy and facilitating conditions do not. Importantly, actual usage of these tools shows a statistically significant negative association with academic performance, suggesting that unstructured adoption can be counterproductive. These findings underscore the need for institutional strategies to ensure pedagogically sound integration of AI technologies. While students perceive AI as a means to improve outcomes, improper use may result in lower grades. The study offers critical implications for higher education, highlighting the necessity of balancing technological innovation with effective instructional design to maximise learning benefits.

This study aims to compare the effectiveness of the use of interactive learning multimedia and presentation media on the learning outcomes of Geography of Senior High School students. This study uses a quantitative approach with a quasi-experimental method and a Nonequivalent Control Group Design. The subjects of the study were students of grade XI Phase F of SMA Negeri 1 Batipuh consisting of two classes, namely the experimental class using interactive learning multimedia and the control class using conventional presentation media. The research instrument was a multiple-choice objective test that had been tested for validity, reliability, difficulty level, and discrimination power. Learning outcome data were analyzed using a t-test. The results showed that the average learning outcome of students in the experimental class was 80.16, while the control class was 75.94. The results of the hypothesis test showed a t-value of 2.247 greater than the t-table of 1.999 at a significance level of 0.05. Thus, it can be concluded that interactive learning multimedia is more effective than presentation media in improving the learning outcomes of Senior High School students in Geography.

This study aims to develop Android-based interactive multimedia in Distributor Less Ignition System (DLI) learning to improve student learning outcomes. The research method used is research and development with the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. The research population included all students of class XI of SMK Muhammadiyah Bligo, with a purposive sampling technique involving two classes totaling 70 students. Data collection instruments include learning outcome tests and student response questionnaires. The results of the media feasibility test showed that the assessment by media experts was 88% and by material experts by 90%, both of which were in the "very feasible" category. The implementation was carried out in two classes, namely the experimental class that uses Android-based interactive multimedia, and the control class that uses conventional methods. The results of the t-test (independent sample t-test) showed a value of sig. (2-tailed) = 0.001 (p &lt; 0.05), which means that there is a significant difference between the learning outcomes of students in the experimental class (mean = 86.7) and the control class (mean = 74.3). Educators' and learners' responses to multimedia use received scores of 92% and 91%, respectively, in the "very feasible" category. Based on these findings, it can be concluded that Android-based interactive multimedia developed using Lectora Inspire software has proven to be effective and feasible to be used as a learning medium to improve students' learning outcomes on the basic competencies of the DLI ignition system in vocational high schools.

Professional experience placements are a requirement for undergraduate nursing students enabling real world skill development. Barriers to meaningful and positive placements have previously been reported, however there is limited research on how the location of placement impacts the student experience and outcomes. This study investigates the placement experiences of undergraduate nursing students at the University of Tasmania (UTAS) over a five-year period, with a focus on urban versus rural settings and year-level differences. Findings reveal that over one-third of students reported constructive placement experiences, with rural placements yielding slightly more positive outcomes than urban ones. First-year students were more likely to report constructive experiences compared to their senior counterparts, suggesting that longer placement durations may contribute to increased dissatisfaction. Quality of placement—defined by supervision and skill development—emerged as the most influential factor in shaping student experiences. While most students praised the quality of supervision, third-year students expressed both the highest praise and criticism. Opportunities for clinical and interpersonal skill development were central to students’ perceptions of placement quality, with rural placements slightly outperforming urban in skill development. However, some students, particularly in later years, felt that certain venues lacked adequate opportunities for skill acquisition. The study underscores the importance of high-quality supervision and appropriate clinical settings in enhancing placement experiences and suggests that constructive placements are more conducive to learning. These insights can inform strategies to improve the educational value of nursing placements across diverse settings.

Artificial intelligence (AI) tools, such as customized chatbots, present an opportunity to enhance active learning in physician assistant (PA) education. This study evaluated student perceptions and outcomes associated with incorporating an AI chatbot designed to promote self-directed learning, retrieval practice, and individualized feedback within a didactic clinical medicine course. Faculty developed a course-specific chatbot (GPT-4o, OpenAI) integrated with lecture materials, open-access medical texts, and sample PANCE-style questions. The chatbot generated customized multiple-choice questions and provided tutoring functions for targeted remediation. Utilization data ("impressions") were collected across modules, and students completed an anonymous Qualtrics survey assessing perceptions of usefulness and engagement. Quantitative data were analyzed descriptively, and qualitative responses underwent thematic analysis. Sixty-three of 70 eligible students (90%) completed at least one survey item. Nearly all respondents (95%) used the chatbot, and 95% agreed or strongly agreed that it improved examination preparation and information retention. Most students identified practice questions and individualized feedback as the most beneficial features of the chatbot. Student use of AI increased significantly over the course, and qualitative analysis revealed themes of enhanced active recall, self-assessment, and confidence. Faculty noted reduced time demands for tutoring and quiz creation following initial tool development. Integration of a customized AI chatbot within PA education promoted active learning, self-efficacy, and AI literacy while ultimately reducing faculty workload. Early exposure to AI-based tools may not only enhance student readiness for didactic and summative assessments but also cultivate the skills necessary to use similar technologies effectively and responsibly in clinical practice.

Ample research investigates returns to teacher preparation and other instructional inputs for the general student population, yet evidence is lacking for students with disabilities (SWDs). This study uses North Carolina data to estimate achievement returns to teacher preparation by classroom type and level of classroom support for SWDs. The findings show that SWDs perform better when placed in integrated classrooms and when these classrooms have co-teachers. Regardless of classroom type, SWDs benefit from more experienced teachers, but only gain from special education certified teachers in certain classroom configurations. These results indicate that education leaders can optimize resource allocation by reducing reliance on separate classrooms for SWDs, investing in an experienced teacher workforce supported by co-teachers, and aligning certification requirements and training more closely with the diverse needs of SWDs.

This study examined the relationships among educators’ self-efficacy, psychological well-being, and instructional practices among teachers in the Province of Antique for the year 2025. Specifically, it sought to determine the extent of teachers’ self-efficacy in classroom management, lesson planning, and student engagement; assess their psychological well-being in emotional, social, and professional domains; evaluate the effectiveness of instructional practices; identify differences based on teacher profile variables; and examine the relationships among the key variables of the study. A descriptive-correlational research design was employed, involving 290 randomly selected teachers from public secondary schools as respondents. Data were gathered through a researcher-developed questionnaire that was expert-validated and pilot-tested for reliability. Statistical analyses included frequency, percentage, mean, t-test, ANOVA, and Pearson r correlation, all tested at a 0.05 level of significance. The findings revealed that teachers demonstrated a high level of self-efficacy, with a mean of 4.32, particularly in classroom management, lesson planning, and student engagement. Psychological well-being was likewise rated high, with an overall mean of 4.28, indicating positive emotional, social, and professional functioning among teachers. Instructional practices were also found to be highly evident, with a mean of 4.30, reflecting the frequent use of student-centered approaches, differentiated instruction, and effective assessment strategies. Significant differences in self-efficacy and instructional practices were observed when teachers were grouped according to educational attainment and teaching experience, while no significant differences were noted based on sex or school level. Correlation analysis revealed positive and significant relationships among self-efficacy, psychological well-being, and instructional practices, suggesting that teachers who are confident and psychologically healthy are more likely to implement effective instructional strategies. The study highlights the vital role of teacher confidence and well-being in strengthening instructional effectiveness and recommends the implementation of professional development initiatives, well-being support programs, mentoring systems, and continuous monitoring to enhance teaching quality and improve student outcomes.