Retention Scores Research Articles

Effect of blended learning approach on secondary school learners’ mathematics achievement and retention

AbstractThe study investigated how blended learning affected secondary school students’ achievement and retention in mathematics. The study used a non-equivalent control group pre-test-post-test quasi-experimental design. The participants in the study were learners drawn from two secondary schools purposively chosen. Using a simple random sampling technique, the SS 1 classes from each school were then divided into experimental and control groups. Learners in the experimental group utilised the blended learning approach, whereas those in the control group utilized the conventional method. The groups received a pretest in week 1, followed by a 4-week intervention period. A posttest was administered in week 6, and a retention test (post-post-test) occurred 4 weeks after the posttest. The Mathematics Achievement Test (MAT), which has a reliability score of 0.86, was used for data collection. Data were analysed and the study questions were reported using the mean and standard deviation, and the hypotheses were tested using analysis of covariance. Results revealed that learners tutored mathematics utilising blended learning improved their mathematics achievement and retention scores more than learners tutored utilising the conventional means. Results indicated no significant gender disparity in the mean achievement scores of learners tutored mathematics utilising blended learning. Results also showed a significant gender difference in the mean retention scores of learners who learnt mathematics using blended learning, favouring female students. Based on the findings, recommendations were made.

The Effects of Learning Style-Based Differentiated Instructional Activities on Academic Achievement and Learning Retention in the Social Studies Course

Today, individuals should adapt themselves to the rapidly changing and developing information age and have learning skills. It is only possible by adopting new approaches and strategies instead of traditional teaching methods and techniques. Different learning and teaching approaches are characterized by various methods and designs, such as differentiated instruction. The primary purpose of differentiated instruction is to employ teaching activities depending on students’ learning styles and interests. This study aimed to determine the effect of learning style-based differentiated instructional activities on 4th-grade students’ academic achievement and learning retention in the social studies course. This study draws attention to the differences between differentiated teaching activities based on learning style and traditional teaching practices and proposes practical solutions for effective social studies teaching. In this study used a quasi-experimental model with pretest-posttest control group designs. The study group consisted of 62 4th-grade primary school students. The experimental group completed learning style-based differentiated instructional activities in the study, while traditional teaching methods were used in the control group. The data were collected with an academic achievement test and interview forms developed by the researchers. The quantitative data were analyzed using arithmetic means, frequency, independent group t-test, and dependent group t-test, and the qualitative data obtained from interviews were examined using descriptive and content analysis approaches. A significant difference was found in the experimental group students’ academic achievement in the social studies course, in which learning style-based differentiated instructional activities were applied. There was a significant difference in the retention scores between the experimental group, in which learning style-based differentiated instructional activities were applied, and the control group, in which the traditional teaching methods were preferred. The difference was in favor of the experimental group. Learning style-based differentiated instructional activities allowed students to participate in the activities actively, facilitated classroom management, and offered an entertaining and well-prepared learning atmosphere where individual differences and learning paces are welcomed. The teacher-centered teaching approach based on traditional methods and the direct transfer of information to students should be replaced with student-centered approaches responsive to learning styles, individual differences, interests, and potentials. Social Studies Course Curriculum and educational materials should be enriched with differentiated instructional activities. Social Studies Course Curriculum and materials (e.g., textbooks, lesson plans, and printed materials) should be enriched with differentiated instructional activities.

Nurturing Childhood Curiosity to Enhance Learning: Evidence from a Randomized Pedagogical Intervention

We evaluate a pedagogical intervention aimed at improving learning in elementary school children by fostering their curiosity. We test the effectiveness of the pedagogy using achievement scores and a novel measure of curiosity. The latter involves creating a sense of information deprivation and quantifying the urge to acquire information and retention ability. The intervention increases curiosity, knowledge retention, and science test scores, with the effects persisting into middle school years. It also leads to more information sharing and peer learning in the classroom. The evidence can help design better pedagogical tools to increase pupil engagement and the quality of learning. (JEL D83, I21, I26, J13, O15)

A four-cohort study testing the relative impact of take-home and in-class examination on students’ academic performance and wellbeing

The current study examines the relative impact of take home (open book) examinations (THE) and in class (closed book) examinations (ICE) on student academic performance and wellbeing outcomes. Specifically, this study contributes to our understanding about students’ long-term knowledge retention, measured four to six months after completing the course. A unique longitudinal dataset consisting of four cohorts of a social science bachelor and master course that implemented either a THE or ICE in successive years was used. Survey data included wellbeing and academic performance measures as well as a 10-item knowledge retention quiz. Within the master course, the ICE cohort had higher examination grades and higher knowledge retention scores than the cohorts that completed a THE. In the bachelor course, there were no differences in knowledge retention across cohorts. Examination score was associated with higher knowledge retention scores across both courses. One bachelor cohort reported lower wellbeing compared to others (cohort 2021–2022); however, we found no further differences in academic or wellbeing outcomes based on examination form. The findings suggest a slight advantage of ICEs over THEs with regard to academic performance.

The effect of spaced learning on the learning outcome and retention of nurse anesthesia students: a randomized-controlled study

BackgroundPoor learning and retention are common problems of students, which may be alleviated by optimization of widely used educational methods such as lectures. This study aimed to investigate the effect of spaced learning on the learning outcome and retention of nurse anesthesia students.MethodsThis was a randomized controlled study with a pre-and post-test design on 64 nurse anesthesia students who were divided into two groups of spaced lecture (n = 32) and conventional lecture (n = 32). The spaced lectures included three 30-minute training sessions with 10-minute intervals while the conventional sessions including 90 min of continuous training. Students’ knowledge was measured using one valid and reliable questionnaire developed by the research team. All students in both groups took a pre-test, and their level of knowledge acquisition was evaluated immediately after the training. Their level of knowledge retention was tested two and four weeks after the lecture.ResultsThere was no significant difference between the two groups regarding demographic characteristics (p > 0.05). In the pre-test, the mean score of knowledge in the intervention group was lower than that in the control group, there was no significant difference (p = 0.177). But after the intervention, the mean scores of learning outcome and retention in the intervention group were significantly higher than those in the control group (p < 0.001, eta = 0.576). Also, the results showed that learning outcome and retention across the three academic semesters in the two groups are significantly different, and students with a higher academic semester obtained a significantly higher mean score of knowledge and retention (p < 0.001, eta = 0.604).ConclusionSpaced learning improves nurse anesthesia students’ knowledge and retention more than conventional method. Future studies focusing on spaced learning should specifically examine the impact of duration and number of intervals, as well as the time gap between training and measurement of learning retention.

Increasing the realism of on-screen embodied instructors creates more looking but less learning.

Although adding embodied instructors on the screen is considered an effective way to improve online multimedia learning, its effectiveness is still controversial. The level of realism of embodied on-screen instructors may be an influencing factor, but it is unclear how it affects multimedia learning. We explored whether and how embodied on-screen instructors rendered with different levels of realism in multimedia lessons affect learning process and learning outcomes. We recruited 125 college students as participants. Students learned about neural transmission in an online multimedia lesson that included a real human, cartoon human, cartoon animal or no instructor. Students learning with cartoon human or cartoon animal instructors tended to fixate more on the relevant portions of the screen and performed better on retention and transfer tests than no instructor group. The real human group fixated more on the instructor, fixated less on the relevant portion of the screen and performed worse on a retention test in comparison to the cartoon human group. Fixation time on the instructor fully mediated the relationship between instructor realism and retention score. The addition of embodied on-screen instructors can promote multimedia learning, but the promotion effect would be better if the embodied instructor was a cartoon animal or cartoon human rather than a real human. This suggests an important boundary condition in which less realism of on-screen embodied instructors produces better learning processes and outcomes.

161 Effects of Sericea Lespedeza Supplementation on Steers Grazing Wild-Type Endophyte-Infected Tall Fescue

Abstract Fescue toxicosis poses a significant challenge to the United States beef industry, resulting in considerable economic losses. This syndrome arises from the consumption of tall fescue (Schedonorus arundinaceous) infected with the wild-type endophyte (WE; Epichloe coenophiala), which produces toxic alkaloids. The most effective solution for mitigating fescue toxicosis is renovating WE tall fescue pastures to novel endophyte-infected (NE) tall fescue. However, pasture renovation is costly and may not be feasible under certain conditions, with the economic profitability taking up to 3 yr. While the potential of condensed tannins (CTs) in specific leguminous forages to reduce the absorption of toxic alkaloids is recognized, their use as supplements remains underexplored. This study aims were to investigate the potential of CT-containing feed supplements, specifically sericea lespedeza (Lespedeza cuneata) pellets, in reducing the post-ingestive effects of fescue toxicosis in steers. Over two summers,12 steers were assigned to either Schedonorus arundinaceous (LES) or LES mixed with polyethylene glycol (LES + PEG) as a positive control for 12 wk. Body weight, hair retention score, rectal and extremities temperatures, cortisol concentrations, and lumen area of caudal arteries were collected at 4-wk intervals. Data were analyzed using a mixed-effect ANOVA test in SAS Studio 3.5. Steers on the LES diet exhibited significantly less (P &amp;lt; 0.05) hair retention scores compared with those on the LES + PEG diet. In 2021, steers on the LES diet showed greater (P = 0.0101) ADG, while in 2022, there was no difference (P = 0.9916) in ADG between the treatments. Steers on the LES diet displayed greater (P = 0.0332) tail skin temperatures and decreased (P &amp;lt; 0.0001) rectal temperatures compared with those on the LES + PEG diet. Hair cortisol concentrations were greater (P &amp;lt; 0.05) in steers on the LES + PEG diet than in those on the LES diet. Additionally, steers supplemented with the LES + PEG diet showed a 21.2% smaller caudal artery lumen area compared with those on the LES diet (P &amp;lt; 0.01). These findings underscore the potential of CTs in reducing the post-ingestive effects of fescue toxicosis. However, further research is needed to explore the complex mechanisms underlying these effects, establish the long-term efficacy of such interventions, and extend the investigation to include a broader range of physiological parameters affecting livestock health and performance.

Traditional Lecture Versus Procedural Video Randomized Trial: Comparative Analysis of Instructional Methods for Teaching Baclofen Pump Management.

This study compared the effectiveness of traditional lectures and microvideos in teaching baclofen pump programming and refilling to physicians who have completed less than 10 refills for the previous 2 yrs. A mixed-method approach was used with 60 participating physicians specializing in physical medicine and rehabilitation or pain management. Preintervention and postintervention assessments were conducted using a rubric, and the participants' perceptions and preferences were gathered through focus group sessions. Two thirds of the participants specialized in physical medicine and rehabilitation. No significant differences in the preintervention, postintervention, or knowledge retention scores were found between the traditional lecture and microvideo groups. Both methods demonstrated comparable effectiveness in improving the baclofen pump refilling and programming skills. Qualitatively, participants perceived both approaches as equally helpful, but those in the microvideo group raised concerns because of instructors' unavailability and online platform navigation. Nevertheless, they preferred the convenience, accessibility, and time efficiency of the microvideos. The study concluded that microvideos are an effective alternative to traditional lectures for acquiring knowledge on baclofen pump programming and refilling. Further research should consider learners' characteristics and investigate the benefits of blended learning in medical education.

The Preliminary Development of a Friction-Based Lateral Screw-Retained Dental Crown—A Comparison between the Prototype Surface Treatment and the Retention Strength

This study aims to develop a novel retention method combining the retrievability of the screw retention method with the ideal occlusal table and the aesthetic capability of cement retention. Coping was developed to have lateral screw access, allowing the screw to lock the coping using lateral forces from screw tightening and friction between the tip of the screw and the sandblasted surface of an abutment. Sandblasting parameters varied based on particle size. The results show a positive correlation to surface roughness and indicate a positive correlation to retention force. The highest surface roughness and retention force result was shown by groups that were sandblasted using 686 μm of aluminum oxide. Experiments on the tightening strength of 48 subjects measured in simulated conditions similar to the assembly conditions of lateral screw retention implants resulted in a mean of 69.75 Nmm with the highest and lowest values of 120.67 Nmm and 34.67 Nmm. This result became the basis of tightening torque variation. Each group’s retention capability is measured and compared to cement-retained dental implants. The results show that the tightening torque correlates positively with retention force, with the highest average retention score showed by lateral screws retained under a tightening torque of 200 Nmm—317.87 N higher than cement-retained screws.

Evaluation of Imaging Findings in Patients with Pretransplant and Posttransplant Tertiary Hyperparathyroidism.

Tertiary hyperparathyroidism, characterized by autonomous overproduction of parathyroid hormone, can be seen in patients with long-standing secondary hyperparathyroidism (pretransplant) or after renal transplant (posttransplant). Parathyroid scintigraphy and ultrasonography are the most commonly used imaging procedures for the preoperative localization of abnormal parathyroid glands. We aimed to evaluate imaging findings in pretransplant and posttransplant tertiary hyperparathyroidism. This study included 32 patients with pretransplant tertiary hyperparathyroidism and 20 patients with posttransplant tertiary hyperparathyroidism. On parathyroid scintigraphy with technetium-99m sestamibi, early-phase and latephase images were acquired. Images were evaluated for the presence and the number of active foci and the degree of uptake on the late-phase image. The existence of an autonomous gland was based on latephase retention and was scored from 0 to 2 (retention score). On ultrasonography, the criteria threshold for autonomy was the maximum length of the largest gland ≥10 mm (ultrasonography score). On parathyroid scintigraphy, the most commonly observed pattern in the pretransplant group was positivity in ≥3 glands, and in the posttransplant group the most commonly observed pattern was positivity in 1 to 2 glands. In pretransplant and posttransplant groups, the criteria threshold for the presence of an autonomous parathyroid gland on parathyroid scintigraphy (grade 2 retention) was met in 26 (81%) and 9 (45%) patients and on ultrasonography in 25 (78%) and 10 (50%) patients, respectively. In the whole group of patients (n = 52), correlation existed between ultrasonography score and retention score. Glandular weight was correlated with both retention score and ultrasonography score. Higher numbers of detectable glands and the presence of parathyroid autonomy were more common in the pretransplant group. This might be explained by parathyroid gland involution after transplant. The results may also suggest that factors other than autonomy are responsible for posttransplant tertiary hyperparathyroidism.

Effectiveness of Team-based Learning Methodology in Improving Learning Outcomes Among 2nd-year Undergraduate Medical Students in Pathology

Abstract Introduction: Team-based learning (TBL) is a student-centric teaching–learning (TL) method and fosters active learning. TBL has an advantage over other small group TL methods for balancing teaching time and resources. Aim: The study aimed to determine the effectiveness of TBL methodology in improving learning outcomes among 2nd-year undergraduate medical students in pathology. Settings and Design: This was a quantitative interventional study involving 100 2nd-year MBBS students in pathology at AIMS, BG Nagara. Methodology: Two groups of 50 students were exposed to three TBL and case-based learning (CBL) sessions on similar topics. For the TBL session, individual readiness assurance test scores and team readiness assurance test scores were obtained. Statistical Analysis Used: For both the TBL and CBL sessions, retention test scores were obtained after 2 weeks and the effectiveness of two methods of learning was determined by comparing the retention test scores by independent Student’s t-test. Feedback on students’ perception of TBL was obtained using a five-point Likert scale. Results: The mean test score of the TBL session was significantly higher than that of CBL sessions (19.80 vs. 15.86, P &lt; 0.0001). Similarly, it was also observed that the retention scores were higher among average performers after the TBL session (19.71 vs. 12.50, P &lt; 0.0002). Conclusion: TBL is more effective than CBL in fostering learning and it selectively benefits average performers more than higher performers, evidenced in this study by better retention of knowledge.

The feasibility of workload monitoring among law enforcement officers: A multi-methodological approach

This study examined the feasibility of workload monitoring to assess internal workload in law enforcement officers (LEO) using a multi-methodological approach. Fifty front-line LEO completed workload surveys on workdays for eight weeks. Retention and adherence were assessed across the survey period. LEO completed usability and likelihood to continue questionnaires, while departmental administrators (n = 8) received workload reports and completed utility and sustainability questionnaires. A subsample of LEO and administrators participated in semi-structured interviews, following consensual qualitative research design. LEO retention (96%), survey adherence (94%), and usability scores (88.3/100) were high, with a moderate likelihood to continue to use the survey. Administration reported high utility and sustainability. The high adherence rates and usability scores, coupled with strong administrative support, suggest that workload monitoring may be a feasible strategy among LEO to monitor occupational workloads. The LEO and administration feedback highlight areas of improvement (e.g., data transparency, departmental collaboration) to inform future implementation.

Impact of Heuristic Approach on Students’ Academic Achievement and Retention in Map Reading and Interpretation Among Secondary Schools, Municipal Zones, Kano-Nigeria

This study explores the impact of employing a heuristic approach on students’ academic achievement and retention in geography education. The sample consisted of 235 SS II students enrolled in public secondary schools in the Municipal Education Zone, Kano, Nigeria. The study utilized a quasi-experimental design, with two schools assigned to the experimental group (heuristic approach) and two schools assigned to the control group (lecture method). The Geography Achievement Test (GAT) was used as the data collection instrument. ANCOVA was used to test the hypothesis using SPSS and the findings revealed a significant difference in the mean academic achievements between students taught geography concepts using the heuristic approach and those taught using the lecture method. The experimental group exhibited higher academic achievement compared to the control group, indicating that the use of the heuristic approach enhances students’ understanding and performance in geography. Also, there was a significant difference in the mean retention scores of male and female students when taught geography using the heuristic approach. Female students achieved higher retention scores than their male counterparts, suggesting that the heuristic approach is particularly effective in facilitating knowledge retention for female students in geography education. Based on the findings, it is recommended that educators and curriculum developers incorporate the heuristic approach into teaching methods for geography concepts. Training programs and workshops can be conducted to familiarize teachers with effective strategies for implementing the heuristic approach in their lessons.

Jigsaw, Think-Pair-Share and Coop-Coop Cooperative Instructional Strategies and Retention of Students’ Knowledge in Carbohydrate

Purpose: This paper aims to compare the effects of Jigsaw, Think-pair-share, and Coop-Coop Cooperative Instructional Strategies on the retention of students' knowledge in Carbohydrate in Jalingo metropolis, Taraba State, Nigeria. Methodology: The study employed a quasi-experimental non-randomized pre-test, post-test design. The study population comprised 1936 students in all 41 public secondary schools in Jalingo metropolis, Taraba State, Nigeria. The sample consisted of 322 students (males = 184, females = 138) drawn from the population. An Achievement Test in Carbohydrate (ATC), consisting of 50 multiple-choice questions, was used to collect data for the study. The reliability index of the ATC was estimated using Kuder-Richardson (K-20) and yielded a value of .86. Both descriptive statistics, including Mean and standard deviation, and inferential statistics, such as Analysis of Covariance, were adopted for the analysis. Findings: Findings revealed that students taught carbohydrates using Jigsaw retained knowledge more than their counterparts taught using think-pair-share and coop-coop cooperative instructional strategies. Significance: There was no significant difference between the mean retention scores of male and female students taught carbohydrates using Jigsaw, Think-pair-share, and Coop–Coop Cooperative Instructional Strategies. The interaction effects between instructional strategies and gender on retention were not statistically significant. Among other recommendations, it was suggested that there is a need for an urgent workshop to address the use of Jigsaw to teach organic concepts and operations to enable chemistry teachers to deploy it appropriately.

Mathematical Literacy of Middle School Students Improving Awareness Levels: Design-Based A Research

Design-based research develops practical solutions to complex real-life challenges through reasoning to improve students' mathematical literacy achievement levels and mathematical literacy awareness levels. In this context, this method was used to determine the needs of the students and to see whether the applications made in line with their deficiencies worked or not, thus to observe that the system worked and their mathematical literacy improved. Working with the real world in the design-based research method provides formal evaluation beyond narrow measurements in reaching research results of contextual learning. This research was designed according to a design-based research model in order to improve the mathematical literacy success levels and mathematical literacy awareness levels of secondary school students. The study group consists of 43 sixth grade students in Dörtyol district of Hatay province in the 2018-2019 academic year, according to the criterion sampling type, one of the purposeful sampling types. Mathematics literacy achievement test and mathematics literacy self-efficacy scale (MOÖYÖ) were used as data collection tools in the study. Descriptive statistics, ANOVA, and independent groups t test were applied in the analysis of quantitative data. According to the quantitative results of the research, students received low scores in the preliminary achievement test, but their intermediate success, final success and retention scores increased; It was concluded that mathematical literacy (ML) scores also increased positively.

Effect of Flipped Classroom Approach on Chemistry Students’ Academic Achievement and Retention in Colleges of Education, Yobe State, Nigeria

This study investigated the effects of flipped classroom approach on Chemistry students’ academic achievement and retention in colleges of education, Yobe State Nigeria. Le Vygotsky’s theory provided the theoritical framework for the study. Two research questions and two hypotheses were formulated to guide the study. A pretest-posttest and postposttest control group quasi-experimental research design was employed in the study. The population of the study comprised of 524 NCE II Chemisty students from two colleges of education in Yobe State. Purposive and simple random sampling techniques were used to select 106 NCE II chemistry students. The experimental group (N=44) were taught redox concepts using flipped classroom approach while the control group (N=62) were taught the same redox concepts using lecture method of teaching. Redox Concept Achievement Test (RECAT) was the instrument used for data collection which was validated and tested for reliability. Mean and Standard Deviation were used to answer the research questions and the hypotheses were tested using independent sample T-test at 0.05 level of significance using SPSS software. The findings of the study revealed that the students taught redox concepts using flipped classroom approach have significantly higher academic achievement and retention scores than those who were taught using lecture method of teaching. Based on the findings, it was recommended among others that Chemistry lecturers/teachers should adopt the use of flipped classroom approach because it is a student-centered learning strategy that improves students’ academic performance.

Cosmetic Breast Augmentation with Autologous Ex Vivo-Expanded Adipose-Derived Mesenchymal Stem/Stromal Cell (Stemform®)-Enriched Fat Grafts: A Study of the First Twenty-Two Real-World Patients

BackgroundFat grafting is commonly utilized in breast surgery, and since it was first described, clinicians and researchers have stridden towards improvement of graft retention. Current advancements include adding adipose-derived mesenchymal stem/stromal cells (MSC(AT)s), which have demonstrated promise for improved graft retention.ObjectivesThis study reports outcomes for the first twenty-two patients undergoing breast augmentation (Stemform BA) or artificial implant replacement (Stemform AIR) with MSC(AT)-enriched fat in a real-world setting.MethodsAutologous MSC(AT)s were isolated and expanded ex vivo, then mixed with lipoaspirate and injected as enriched fat for Stemform BA and AIR. The breast volume was measured preoperatively and at 3 and 12 months postoperative using a 3D Infinity Dual-Lens Camera and LifeVizApp software. Additionally, independent plastic surgeons evaluated clinical images, and patient satisfaction was obtained at equal time points.ResultsTwenty-two patients were included. All completed 3 and 12 months clinical follow-up and 3 months volume measurements. Nineteen patients completed 12 months volume measurements. The median fat graft retention at 12 months was 95.7% (IQR = 82.44–103.12%) for Stemform BA patients and 113.0% (IQR = 94.8–131.2%) for Stemform AIR patients. The Stemform BA patients had a median breast enlargement of 172.0% (IQR = 156.7–241.0%). The implant replacement volume of Stemform AIR patients was 102% (IQR = 85.1–130.3%). The patient reported 92.8% and 100% would elect to repeat treatment if they had the opportunity for Stemform BA and Stemform AIR, respectively.ConclusionBreast augmentation and breast implant replacement patients receiving ex vivo-expanded MSC(AT)-enriched fat grafts had high graft retention and patient satisfaction scores. The paper confirms the clinical efficacy of using ex vivo-expanded MSC(AT)s.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Instructor's direct gaze not body orientation affects learning

AbstractBackgroundLittle is known about the effectiveness of instructors when presenting content in videos alone. In recent years, researchers have increasingly begun to explore the effects of instructors' social cues (e.g., eye gaze, body orientation, etc.) on learning. However, previous studies exploring the effects of eye gaze have confounded the role of body orientation, while studies exploring body orientation have confounded the role of eye gaze.ObjectivesTo explore the role of direct gaze and body orientation in learning with instructional videos, absent an instructional screen, in a less confounded manner.MethodsA total of 63 subjects were presented select concepts regarding schizophrenia. Eye‐tracking technology combined with current theories of parasocial interaction and social agency was used to explore different social cues that affect learning performance. Students were randomly assigned to one of three experimental conditions: frontal body + direct gaze group (FD group), frontal body + no direct gaze group (FND group), and lateral body + no direct gaze group (LND group).Result and ConclusionsDirect gaze facilitated students' immediate retention and transfer scores, reduced learners' extraneous cognitive load, and guided students' attention to the instructor. However, counter to our expectations, parasocial interaction did not affect social cues.ImplicationsIn both online and offline classes, instruction is expected to be enhanced by focusing on the camera to the extent possible, particularly when instructional screens are absent.

From tradition to innovation: a comparison of the traditional 4-step approach versus a blended learning modification for technical skills teaching

BackgroundThis experimental study was performed to evaluate the role of blended learning for technical skill teaching on the European Trauma Course (ETC). While online modules are extensively used for theoretical teaching, their role in skills training remains less well explored. The ETC currently relies on the established 4-step technique for teaching technical skills. However, the required large cohort of skilled instructors and the time intensity prove increasingly challenging in a current climate of staff shortages and funding constraints. This study assesses if blended learning, combining pre-course online elements with face-to-face training matches the effectiveness of the traditional 4-step approach whilst being more time-efficient.MethodsIn a randomised, multi-centre trial, the conventional face-to-face 4-step technique for teaching a skill of medium complexity, the application of a pelvic binder, was compared with an innovative blended approach. It was hypothesised that the blended approach was non-inferior for skill performance measured after the teaching session and after two days (skill retention) with the time needed for teaching and student/teacher satisfaction as secondary outcomes.ResultsNinety participants, divided into 44 traditional and 46 blended method students, were analysed. Independent-samples t-test showed no significant difference in performance scores and non-inferiority of the blended approach with a half of one standard deviation margin. A statistically significant difference in mean retention scores favored the blended approach. A Mann–Whitney U Test revealed no significant difference in candidate satisfaction levels but a statistically significant difference in instructors' satisfaction levels in favour of the blended approach. Analysis with Welch' t-test demonstrated that the face-to-face teaching time needed for the blended approach was significantly shorter (by 6 min).ConclusionsThe integration of a blended approach with the 4-step technique for teaching pelvic binder application in the ETC streamlined teaching without compromising skill acquisition quality. This innovative approach addresses traditional limitations and shows promise in adapting medical education to modern learning and teaching demands. We suggest that blended learning could also be applied for other skills taught on life support courses.Trial registration: University of Dundee (Schools of Medicine and Life sciences Research Ethics Committee, REC number 22/59, 28th June 2022).

Use of Low-Cost Task Trainer for Emergency Department Thoracotomy Training in General Surgery Residency Program

Emergency department thoracotomy (EDT) is an uncommon but potentially lifesaving procedure that warrants familiarity with anatomy, instruments, and indications necessary for completion. To address this need, we developed a low-cost EDT trainer. The primary objective of this study was to compare the effectiveness of a low-cost EDT trainer to teach emergency department thoracotomy with a discussion-based teaching session. Secondary objective was to study the face validity of the low-cost EDT trainer. A prospective 2-phase randomized control study was conducted. Participants were randomly divided into two groups. In phase one, baseline medical knowledge for both groups was assessed using a multiple-choice question pretest. In Group 1, each participant was taught EDT using a one-on-one discussion with a trauma surgeon, whereas Group 2 used the EDT trainer and debriefing for training. In phase 2 (1 month later), all participants completed a knowledge retention test and performed a videoed EDT using our EDT trainer, the video recordings were later reviewed by content experts blinded to the study participants using a checklist with a maximum score of 22. The participants also completed a reaction survey at the end of phase 2 of the study. OhioHealth Riverside Methodist Hospital, an urban tertiary care academic hospital in Columbus, Ohio. Nine senior surgery residents from training years 3 to 5. The mean score for the performance of the procedure for the simulation-based (Group 2) was significantly higher than that of the discussion-based (Group 1) (Rater 1: 21.2 ± 0.8 vs. 19.0 ± 2.0, p = 0.05, Rater 2: 20.4 ± 1.5 vs. 18.3±1.0, p = 0.04). Group 2 also was quicker than Group 1 in deciding to start the procedure by approximately 56 seconds. When comparing the mean pretest knowledge score to the mean knowledge retention score 30 days after training, the discussion-based group improved from 58.33% to 81.25% (p = 0.01); the simulation-trained group's scores remained at 68.33%. All the participants agreed or strongly agreed that the simulator provided a realistic opportunity to perform EDT and improved their confidence. The results of this pilot studysupport our hypothesis that using alow-cost EDT trainer effectively improves general surgery residents' confidence and procedural skills scores in a simulated environment. Further training with low-cost simulators may provide surgical residents with deliberate practice opportunities and improve performance when learning low-frequency procedures.