Sequential Explanatory Mixed Methods Study Research Articles

A Tracer Study of the Business Graduate Programs of a Catholic University in the Philippines

The success of any degree program being delivered by higher education institutions is measured using the employment performance of its graduates as they navigate the dynamic labor market after completion of their studies. The tool used to gauge this metric is known as a graduate tracer study. Thus, this explanatory sequential mixed methods study may provide the graduate school the baseline employment information, the extent of practice of program competencies and demonstration of graduate attributes of business management major graduates spanning the years 2017-2021 and their level of satisfaction with the graduate programs. The results revealed that outcomes were achieved by the graduates as the graduate degree contributes to their development of competencies and these graduates were extremely satisfied with the delivery and implementation of the programs. They also demonstrated the attributes in their workplace. The results of the study are consistent with the emerging framework of the quality delivery of business graduate programs. It upholds that the satisfaction of the graduates in the delivery, and instruction of the programs, will result in the development of competencies, unlocking of knowledge, skills, and abilities and improve the social and economic status of the graduates.

Decision-makers’ experiences with rapid evidence summaries to support real-time evidence informed decision-making in crises: a mixed methods study

BackgroundThere is a clear need for research evidence to drive policymaking and emergency responses so that lives are saved and resources are not wasted. The need for evidence support for health and humanitarian crisis is even more pertinent because of the time and practical constraints that decision-makers in these settings face. To improve the use of research evidence in policy and practice, it is important to provide evidence resources tailored to the target audience. This study aims to gain real-world insights from decision-makers about how they use evidence summaries to inform real-time decision-making in crisis-settings, and to use our findings to improve the format of evidence summaries.MethodsThis study used an explanatory sequential mixed method study design. First, we used a survey to identify the views and experiences of those who were directly involved in crisis response in different contexts, and who may or may not have used evidence summaries. Second, we used the insights generated from the survey to help inform qualitative interviews with decision-makers in crisis-settings to derive an in-depth understanding of how they use evidence summaries and their desired format for evidence summaries.ResultsWe interviewed 26 decision-makers working in health and humanitarian emergencies. The study identified challenges decision-makers face when trying to find and use research evidence in crises, including insufficient time and increased burden of responsibilities during crises, limited access to reliable internet connection, large volume of data not translated into user friendly summaries, and little information available on preparedness and response measures. Decision-makers preferred the following components in evidence summaries: title, target audience, presentation of key findings in an actionable checklist or infographic format, implementation considerations, assessment of the quality of evidence presented, citation and hyperlink to the full review, funding sources, language of full review, and other sources of information on the topic. Our study developed an evidence summary template with accompanying training material to inform real-time decision-making in crisis-settings.ConclusionsOur study provided a deeper understanding of the preferences of decision-makers working in health and humanitarian emergencies about the format of evidence summaries to enable real-time evidence informed decision-making.

Classification of periviable pregnancy-ending interventions for maternal life endangerment as induced abortion

ObjectivesTo explore how US obstetrician-gynecologists (OB/GYNs) classify periviable pregnancy-ending interventions for maternal life endangerment. Study designFrom May to July 2021, we performed an explanatory sequential mixed methods study of US OB/GYNs, recruited through social media and professional listservs. We administered a cross-sectional survey requesting institutional classification of labor induction or surgical evacuation of a 22-week pregnancy affected by intrauterine infection, using chi-square tests and logistic regression to compare determinations by physician and institutional factors. We then conducted semistructured interviews in a diverse nested sample to explore decision-making, merging quantitative and qualitative data in a mixed methods analysis. ResultsWe received 209 completed survey responses, with 101 (48.3%) current abortion providers and 48 (20.1%) never-providers, and completed 21 qualitative interviews. Fewer than half of respondents reported that pregnancy-ending intervention for 22-week intrauterine infection would be classified as induced abortion at their institution (induction: 21.1%, dilation & evacuation: 42.6%, p < 0.001). In addition to procedure method, decision-making factors for classification as abortion included personal experience with abortion (with more experienced participants more likely to identify care as abortion) and state and institutional abortion regulations (“I have to call it a medical [induction]… I’m not allowed to use the word abortion”). ConclusionsMost OB/GYNs do not classify periviable pregnancy-ending interventions for life-threatening maternal complications as induced abortion, especially when physicians and institutions have less abortion expertise. Differential classification of pregnancy-ending care may lead to undercounting of later abortion procedures, masking the impact of abortion restrictions. ImplicationsUnder unclear legal definitions, legislative interference, and administrative overreach, subjectivity in classification creates inconsistency in care for pregnancy complications. Failure to classify life-saving care as abortion contributes to stigma and facilitates restrictions, with increased danger and less autonomy for pregnant people.

Barriers and facilitators for healthcare professionals to the implementation of Multidisciplinary Timely Undertaken Advance Care Planning conversations at the outpatient clinic (the MUTUAL intervention): a sequential exploratory mixed-methods study

BackgroundAdvance Care Planning (ACP) enables patients to define and discuss their goals and preferences for future medical treatment and care. However, the structural implementation of ACP interventions remains challenging. The Multidisciplinary Timely Undertaken Advance Care Planning (MUTUAL) intervention has recently been developed which takes into account existing barriers and facilitators. We aimed to evaluate the MUTUAL intervention and identify the barriers and facilitators healthcare professionals experience in the implementation of the MUTUAL intervention and also to identify suggestions for improvement.MethodsWe performed a sequential exploratory mixed-methods study at five outpatient clinics of one, 300-bed, non-academic hospital. Firstly, semi-structured interviews were performed with a purposive sample of healthcare professionals. The content of these interviews was used to specify the Measurement Instrument for Determinants of Innovations (MIDI). The MIDI was sent to all healthcare professionals. The interviews and questionnaires were used to clarify the results.ResultsEleven healthcare professionals participated in the interviews and 37 responded to the questionnaire. Eight barriers and 20 facilitators were identified. Healthcare professionals agreed that the elements of the MUTUAL intervention are clear, correct, complete, and simple - and the intervention is relevant for patients and their proxies. The main barriers are found within the user and the organisational domain. Barriers related to the organisation include: inadequate replacement of staff, insufficient staff, and insufficient time to introduce and invite patients. Several suggestions for improvement were made.ConclusionOur results show that healthcare professionals positively evaluate the MUTUAL intervention and are very receptive to implementing the MUTUAL intervention. Taking into account the suggestions for improvement may enhance further implementation.

Organizational-Professional Conflict in the Collegiate and Secondary School Practice Settings: A Sequential, Mixed-Methods Study.

Athletic trainers (ATs) are employed in various settings, which may use 1 of 3 organizational infrastructure models: (1) the sport/athletic model, (2) the medical model, and (3) the academic model. These different settings and organizational infrastructure models may result in varying levels of organizational-professional conflict (OPC). However, how OPC may differ across infrastructure models and practice settings is not known. To examine the prevalence of OPC among ATs in various organizational infrastructures and explore ATs' perceptions of OPC, including its precipitating and mitigating factors. Sequential explanatory mixed-methods study with equal emphasis on quantitative and qualitative components. Collegiate and secondary school institutions. Five hundred ninety-four ATs from collegiate and secondary schools. We conducted a national cross-sectional survey using a validated scale to assess OPC. We then followed the quantitative survey with individual interviews. Trustworthiness was established with multiple-analyst triangulation and peer debriefing. Athletic trainers experienced low to moderate degrees of OPC with no differences across practice settings or infrastructure models. Poor communication, others' unfamiliarity with the AT's scope of practice, and lack of medical knowledge were precipitating factors for OPC. Organizational relationships founded on trust and respect for one another; administrative support in that ATs were listened to, decisions were endorsed, and appropriate resources provided; and autonomy given to the AT were key components to preventing OPC. Most ATs experienced primarily low to moderate OPC. However, OPC continues to permeate professional practice to some extent in collegiate and secondary school settings, regardless of the infrastructure model used. The findings of this study highlight the role of administrative support that allows for autonomous AT practice as well as effective communication that is direct, open, and professional to decrease OPC.

Patients' experiences and reasons for unplanned return visits to the emergency department: A qualitative study.

The aim of this study was to explore the reasons for and experiences of patients who make an unplanned return visit to the emergency department. This study forms the qualitative phase of a larger explanatory sequential mixed methods study and is informed by interpretive description. The paper was prepared using the consolidated criteria for reporting qualitative research. Semi-structured patient interviews were conducted over a 3-month period (July-September 2021). Data were analysed using reflexive thematic analysis. Interviews from 13 participants generated findings related to experiences at and following their initial visit that contributed to their decision to return to the emergency department. Four themes were developed: (1) Patients experience barriers to feeling heard and having their concerns addressed; (2) Patients have little choice but to place their trust in clinicians; (3) Patients unexpectedly experience persistent symptoms which cannot be managed at home; and (4) Patients develop a sense of urgency about having their condition treated. A negative experience at the initial ED visit may have dual conflicting impacts. It can contribute to patients' perceived need for a return visit because they are ill-equipped to manage their condition at home, and it can also contribute to their initial reluctance to return to the ED when symptoms persist. Nurses and other clinicians working in ED need to actively build patient's experiential trust through clear communication, timely consultation and shared decision-making at discharge, which in turn can increase patient's confidence and capability to self-manage their condition. This study adds to the current body of literature about return visits by highlighting that a more positive experience of ED may assist patients to make better-informed decisions about when and how to seek treatment and minimize unnecessary and unplanned return visits. Whilst not an intended topic for exploration in this study, the COVID-19 pandemic influenced patients' experiences at both initial and return ED visits and limited their ability to access primary healthcare options. These experiences contributed to patients' decisions to make a return visit.

Design and implementation of the participatory German network for translational dementia care research (TaNDem): A mixed-method study on the perspectives of healthcare providers and dementia researchers in dementia care research.

Currently, there is a lack of interaction between research and healthcare practice. As a result, research findings reach healthcare practice only late, and topics relevant to practice are often not known in research. Involving people living with dementia (PlwD), their relatives and healthcare providers in dementia care research can accelerate this process. For inclusion, firm and reliable structures are needed, which are to be established with the help of the Translational Network for Dementia Care Research in Germany. However, there is only limited knowledge about the priorities, expectations and conditions of stakeholders (healthcare providers and dementia researchers) for such cooperation within a network. The aim is to gather stakeholders' views on (i) future research topics to be addressed within the dementia care research network, (ii) the nature of collaboration within the network and (iii) the facilitating and hindering factors for establishing such a network. Within an exploratory sequential mixed-method study, we interviewed 87 stakeholders within eleven semistructured focus group interviews. The interviews were transcribed, pseudonymized and analyzed using qualitative content analysis. The qualitative data were analyzed with MAXQDA. Based on the qualitative results found in the focus group interviews, a supplementary online questionnaire was developed to prioritise and rank these findings afterwards. Stakeholders prioritized a comprehensible transfer of research results into practice, increased involvement of PlwD and their relatives (additionally marginalized groups such as people with a migrant background) in research and exchange between researchers. Cooperation should preferably occur in a regional context with local contacts, and the latest research results should be made available via an online database. The stakeholders' time, finances and human resources should be considered. Stakeholders have partly similar preferences and goals for cooperation and involvement, emphasizing that such interaction in a network offers the possibility of long-term, effective collaboration and added value for practice and research. For this study, dementia healthcare providers and dementia care researchers were asked about their perspectives. Their involvement is further elucidated in the manuscript text.

Development of the Cardiovascular Assessment Screening Program (CASP) using the qualitative findings of a mixed methods study and applying the TDF to address the barriers of and facilitators to comprehensive screening for cardiovascular disease

BackgroundThere is inconsistent utilisation of clinical practice guidelines (CPGs) for cardiovascular disease (CVD) screening and management by healthcare professionals to identify CVD risk factors early and to intervene using current recommendations. This manuscript reports on the first phase of an exploratory sequential mixed methods study describing the integration of the qualitative study findings with the Theoretical Domains Framework (TDF) that led to the development of the Cardiovascular Assessment Screening Program (CASP). The main objective of the qualitative study was to inform the development of CASP.MethodsFocus groups (5) and interviews (10) were conducted in rural and urban settings in one Canadian province with target health professionals, managers in health care organizations, and the public to obtain different perspectives to inform the CASP intervention. Three focus groups were held with nurse practitioners and two with members of the public; individual interviews were conducted with target groups as well. Application of the TDF provided a comprehensive approach to determine the main factors influencing clinician behaviour, to assess the implementation process, and to support intervention design. Behaviour change techniques, modes of delivery, and intervention components were selected for the development of the CASP.ResultsThemes identified such lack of knowledge about comprehensive screening, ambiguity around responsibility for screening, lack of time and commitment to screening were addressed in the components of the CASP intervention that were developed, including a website, education module, decision tools, and a toolkit.ConclusionCASP is a theory-informed intervention developed through the integration of the findings from the focus groups and interviews with selected TDF domains, behaviour change techniques, and modes of delivery available in the local context that may be a useful approach for knowledge translation of evidence into practice.

Development and validation of a task load index for process control room operators (PCRO-TLX)

Process control room operators (PCRO) perform a range of complex cognitive safety-critical tasks. The aim of this exploratory sequential mixed methods study was to develop an occupation specific tool to measure the task load of PCRO using NASA Task Load Index (TLX) methodology. Participants were 30 human factors experts and 146 PCRO at two refinery complexes in Iran. Dimensions were developed via a cognitive task analysis, a research review, and three expert panels. Six dimensions were identified: perceptual demand, performance, mental demand, time pressure, effort, and stress. Data from 120 PCRO confirmed that the developed PCRO-TLX has acceptable psychometric properties, and a comparison with the NASA-TLX confirmed that perceptual, not physical, demand was relevant for measuring workload in PCRO. There was a positive convergence of scores of the Subjective Workload Assessment Technique and the PCRO-TLX. This reliable tool (α = 0.83) is recommended for risk assessing the task load of PCRO. Practitioner summary: There are benefits of having a specific tool to measure task load in safety critical roles. Thus, we developed and validated an easy-to-use targeted tool, the PCRO-TLX, for process control room operatives. Timely use and response will assure optimal production alongside health and safety in an organisation. Abbreviations: PCRO: process control room operator; TLX: task load index; PCRO-TLX: process control room operator task load index; NASA-TLX: National Aeronautics and Space Administration task load index; SWAT: subjective workload assessment technique; DALI: driving activity load index; SURG-TLX: surgery task load index; SIM-TLX: virtual reality simulation task load index; VACP: visual, auditory, cognitive and psychomotor; CVI: content validity index; CVR: content validity ratio; RMSEA: root mean square of error approximation; GFI: goodness of fit index; AGFI: adjusted goodness of fit index; CFI: comparative fit index; ANOVA: analysis of variance; CI: confidence interval

Electronic Health Record Use and Perceptions among Urologic Surgeons.

Electronic health records (EHRs) have become widely adopted with increasing emphasis on improving care delivery. Improvements in surgery may be limited by specialty-specific issues that impact EHR usability and engagement. Accordingly, we examined EHR use and perceptions in urology, a diverse surgical specialty. We conducted a national, sequential explanatory mixed methods study. Through the 2019 American Urological Association Census, we surveyed urologic surgeons on EHR use and perceptions and then identified associated characteristics through bivariable and multivariable analyses. Using purposeful sampling, we interviewed 25 urologists and applied coding-based thematic analysis, which was then integrated with survey findings. Among 2,159 practicing urologic surgeons, 2,081 (96.4%) reported using an EHR. In the weighted sample (n = 12,366), over 90% used the EHR for charting, viewing results, and order entry with most using information exchange functions (59.0-79.6%). In contrast, only 35.8% felt the EHR increases clinical efficiency, whereas 43.1% agreed it improves patient care, which related thematically to information management, administrative burden, patient safety, and patient-surgeon interaction. Quantitatively and qualitatively, use and perceptions differed by years in practice and practice type with more use and better perceptions among more recent entrants into the urologic workforce and those in academic/multispecialty practices, who may have earlier EHR exposure, better infrastructure, and more support. Despite wide and substantive usage, EHRs engender mixed feelings, especially among longer-practicing surgeons and those in lower-resourced settings (e.g., smaller and private practices). Beyond reducing administrative burden and simplifying information management, efforts to improve care delivery through the EHR should focus on surgeon engagement, particularly in the community, to boost implementation and user experience.

Preparing for the Future While Living in the Present: Older Adults' Experiences Creating a Legacy of Values.

A legacy of values (e.g., legacy letter) is a nonlegal way to intentionally communicate intangible assets (e.g., values, life lessons, and emotional and supportive instruction) with others. There is scant research on legacy creation outside of a palliative care context, and no studies have explored the experiences of community-dwelling older adults creating a legacy of values. As part of an exploratory sequential mixed methods study, we conducted semistructured interviews with older adults (N = 16) who had previously created a legacy of values. We analyzed transcribed interviews using an interpretive descriptive approach. We iteratively coded interviews deductively with sensitizing concepts identified in the literature (existential well-being, end-of-life preparation and completion, generativity, and resilience), and inductively, based on participants' descriptions. Codes were categorized by patterns of motivations, content, outcomes, and meaning, and thematically summarized. We conceptualized the overall experience of creating a legacy of values as Preparing for the Future While Living in the Present and identified 4 themes: Preserving the Intangible for You and for Me, Sharing What I Want You to Know, Obtaining Peace through Reflection and Preparation, and Living into a Continuing Legacy. Participants attained peace, realized their life was not complete, and were challenged to live intentionally through legacy creation. Creating a legacy of values may concurrently prepare older adults for the end of life and the remainder of life. These findings offer insight into a generative act that can promote intentional living among older adults.

How Teachers Do and Don’t Address Issues of Diversity in Literacy Instruction

Discussions regarding how to embed culturally relevant and responsive literacy learning towards more socially just and equitable classrooms have prompted the need for additional research. This sequential exploratory mixed-methods study explores (a) 288 literacy teachers’ perceptions of their abilities to address issues of bias, equity, and diversity in their classrooms, (b) literacy teacher beliefs on their practices and material resources reflecting intentionality towards diversity and equity, and (c) 12 literacy coaches’ reflections and reactions to teacher perspectives concerning their ability to address issues of diversity in their classrooms. Findings reflect strong correlations between those who can identify bias and bring issues of diversity into their instruction; number of years of teaching experience as well as advanced degrees to diversity being recognized as an asset to educational systems; how effective communication fosters pluralistic classroom spaces; and the need for ongoing professional development for all teachers.

Acceptability of Australian prehospital care quality indicators: An explanatory sequential mixed methods study

Background Systematically developed quality indicators (QIs) facilitate the measurement and monitoring of quality of care and ultimately meaningful quality improvement. The aim of this study was to evaluate the acceptability of a predetermined suite of 84 scientifically valid prehospital care QIs from the provider perspective. Methods An explanatory sequential mixed methods study design was used. Quantitative data were obtained from 36 participants of an online survey in which they rated the acceptability of the QIs using a five-point numerical rating scale. Qualitative data were gathered by conducting semi-structured interviews with a purposive sample of nine survey participants. The successional collection of quantitative and qualitative data facilitated integrated interpretations and conclusions about the acceptability of the QIs. Results Generally, the acceptability of all QIs in the suite was rated highly. Data suggested a positive association between acceptability and other key characteristics of QIs. QIs that were seen as clear, supported by scientific evidence, practical and meaningful tended to be more acceptable than those which were not. The benefits of outcome type QIs were recognised, but participants raised concerns about their sensitivity in the measurement of prehospital quality of care. To be acceptable, QIs which included time intervals needed to be specific about time-critical interventions. Further, the high acceptability of the QIs was explained by a connection to participants’ professional values and qualities. Assessing the QIs’ acceptability from a healthcare provider perspective meant that QIs on patient satisfaction frequently received lower ratings. Conclusion The findings of this study provide evidence of the acceptability of prehospital care providers of a proposed suite of QIs. Future research should evaluate the feasibility and reliability of the QIs. There is also a need to investigate how acceptable the proposed QIs are to patients and communities.

Evaluation of a Mobile-Based Immunization Decision Support System for Scheduling Age-Appropriate Vaccine Schedules for Children Younger Than 2 Years in Pakistan and Bangladesh: Lessons From a Multisite, Mixed Methods Study.

Missed opportunities for vaccination (MOVs), that is, when children interact with the health system but fail to receive age-eligible vaccines, pose a crucial challenge for equitable and universal immunization coverage. Inaccurate interpretations of complex catch-up schedules by health workers contribute to MOVs. We assessed the feasibility of a mobile-based immunization decision support system (iDSS) to automatically construct age-appropriate vaccination schedules for children and to prevent MOVs. A sequential exploratory mixed methods study was conducted at 6 immunization centers in Pakistan and Bangladesh. An android-based iDSS that is packaged in the form of an application programming interface constructed age-appropriate immunization schedules for eligible children. The diagnostic accuracy of the iDSS was measured by comparing the schedules constructed by the iDSS with the gold standard of evaluation (World Health Organization-recommended Expanded Programme on Immunization schedule constructed by a vaccines expert). Preliminary estimates were collected on the number of MOVs among visiting children (caused by inaccurate vaccination scheduling by vaccinators) that could be reduced through iDSS by comparing the manual schedules constructed by vaccinators with the gold standard. Finally, the vaccinators' understanding, perceived usability, and acceptability of the iDSS were determined through interviews with key informants. From July 5, 2019, to April 11, 2020, a total of 6241 immunization visits were recorded from 4613 eligible children. Data were collected for 17,961 immunization doses for all antigens. The iDSS correctly scheduled 99.8% (17,932/17,961) of all age-appropriate immunization doses compared with the gold standard. In comparison, vaccinators correctly scheduled 96.8% (17,378/17,961) of all immunization doses. A total of 3.2% (583/17,961) of all due doses (across antigens) were missed in age-eligible children by the vaccinators across both countries. Vaccinators reported positively on the usefulness of iDSS, as well as the understanding and benefits of the technology. This study demonstrated the feasibility of a mobile-based iDSS to accurately construct age-appropriate vaccination schedules for children aged 0 to 23 months across multicountry and low- and middle-income country settings, and underscores its potential to increase immunization coverage and timeliness by eliminating MOVs.

Introducing misoprostol for treatment of incomplete abortion: A feasibility and acceptability study in secondary-level health facilities in Myanmar

ObjectiveTo assess the feasibility and acceptability of misoprostol as a treatment option for incomplete abortion in secondary hospitals in Yangon and Mandalay, Myanmar. MethodsAn explanatory sequential mixed methods study was conducted. Women seeking treatment for an incomplete abortion with a uterine size <12 weeks were eligible to participate in the prospective cohort including sublingual administration of 400 μg misoprostol, clinical assessment 7–10 days after administration, and patient interview. Treatment efficacy was assessed, defined as proportion of participants with complete uterine evacuation with misoprostol alone. After the cohort, provider interviews were conducted to understand how their experiences with misoprostol may have influenced cohort findings. Study sites included seventeen secondary health facilities in four townships in Yangon and Mandalay, Myanmar. ResultsA total of 110 women were enrolled from July 2018 to January 2019; 96 completed follow-up. In 75 % of cases, incomplete abortion was successfully treated with misoprostol. Treatment efficacy varied significantly by region (Yangon 85 %, Mandalay 67 %; p = 0.048), driven by providers’ variable comfort with misoprostol and proclivity to intervene with additional treatment. With experience, all were willing to incorporate the protocol into practice by study end. Patient acceptability and satisfaction were high. ConclusionMisoprostol is an acceptable and feasible treatment option for women seeking postabortion care at secondary facilities in Myanmar. Extensive health provider training and support systems and continued implementation experience are crucial to effectively translate clinical PAC guidelines into practice in Myanmar.

Individual differences in self-regulated learning profiles of Chinese EFL readers: A sequential explanatory mixed-methods study

AbstractThis study explored the latent profiles of self-regulated learning (SRL) strategies (cognitive, metacognitive, and motivational regulation) endorsed by Chinese English-as-a-foreign-language (EFL) readers in a high-stakes testing environment, and also their associations with individual factors (gender, grade, reading proficiency, and motivational beliefs). With a sequential explanatory mixed-methods design, students in grades 11 and 12 (n = 1,113) completed a reading comprehension test and a questionnaire regarding their strategy use and individual factors, and some (n = 16) were randomly selected for follow-up semi-structured interviews. Findings revealed three SRL profiles, characterized by high, medium, and low levels of SRL-strategy use. Self-efficacy and extrinsic motivation most powerfully predicted an individual’s profile membership; all the intrinsic and extrinsic motivation variables were significantly higher for learners from the higher strategy-use profile. Moreover, reading proficiency did not significantly predict profile membership, but more self-regulated students still achieved higher reading scores as a group tendency.

A mixed methods study to assess perception of interprofessional learning among pre-university students for medicine and dentistry

Interprofessional education (IPE) leads to positive mutual attitudes, better understanding of professional roles in caring for patients.This study was undertaken to assess the perception of interprofessional education of pre-university students even before they enter professional courses.: This is a mixed methods sequential explanatory study design involving sixty-four pre-university students, who were exposed to interprofessional related activity by interacting with medical and dental students on given health scenarios. The interprofessional education and interdisciplinary education perception scale (IEPS) to measure the student’s perception towards IPE. Wilcoxon Signed Rank test were calculated. The qualitative analysis was done to further analyse the quantitative data through online interviews.The student’s perception towards competence &amp; autonomy, perceived need for cooperation, perception of actual cooperation and understanding other’s value were significantly higher from somewhat disagree of score 3 (P&amp;#60;0.001). Most foundation year students realized that by learning with various professional students would make them effective member of health care team and promote collaborative practice. : It can be a good idea to sensitize the pre university students to interprofessional education.

Assessment of Gaming Addiction and Perceived Psychological Distress Among Filipino Young Adults During COVID-19 Pandemic

&lt;p style="text-align:justify"&gt;Online game addiction and psychological distress are two continuously developing problems in the Philippines, with Filipinos aged 18 to 24 being the second largest age group to overuse interactive online-related games. This sequential explanatory mixed method study aimed to assess the young adults’ gaming addiction and perceived psychological distress during the COVID-19 pandemic and identify the other factors contributing to the respondents’ frequent engagement in online interactive games, which served as a basis for a preventive intervention program. The researcher administered the survey questionnaires of the Gaming Addiction Scale and Depression Anxiety Stress Scale-21 to 399 young adults aged 18–24 and a semi-structured interview guide to 20 addicted and non-addicted gamers. Key results showed that a small percentage of the respondents experienced polythetic and serious monothetic addiction to interactive online games. In contrast, half of the respondents manifested mild to moderate symptoms of depression and anxiety during the COVID-19 pandemic. Major findings also found no significant gender differences in the level of online game addiction and psychological distress during the COVID-19 pandemic, and a moderate level of relationship substantiated the association. Further results revealed that the negative compensatory factors were associated with addicted gamers’ frequent engagement with online games, whereas non-addicted gamers were associated with positive, beneficial factors. This phenomenon has hardly ever been the focus of in-depth research, and the results of this study can be used to further refine the conceptualization of “internet gaming disorder” as a mental disorder and develop a more comprehensive treatment method.&lt;/p&gt;

The role of motivational components in metamotivational monitoring in medical students: a mixed method study

BackgroundIn metamotivational monitoring, students try to identify the declined motivational component in order to regulate their motivation. There is scarcity of evidence on which motivational components are targeted by the medical students when they use each motivational regulation strategies. This study aims were identifying motivational components in motivational regulation process, developing a measurement tool and, testing the predictive relationship between the motivational components and motivational regulation strategies.MethodsThis exploratory sequential design mixed method study is part of a project has been started from 2018 with medical students at Tehran University of Medical Science. First, in a qualitative study conducting a semi-structured in-depth interview, the motivational components were explored. The interviews continued until saturation of data. Then, in a psychometric study the validity and reliability evidence of questionnaire obtained. In the quantitative study, applying the convenience sampling method, 508 students completed the questionnaires. Predictive relation between the motivational regulation strategies and motivational components was assessed utilising Structural Equation Modelling. Path coefficients, T-Value, and R2 index were reported by SmartPLS software.ResultsIn the Exploratory Factor Analysis of Motivational Components Questionnaire (MCQ), 6 factors were discovered that explained 74% of the total variance. All paths in seven models of SEM showed a T-Value above 1.96 that means there is a significant correlation between all strategies and components. In examining the predictive relationships, each of the four components of self-efficacy, intrinsic value, self-relevant value and promotion value were specifically predicted by two motivational regulation strategies.ConclusionsEvidence of validity and reliability of the MCQ indicates that this questionnaire can be used in medical education contexts. Health Profession Educators can improve the academic motivation of students by identifying one or more declined motivational component and teaching specific motivational regulation strategies. It is recommended to hold training courses on motivational regulation strategies for medical school faculty, study-skills advisors, and students.

The impact of remote consultations on the health and wellbeing of first contact physiotherapists in primary care: Amixed methods study.

First Contact Physiotherapists (FCPs)were introduced to reduce demands on GPs by providing improving access to expert musculoskeletal care. FCPs experience similar workplace stressors to GPs and there is an emerging concern that remote consultations are causing further impacts to their wellbeing. To explore the impact of remote consultations on FCPs. A mixed methods sequential explanatory study with FCPs was conducted. An online survey measured the usage and impact of remote consultations. Semi-structured interviews explored the lived experiences of using remote consultations. The online survey was completed by 109 FCPs. A key benefit of remote consultations was patient convenience; perceived challenges included IT issues, poor efficacy, FCP anxiety, isolation, and increased workload. FCPs viewed remote consultations as a 'challenge' rather than a 'threat'. Nearly two thirds of the FCPs had not received relevant training, yet over half were interested. Follow-up interviews with 16 FCPs revealed 4 themes: (1) Remote consultations provide logistical benefits to the patient; (2) Compromised efficacy is the key challenge of remote consultations; (3) Challenges for FCPs working in areas of high deprivation; and (4) Remote consultations impact the health, wellbeing and work satisfaction of FCPs. Remote consultations offer a convenient alternative for patients, but may add to FCP stress particularly in areas of high socioeconomic deprivation. Further research is required to understand how remote consultations can be enhanced when communication barriers and lower levels of digital literacy exist. Continued monitoring of job satisfaction and resilience levels is important to ensure FCPs remain in their role.