Sequential Explanatory Mixed Methods Study Research Articles

Integrated virtual simulation and face-to-face simulation for clinical judgment training among undergraduate nursing students: a mixed-methods study

BackgroundVirtual simulation and face-to-face simulation are effective for clinical judgment training. Rare studies have tried to improve clinical judgment ability by applying virtual simulation and face-to-face simulation together. This study aimed to evaluate the effect of an integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program on enhancing nursing students’ clinical judgment ability and understanding of nursing students’ experiences of the combined simulation.MethodsA sequential exploratory mixed-methods study was conducted in a nursing simulation center of a university in Central China. Third-year nursing students (n = 122) taking clinical training in ICUs were subsequentially assigned to the integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program arm (n = 61) or the face-to-face simulation-only arm (n = 61) according to the order in which they entered in ICU training. Clinical judgment ability was measured by the Lasater Clinical Judgment Rubric (LCJR). Focus group interviews were conducted to gather qualitative data.ResultsStudents in both arms demonstrated significant improvement in clinical judgment ability scores after simulation, and students in the integrated arm reported more improvement than students in the face-to-face simulation-only arm. The qualitative quotes provided a context for the quantitative improvement measured by the LJCR in the integrated arm. Most of the quantitative findings were confirmed by qualitative findings, including the domains and items in the LJCR. The findings verified and favored the effect of the combination of non-immersive virtual simulation and high-fidelity face-to-face simulation integrated program on enhancing nursing students’ clinical judgment ability.ConclusionsThe integrated virtual simulation and face-to-face simulation program was feasible and enhanced nursing students’ self-reported clinical judgment ability. This integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program may benefit nursing students and newly graduated nurses in the ICU more than face-to-face simulation only.

Library space design to promote student engagement: A comparison of graduate and undergraduate students

This article explores the library space needs and wants of graduate and undergraduate students at a medium-size state University in Southwest Florida. The researcher conducted a sequential explanatory mixed methods study in which they administered a survey to all currently enrolled graduate and undergraduate students at the university and followed up with semi-structured interviews to better understand students library space needs/wants and how those elements contribute to student success through a lens of academic and social engagement. The researcher identified several library space needs that were common to both graduate and undergraduate students including: comfortable and functional furniture, a variety of study spaces including a mix of individual and group spaces, conducive noise levels, technology, whiteboards, windows to let in natural light, seclusion food and drink options nearby, safety and security, adequate lighting and electrical outlets, and effective wayfinding. An additional need of separate graduate student space was also identified. Findings from this study can help inform the design of library spaces to better support student success through engagement.

Challenges of safety culture in Surgical Center: mixed methods study.

to analyze the safety attitudes of health and support areas professionals working in Surgical Center. sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture.

Patient perceptions of nurses' cultural competence in public sector hospitals in Gauteng.

Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses' cultural competence are largely unexplored in South Africa. This study explored how the concept of cultural competence is perceived by patients. Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals - district (level one), regional (level two), and academic (tertiary, level three). This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch's eight steps of data analysis. Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses' level of cultural competence. Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients. Patients' perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

Emergency Department and Dental Clinic Perceptions of Appropriate, and Preventable, Use of the ED for Non-Traumatic Dental Conditions in Hot-Spot Counties: A Mixed Methods Study.

Frequency of emergency department (ED) use for nontraumatic dental conditions (NTDC) is a well-researched community health concern. However, research predominately relies on ambulatory ED discharge records. This explanatory sequential mixed methods study reviewed NTDC ED use in hot-spot counties and assessed perceptions around preventable and appropriate use among EDs and dental clinics. Tooth pain data (2015-2021) were drawn from State Medicaid, and the Early Notification of Community-Based Epidemics (ESSENCE). NTDC data were compiled using International Classification of Disease, Ninth and Tenth Revisions. Employing extreme case sampling, providers in counties with the highest per-capita NTDC ED use were interviewed. North Dakota experienced a decline in NTDC ED visits between 2017 and 2020, though the rate is now increasing. The greatest proportion of NTDC ED visits were among persons ages 20 to 34 and 35 to 44. ED and dental care staff have misconceptions around each other's roles in reducing NTDC ED visits, but unanimously suggest community-level prevention as a solution. NTDC ED use was perceived as "appropriate" care. However, there is consensus that improved access to, and utilization of, affordable and quality preventative dental care would reduce NTDC ED visits and improve overall community health, especially among populations experiencing greater inequities.

Designing the Future of Medical Education: The EPA Framework as a Catalyst to Inform Family Planning and Reproductive Health Fellowship Training Program in Ethiopia Medical Education: An Exploratory Sequential Mixed Method Study.

Entrustable Professional Activities (EPAs) are tasks or responsibilitieswithin a specific field that can be given to a learneronce they are competent to perform them independently. EPAs are being used in various specialty programs and serving as valuable tool to inform educational program. However, due to disparities in professional practice between different contexts, the automatic transfer of a set of core EPAs is not feasible. Hence, our study aims to develop an EPA framework to inform the Family Planning and Reproductive Health Fellowship Program in the local context of Ethiopia. We employed an exploratory mixed-method design, which involved the collection of qualitative data using the Nominal Group Technique and quantitative data through a nationwide survey in all residency training institutions across the country. Qualitative data analysis involved several steps, including compiling a list of tasks, removing duplicate tasks, reviewing EPAs using criteria and an equal rubric tool. For quantitative data analysis, descriptive statistics, validity index analysis, and intra-class correlation coefficients, were used. Seven senior panelists were able to propose a total of 57 EPAs, with 17 remaining after qualitative data analysis. The panelist evaluated the relevance of each EPA in the second phase. As a result, 17 EPAs received a content validity index of >0.83, indicating satisfactory relevance. In the national survey, experts reached a high level of final agreement regarding the relevance and representativeness of all 17 EPAs (ICC = 0.815, 95% CI [0.0.756,0.865], p.0001). The final set of 17 end-of-training EPAs is valid, acceptable and representative of the discipline, and they can be used as a framework to inform Family planning and Reproductive Health Fellowship Program in Ethiopian medical education once these core EPA statements are described in sufficient detail. This can contribute to raise the quality of training and hence the quality of patient care.

Eudemonia of People Living with HIV at an Anti-Retroviral Therapy Center, Ron, Gadag District - A Mixed Method Feasibility Study

Background In the realm of health and wellbeing the cursed part is the illness. Times elapsed health problems and challenges evolved constantly. In 1980s the first case of HIV Human Immunodeficiency Virus was reported and according to World Health Organization WHO 36.9 million people worldwide are living with HIVAIDS Acquired Immunodeficiency Syndrome.Aim This study aimed to explore the meaning of lived experiences of people living with HIV PLHIV and evaluate the effectiveness of health interventions on the state of health of PLHIV at an Anti-retroviral therapy ART center Ron Gadag District.Methods A sequential exploratory mixed-method study was conducted from August 2022 to September 2022. The qualitative strand with five samples explored lived experiences of PLHIV to develop health related counselling programme and quantitative strand with 14 samples tested the health-related counselling programme developed based on the data extracted from qualitative strand leading to first level integration in addition to administration of oral zinc 20 mgday for one month. Qualitative data analysis was done using QDA Miner lite version 3.0 and quantitative data analysis was done using IBM SPSS version 29.0 followed by mixing of data by integrated analysis.Results After qualitative analysis six themes and twenty-one sub-themes were derived in development of phenomenology. After quantitative analysis H1 amp H2 were accepted as P value obtained was 0.001 for df - 01 at 5 level of significance. The integrated analysis showed that findings from both the strands complemented supported and synergized the state of eudemonia among PLHIV.Conclusion The study concluded that administration of oral zinc supplementation and regular health related counselling sessions are effective strategies in maintaining eudemonia of people living with HIV amp AIDS.

Scale Development and Inferential Analysis of Service Quality in Higher Education: A Sequential Exploratory Mixed-Method Study

In response to the consumer-oriented shift in higher education, institutions are embracing technology and flexible delivery to enhance services. This is critical for student attraction, retention, and academic success. Consequently, the focus on service quality and student satisfaction has grown. This study investigates service quality expectations and perceptions of students in a local Caribbean -based tertiary institution. A novel scale, the “Service Quality Scale for Higher Education (SQSHE),” is developed using a sequential-exploratory mixed-method approach. The SERVQUAL-driven Disconfirmation framework informs this scale, measuring the gap between expected and perceived service encounters. Three focus group interviews generate a 53-item pool, refined to a 23-item scale with four dimensions: student well-being, service efficiency, social interaction, and value co-creation. The SQSHE demonstrates reliability, stability, and internal consistency. Data from 179 participants via an online questionnaire reveal four service quality dimensions, with two displaying significant negative gap scores. This culturally relevant four-factor scale contributes significantly to higher education research. By addressing student expectations, institutions can enhance strategies to elevate satisfaction and success rates.

Investigating the Development and Psychometric Testing of the Information and Communication Technology Use Scale in Iranian Patients With Chronic Conditions

Background: The high prevalence and associated costs of chronic diseases have challenged global community health. The use of information and communication technology offers patients and healthcare providers the ability to respond to healthcare needs. This study develops an information and communication technology use scale for patients with chronic diseases and evaluates its psychometric properties. Methods: This exploratory sequential mixed-method study was conducted in Kashan City, Iran from September 2020 to July 2021. In the qualitative phase, 18 patients with chronic conditions were recruited via the purposeful sampling method. The initial pool of 33 items was extracted in this phase. Psychometric evaluation of the scale was examined through face, content, and construct validity. The internal consistency of the scale was assessed with the Cronbach α and its stability was examined by the test re-test. To evaluate the scale’s construct validity, a cross-sectional study was performed with 300 patients referring to hospital wards and private centers that provide services to patients with chronic diseases. A sequential sampling method was used to select the subjects. The exploratory factor analysis was performed using principal component analysis and the varimax rotation method in the SPSS software, version 16. Results: The initial version of the scale consisted of 33 items. A total of 6 items were removed in the face and content validity evaluation phase. Factor analysis with the removal of 4 items resulted in the extraction of 4 factors that explained 67.45% of the variance in the total scale score. The Cronbach α coefficient and intra-class correlation coefficient were estimated at 0.93 and 0.88, respectively. Conclusion: The scale developed in this study is a valid and reliable tool for measuring formation and communication technology use (including its dimensions) in patients with chronic diseases.

Digital Generations Paradox in Pre- and In-service Teachers’ Literacy Practices: An Explanatory Sequential Mixed Methods Study/Hizmet Öncesi ve Hizmet İçi Öğretmenlerin Okuryazarlık Uygulamalarında Dijital Nesiller Paradoksu: Açıklayıcı Sıralı Karma Yöntemler Araştırması Çalışması

Digital practices have become more prominent due to the growing demand in digital exposure in education. While technology has been used as a metaphorical divide between generations in many studies, very few studies include individuals’ definitions of their generational sense of belonging. By administering an online questionnaire (N=111) and conducting semi-structured interviews with pre-service and in-service teachers (n=6), this mixed methods study aimed to capture participants’ self-definitions and changes in these definitions. The results of this study provided evidence about the convergence impact of technology in educators’ personal and professional lives. This study contributes to the field of digital literacy by offering different perspectives about digital generations and discussing the use of technology to create collaborative and cooperative educational settings.

Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients With Prostate Cancer

ObjectivesTo characterize unmet sexual health resource needs and preferences for interventions to address unmet needs among female partners of patients with prostate cancer (PCa), given the significant negative impact of PCa on the sexual health of partners. MethodsWe conducted an exploratory sequential mixed methods study of female partners recruited from multiple U.S. clinical locations, websites, and support groups for caregivers. We first conducted semi-structured in-depth interviews. Qualitative results informed development of a cross-sectional survey, which was administered to a larger sample of partners. ResultsOverall, 12 and 200 female partners participated in the qualitative and quantitative portions of the study. Major emergent themes from interviews were the benefits and drawbacks of technology-based interventions, the importance of sexual health resources throughout the PCa journey, and a desire for sexual health support groups that include partners. In the survey, the most common sexual health topics that partners wanted more information about were male libido problems (30.0%), erectile dysfunction (26.5%), and female libido and arousal problems (24.5%). Additionally, 41.5% wanted more information about sexual health websites, 35.0% about partners-only support groups, 29.5% about support groups for couples, and 23.5% about sexual medicine specialists. ConclusionsTo our knowledge, this is the largest study to date on female partners’ unmet sexual health resource needs and preferences for sexual health interventions. Partners prefer technology-based interventions, desire sexual health-focused support groups, and want more information about a variety of sexual issues and specialists who treat them.

Perceptions of Undergraduate Students Regarding the Inclusion of Clinical Audit in their Curriculum

Objective: To find out undergraduate students' perceptions regarding the inclusion of clinical audits in their curriculum. Study Design: Exploratory sequential mixed methods study. Place and Duration of study: Combined Military Hospital, Lahore Pakistan, from Dec 2022 to Mar 2023. Methodology: The first phase of the study comprised a quantitative research questionnaire regarding undergraduate students' perceptions about the inclusion of a clinical audit in their curriculum. These perceptions were explored in depth in the second phase with focus group discussions (FGD). Thirty students participated in the study, ten from the fourth year and twenty from the final year MBBS. Results: The study included 30 participants. The results showed that (24, 80%) of participants were able to develop skills as team members, (22, 73%) were able to identify audit topics, collect data, write audit reports and understand conflicts of interest, and (21, 70%) were able to write audit proposal and develop skill in life long audit learning. The key themes emerging from clinical audit focus group discussions (FGD) were better clinical care, patient safety, lack of understanding about audit by students and faculty and improper implementation mechanisms. Conclusion: In conclusion, a clinical audit promotes a safe, good-quality, and evidence-based environment for patient care. It also decreases the risk of clinical negligence and should be incorporated as an integral part of the undergraduate curriculum.

Gendering trust in general surgery training: Examining the role of trust between residents and attendings

In medical training and throughout medical careers, women face a disadvantage –especially in surgery. To better understand its origins, this study examines the role of gender in surgical training, focusing on trust between faculty and medical residents. An environment of trust enables surgical residents to gain hands-on experience and acquire practical skills during surgeries performed jointly with faculty. In this sequential explanatory mixed-methods study, 105 surgical encounters were rated utilizing the OpTrust tool, an instrument designed to measure entrustment between surgery residents and faculty. Furthermore, seventeen attendings and ten surgery residents gave in-depth interviews. Entrustment was modeled using linear regression models with robust estimators, controlling for resident and faculty demographic background and intraoperative factors. The results revealed gender disparities in trust. Prior experience in the operating room benefited male trainees more than female trainees in terms of faculty trust. Qualitative results indicate that gender stereotypes and biases may influence attendings’ trusting behaviors toward female residents, thus limiting their active participation inside the Operating Room. These findings can inform interventions to ensure equal surgical opportunities for female residents.

Social support in low-income women with Fibromyalgia Syndrome from a sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain): a mixed method study

BackgroundWomen with Fibromyalgia Syndrome (FMS) can benefit form adequate social support to fight the consequences of their illness, but the extent to which this is available to those with low incomes who live in depressed areas of Tenerife (Canary Islands, Spain) is currently unknown. The purpose of this study was to explore social support in low-incomes women with FMS in sub-urban and peri-urban areas of Tenerife.MethodologyA sequential exploratory mixed method study was carried out from January 20, 2023, to June 10, 2023, at the Fibromyalgia and Chronic Fatigue Association of Tenerife (AFITEN) using non-probability convenience sampling. Social support was analyzed quantitatively through MOS-SSS survey and Duke-UNC-11 questionnaire, while qualitative data were obtained through semi-structured interviews to identify social support providers and analyze their satisfactions levels.ResultsA total of 49 women, with a mean age of 57.80 years-old (SD = 13.25) were finally included in this study. MOSS-SSS and Duke-UNC-11 both indicated lower social support levels at 68.6 (SD =16.3) and 38.0 (SD = 9.74), respectively. The qualitative analysis revealed that partners and friends provided the most significant support with the highest satisfaction scores.ConclusionsThe socioeconomic status of low-income women with FMS living in sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain) influences on their social support, with the affective support and confidentiality being the most affected dimensions.

Development of a plant-based culinary nutrition model for sports science students

Introduction: Food and fitness levels are key factors required to maintain functional life. Hence, nutrition education is crucial in spreading awareness among Sports Science students. There is a paucity of plant-based nutrition knowledge and plantbased culinary skills for fitness locally. Therefore, this study aimed to develop a valid Plant-Based Culinary Nutrition Model (PBCNM) with nutrition knowledge and basic culinary skills to improve fitness among Sports Science students. Methods: This exploratory sequential mixed method study consisted of 2 phases. In Phase 1, a three-round modified Delphi method was conducted with 13 experts to generate a questionnaire that was validated. Lawshe worksheet determined the content validity ratio (CVR) for an item. Content validity index (CVI) for each section and the overall instrument was calculated. In Phase 2, quantitative data collection and analysis addressed the research questions and research gaps leading to model development. A total of 271 undergraduate Sports Science students at higher learning institutions were recruited as respondents. Results: In Phase 1, CVR of the overall survey was 1.0 and CVI was 0.834. Subsequently, the questionnaire was pilot tested for reliability and a Cronbach’s alpha score of 0.836 was obtained for the overall questionnaire. In Phase 2, the respondents’ mean and standard deviation score for the model’s components and needs was 4.21±0.73 for items 1-15. The integration of experts’ perspectives on the need of PBCNM for fitness and feedback from respondents resulted in the development of PBCNM. Conclusion: This study highlighted PBCNM as a helpful guideline for better fitness management.

A Study of Effective Dual Language Program Models for Non-Native Spanish Speakers

As the United States population becomes increasingly ethnically and linguistically diverse, more school districts, families, and students are beginning to recognize the need and value of bilingual education, specifically dual language programs, for both native and non-native Spanish speakers (Collier & Thomas, 2020). With dual language programs on the rise, it is important to consider which program model(s) most benefit the students within a particular program. The purpose of this explanatory sequential mixed methods study was to compare the effect of different dual language program models (including immersion programs) on primary-level students’ Spanish and English language acquisition by the time students reach fourth grade. The study fRobocused specifically on non-native Spanish speakers, utilizing both quantitative and qualitative data. Such data included Spanish and English literacy levels of students who had been in a dual language program from kindergarten through fourth grade and evidence from surveys and interviews of students and teachers. The study compared two schools, one with an 80:20 program model and one with a 50:50 program model. Overall, School 1’s 80:20 dual language program model appeared to be more effective than School 2’s 50:50 model in equally developing students’ Spanish and English language acquisition. Teachers and students from both schools indicated room for growth in their respective programs.

The Effects of Ecology-Oriented Instruction on Enhancing EFL Learner’s Writing Competence

The twenty-first century has witnessed an unprecedented pace of environmental issues with catastrophic consequences. Accordingly, an increasing number of initiatives have been seized to solve ecological problems in cooperation. In this regard, integrating eco-friendly practices into EFL classes has received considerable attention globally. However, the effects of ecology-oriented writing instruction have not been explored thoroughly in the Iraq context. Thus, this study was carried out to fill this gap in the literature with 30 EFL learners who studied at a language preparatory school of a private university in the spring semester of the 2022-2023 Academic Year in Erbil. Participants, whose ages were between 18 and 24, were chosen through the convenience sampling method. The study lasted eight weeks when data were gathered via writing exams and interviews in this explanatory sequential mixed-methods research design study. Control group students were exposed to traditional instruction, while experimental group students’ lessons were enriched by ecology-oriented writing topics. The in-depth analysis was performed through SPSS 27 and NVivo. The former revealed that experimental group students increased their writing competence more substantially than the control group students. Likewise, interview findings unearthed that students’ awareness about ecological problems increased dramatically in the experimental group, while the difference was not significant in the control group. The findings of this study may drive authorized bodies to integrate eco-friendly approaches into academic writing lessons on a global scale.

Co-design of a question prompt list about pregnancy and childbearing for women with polycystic kidney disease: an exploratory sequential mixed-methods study

BackgroundAlthough women with polycystic kidney disease (PKD) generally have healthy pregnancies and babies, pregnancy is associated with a greater risk of maternal complications and requires planning and management of their condition. Given these possible complications, routine communication about childbearing between women with PKD and their treating team is important. A question prompt list (QPL), a structured list of questions used by patients during consultations with healthcare providers, may be beneficial in assisting women with PKD to discuss their childbearing concerns with, and seek related information from, their treating team. The aims of this study were to co‐design a QPL about pregnancy and childbearing for women with PKD, and evaluate its comprehensibility, salience, and acceptability.MethodsAn exploratory sequential mixed‐methods study of women of reproductive age with PKD living in Australia, using an experience‐based co‐design approach with two phases. Women were recruited from a metropolitan public health service and via social media and invited to complete an anonymous online survey about the development of the PKD QPL (phase one) and participate in an online discussion group about its refinement (phase two).ResultsSixteen women completed the development survey and seven participated in the evaluation discussion group. Participants reported that women with PKD would value and use a QPL to prompt discussions with and seek further information about pregnancy and childbearing from their healthcare providers. Women identified four main topics for the QPL: ‘thinking about having a baby’, ‘pregnancy’, ‘my medications’ and ‘after my baby is born’. Within each section a series of questions was developed. Based on the findings, a QPL about pregnancy and childbearing for women with PKD was co-designed.ConclusionsWomen with PKD often find it difficult to access information and have discussions with their health care providers about pregnancy and childbearing. The PKD QPL co-designed in this study was perceived to be an acceptable tool which will, from the perspectives of participants, assist women with PKD to access information more easily about pregnancy, childbearing and PKD; ask more targeted questions of their treating team; and make informed childbearing decisions.

Clinicians' Insights on Emergency Department Boarding: An Explanatory Mixed Methods Study Evaluating Patient Care and Clinician Well-Being.

The aim of this study was to describe clinicians' insights into the quality and safety of patient care delivered to emergency department (ED) boarding patients, as well as clinician safety and satisfaction related to ED boarding. This was a single-site, mixed methods sequential explanatory study. Quantitative data were obtained from a cross-sectional survey sent to ED attending physicians, resident physicians, advanced practice providers, and nurses. Semistructured focus group interviews with a subsample of participants sought to add depth to the interpretation of survey data and identify areas of improvement in boarding care. Chi-square and Wilcoxon rank sum tests were used to evaluate for response differences between groups. Qualitative data were thematically coded and analyzed. A total of 94 questionnaires were obtained for a response rate of 34.1%. Clinicians reported that boarding highly contributed to the perception of burnout. All groups reported high rates of perceived verbal and/or physical abuse from boarding patients (86.8% of nurses, 41.1% of providers, p = 0.0002). A total of 39 clinicians participated in focus groups regarding boarding care, and six themes were identified, including patient safety concerns, lack of knowledge/resources/training, and poor communication. Key themes identified as possible solutions to improve care included standardization of care, proactive planning, and culture change. Clinicians identified many concerns regarding patient safety and the quality of care delivered to boarding patients and identified several areas for improvement. Clinicians also felt that boarding negatively affected their satisfaction and safety.

Measuring Faculty Engagement in Online Formative or Whole-Person Education

The COVID-19 pandemic reinforced the importance of supporting students’ comprehensive well-being when teaching online. One promising approach is formative or whole-person education, which emphasizes wholeness, purpose, and community. We created a scale using a polytomous Item Response Theory modeling approach, measuring the extent to which postsecondary teachers engage in formative education online. To our knowledge, this is the first scale designed to measure this construct. The scale was developed within an exploratory sequential mixed methods study on formative education online that also included semi-structured interviews with 37 faculty members. Results from the qualitative analysis were used to develop initial items. This data-informed process increased the construct validity of the scale. We refined the original item pool through a pilot test using a sample of 308 instructors. This article presents psychometric results for the final, 10-item scale using a sample of 245 instructors. Evaluation of item fit statistics, item trace lines, and the total information curve indicate that the graded response model was appropriate for this scale. The Cronbach’s alpha and marginal reliability coefficients for the final scale were .90 and .91, indicating good reliability. Future research can explore how this scale might be adapted for in-person learning environments and other contexts.