Small Group Activities Research Articles

Health Justice and Systems of Care: A Required Longitudinal Course for MD Students.

Medical education has acknowledged the impact of structural societal factors on health, prompting the need for curricula seeking to eliminate health inequities upstream while simultaneously caring for downstream effects of existing inequities. The Keck School of Medicine of USC (KSOM) implemented one such comprehensive curriculum, Health Justice and Systems of Care (HJSC), integrating health systems science, structural competency, and service-learning in a required course spanning the pre-clerkship and clerkship phases with an optional post clerkship elective. The HJSC course addresses topics including racism in medicine, health inequities, and health systems science. Using transformative learning theory, it fosters critical consciousness and structural competency. Assessments include case analyses, reflections, team-based learning sessions, and group projects related to social justice in healthcare. The program aims to instill cultural humility and practical application, fostering a holistic approach to medical education that implores physicians to become advocates for health justice. Feedback from students indicated generally positive perceptions of the curriculum. Students provided overall positive comments about discussions with guest speakers. However, students expressed a desire for more concrete examples of how health inequities can be remedied. Some found small-group activities less engaging. Other challenges included providing students of different readiness levels with tailored experiences and seamlessly integrating HJSC content within basic and clinical sciences courses. Next steps include continuing to integrate content into the science curriculum and clerkships, improving opportunities for meaningful student interactions, and enhancing faculty development to address health justice concerns in clinical settings.

A comparative study on the effects of peer influence on willingness to communicate in speaking activities in online and face-to-face EFL lessons

The purpose of the study is to investigate whether English as a foreign language (EFL) learners are more willing to communicate and study with the same partners or different partners in speaking activities in pairs or small groups and to determine whether there are similarities or differences in learners’ views regarding the same and different partners according to different learning environments (face-to-face and online). A qualitative research design was adopted in the study. The participants were EFL learners at the School of Foreign Languages (SFL) of a state university in Izmir, Turkey. The participants were divided into two groups. The first group (FF) included 20 students who took face-to-face education and the second group (OL) consisted of 20 students who took online education. The qualitative data were collected from both groups by means of a structured written interview form. The results revealed two main themes (1-Feelings, 2- English language production process) and ten sub-themes (1a- positive feelings, 1b- negative feelings, 1c- both positive and negative feelings, 2a- developing intimacy, 2b- collaboration and ease of communication, 2c- insufficiency of English language production, 2d-increase of knowledge, 2e-use of speaking skills, 2f- insufficiency of socialization and interaction, 2g- challenges of online education). The study compares both groups with respect to the above themes and subthemes and discusses implications for the teaching of English.

온라인 불교교육에 대한 학습자 요구도 분석: FGI를 중심으로

The purpose of this study is to examine learners’ needs related to online Buddhist education. For this purpose, focus group interviews were conducted and analyzed with seven learners who participated in online Buddhist education. Learners’ needs related to online Buddhist education were centered around ‘motivation to use online Buddhist education,’ ‘experience of participating in online Buddhist education,’ and ‘support needed to increase the field usability of online Buddhist education.’ From the ‘motivation for using online Buddhist education’, ‘desire to study Buddhism’, ‘acquiring psychological stability’, ‘communication with believers’, ‘desire to live a spiritual life’, and ‘strengthening accessibility to Buddhist content through non-face-to-face’ were derived. From the ‘experience of participating in online Buddhist education’, ‘various teaching methods through online’, ‘use of various class contents’, ‘progress-oriented classes’, ‘specific classes’, and ‘communication in non-face-to-face classes’ were derived. From ‘Support needed to increase field usability of online Buddhist education’ to ‘Need to improve system for non-face-to-face classes’, ‘Development of highly attractive non-face-to-face content’, ‘Development of communicative small group activity classes’, ‘Instructors and learners’ ‘Strengthening communication among students’, ‘Need to systematize non-face-to-face Buddhist curriculum’, ‘Need to evaluate online classes’, and ‘Need to consider non-face-to-face counseling’ were identified. This study is significant in that it contributed to deriving directions for the composition, content, and methods of online Buddhist education and diversifying Buddhism-related research methods by conducting a needs analysis of learners.

Building with Butterflies: The Role of Design and Art in Co-creating New Identities for Services

The workshop will build upon and explore the design approach that was developed through a collaboration between Trindlemoss Day Opportunities for people with learning disabilities and two interns from the Glasgow School of Art (GSA). It will involve the interns and the service delivery team sharing their process and learnings and demonstrating some of the key engagement methods from their work, and encourage reflection on the role of art and design in reshaping services.
 In North Ayrshire, our learning disability day services underwent a situational change, involving a merging of 2 separate building-based services within a new site. Along with this physical change, we recognised a need for a change in practice and ethos, moving away from a rigid, building based, model of provision, to a much more community oriented/distributed model, integrated with a variety of service and third sector partners. For individuals and staff who had been accessing and working within the services for a long time, this presented a profound shift in thinking and practice. 
 Engaging customers, their families, and staff in an ongoing conversation about this process was critical but we tended to default to traditional methods of doing this. Working with interns from GSA provided an opportunity to take a creative, design led co-creation approach to engage with customers and staff. The brief was to deliver artefacts which captured the journey so far and hopes for the future, in a form shaped by the conversations they had, and thereby create a foundation for change. Recognising the need for flexibility to support engagement with customers with a wide range of abilities and communication preferences, the interns developed a variety of approaches including gamifying conversations through the use of physical board games. These are approaches which are best experienced, rather than described.
 The work led to a variety of outputs, including a visual identity for the centre to be used in branding; on-site art installations which reflected themes of growth and empowerment; and value and vision statements which underpin all aspects of the work, and which will be core to the identity of the service going forward.
 As a hands-on exploration of design-led approaches to co-creation, the workshop will have relevance for anyone seeking to engage service users from marginalised (and other) communities in ways that amplify their voice in an authentic and joyful manner. The theme of integration will be central to the workshop: pursuing integration with new collaborators; integrating customers and staff in shared conversations; integrating notions of external community identity, reversing the frequently inward facing service discussions; and integrating the personal and collective resources of individuals within creative activity.
 Workshop structure:
 Presentation: Introduction to Trindlemoss Day Opportunities: our change journey – 5 minutes
 Presentation: The work of the GSA interns: new perspectives, new tools – 15 minutes
 Activity: Using design based tools – small group activity for workshop participants – 20/30 minutes
 Open discussion: Design based thinking and practice as a lever for equity and integration – 15 minutes
 Summary and close – 5 minutes

Importance of incorporating ultrasonography into undergraduate medicine practices

Introduction: Ultrasound as a learning tool is a new and promising approach. Furthermore, its use in the point of care model (POCUS) has been incorporated into today's medical practice. Objective: Collect student perception about ultrasound as a teaching tool in the basic cycle of the medicine course. Methodology: a focus group was structured with students from the first three periods and the data was analyzed by a system and three independent researchers. Results: Participants (n=20) recognized ultrasound as a theoretical-practical integration tool and the activity in small groups as an excellent opportunity. On the other hand, immediate applicability in learning was not always perceived and, among so many disciplines, its use may be threatened. Conclusion: Through US teaching, the association of fundamental undergraduate content, such as anatomy, physiology and semiology, becomes more palpable and less abstract to the student. In this way, it becomes a tool with the potential to play a strategic and methodological role in teaching the basic cycle in the medical course, contributing to the practice of POCUS, certainly incorporated into the daily professional lives of future doctors.

Implementation of COIL in mental health education: Outcomes of a collaboration between Spain and the United States nursing students

Collaborative International Online Learning (COIL) provides students meaningful and valuable engagement with students in another country to reach the goals of academic programs at the participating institutions. The strategy has demonstrated benefits for nursing students, including the acquisition of self-awareness, empathy, cultural humility, and leadership skills. The aim of this study was to share the results of the partnership in a COIL project using digital technology between a university in the United States and a university in Spain. The goals of this collaboration were twofold: to expose students in the U.S. and Spain to an international experience on mental health and to provide a comparative view of their respective health care systems. The chosen technique focuses on perceptions of mental health and how mental health care is delivered in clinical settings. A total of 166 students took part in this experience. The virtual exchange allowed students and faculty to share best practices in caring for people with mental illness. Nursing students providing care to COVID-19 patients reflected on lessons learned during the pandemic and its impact on community mental health. Small group activities such as icebreakers, homework assignments, and reflections were used to share and compare experiences. Students completed COIL surveys, which demonstrated that students from both countries perceived learning gains using evidence-based best practices related to key nursing concepts in a mutually respectful virtual exchange. The results show a perceived increase in the comprehension of mental health-related content and enhancement of clinical practice. Therefore, the COIL methodology is a feasible option as it allows for an intercultural exchange with an in-depth examination of content from the learners and teaching perspectives. In addition, it prepares students to work in international teams virtually.

Comparative Study in Adults who Stutter with and without Social Anxiety

Background: Stuttering, a complex fluency disorder, often coexists with social anxiety, impacting individuals' communicative competence and quality of life. The intersection of these conditions can exacerbate the challenges faced by adults who stutter, influencing their social participation, educational and professional success, and social status. Objective: The study aimed to elucidate the relationship between stuttering and social anxiety in adults and to determine the extent to which social anxiety affects stuttering severity across various social situations. Methods: A cross-sectional analysis was conducted with 80 adults, split into two groups based on the presence (30 participants) or absence (50 participants) of social anxiety. Data were collected on stuttering frequency and severity during common social interactions such as using a telephone, eating, and speaking in public. Stuttering severity was classified as none, mild, moderate, or severe. Statistical analysis was employed to compare the prevalence of stuttering across different social scenarios between the two groups. Results: The presence of social anxiety was associated with higher instances of no stuttering during telephone use (86.7%), small group activities (60%), and eating in public (56.7%). In contrast, participants without social anxiety showed higher rates of mild stuttering in these situations (62%, 68%, and 50%, respectively). Social anxiety did not correlate with moderate or severe stuttering in any assessed situation. Conclusion: Social anxiety in adults who stutter correlates with a reduced frequency of stuttering in certain social situations. However, the absence of social anxiety is associated with an increased occurrence of mild stuttering. These findings suggest that social anxiety may have a mitigating effect on stuttering severity, highlighting the need for integrated clinical approaches to address both speech and psychological aspects of stuttering.

Preservice Elementary Teachers’ Knowledge Resources for Blending Arguments and Representations in Science

ABSTRACT This study investigates how preservice elementary teachers (PSTs) engage and reflect on two science disciplinary practices: engaging with representations and engaging in evidence-based arguments. In the context of elementary science, teachers blend multiple practices across curricular topics and instruction. However, studies of teachers’ use of various practices often examine them independently. Contrastingly, here we examine the blending of these two practices with a focus on PSTs’ myriad ways of sensemaking about these practices, referred to as knowledge resources. Data involve audio recordings of PSTs discussing arguments and representations while engaged in small group activities centered on carefully designed teaching cases where the PSTs were tasked to imagine that they are the teacher in an elementary classroom. Analyses reveal that the PSTs used a variety of knowledge resources for analyzing existing representations, generating new representations, and evaluating and generating both existing and new arguments. We also found that PSTs’ knowledge resources about arguments and representations were brought together in two ways: generating arguments based on given representations to enhance their understanding and generating representations in response to student arguments to enhance student understanding. These findings are important for teacher education, how PSTs are taught to engage with these practices, and how they conceptualize different instructional strategies for supporting elementary students’ understanding and use of these practices.

L2 Willingness to Communicate of Indonesian High School Learners of English: An Exploratory Survey Study

This study intends to explore Indonesian Senior High School learners’ second/foreign language (L2) Willingness to Communicate (WTC) in English. It employed a Google Form questionnaire as the method of collecting data. 159 L2 learners from more than six islands in Indonesia participated in this study. This study found that learners generally reported a moderate level of L2 WTC. They were moderately enthusiastic to speak in English class, moderately confident to use English in communication, and moderately willing to use English in small groups and pair work activities. However, seen from rather big standard deviations of the mean scores, the participants’ responses may be very heterogeneous, suggesting rather spread out values away from the mean scores. Pedagogical implications include promoting small-group activities and minimising whole-class discussions.

Bridging group work and whole-class activities through responsive teaching in science education

Previous studies have shown both benefits and challenges of group work and whole-class activities in educational settings. One overall finding in the existing literature is that it is challenging for teachers to facilitate whole-class conversations that realise the rich potential of student discussions and undertakings during group work. This article investigates how teachers can facilitate productive consolidating whole-class conversations building on students’ group work experiences by enacting responsive teaching practices, implying foregrounding students’ experiences and ideas, and pursuing the substance of the students’ experiences and ideas in instructional work. Based on a sociocultural perspective, we analyse sequences of classroom interactions where students’ experiences from their lifeworld are invoked in a) settings where student engage in small group activities and b) teacher facilitated whole-class conversations. The educational context is a science project about genetics involving lower secondary school students and their science teacher. Our analysis shows that in group work settings, students’ everyday experiences are invoked but are seldom picked up on and pursued in group conversations as resources for engaging with science matters. In whole-class conversations facilitated by the teacher, especially in situations in which the teacher assumed a responsive teaching approach, students’ everyday experiences were more often realised as resources for shared meaning making and engagement with scientific concepts and ideas. We discuss this study’s implications for teachers designing productive learning activities that combine group work and whole-class activities.

Curriculum Innovation: Design and Implementation of Synchronous and Asynchronous Curricula to Enhance Residents' EEG Knowledge and Experience.

There is a need for structured EEG education opportunities to enhance neurology resident education. To address this need, the American Epilepsy Society (AES) supported the development and implementation of both synchronous and asynchronous EEG courses. To produce EEG curricula that enhance resident EEG learning, increase interest in EEG and improve participants' knowledge, and to ensure that courses were highly used and available to the broadest range of learners. A multi-institutional group of EEG educators developed both courses. The synchronous curriculum consisted of a mixture of brief "mini-lectures" and interactive small group activities with self-assessment quizzes at the start and end of the course. The online asynchronous EEG curriculum consisted of self-directed slide sets, multiple-choice self-assessment quizzes and a structured EEG self-assessment tool. Courses were evaluated using postcourse surveys, analysis of pretest and posttest data, and analysis of user data from the asynchronous curriculum. Between 2019 and 2021, 56 residents participated in the synchronous EEG courses. On the resident survey, mean Likert scores for course design, planning, and learning outcomes ranged from 4.6 to 5.0 for the in-person courses and from 3.9 to 4.5 for the virtual course. On the 24-item pretests and posttests, overall median scores increased from 60% (14.5/24) to 75% (18/24; p < 0.001). More than 2,300 learners completed the first submodule of the asynchronous curriculum, but only 164 completed all sections. Most of those who completed the asynchronous curriculum reported that it was effective and appropriate for resident-level learning. The AES EEG courses provide EEG learning opportunities for neurology residents beyond what is available at their home institutions. There is evidence for the effectiveness of the synchronous course, but the scope is limited to a small number of attendees. The asynchronous curriculum is more broadly available, but very few learners completed all elements. Future steps will include expansion of the in-person synchronous course and providing guidance to learners about the core and optional components of the asynchronous curriculum to increase the impact of both educational offerings.

A33A novel form of communication training for Medical Support Workers at a large teaching hospital

The Medical Support Worker (MSW) Programme, funded by NHSEI, enables International Medical Graduates (IMG) and refugee doctors to work in the NHS, whilst acquiring General Medical Council (GMC) registration [1]. MSWs and IMGs have a recognized set of learning needs, with communication difficulties the most reported challenge amongst IMGs [2]. North Bristol Trust (NBT) employed a second cohort of 30 MSWs in July 2022, all of whom previously practiced medicine in Myanmar. NBT enlisted the assistance of a local Community Theatre to create and deliver a novel training programme with an emphasis on improving confidence in communication. Reflective pieces completed by MSWs one month in to post, alongside two probing questionnaires, highlighted the demand for communication training. A local Community Theatre, with prior experience of working with migrants, refugees, and vulnerable groups, was contacted. The Community Theatre met with both current and former MSWs to further identify development needs. Subsequently four two-hour workshops, with specific focuses, were designed: Session 1: Informal conversation, talking about yourself Session 2: Voicing opinions and interpretations, acknowledging mistakes Session 3: Talk about yourself, interview practice, body language Session 4: Public speaking, dealing with conflict Workshops consisted mostly of games and small group activities with an element of performance. The programme was evaluated using a feedback form, consisting largely of Likert scale questions, completed after the 4th session. Communication, social skills or cultural change were highlighted as the biggest challenges by MSWs (64%). Confidence in tasks that involved speaking in front of groups, dealing with conflict, or speaking to relatives was low (13.6-22%). Only 52% of MSWs felt confident speaking to colleagues. The sessions were well received with 100% of respondents reporting both to have enjoyed the sessions and that they would recommend the sessions to other MSWs. Results showed improvements in confidence, specifically with regards to: conversing with colleagues (94%), informal conversation (87.5%), public speaking (88%), raising concerns (100%) and offering opinions (100%). This novel locally developed communication training addresses some of the unique learning needs of MSWs and improves communication skills in a range of areas. The programme is being considered for expansion to international nurses and IMGs at NBT. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Embracing Culturally Relevant Computational Thinking in the Preschool Classroom: Leveraging Familiar Contexts for New Learning

AbstractComputational thinking (CT) is an important twenty-first century skill that begins developing early. Recent interest in incorporating early CT experiences in early childhood education (i.e., preschool) has increased. In fact, the early years mark an important time during which initial competencies are acquired, interest and motivation begins to form, and in which children may develop a sense of belonging in STEM fields. As a result, providing children with access to robotics and computer science experiences to support CT that are also developmentally appropriate and culturally relevant is key. This paper uses the “powerful ideas” of computer science, seven developmentally appropriate CT concepts that children can learn, as a framework and explores the experiences of two (composite) teachers who participated in and co-developed a culturally relevant robotics program and the processes they undertake to support children’s CT development and learning. This paper considers practices that support the seven key powerful ideals while leveraging existing instructional routines and contexts that are already occurring in most classrooms, such as centers, small group activities, classroom environments, and read-alouds. Of note, this paper prioritizes approaches that acknowledge, center, and feature the ethnic, cultural, and linguistic backgrounds of young children and their families. Identifying affordable and accessible practices, this paper provides educators with tangible, integrated, and authentic practices to support children’s computational thinking, STEM learning, and sense of belonging.

Addressing Language Diversity in Early Years Mathematics: Proposed Classroom Practices through a Live Brief Assessment

There is a growing emphasis on the role of language in teaching and learning mathematics, most significantly in classrooms with increased language diversity. Consequently, teachers face considerable challenges in accommodating diverse needs and must employ strategies to support all students. It is, therefore, crucial to provide prospective teachers with opportunities to enhance their pedagogical approaches while raising their awareness of the relationship between language and mathematics. In this respect, Live Brief assessments in Higher Education, which involve students working on authentic projects/tasks from a school, may be a promising avenue. This research draws on the 19 Live Brief group presentations prepared by a total of 118 Year 1 prospective primary school teachers, specifically focusing on the language-related challenges faced by a local school in early years mathematics. The data encompassed prospective teachers’ proposed practices, including one-to-one, small group and whole class activities, that aimed to address language diversity. Data analysis was informed by Moschkovich’s three perspectives on the relation between language and teaching and learning mathematics, namely lexicon, register and situated-sociocultural perspectives. While a lexicon perspective was commonly evident in the activities, the manifestation of a situated socio-cultural perspective mainly in the one–to-one activities is noteworthy, given its social and discursive nature. Three themes encapsulated a range of practices suggested in the findings: explicit vocabulary teaching, different strategies of scaffolding and utilising multi-sensory approaches. While the lexicon and register perspectives were commonly evident, the situated socio-cultural perspective was much less commonly manifested in the practices. We offer implications to initial teacher education curriculum, future research and policies about teaching and learning mathematics.

Piloting a Transition of Care Curriculum at Two Bi-coastal Medicine-Pediatrics Residency Programs.

Lack of consistency in primary care residency training exists in transitions of care (TOC) of adolescents from pediatric to adult medicine, which can lead to conflicting or incomplete training. To fill this gap, we developed a curriculum based on the Got Transition Six Core Elements and piloted it at two bicoastal, academic Medicine-Pediatrics (Med-Peds) residency programs. The goals of this project are to increase resident TOC knowledge, increase transition discussion comfort and skills, and obtain feedback for curriculum improvement. Two educational sessions were held at both institutions between 2020-2021. Of 32 potential resident participants, 26 participated in session one and 22 participated in session two. Sessions included a didactic presentation, small group activities, and a guest speaker discussing transitional experience. Electronic pre-session, post-session, and retention surveys evaluated resident knowledge, comfort, and self-reported skills of TOC. A Hybrid Type II design was used with mixed methods to evaluate curriculum effectiveness and implementation. The first and second sessions had 81% and 68% attendance, respectively. Eighty-four percent completed the pre-session survey, 65% completed the post-session survey, and 68% completed the retention survey. TOC knowledge increased by 19% overall (p<0.001). First-year residents gained the most knowledge and implementation skills. Residents participating in alternating medicine and pediatric clinics gained more knowledge than those in a combined Med-Peds clinic (p=0.001). Comfort increased for both initiating and continuing TOC discussions after the first session. Knowledge retention was not statistically significant. A standardized TOC curriculum can improve resident knowledge and is easily implemented at multiple institutions. Early-in-training residents and those in alternating medicine and pediatric clinics particularly benefit.

Disrupting Faculty-on-Faculty Bullying in Academic Medicine: An Innovative Workshop.

Bullying, a severe form of mistreatment, occurs when an individual in an authority position intentionally imposes negative persistent behaviors on a target. In academic medicine, bullying is used to impede the target's professional growth. While there is abundant literature on how to disrupt other forms of mistreatment, the literature related to bullying among academic medical faculty members is scarce. We developed an interactive workshop on disrupting faculty-on-faculty bullying in academic medicine, with a focus on gender-based bullying, following Kern's model of curriculum development. The workshop consisted of three didactics on the scope of bullying in academic medicine: identifying bullying behaviors, learning strategies to mitigate bullying, and understanding what constitutes comprehensive antibullying policies. The workshop also included three small-group activities to reinforce learned concepts. Eighty-seven faculty attended one of three workshops held over a 6-month period. We received 24 completed evaluations for a 28% rate of return. Most participants rated workshop activities as being well taught and of great value. Many respondents commented that after participating in the workshop, they realized they had likely experienced or witnessed bullying in their careers and that mitigating bullying required effort at multiple levels (individual, institutional, national). This workshop fills a need in academic medicine through addressing how faculty members and institutions can help themselves and others to disrupt bullying. We will continue to disseminate this workshop at national conferences and at individual institutions. This resource will allow other educators to offer the workshop at their home institutions.

컨설턴트 양성 관련 국내 학술연구의 결과 및 동향 분석

The purpose of this study is to analyze the results and trends of domestic academic research on consultant training programs and to present directions and tasks for follow-up research. A total of 37 domestic academic research materials were collected on December 31, 2022, for the subjects of analysis. The quantitative characteristics of academic research were analyzed for the publication year, research type, research personality, and research field. Five research topics were analyzed as standards, and the results are as follows. First, most of the domestic research on consultant training programs are focused on providing basic information rather than program designs and development. Program design and development were mainly carried out in connection with analysis, implementation, and evaluation. The content of the programs had a relatively high proportion of methodological expertise, and about half of the programs included a practice course. In terms of implementation-related research, the programs conducted interim checks and small group activities. Evaluation-related research was conducted using questionnaires and interviews to assess satisfaction and program effectiveness, and overall, satisfaction with the practice course was high. There were no studies on systems, and they were merely mentioned briefly at the end of the research.

중학교 과학 수업에서 학생 행위주체성 발현을 위한 문제중심학습 활용 프로그램 개발 및 적용

Objectives The purpose of this study is to develop a program using problem-based learning to express student agency in middle school science classes and to verify the effectiveness of the program by applying it to science classes in the third grade of middle school.&#x0D; Methods Among the existing models of problem-based learning, the program was developed using the model of IMSA, and the validity of the program was reviewed by six incumbent science teachers with more than five years of educational experience. The developed program was applied to 180 third grade students at S Middle School in I City in December 2022, a pre-post test using tools to measure student agency for middle and high school students and class satisfaction survey were conducted on 135 students who agreed to participate in this study and participated in both the pre- and post-test in questionnaires. In order to analyze the results of the survey using the tools to measure student agency, a paired t-test was conducted using SPSS 12.0. In addition, the course was recorded to understand the meaning of the survey results in detail, and various data such as small group activity papers, student output, course-based evaluation data, and researchers' observation journals were used as auxiliary data. In addition, a class satisfaction survey was conducted to confirm the perception of the classes of students who participated in the program, In order to understand students' perceptions of the class in depth, semi-structured interviews were conducted after class, and the transcribed data were analyzed by recording them.&#x0D; Results A total of six classes were developed and applied to students, and their effectiveness was verified. As a result of paired t-test for survey using the tools to measure student agency, there was statistically significant differnece between the pre- test and the post-test in both total student agency and their 3 sub-domains. In addition, it was confirmed that the components of student agency, such as a sense of purpose, reflective behavior, investment of time and effort, and responsibility, appeared in the course of the class. In addition, the average of the class satisfaction survey was high at 4.13. And it was confirmed that the perception of the class was positive through semi-structured interviews conducted after class.&#x0D; Conclusions The program using problem-based learning for the expression of student agency developed in this study is effective in expressing student agency, and students' perception of the class is positive. Therefore, this study is expected to help middle school science teachers in the field who are considering designing the class support the expression of student agency, and to provide students who experience this program an opportunity to learn whole middle school science concepts.

Teaching Clinical Reasoning inthe Preclinical Period.

Developing the clinical reasoning skills necessary to becoming an astute diagnostician is essential for medical students. While some medical schools offer longitudinal opportunities for students to practice clinical reasoning during the preclinical curriculum, there remains a paucity of literature fully describing what that curriculum looks like. As a result, medical educators struggle to know what an effective clinical reasoning curriculum should look like, how it should be delivered, how it should be assessed, or what faculty development is necessary to be successful. We present our Introduction to Clinical Reasoning course that is offered throughout the preclinical curriculum of the Uniformed Services University of the Health Sciences. The course introduces clinical reasoning through interactive lectures and 28 case-based small group activities over 15 months.The curriculum is grounded in script theory with a focus on diagnostic reasoning. Specific emphasis is placed on building the student's semantic competence, constructing problem lists, comparing and contrasting similar diagnoses, constructing a summary statement, and formulating a prioritized differential diagnosis the student can defend. Several complementary methods of assessment are utilized across the curriculum. These include assessments of participation, knowledge, and application. The course leverages clinical faculty, graduate medical education trainees, and senior medical students as small group facilitators. Feedback from students and faculty consistently identifies the course as a highly effective and engaging way to teach clinical reasoning. Our Introduction to Clinical Reasoning course offers students repeated exposure to well-selected cases to promote their development of clinical reasoning. The course is an example of how clinical reasoning can be taught across the preclinical curriculum without extensive faculty training in medical education or clinical reasoning theory. The course can be adapted into different instructional formats to cover a variety of topics to provide the early learner with sequential exposure and practice in diagnostic reasoning.

The “School in the Green”: An Experience of Developing Scholastic Intelligence Through the Enhancement of the Naturalistic and Visual-Spatial Ones

The "Cipolletti" Institute has launched, from the 2020-21 school year to today, in the summer months, the experience of the "School in the Green", located in a wood in the town of Banzano di Montoro (AV- Italy). It is a space equipped for the safety of kindergarten and primary school children, in which motor, artistic, and laboratory activities are carried out in English since the Institute is a bilingual school. The school, which has been using the "Embodied cognition" model for years, has intended to integrate "Embodied" learning, precisely "Embodied", with outdoor teaching, trying to develop, in parallel with scholastic intelligence, also naturalistic intelligence, and visual-spatial. Among the scientific assumptions is that of Waldpädagogik, of experiential pedagogy that values discovery learning. The project of the "School in the Green" was supervised by the Chair of Developmental and Educational Psychology of the Department of Medicine, Surgery, Dentistry "Scuola Medica Salernitana" of the University of Salerno (Italy), and the same Department sponsored the project. The activities carried out were: Study science directly through sensory experience in nature; Music and movement workshop with Orff instruments; Sensory and musical journey with handcrafted instruments; Motor paths and motor coordination to develop naturalistic intelligence and visual-spatial intelligence; Motor-sport activity in the greenery; Immersive learning of the English language; Peer tutoring for learning English; Small group activity in Spanish; Learning of less widespread languages with the 3D construction of morpho-phonemes (for example Korean, Portuguese); Theatrical activities in nature; Garden care; Workshop for flower arrangements; Outdoor cooking workshop¸local field trips. This short article reports the theoretical construct of reference and research to evaluate whether school learning activities benefit from being implemented in a naturalistic context.