Traditional Training Research Articles

Comparing physiological and psychological effects of virtual reality vs. traditional high-intensity interval training in healthy individuals: results from a preliminary pilot randomised controlled trial

BackgroundPhysical inactivity is a growing concern, contributing significantly to the development of chronic diseases. Virtual reality and active video games have emerged as potential solutions to promote physical activity by integrating immersive experiences with exercise. High-intensity interval training (HIIT) is a time-efficient method for improving fitness, but its intensity may reduce motivation. Recent studies suggest that virtual reality (VR) could enhance both the psychological experience and motivation to engage in exercise, making it a promising alternative to traditional HIIT training.ObjectivesThe study aimed to explore the feasibility, efficacy, and potential effects of VR compared to traditional HIIT in terms of physiological and psychological outcomes in physically active adults.MethodsUsing a parallel-design pilot randomised controlled trial, 10 participants completed the study and were randomly allocated to either the VR group (n = 5) or non-VR group (n = 5). The VR group participated in a single session of HIIT using the Facebook Oculus Quest 2 VR headset, while the non-VR group underwent a single session of traditional HIIT training. Physiological outcomes, including heart rate parameters (measured using a Polar HR monitor) and rating of perceived exertion (RPE, assessed using the Borg scale), as well as psychological outcomes of the flow experience (measured using the Flow State Scale questionnaire) were assessed.ResultsStatistical analysis showed no significant difference in heart rate parameters between the VR and non-VR groups, indicating that both interventions achieved comparable exercise intensity and meeting the recommended levels for health benefits. However, the VR group demonstrated a lower RPE score (p < 0.001, d = − 3.7; BF10 = 58.7), suggesting a reduced perception of effort during the exercise session compared to the non-VR group. Additionally, the VR group reported a significantly higher post-intervention flow state score — a state of deep focus and immersion — in the subscale of unambiguous feedback (p = 0.04, d = 1.6; BF10 = 2.2), reflecting clear, immediate feedback and a more engaging, intrinsically motivating exercise experience.ConclusionsThis pilot study suggests that fully immersive VR can be an effective alternative to traditional HIIT, providing a high-flow experience and potentially enhancing motivation among physically active users.Trial registrationClinicalTrials.gov, NCT06420414. Registered 20 May 2024 — retrospectively registered, https://clinicaltrials.gov/study/NCT06420414

A randomized control trial to compare Quiet Eye training efficacy to traditional technical training with undergraduate student nurses' peripheral intravenous cannulation performance: a protocol.

Peripheral intravenous cannulation (PIVC) is a common and complex procedure with low first-attempt success rates, causing patient suffering and increased healthcare costs. Quiet Eye (QE) training, a gaze-focused approach, has shown promise in improving procedural PIVC skills. We will examine the effectiveness of traditional technical training (TT) and QE training (QET) on student nurse PIVC performance. Forty-four participants will be randomly assigned to either the TT or QET groups using a blocked randomization method to ensure balanced group sizes. Blinded outcome assessments will minimize bias. Data will be collected using a structured questionnaire and a mobile eye tracker to simultaneously record gaze and hand movements. Participants will complete pre-intervention, post-intervention, and one-week retention tests using a light-skinned manikin arm. A transfer task, utilizing a dark-skinned manikin arm, will assess participants' skills post-trials. The TT group will receive traditional instruction on hand movement improvement; the QET group will receive feedback on their gaze behaviours. The primary outcome measure will be PIVC first attempt success defined as being able to flush the inserted catheter with 10 mL (maximum) normal saline into the vessel. A trial will be considered unsuccessful if more than gentle pressure on the syringe plunger is needed to flush the catheter or if the participant abandoned the attempt before attempting the flush. Other dependent variables will be QE duration (%), number of fixations, total movement time(s), and movement phase time(s). We will analyze data with descriptive and inferential statistics, including mixed model ANOVA and Chi-Square tests. This study examines the significance of improving PIVC first attempt success rates and highlights QET potential as an intervention. Emphasis is placed on critical implications for health care, particularly the importance of integrating QET into nursing education programs. Future research utilizing large-scale trials and longitudinal designs is recommended.

The use of virtual reality in human training: trends and a research agenda

Traditional classroom training sessions can negatively impact participants’ engagement and knowledge retention. In response, several organisations are moving towards innovative and more engaging approaches, such as virtual reality (VR). By using VR, participants can immerse in a simulated environment, acquiring experiences in rare and hazardous situations that cannot be experienced in the natural environment without risk to the participants. VR has been applied in several areas, and this study aims to understand the applicability and impact of VR simulators on human training and perspectives of this emergent area. Drawn on a rigorous systematic literature review of 82 articles, the study presents findings from the thematic analysis. First, descriptive results outline the VR literature and its applications as an innovative training and learning tool. Second, a prescriptive thematic analysis has identified emerging themes related to behavioural, technological, and organisational benefits. The results also show the VR challenges related to technological limitations, restricted resources, and academic research. This study demonstrates the development of VR in human training, presenting contributions to theory and practice. The study presents some limitations related to the scope and focus of the study, and future pathways to address these limitations are suggested. For instance, the research protocol did not consider conference papers or articles that were not in English, and it was limited to a search period. Furthermore, emergent topics such as artificial intelligence and VR technology's physiological-emotional and sensory aspects in training should be addressed. Therefore, future studies should address these topics and use the research agenda suggested in this study.

Comparison of the effects of isoinertial and traditional strength training in male tennis players

&amp;lt;p style=&amp;quot;text-align: justify;&amp;quot;&amp;gt;The goal of the research was to determine the effects of six weeks of isoinertial training on explosive strength, speed, and agility compared to traditional strength training in tennis players. The subjects, thirty male tennis players aged 20 to 35, were divided into three groups: the experimental group 1 (E1; n=10), which performed strength training on an isoinertial device; the experimental group 2 (E2; n=10), which performed traditional strength training; and the control group (C1; n=10). E1 and E2 groups had a total of six weeks of training with two training sessions per week, with three exercises per training session performed in four series for six to eight repetitions. The results showed that isoinertial strength training has a positive effect in the variables squat jump (SJ), countermovement jump (CMJ), 5-meter sprint (5M), 20-meter sprint (20M), agility T-test (T-test), and 505 agility test (505). Post hoc analysis revealed that there are significantly better effects of isoinertial training compared to isodynamic training in the countermovement jump (CMJ), 5-meter sprint (5M), and 20-meter sprint (20M). The E1 group had significantly better results than the C1 group in all tests. The E2 group had significantly better results compared to the C1 group in the variables SJ, 20M, and T-test. The results also show that six weeks of isoinertial training produce better results in the development of variables CMJ and 20M compared to the traditional strength training group. Accordingly, fitness and tennis coaches should also use this training method when working with tennis players.&amp;lt;/p&amp;gt;

Сравнительная оценка подходов к подготовке бакалавров по авиационным двигателям

The paper presents preliminary results of a comparative assessment of two modern approaches to bachelor's degree training: traditional classroom methods and training with immersive technologies, evaluated by the criterion of knowledge acquisition efficiency in the field of 24.03.05 Aircraft Engines. The platform "Virtual pavilion for studying of aircraft engines design" was used as an immersive educational environment. It is a set of interconnected educational spaces: a virtual hangar, a training laboratory, an engine design class and a workshop-simulator. The platform is equipped with tools for interacting with objects during practical tasks, IT databases aintegrated into the environment with information about the studied engines, and their interactive models as digital replicas of engines displayed in the Center for the History of Aircraft Engines at Samara University. An attempt was made to assess the quality of students' learning in the discipline "Introduction to the Specialty" using testing methods. The analysis results suggest that employ-ing immersive technologies in studying complex technical objects can reduce reliance on traditional methods such as drawings, diagrams, cutaway models, and full-scale samples. Instead, virtual simulators, laboratories, libraries, and other tools, including those supporting distance learning, can be increasingly utilized.

Метод разработки интеллектуальных тренажёров на основе онтологии предметной области

In academic disciplines, students are required to learn many new concepts, which necessitates extensive training with feedback. An intelligent simulator enables students to practice solving simple problems while receiving explanations for their mistakes, allowing teachers to focus on addressing more complex issues during lessons. This paper presents a method for developing intelligent simulators based on the ontology of the subject domain, implemented as web appli-cations suitable for both classroom and extracurricular use. Representing the problem and the subject area model in RDF format enables logical inference using the Apache Jena Reasoner inference engine. An example is provided of an intelligent simulator designed for learning the order of operations in expressions, supporting the C++, C#, and Python programming languages. The simulator can explain errors, generate explanatory hints, and engage in educational dia-logue through guiding questions. The simulator was tested with undergraduate and graduate students of the Faculty of Electronics and Computer Engineering at Volgograd State Technical University. Most students found the simulator to be more useful than traditional training tests. It can be employed both for independent study and as part of the educa-tional process in classroom settings.

Enhancing difficult airway management training: the role of virtual reality and adaptive learning

Emergency physicians play a central role in healthcare. They often must make quick and accurate decisions to save patients’ lives. Among the critical procedures they have to master is difficult airway management (DAM), a procedure required to establish and maintain a patient’s airway for adequate ventilation and oxygenation. To ensure optimal proficiency in DAM, the clinical skills that comprise this procedure must be regularly practiced and updated. However, traditional training approaches present significant organizational challenges in terms of time and cost. In response to these issues, we have developed an innovative education and training application employing immersive Virtual Reality (VR) for teaching basic to advanced DAM procedures, supported by an Adaptive Learning system. To evaluate the effectiveness of our DAM training system, we conducted experiments with a control group trained using traditional methods and two VR subgroups, one with and one without the Adaptive Learning component. Our results show that simulating the DAM procedure in VR is effective in improving students’ knowledge and produces comparable learning outcomes to traditional teaching methods. Interestingly, our study did not provide conclusive evidence that the adaptive design was superior to the non-adaptive one in terms of knowledge and acquisition of skills. However, it demonstrated greater efficiency, particularly in reducing training time.

Dual-task resistance training improves strength and reduces pain more than resistance exercise alone in elbow fracture rehabilitation: A Randomized Controlled Trial.

To examine the effects on strength, pain intensity, range of motion (ROM), and functionality of a 12-week dual-task resistance exercise program in patients undergoing rehabilitation from elbow fractures. Randomized Controlled Trial SETTING: Rehabilitation hospital. Individuals undergoing elbow fracture rehabilitation. Randomization was performed sequentially using numbered envelopes containing assignments to either an intervention group (dual-task resistance training using a mathematical task with self-regulation, n=18) or a control group (traditional resistance training, n=14) for 12 weeks. Measures: The primary outcomes were muscle strength for elbow flexors and extensors and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale-11 and disability using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and passive ROM. Dual-task resistance training improved strength and reduced pain more than resistance training alone (p<0.05), and only the dual-task group improved in kinesiophobia (p<0.05). The linear regression showed a significant negative association between kinesiophobia and increased elbow strength in the dual-task group (flexion, r=-0.53, p=0.024; extension, r=-0.65, p=0.004) but not in the control group (p>0.05). No significant differences were observed between the group for disability and passive ROM (p>0.05). Dual-task resistance training and traditional resistance training both enhance strength, reduce pain, improve functionality, and increase ROM after 12 weeks of elbow fracture rehabilitation. However, dual-task resistance training is superior to resistance training alone in enhancing strength and reducing pain.

Comparison of the effect of quick response code-based training and traditional methods on the knowledge, skill, and satisfaction of the nursing students in using medical device

Nurses acknowledge that their understanding of the shortcomings in the utilization of medical devices stems from insufficient knowledge about their correct usage. The use of Quick Response (QR) technology has paved a new gateway for accessing information and resources. The available evidence confirmed the usefulness of QR codes for use in clinical settings as a tool for training. The present research performed a quasi-experimental research design to compare the effect of QR code-based training and traditional methods on the knowledge, skill, and satisfaction of the nursing students in using medical device. For the control group, textual Persian manuals, visual aids in the form of pictures, and URLs were available to the students. For the intervention group, the training approach based on QR codes was explained on the first day of their presence at the heart center. The knowledge, skill and satisfaction evaluations were conducted at the end of the clinical course on day 10. The group of nursing students who used the QR code-based training method had a statistically significant higher mean knowledge and skill score compared to the traditional training method group. The level of satisfaction among students who received training using QR codes was non-significantly higher than traditional method group. Nursing managers and educators can enhance the delivery of high-quality nursing care by using QR code.

A comparison of acute affective responses, physiological measures and training volume between superset and traditional resistance training in untrained adults

A comparison of acute affective responses, physiological measures and training volume between superset and traditional resistance training in untrained adults

WHO public health laboratories webinar series – an online platform to disseminate testing recommendations and best practices during health emergencies

Laboratories play a central role in managing public health emergencies. The COVID-19 pandemic imposed unique challenges on global laboratory systems, including testing protocol uncertainties, supply shortages, rapid need for information dissemination, and disruptions to traditional training methods. In response, the WHO established the Public Health Laboratories (PHL) knowledge sharing webinar series whose goals were to respond to the increased demand in up-to-date and reliable information, which WHO is in a unique position to provide. It also aimed to enhance peer-to-peer exchanges across laboratories. This article outlines the PHL webinar series delivery format and presents how the webinar series was received and perceived by participants and how it evolved to support the response to other health emergencies. Contents of the knowledge sharing sessions, as well as attendance, participants’ satisfaction and application of learning were monitored over time using registration forms, satisfaction polls, an annual survey and focus group discussions. From May 2020 to December 2023, 48 sessions attracted 58,688 registrations from 204 countries and territories. Thirty-five sessions featured presentations of WHO guidance, tools or documents and 39 sessions featured country experience sharing. Initially focused on COVID-19, the series became a tool to rapidly disseminate guidance and best practices during new health emergencies and to address cross-cutting topics relevant to the laboratory workforce. Feedback data shows participants found the webinars very useful (86% respondents), reporting knowledge gains in biosafety, quality management, and laboratory practices. The series facilitated knowledge application, with foreseen changes in workplace procedures and training activities (43% respondents). Barriers such as resource limitations, additional training needs, and connectivity issues were frequently identified. Evidence that this knowledge was subsequently applied by participants, such as through changes in workflow, onwards training events and procedural changes further reinforces the efficacy with which the series was able support the laboratory workforce globally in addressing challenges of the COVID-19 pandemic and other health emergencies. The series utilized sessions on cross-cutting topics to run routinely and to keep a high level of engagement with laboratory professionals globally. This enabled it to act as an adaptable tool that was leveraged effectively and quickly during health emergencies for just-in-time learning.

Construcción conceptual en física a través de métodos didácticos inductivos

This contribution shows the development and evaluation of an educational process withmathematics teachers in training, focused on the use of teaching strategies with inductive characteristics, in Mathematics and Physics subject of the Bachelor’s Degree in Mathematics Teaching at the University of Colima, Mexico. The experience includes 19 students, who have had disciplinary training in mathematics and master the procedural knowledge and algebraic language involved in Physics at the basic levels, but they had had little access to conceptual knowledge of both classical physics and modern physics. With this principle, the course focused on reflection and problem solving. From this logic, the proposal included searching for both the procedural and conceptualdomain, this second one is the central objective of this research. The inductive methods included theuse of audiovisual materials and readings, that go more in the order of dissemination. The results of their work show that, without omitting a more traditional training process, such as problem-solving or classic physics textbooks, the incorporation of inductive strategies focused on the particularities of concepts like “motion” or “light” allows for a deeper understanding of fundamental principles,serving as a functional complement for a more comprehensive understanding.

Exercise intensity and training alter the innate immune cell type and chromosomal origins of circulating cell-free DNA in humans

Exercising regularly promotes health, but these benefits are complicated by acute inflammation induced by exercise. A potential source of inflammation is cell-free DNA (cfDNA), yet the cellular origins, molecular causes, and immune system interactions of exercise-induced cfDNA are unclear. To study these, 10 healthy individuals were randomized to a 12-wk exercise program of either high-intensity tactical training (HITT) or traditional moderate-intensity training (TRAD). Blood plasma was collected pre- and postexercise at weeks 0 and 12 and after 4 wk of detraining upon program completion. Whole-genome enzymatic methylation sequencing (EM-seq) with cell-type proportion deconvolution was applied to cfDNA obtained from the 50 plasma samples and paired to concentration measurements for 90 circulating cytokines. Acute exercise increased the release of cfDNA from neutrophils, dendritic cells (DCs), and macrophages proportional to exercise intensity. Exercise training reduced cfDNA released in HITT participants but not TRAD and from DCs and macrophages but not neutrophils. For most participants, training lowered mitochondrial cfDNA at rest, even after detraining. Using a sequencing analysis approach we developed, we concluded that rapid ETosis, a process of cell death where cells release DNA extracellular traps, was the likely source of cfDNA, demonstrated by enrichment of nuclear DNA. Further, several cytokines were induced by acute exercise, such as IL-6, IL-10, and IL-16, and training attenuated the induction of only IL-6 and IL-17F. Cytokine levels were not associated with cfDNA induction, suggesting that these cytokines are not the main cause of exercise-induced cfDNA. Overall, exercise intensity and training modulated cfDNA release and cytokine responses, contributing to the anti-inflammatory effects of regular exercise.

Incidental Nonspeech Auditory Learning Scaffolds Phonetic, Category, and Word Learning in a Foreign Language Classroom

AbstractThere is considerable lab‐based evidence for successful incidental learning, in which a learner's attention is directed away from the to‐be‐learned stimulus and towards another stimulus. In this study, we extend incidental learning research into the language learning classroom. Three groups of adult second language (L2) learners (N = 52) engaged in structured classroom Mandarin learning took part in an 8‐week study. One group served as a classroom‐only control group. The second group underwent additional intentional auditory training involving Mandarin speech and explicit feedback. The third group underwent additional incidental learning combined with nonspeech “perceptual building block” categories—categories that share critical perceptual dimensions with target L2 speech categories but that are not perceived as speech. We demonstrate that when supplemented with structured classroom learning, incidental learning involving nonspeech analogs promotes phonetic, category, and word learning equivalent to learning from more traditional intentional auditory training.

Faster intervals, faster recoveries - intensified short VO2max running intervals are inferior to traditional long intervals in terms of time spent above 90% VO2max.

High intensity interval training for improving maximal oxygen consumption (VO2max) is a fundamental component of specific preparation phases for middle- and long-distance runners. In this context, short intervals are very popular in practice. The aim of the present study was to determine whether increasing the intensity of short intervals around maximal aerobic speed (vVO2max), compared to traditional long interval runs, leads to a greater time spent above 90% VO2max. 12 highly trained middle distance runners (7 males, 5 females) completed two VO2max sessions (4 × 3 min at 95% vVO2max, recovery: 3 min at 50% vVO2max vs. 24 × 30 s at 100% vVO2max, recovery: 30 s at 55% vVO2max) on the treadmill in randomized order. Spiroergometric data, lactate accumulation, heart rate (HR) and perceived exertion was determined. This allowed the recording of time above 90% VO2max and time above 90% HRmax. To analyze differences between the interval sessions, the paired t-test respectively the Wilcoxon test, if data were not normally distributed, were applied. The time spent above 90% VO2max was significantly lower in the 30-s intervals, despite the higher intensity, compared to the 3-min session (201.3 ± 268.4 s vs. 327.9 ± 146.8 s, p = 0.05, r = 0.57). In contrast, the time spent above 90% HRmax was significantly higher for the 30-s intervals than for the 3-min intervals (820 ± 249 s vs. 545 ± 131 s, p < 0.001, d = 1.73). The blood lactate concentrations showed higher values in the 3-min session (9.69 ± 1.82 mmol/L) compared to the 30-s session (7.59 ± 2.01 mmol/L, p < 0.001, d = 2.34). There was no statistical difference in the rating of perceived exertion between the two sessions (30-s session: 6.5 ± 1.0 vs. 3-min session: 6.8 ± 1.2; p = 0.26). The present study showed that intensified 30-s intervals were inferior to traditional 3-min intervals regarding the time spent above 90% VO2max. Given the observation of an opposing trend in the time spent above 90% HRmax, this parameter should be interpreted with caution in traditional training settings.

Leveraging virtual reality for advanced scrub nurse education: A non-randomized comparative study of training effectiveness

BackgroundProximal femur fractures are common among the elderly, often leading to various complications if the waiting period for surgery is prolonged. Traditional manual-based training for scrub nurses poses challenges in visualizing and understanding surgical procedures. Virtual Reality (VR) offers a potential solution by providing an immersive and interactive learning environment. PurposeThis study aimed to evaluate the effectiveness of VR-based training compared to traditional manual-based training for scrub nurses involved in orthopedic trauma surgeries. MethodsA single-center non-randomized comparative study was conducted with 10 scrub nurses at a tertiary emergency medical facility in eastern Asia. Participants were divided into a manual-based learning group and a VR-based learning group. The effectiveness of each training method was assessed using self-assessment and peer assessment questionnaires, as well as by measuring surgery time, anesthesia time, and the number of instrument errors. FindingsThe VR group reported significantly higher self-assessment scores in terms of realism, understanding of surgical procedures, and instrument preparation (p < .05). Peer assessments indicated no significant differences between the groups in practical performance (p > .05). The Steps for Coding and Theorization (SCAT) analysis revealed that VR enhanced the learning experience by providing a dynamic and immersive environment, although some limitations, such as difficulties in fine hand movements and potential for motion sickness, were noted. ConclusionsVR-based learning offers significant advantages over traditional manual-based learning for scrub nurses by enhancing understanding of surgical procedures and improving instrument preparation. Integrating VR into nursing education can enhance training outcomes, but further research is needed to address its limitations and optimize its use.

Effectiveness of high-fidelity clinical simulation in cardiopulmonary resuscitation training: A systematic review and meta-analysis of controlled trials

BackgroundHigh-fidelity simulation enhances cardiopulmonary resuscitation (CPR) training in a safe environment. MethodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the effectiveness of high-fidelity simulation compared to traditional CPR training. Medline, CINAHL, Scopus and Web of Science were searched for studies, assessing theoretical knowledge and practical skills. RoB 2 was used to assess risk of bias and standardized mean difference (SMD) for effect sizes, assuming a random effects model. The protocol was registered in PROSPERO (ID: CRD42023441692). ResultsTwelve studies with 1,520 participants were included. Simulation improved compression depth [SMD = 0.33, 95% CI 0.15-0.50, I² = 23%] and CPR knowledge retention [SMD = 1.53, 95% CI 0.94-2.12, I² = 79%]. Lack of data made follow-up analysis difficult. ConclusionHigh-fidelity simulation improves CPR skills in the short term compared to traditional training. Further studies are needed to confirm its effectiveness in the medium and long term.

The Effect of Stoma Care Teaching Based on the ARCS Motivation Model on Nursing Students' Learning Motivation, Self-Efficacy and Knowledge Levels

AimThis study aims to examine the effect of stoma care education based on the ARCS (Attention-Relationship-Confidence-Satisfaction) motivation model on nursing students' learning motivation, self-efficacy and knowledge levels. BackgroundNursing education is pivotal in ensuring that students gain the necessary knowledge and skills to provide quality care. Motivation and academic self-efficacy are key factors in student success. DesignThe study employed a randomized controlled pre-test-post-test experimental design. MethodsThis study, conducted between May and July 2024 at Atatürk University Faculty of Nursing, included 46 students attending the Fundamentals of Nursing course. Participants were divided into experimental and control groups, both receiving traditional stoma care training. The experimental group additionally received training based on the ARCS motivation model, designed to enhance attention, relevance, confidence and satisfaction. Data were collected using the "Introductory Information Form," "Motivation Scale for Instructional Material," the "Academic Self-Efficacy Scale," "Stoma Care Practice Knowledge Level Assessment Form." Pre-tests and post-tests covered motivation, knowledge and academic self-efficacy. ResultsStudents in the experimental group showed significant increases in post-test scores for "Attention," "Relevance," "Confidence," "Satisfaction," "Academic Self-Efficacy," and "Knowledge Test"(p<0.05). In the inter-group comparison, the post-test scores of the experimental group were significantly higher than those of the control group across all these dimensions (p<0.05). The most notable difference was observed in the "Knowledge Test" results (ES=4.786, p=0.001), where the experimental group outperformed the control group. ConclusionsAs a result, it was concluded that stoma care teaching based on the ARCS motivation model increased nursing students' nursing students' learning motivation, self-efficacy and knowledge levels.

Effects of body weight-supported Tai Chi Yunshou training on upper limb motor function in stroke patients: A three-arm parallel randomized controlled trial.

To form a unique body weight support-Tai Chi Yunshou (BWS-TCY) training method, apply it to the treatment of upper limb dysfunction after stroke, and provide a new safe and effective treatment method for the clinic. A total of 93 subjects were recruited and randomly divided into conventional rehabilitation treatment (CRT) group, BWS-TCY group and traditional robot-assisted training (RAT) group in equal proportions. Subjects in the CRT group received 60 minutes of CRT daily. Subjects in the BWS-TCY group received 30 minutes of CRT and 30 minutes of BWS-TCY. Subjects in the RAT group received 30 minutes of CRT and 30 minutes of RAT. All interventions were conducted 5 days per week for 12 weeks. Outcome assessments included the Fugl-Meyer Upper Extremity Motor Function Assessment (FMA-UE), Wolf Motor Function Test (WMFT), absolute angular error (AAE), joint range of motion (JMA), modified Barthel Index (MBI), and stroke-related quality of life. Table (SS-QOL). Outcome measures were assessed at baseline, 4 weeks, 8 weeks, and 12 weeks later, and statistical analyzes were performed using two-way repeated measures analysis of variance. After 12 weeks of intervention, significant improvements were observed in all evaluation indicators for the three groups of subjects compared to before the intervention. The upper limb motor function (FMA-UE and WMFT) and proprioception (AAE) showed time effects, time × group interaction effects, and group effects. When comparing the groups, the FMA-UE in the BWS-TCY group, as well as the WMFT and MBI, showed statistically significant differences compared to the CRT group (P<0.05), but not statistically significant compared to the RAT group (P>0.05). The AAE of the BWS-TCY group showed no statistical difference (P>0.05) when compared to the CRT group and RAT group. Furthermore, a time effect was observed on the rotation direction (P<0.05), and pairwise comparison between groups revealed that the BWS-TCY group performed better than both the CRT group and the RAT group. After 12 weeks of intervention, there were time effects and interaction effects between BWS-TCY and daily living activities (MBI) and quality of life (SS-QOL), but no group effect was observed. There was no statistical difference between the two groups in SS-QOL. However, there was a statistical difference (P<0.01) in MBI between the two groups. The 12-week BWS-TCY intervention has been shown to effectively improve upper limb motor function. Retrospectively registered at chictr.org.cn on August 31, 2022 [ChiCTR2200063150] https://www.chictr.org.cn/showproj.html?proj=176229.

Impact of Simulation-Based and Flipped Classroom Learning on Self-Perceived Clinical Skills Compared to Traditional Training

Introduction: Traditional medical education often emphasises theory, but clinical competence relies greatly on practical, hands-on skills. This quasi-experimental study examines how a combined approach—flipped classroom learning and simulation-based internships—affects medical students’ self-assessed clinical abilities. This model seeks to build students’ understanding, practical skills, and confidence in clinical settings through online preparation and realistic simulation exercises. Methods: This study examined changes in medical students’ self-perceived clinical skills after a flipped classroom and simulation-based internship. A total of 391 third- and fourth-year students completed a nine-hour program with morning practice sessions and afternoon high-fidelity scenarios. Surveys before and after the program assessed self-perceived thoracic and abdominal/general skills. Principal Component Analysis (PCA) confirmed the survey’s structure. ANCOVA controlled baseline scores and paired Wilcoxon tests examined subgroup improvements. Results: After the program, significant improvements were observed in self-perceived clinical skills across all domains. Thoracic skills increased from a median of 2.19 to 7.36, and abdominal skills from 5.11 to 9.46. Medical history, vital signs, and blood pressure scores also improved significantly. Third-year students and those attending the Clinical Methodology course showed the greatest gains. All post-intervention improvements were statistically significant (p &lt; 0.001). Conclusions: The combination of flipped classroom learning and intensive simulation training markedly improved students’ perceived clinical competence. These findings suggest that such methods boost students’ practical skills and confidence. Further research is recommended to explore the long-term impact of this approach on skill retention and professional practice.