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Fulltext Implementing blended learning in emergency airway management training: a randomized controlled trial

Kho MHT, Chew KS, Azhar MN, Hamzah ML, Chuah KM, Bustam A, et al.

BMC Emerg Med, 2018 01 15;18(1):1.
PMID: 29334925 DOI: 10.1186/s12873-018-0152-y

BACKGROUND: While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training.
METHODS: A single-center prospective randomised controlled trial involving 30 doctors from Sarawak General Hospital, Malaysia was conducted from September 2016 to February 2017 to compare the effectiveness of BL versus F2FL for emergency airway management training. Participants in the BL arm were given a period of 12 days to go through the online materials in a learning management system while those in the F2FL arm attended a-day of face-to-face lectures (8 h). Participants from both arms then attended a day of hands-on session consisting of simulation skills training with airway manikins. Pre- and post-tests in knowledge and practical skills were administered. E-learning experience and the perception towards BL among participants in the BL arm were also assessed.
RESULTS: Significant improvements in post-test scores as compared to pre-test scores were noted for participants in both BL and F2FL arms for knowledge, practical, and total scores. The degree of increment between the BL group and the F2FL arms for all categories were not significantly different (total scores: 35 marks, inter-quartile range (IQR) 15.0 - 41.0 vs. 31 marks, IQR 24.0 - 41.0, p = 0.690; theory scores: 18 marks, IQR 9 - 24 vs. 19 marks, IQR 15 - 20, p = 0.992; practical scores: 11 marks, IQR 5 -18 vs. 10 marks, IQR 9 - 20, p = 0.461 respectively). The overall perception towards BL was positive.
CONCLUSIONS: Blended learning is as effective as face-to-face learning for emergency airway management training of junior doctors, suggesting that blended learning may be a feasible alternative to face-to-face learning for such skill training in emergency departments.
TRIAL REGISTRATION: Malaysian National Medical Research NMRR-16-696-30190 . Registered 28 April 2016.

Matched MeSH terms: Computer-Assisted Instruction/methods*
Fulltext Early Nutrition eAcademy Southeast Asia e-Learning for Enhancing Knowledge on Nutrition during the First 1000 Days of Life

Brands B, Chomtho S, Suthutvoravut U, Chiong Meng Boey C, Tang SF, Godfrey KM, et al.

Nutrients, 2020 Jun 18;12(6).
PMID: 32570814 DOI: 10.3390/nu12061817

BACKGROUND: The double burden of both under- and overnutrition during the first 1000 days is highly prevalent in Southeast Asia (SEA), with major implications for lifelong health. Tackling this burden requires healthcare professionals (HCPs) to acquire evidence-based current knowledge and counselling skills. We assessed the needs of HCPs in SEA and developed a continuing medical education/professional development (CME/CPD) program using an e-learning platform to reduce existing gaps.
METHODS: European, Thai and Malaysian universities collaborated with SEA national nutrition associations in the Early Nutrition eAcademy Southeast Asia (ENeA SEA) project. We assessed HCPs' needs using questionnaires and mapped CME/CPD programmes and regulations through stakeholder questionnaires. Using a co-creation approach, we established an e-learning platform. Evaluation in users was undertaken using questionnaires.
RESULTS: HCPs in SEA reported major training gaps relating to the first 1000 days of nutrition and limited impact of existing face-to-face training. Existing pre/postgraduate, residency and CME/CPD programmes did not adequately address the topic. To address these gaps, we produced a targeted e-learning platform with six modules and CME-tests. National ministries, Thai and Malaysian universities, and professional associations endorsed the training platform. To date, over 2600 HCPs have registered. Evaluation shows high acceptance and a very positive assessment.
CONCLUSIONS: Dedicated e-learning can reduce major gaps in HCP training in SEA regarding nutrition during the first 1000 days of life at scale and is highly valued by both users and key stakeholders.

Matched MeSH terms: Computer-Assisted Instruction/methods*
The use of the liquid crystal display (LCD) panel as a teaching aid in medical lectures

Wong KT

Med Teach, 1992;14(1):33-6.
PMID: 1376854

The liquid crystal display (LCD) panel is designed to project on-screen information of a microcomputer onto a larger screen with the aid of a standard overhead projector, so that large audiences may view on-screen information without having to crowd around the TV monitor. As little has been written about its use as a visual aid in medical teaching, the present report documents its use in a series of pathology lectures delivered, over a 2-year period, to two classes of about 150 medical students each. Some advantages of the LCD panel over the 35mm slide include the flexibility of last-minute text changes and less lead time needed for text preparation. It eliminates the problems of messy last-minute changes in, and improves legibility of, handwritten overhead projector transparencies. The disadvantages of using an LCD panel include the relatively bulky equipment which may pose transport problems, image clarity that is inferior to the 35mm slide, and equipment costs.

Matched MeSH terms: Computer-Assisted Instruction
Fulltext Dataset on the Acceptance of e-learning System among Universities Students' under the COVID-19 Pandemic Conditions

Al-Okaily M, Alqudah H, Matar A, Lutfi A, Taamneh A

Data Brief, 2020 Aug 18.
PMID: 32837976 DOI: 10.1016/j.dib.2020.106176

The COVID-19 pandemic has produced an unprecedented change in the educational system worldwide. Besides the economic and social impacts, there is a dilemma of accepting the new educational system "e-learning" by students within educational institutions. In particular, universities students have to handle several kinds of environmental, electronic and mental struggles due to COVID-19. To catch the current circumstances of more than two hundred thousand Jordanian university student during COVID-19. 2,500 students have been randomly selected to respond on an online survey using universities' portals and websites between March and April 2020. At the end of the data gathering process, we have received 587 records. The dataset includes 1) Demographics of students; 2) students' perspectives concerning the factors influencing their intention to use e-learning system within the Jordanian universities context. Data were analyzed using Partial Least Squares - Structural Equation Modelling (PLS-SEM). Next, the result has confirmed the positive of direct effect variables (subjective norm, perceived ease of use, and perceived usefulness) on the students' intention to use e-learning system. Next, the result has also confirmed the mediating effect of perceived usefulness and perceived ease of use between subjective norm and the behavioral intention to use the e-learning system with partially supported.

Matched MeSH terms: Computer-Assisted Instruction
Fulltext Effects of COVID-19 in E-learning on higher education institution students: the group comparison between male and female

Shahzad A, Hassan R, Aremu AY, Hussain A, Lodhi RN

Qual Quant, 2020 Aug 04.
PMID: 32836471 DOI: 10.1007/s11135-020-01028-z

In response to the emerging and ever solution to the COVID-19 outbreak. This study proposes a theoretical framework based on literature and model to determined E-learning portal success. The study compared males and females to E-learning portal usage. The study objective is to check the difference between male and female E-learning portals' accessibility among the students' perspective. The study included service quality, system quality, information quality, user satisfaction, system use, and E-learning portal success. The empirical data of 280 students participated from the different universities of Malaysia through google surveys analyzed using the Partial Least Squares Structural Equation Modelling. The study further divided the full model into two domains, which are female and male. In the male model, information quality and system quality have direct relationships with user satisfaction. Information quality also supported the relationship with system use. At the same time, there is a positive relationship between user satisfaction and E-learning portals. Likewise, in the female model, E-service quality and Information quality both are supported by system use and user satisfaction. Similarly, system quality has a positive relationship with user satisfaction, and user satisfaction has a positive relationship with E-learning portals. The study will be further helpful for the Malaysian universities policy-makers such as top management, ministry of higher education, Malaysian universities union in designing the policies and programs on E-learning Portal Success in the country. The findings of the study reveal that males and females have a different level of in terms of usage of towards E-learning portals in Malaysian Universities.

Matched MeSH terms: Computer-Assisted Instruction
Fulltext Screening of medical students’ intention to practice mobile – learning in Malaysia

Sohayla M. Attalla, Nihal A. Hanafy, Mahfuza Akter, Sakinah Ruhi

Malaysian Journal of Medicine and Health Sciences, 2020;16(107):40-45.
MyJurnal

Introduction: The twenty-first-century learning is adopting the student-centered learning techniques and the teach- ers are mainly facilitators to direct the process of learning and so social media and mobile applications became an important learning platform. Mobile learning (M-learning) is the practice of learning activities through a portable device such as cellular phone or a personal digital assistant. The aim of this research is to screen the medical stu- dents’ intention toward the adoption of M-learning and to determine factors affecting the intentions of the medical students to practice M-learning. Methods: A cross-sectional study among medical students was performed through a questionnaire based on the Theory of Reasoned Action and the Technology Acceptance Model. The study included 129 students in different stages of the medical study. Results: Results showed that the factors affecting the students’ inten¬tion to practice M-learning include the students’ attitude, perceived usefulness, perceived ease of use, and availability of resources. In the current sample 82.7% of students are already using M-Learning; 41.7% are using it for assessment, 22.8% are using it for learning and 35.5% are using it for both. Conclusion: It was concluded that most medical students have higher intention to adopt M-learning and they are mostly using it for assessment purposes rather than in learning.

Matched MeSH terms: Computer-Assisted Instruction
Fulltext Performance of dental undergraduate students using international caries detection and assessment system (icdas)

Sanus,M,A,, Nordin,M,A,, Rusli,M,R,, Mohamed,Z,N,h,

Compendium of Oral Science, 2020;7(1):13-19.
MyJurnal

Abstract
Objectives: This study aimed to assess intra- and inter-examiner reliability of International Caries Detection
and Assessment System (ICDAS) and modified epidemiology ICDAS (MOD) code by undergraduate dental
students with different clinical experiences.
Methods: A total of 150 dental undergraduate students with varying clinical experiences (0, 1 and 2 years of
clinical experience) were recruited. Participants received training through a theoretical lecture on ICDAS criteria
by an experienced National Benchmark Group (NBG) examiner and underwent e-learning program prior to
ICDAS calibration. Visual examination on extracted permanent teeth (N= 45) with different location and stages
of caries progression ranging from ICDAS scores 0 to 6, was performed using the ICDAS criteria. The
assessments were repeated after one hour. The data were analysed to evaluate inter-examiner and
intra-examiner reliability in the form of kappa scores using SPSS 23 Software.
Results: Mean kappa values for intra- and inter-examiner reliability for ICDAS code, were between 0.41 to
0.60, and 0.61 to 0.80 respectively. For MOD code, mean kappa values for intra- and inter-examiner reliability
were between 0.61 to 0.80. Good intra-examiner agreement (>0.61) was observed in both ICDAS and MOD
code for all groups.
Conclusion: All students performed similar agreement, therefore, clinical experience within 2 years does not
influence the performance of visual inspection in detecting caries using ICDAS. The results of the study shows
that ICDAS and modified epidemiology ICDAS codes has good reproducibility and is feasible to be used as a
tool in clinical practice as well as patient education.

Matched MeSH terms: Computer-Assisted Instruction
Performance of emergency physicians in point-of-care echocardiography following limited training

Bustam A, Noor Azhar M, Singh Veriah R, Arumugam K, Loch A

Emerg Med J, 2014 May;31(5):369-73.
PMID: 23428721 DOI: 10.1136/emermed-2012-201789

OBJECTIVES: The aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients.
METHODS: Following a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist.
RESULTS: 100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland-Altman limits of agreement for left ventricular function was -9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%.
CONCLUSIONS: Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
Study site: Trauma and emergency department, University of Malaya Medical Centre, Kuala Lumpur

Matched MeSH terms: Computer-Assisted Instruction*
Cytopathology whole slide images and adaptive tutorials for postgraduate pathology trainees: a randomized crossover trial

Van Es SL, Kumar RK, Pryor WM, Salisbury EL, Velan GM

Hum Pathol, 2015 Sep;46(9):1297-305.
PMID: 26093936 DOI: 10.1016/j.humpath.2015.05.009

To determine whether cytopathology whole slide images and virtual microscopy adaptive tutorials aid learning by postgraduate trainees, we designed a randomized crossover trial to evaluate the quantitative and qualitative impact of whole slide images and virtual microscopy adaptive tutorials compared with traditional glass slide and textbook methods of learning cytopathology. Forty-three anatomical pathology registrars were recruited from Australia, New Zealand, and Malaysia. Online assessments were used to determine efficacy, whereas user experience and perceptions of efficiency were evaluated using online Likert scales and open-ended questions. Outcomes of online assessments indicated that, with respect to performance, learning with whole slide images and virtual microscopy adaptive tutorials was equivalent to using traditional methods. High-impact learning, efficiency, and equity of learning from virtual microscopy adaptive tutorials were strong themes identified in open-ended responses. Participants raised concern about the lack of z-axis capability in the cytopathology whole slide images, suggesting that delivery of z-stacked whole slide images online may be important for future educational development. In this trial, learning cytopathology with whole slide images and virtual microscopy adaptive tutorials was found to be as effective as and perceived as more efficient than learning from glass slides and textbooks. The use of whole slide images and virtual microscopy adaptive tutorials has the potential to provide equitable access to effective learning from teaching material of consistently high quality. It also has broader implications for continuing professional development and maintenance of competence and quality assurance in specialist practice.

Matched MeSH terms: Computer-Assisted Instruction/methods*
Fulltext Effect of online formative assessment on summative performance in integrated musculoskeletal system module

Mitra NK, Barua A

BMC Med Educ, 2015;15:29.
PMID: 25884641 DOI: 10.1186/s12909-015-0318-1

BACKGROUND: The impact of web-based formative assessment practices on performance of undergraduate medical students in summative assessments is not widely studied. This study was conducted among third-year undergraduate medical students of a designated university in Malaysia to compare the effect, on performance in summative assessment, of repeated computer-based formative assessment with automated feedback with that of single paper-based formative assessment with face-to face feedback.
METHODS: This quasi-randomized trial was conducted among two groups of undergraduate medical students who were selected by stratified random technique from a cohort undertaking the Musculoskeletal module. The control group C (n = 102) was subjected to a paper-based formative MCQ test. The experimental group E (n = 65) was provided three online formative MCQ tests with automated feedback. The summative MCQ test scores for both these groups were collected after the completion of the module.
RESULTS: In this study, no significant difference was observed between the mean summative scores of the two groups. However, Band 1 students from group E with higher entry qualification showed higher mean score in the summative assessment. A trivial, but significant and positive correlation (r(2) = +0.328) was observed between the online formative test scores and summative assessment scores of group E. The proportionate increase of performance in group E was found to be almost double than group C.
CONCLUSION: The use of computer based formative test with automated feedback improved the performance of the students with better academic background in the summative assessment. Computer-based formative test can be explored as an optional addition to the curriculum of pre-clinical integrated medical program to improve the performance of the students with higher academic ability.

Matched MeSH terms: Computer-Assisted Instruction*
Academic Staff Perspectives Towards Adoption of E-learning at Melaka Manipal Medical College: Has E-learning Redefined our Teaching Model?

Bhardwaj A, Nagandla K, Swe KM, Abas AB

Kathmandu Univ Med J (KUMJ), 2015 12 2;13(49):12-8.
PMID: 26620743

BACKGROUND: E-learning is the use of Information and Communication Technology (ICT) to provide online education and learning. E- Learning has now been integrated into the traditional teaching as the concept of 'blended learning' that combines digital learning with the existing traditional teaching methods to address the various challenges in the field of medical education. Structured e-learning activities were started in Melaka Manipal Medical College in 2009 via e-learning platform (MOODLE-Modular Object-Oriented Dynamic Learning Environment).
OBJECTIVES: The objective of the present study is to investigate the faculty opinions toward the existing e-learning activities, and to analyse the extent of adopting and integration of e-learning into their traditional teaching methods.
METHODS: A cross sectional study was conducted among faculties of Medicine and Dentistry using pre-tested questionnaires. The data was analyzed by using the statistical package for social science, SPSS, version 16.0.
RESULTS: The result of our survey indicates that majority of our faculty (65.4%) held positive opinion towards e-learning. Among the few, who demonstrated reservations, it is attributed to their average level of skills and aptitude in the use of computers that was statistically significant (p<0.05).
CONCLUSION: Our study brings to light the need for formal training as perquisite to support e-learning that enables smooth transition of the faculty from their traditional teaching methods into blended approach. Our results are anticipated to strengthen the existing e-learning activities of our college and other universities and convincingly adopt e-learning as a viable teaching and learning strategy.

Matched MeSH terms: Computer-Assisted Instruction/statistics & numerical data*
Crossing cultural boundaries: flexible approaches and nurse education: a case study

McKenna LG, Samarawickrema RG

Comput Inform Nurs, 2003 Sep-Oct;21(5):259-64.
PMID: 14504602

Computer-mediated conferencing commonly is used to promote collaborative learning, including student learning across distance. This article presents the outcomes and experiences of Master of Nursing students in three countries using flexible learning approaches facilitated by the use of computer-mediated conferencing. It examines issues relating to support for global nursing education, presents an evaluation of one particular unit, and presents themes in the feedback from students about their experience. The authors report the findings in three categories: broadened perspectives, tackling the technology, and adaptive learning. Furthermore, the article offers suggestions for enhancing student-learning experiences when computer-mediated conferencing facilities are used.

Matched MeSH terms: Computer-Assisted Instruction/methods*
Fulltext Perception towards E-learning and COVID-19 on the mental health status of university students in Malaysia

Moy FM, Ng YH

Sci Prog, 2021;104(3):368504211029812.
PMID: 34260295 DOI: 10.1177/00368504211029812

The COVID-19 pandemic has disrupted the lives of all including university students. With the preventive measures to reduce the transmission of COVID-19, all face-to-face teaching and learning are converted to e-learning. The COVID-19 pandemic and the implementation of e-learning may influence these students' mental conditions. This study aimed to determine the association of factors with mental health status (depression, anxiety and stress) among university students in Malaysia. Study participants were tertiary education students from both the private and public universities in Malaysia. Participants were recruited via university emails and social media. The survey was administered via the online REDCap platform, from April to June 2020, during the movement control order period in the country. The questionnaire captured data on socio-demographic characteristics, academic information, implementation of e-learning, perception towards e-learning and COVID-19; as well as DASS 21 to screen for depression, anxiety and stress. The levels of stress, anxiety and depression were 56.5% (95% CI: 50.7%, 62.1%), 51.3% (95% CI: 45.6%, 57.0%) and 29.4% (95% CI: 24.3%, 34.8%) respectively. Most participants had good perception towards e-learning but negative perception on COVID-19. From the multivariate analysis, participants with positive perception on COVID-19 were protective towards stress (aOR: 0.96; 95% CI: 0.92, 0.99), anxiety (aOR: 0.94, 95% CI: 0.90, 0.98) and depression (aOR: 0.95; 95% CI: 0.91, 0.99). Older students were 14% (aOR: 0.86, 95% CI: 0.79, 0.94) and 11% (aOR: 0.89: 95% CI: 0.80, 0.99) less likely for anxiety and depression, respectively. Students originated from the Malay ethnicity had higher odds (aOR: 1.93; 95% CI: 1.05, 3.56) for depression. These findings demonstrated that the mental status of university students was greatly affected during the COVID-19 pandemic. Timely and credible information should be disseminated to alleviate their negative perception towards COVID-19.

Matched MeSH terms: Computer-Assisted Instruction/methods
Technology-enhanced learning in transnational higher education

Arunasalam N

Br J Nurs, 2016 Nov 24;25(21):1201-1205.
PMID: 27882796

Some university schools of nursing in Australia and the UK have developed collaborative links with Malaysia to deliver part-time Transnational Higher Education (TNHE) post-registration top-up nursing degree courses. It enables nurses trained to diploma level to upgrade to a degree qualification. The views of 18 Malaysian nurses who had studied with one Australian and two UK TNHE universities were explored using a hermeneutic phenomenological approach. Participants recruited via convenience and snowball sampling methods were interviewed in English and Bahasa Malaysia (Malaysian language). Thematic analysis were used to analyse data. Findings indicated nurses' frustration with technology-enhanced teaching and learning and a lack of support throughout the programme. Although nurses developed confidence in using computer technology, they remained disappointed with the level of academic support. The data and some useful strategies outlined provide important insights for TNHE providers, the Malaysian Nursing Board and private hospital employers to consider for enhancing nurses learning and experiences.

Matched MeSH terms: Computer-Assisted Instruction
Fulltext Translating evidence to practice in the health professions: a randomized trial of Twitter vs Facebook

Tunnecliff J, Weiner J, Gaida JE, Keating JL, Morgan P, Ilic D, et al.

J Am Med Inform Assoc, 2017 03 01;24(2):403-408.
PMID: 27357833 DOI: 10.1093/jamia/ocw085

Objective: Our objective was to compare the change in research informed knowledge of health professionals and their intended practice following exposure to research information delivered by either Twitter or Facebook.
Methods: This open label comparative design study randomized health professional clinicians to receive "practice points" on tendinopathy management via Twitter or Facebook. Evaluated outcomes included knowledge change and self-reported changes to clinical practice.
Results: Four hundred and ninety-four participants were randomized to 1 of 2 groups and 317 responders analyzed. Both groups demonstrated improvements in knowledge and reported changes to clinical practice. There was no statistical difference between groups for the outcomes of knowledge change (P = .728), changes to clinical practice (P = .11) or the increased use of research information (P = .89). Practice points were shared more by the Twitter group (P

Matched MeSH terms: Computer-Assisted Instruction

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