The present study proposed a new instrument for the assessment of the current faculty development programs at Iranian medical universities. Although the literature concerning the subject of faculty development activities has already identified strengths and weakness of such programs, it is still questionable whether these activities can be assessed using a pedagogical and managerial comprehensive approach. Therefore, it was determined to develop an instrument to examine faculty development activities that address all components of programs from planning and implementing to evaluating phases, with the possibility of utilizing this instrument as a tool to assess faculty development activities.

Background: This study aimed to assess the impact of telephone counseling on quality of life in patients with coronary artery bypass graft. Methods: A quasi-experimental study was conducted with 71 discharged patients after coronary artery bypass graft surgery at Ekbatan Edcuational hospital in Hamadan, Iran, in 2014. The patients were randomly allocated into intervention (n = 36) and control group (n = 35). The intervention group received education and counseling about therapeutic plan via telephone after discharge. Patients in the control group received only routines. All patients completed the quality of life questionnaire before and after the intervention period of five weeks. Results: There was no significant difference between intervention and control group about quality of life before intervention (p = 0.696). However, there was significant and positive deference between the two groups in favor of the telephone counseling after the intervention (P = 0.01) and control group (P = 0.04). Quality of life in the intervention group was significantly better compared to control group (P = 0.01). Conclusions: Telephone counseling could be a cost-effective patient counseling plan for therapeutic adherence after coronary artery bypass surgery in order to improve the patients' quality of life. Practice implications: Telephone counseling is feasible to implement and well accepted for patient counseling for many diseases. (C) 2017 Elsevier B.V. All rights reserved.

This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing, and physiotherapy students, their supervisors, and two members of the emergency department's management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors, and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team.

Interprofessional education (IPE) for teams of undergraduate students has since 1999 been carried out at the orthopedic emergency department at the Karolinska University Hospital. During a 2-week period, teams of medical, nursing and physiotherapy students practice together. With the aim of training professional and collaboration skills, the teams take care of patients with varying acute complaints, under the guidance of supervisors from each profession. This study describes the educational model and compares the attitudes of the different student categories participating in this unique IPE model. All students who participated in this experience during the period 2008-2010 were asked to fill in a questionnaire on completion of their training period. Results showed that all three categories, with no significant difference, highly appreciated the setting and the team training. Results also showed that the training significantly increased the students' knowledge of their own professional role as well as their knowledge of the other professions. We conclude that training at an emergency department can provide excellent opportunities for interprofessional team training for undergraduate students. The teamwork enhances the students' understanding of the professional roles and can contribute to a more holistic approach to patient care.

Introduction: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated. Methods: Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior. Results: GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user. Discussion: Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.

Objective: This study aimed at creating electronic cases (e-cases) and analyzing their validity as a diagnostic assessment tool within the context of continuing medical education (CME) to measure general practitioners' (GPs) knowledge of common infectious disease. Methods: We designed assessment e-cases in an electronic CME platform. The e-cases were designed to measure GPs' knowledge about diagnosis and treatment of common infectious disease in outpatient settings. The data collected were analyzed for five forms of evidence: content, response process, internal structure, relations with other variables and consequences. Results: A total of 46 GPs participated in the study. Among them, 87% perceived the e-cases as resembling the patients whom they visit in their everyday practice. Although attendance in this activity made 85% of the participants more cautious about prescription of antibiotics, we could not detect any statistically significant association between the assessment scores and the physicians' previous antibiotic prescription. The diagnos- e tic assessment with e-cases was supported by most of the elements of validity evidence, including content, response process, internal structure and consequences. Conclusions: Overall, evidence suggests that using e-cases might be a valid diagnostic assessment CME activity to measure GPs' knowledge of common infectious disease, but more research is necessary.

Background: General practitioners (GP) update their knowledge and skills by participating in continuing medical education (CME) programs either in a traditional or an e-Learning format. GPs' beliefs about electronic format of CME have been studied but without an explicit theoretical framework which makes the findings difficult to interpret. In other health disciplines, researchers used theory of planned behavior (TPB) to predict user's behavior. Methods: In this study, an instrument was developed to investigate GPs' intention to use e-Learning in CME based on TPB. The goodness of fit of TPB was measured using confirmatory factor analysis and the relationship between latent variables was assessed using structural equation modeling. Results: A total of 148 GPs participated in the study. Most of the items in the questionnaire related well to the TPB theoretical constructs, and the model had good fitness. The perceived behavioral control and attitudinal constructs were included, and the subjective norms construct was excluded from the structural model. The developed questionnaire could explain 66 % of the GPs' intention variance. Conclusions: The TPB could be used as a model to construct instruments that investigate GPs' intention to participate in e-Learning programs in CME. The findings from the study will encourage CME managers and researchers to explore the developed instrument as a mean to explain and improve the GPs' intentions to use eLearning in CME.

Digital competence is a skill associated with the 21- century abilities essential to contribute to today’s and tomorrow’s digital and technical environments. Computational Thinking (CT), which is a thought process for problem-solving, is one of the emerging trends that make up digital competence. In our explorative study, we have used educational robotics with four pre-service teachers during their four- week s placement at different preschools. We applied three distinct and complementary approaches to design and conduct this study: Systems Thinking (ST); Technological Pedagogical Content Knowledge; and Computing Pedagogy. Our findings are categorized in two main perspectives: pre-service teachers and children. In the pre-service teachers' perspective, the participants indicated that their educational program lacks specific content and activities related to digital competence, CT, and programming. Despite the initial pre-service teachers’ thoughts on improvement of children's CT concepts, the findings show that CT practices such as collaboration and trial and error were developed. From the children’s perspective, the empirical findings illustrate that digital competence and CT development vary depending on the age of the children; whereas logical thinking and pattern recognition are skills that were present along the whole age range of children (ages 2-6), other CT skills like algorithmic thinking were developed among older children only (aged 5-6). We learned that an ST approach can behelpful, as multiple factors are involved in the practice. It reveals the underlying features of the situation that emerge when components of the system interact with each other.

Background: Based on common geography, sociopolitics, epidemiology, and healthcare services, the Nordic countries could benefit from increased collaboration and uniformity in the development of simulation-based learning (SBL). To date, only a limited overview exists on the Nordic research literature on SBL and its progress in healthcare education. Therefore, the aim of this study is to fill that gap and suggest directions for future research.

Methods: An integrative review design was used. A search was conducted for relevant research published during the period spanning from 1966 to June 2016. Thirty-seven studies met the inclusion criteria. All included studies were appraised for quality and were analyzed using thematic analysis.

Results: The Nordic research literature on SBL in healthcare revealed that Finland has published the greatest number of qualitative studies, and only Sweden and Norway have published randomized control trials. The studies included interprofessional or uniprofessional teams of healthcare professionals and students. An assessment of the research design revealed that most studies used a qualitative or a descriptive design. The five themes that emerged from the thematic analysis comprised technical skills, non-technical skills, user experience, educational aspects, and patient safety.

Conclusion: This review has identified the research relating to the progress of SBL in the Nordic countries. Most Nordic research on SBL employs a qualitative or a descriptive design. Shortcomings in simulation research in the Nordic countries include a lack of well-designed randomized control trials or robust evidence that supports simulation as an effective educational method. In addition, there is also a shortage of studies focusing on patient safety, the primary care setting, or a combination of specialized and primary care settings. Suggested directions for future research include strengthening the design and methodology of SBL studies, incorporating a cross-country comparison of studies using simulation in the Nordic countries, and studies combining specialized and primary care settings.

This proof-of-concept trial explored whether using Google Glass to augment instruction of vestibular assessment and treatment skills increased student competence. In 2015, 103 physiotherapy students with no prior vestibular examination training participated in a lab for adults with vestibular dysfunction led by experienced clinicians. Half were randomised (blocked on gender and self-efficacy) to standard lab instruction and half to the experiential lab wherein the instructor used the Google Glass video function in real time, along with verbal instruction. Students completed a pretest questionnaire to establish self-reported skill level in vestibular dysfunction assessment and treatment. Another faculty member assessed students' competence in these clinical skills after 7 days. A student evaluation of teaching was completed after the teaching session. No between-group differences existed regarding change in self-efficacy scores for vestibular assessment and treatment skills preintervention and postintervention. Students in the Google Glass group scored slightly better on the clinical skills check (median score of 19 (range 16–20) versus 18 (range 16–20); p=0.03). 40 students (77%) in the Google Glass group performed the assessment satisfactorily versus 30 (59%) (p=0.049) in the standard lab group. The majority of students evaluated the video quality as unacceptable. This novel study demonstrated that using Google Glass to live stream vestibular assessment and treatment techniques in first-person view had a significant but small impact on acquisition of these clinical skills.

Objective: To determine the potential of providing health-related services on the Internet or via mobile phones to diabetic patients in a large city in Iran, a middle-income country. Background: Diabetes mellitus (DM) is increasing worldwide, especially in developing countries, as a consequence of urbanisation, which is associated with risk factors for diabetes such as physical inactivity and high sugar and fat diets. The use of the Internet and mobile services is increasing worldwide. Independent use of the Internet and mobile technologies by patients could be a key step towards self-care management of DM. Methods: A two-part validated questionnaire was completed by patients who attended one of two diabetic clinics for a routine check-up. The first part consisted of 16 demographic-related items. The second part contained 26 items about the specific use of the Internet and mobile services to access information. Results: In total, 407 questionnaires were completed. The results showed that 108 (26.5%) of the respondents had routine access to the Internet, of which 95.4% had routine access to mobile services and 77.8% were positive about using an official Iranian website for medical information. However, 55% of the respondents preferred to obtain health-related information from television, radio, and educational films. Conclusions: The data suggest that the diabetic patients who used the Internet in this study were willing to receive educational material via the Internet. However, many still preferred traditional sources of health-related information. The findings indicated that our future effort in self-care management should focus on early technology adopters to increase the penetration rate of technology in the field of health care.

Objective: The objective of this article is to explorethe educational needs and design aspects ofpersonalised internet-enabled education for patientswith diabetes in Iran.Design: Data were collected using semistructuredinterviews and then qualitatively analysed usinginductive content analysis.Participants: 9 patients with type 2 diabetes wereincluded. Inclusion criteria were access to andknowledge on how to use the internet. The selectionensured representation based on gender, age,occupation and educational background.Setting: The sample population was patients withdiabetes who were admitted to an outpatient diabetesclinic in Mashhad, a large city of Iran with about 3million inhabitants.Results: 4 core categories emerged from the data: (1)seeking knowledge about diabetes, including specificknowledge acquisition, patient’s interactions andlearning requirements; (2) teaching and learning,including using different teaching methods anddifferent ways to learn about the disease; (3)facilitators, including internet and mobile phone use tolearn about the disease; and (4) barriers, including lackof internet access, uncertainty of access to the internetand lack of website in the local language and alsoperceived cultural barriers, such as patients’ fears ofthe internet, lack of time and awareness.Conclusions: This study provides a betterunderstanding of the patient’s educational expectationsand technical needs in relation to internet-enablededucation. This knowledge will inform the developmentof functional mock-ups in the next research phaseusing a design-based research approach in order todesign internet-enabled patient education for selfmanagementof diabetes.

Background The number of people with diabetes is estimated to increase to 642 million by 2040, with most having type 2 diabetes. Patients with diabetes require continuous monitoring and possible treatment changes. Patient education is the process of enabling individuals to make informed decisions about their personal health-related behaviours and internet-enabled interventions have the potential to provide support and information to patients with diabetes. Objective The aim of the study was to design a portal prototype based onto two models of care and a contextualised education programme to support the self-management of diabetes patients by involving stakeholders in the Iranian province of Razavi-Khorasan. Methods A Design-Based Research framework was adopted. A qualitative research method was used to analyse interviews with patients and care givers. Mock-ups were developed first and designed with features of user-driven and self-care models of care. The mock-ups also had adaptation features, such as for control of the disease, ability to cure self, and family support. The portal prototype was developed iteratively by building on the mock-ups and evaluated through interviews. The features and elements of the mock-ups and the portal prototype were evaluated in an outpatient diabetes clinic in Mashhad. Results Thirty-three participants were involved in the study. The evaluation of the mock-ups resulted in two themes and seven categories: 1) self-care improvement, including self-care requirements and self-management, and 2) educational usefulness, including medical information, information mode, mobility, interaction, and efficiency. The mock-up evaluation was used as a basis for designing a portal prototype. Next, the portal prototype was evaluated, and three categories emerged from the interview data: 1) user experience, 2) functionality, and 3) interactivity. Participants were not able to prioritise between the two care models. Some functionalities of the portal could benefit from the development within a cultural context to determine differences to the best way to present material. Conclusions A portal prototype has been designed to include two care models to support self-management and functionalities that support aspects of culture-specific diabetes self-care. This study provides guidance on developing an internet-enabled educational portal, aimed at providing support for patients in their social context.

BACKGROUND:

Simulation can be used for educating, evaluating and assessing psychometric properties of an instrument. The aim of this study was to contextualize and assess the validity and reliability of the Interprofessional Collaborative Assessment tool (ICAR) in an Iranian context using simulation.

METHODS:

In this descriptive study, contextualization of the ICAR was assessed through several steps. Firstly, validity assessment was approved through expert panels and Delphi rounds. Secondly, reliability assessment was done by arranging a simulation video and assessing reproducibility, test-retest (ICC), internal consistency (Cronbach's Alpha) and inter-rater reliability (Kappa).The participants included 26 experts, 27 students and 6 staff of the Standardized Simulation Office of Teheran University of Medical Sciences.

RESULTS:

Contextualization and validity of the ICAR were approved in an Iranian context. The reliability of the tool was computed to be 0.71 according to Cronbach´s Alpha. The test-retest was calculated to be 0.76.

CONCLUSION:

The Iranian ICAR can be a useful tool for evaluating interprofessional collaborative competencies. The development of the instrument through a simulation scenario has been a positive prospect for researchers.

The objective of this review is to evaluate the effectiveness of virtual patient simulation as an educational intervention versus traditional learning, other types of e‐Learning interventions and other forms of virtual patient simulation interventions for delivering pre‐registration and post‐registration healthcare professional education. We will primarily assess the impact of these interventions on learners’ knowledge, skills and attitudes. Our secondary objective is to assess the cost‐effectiveness of these interventions.

Background: Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. Objective: The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. Methods: We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. Results: A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I-2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I-2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals' cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I-2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I-2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. Conclusions: We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.

Objective To determine the impact on emergency department (ED) throughput times and proportion of patients who leave without being seen by a physician (LWBS) of two triage interventions, where comprehensive nurse-led triage was first replaced by senior physician-led triage and then by interprofessional teamwork. Design Single-centre before-and-after study. Setting Adult ED of a Swedish urban hospital. Participants Patients arriving on weekdays 08: 00 to 21: 00 during three 1-year periods in the interval May 2012 to November 2015. A total of 185 806 arrivals were included. Interventions Senior physicians replaced triage nurses May 2013 to May 2014. Interprofessional teamwork replaced the triage process on weekdays 08: 00 to 21: 00 November 2014 to November 2015. Main outcome measures Primary outcomes were the median time to physician (TTP) and the median length of stay (LOS). Secondary outcome was the LWBS rate. Results The crude median LOS was shortest for teamwork, 228 min (95% Cl 226.4 to 230.5) compared with 232 min (95% Cl 230.8 to 233.9) for nurse-led and 250 min (95% Cl 248.5 to 252.6) for physician-led triage. The adjusted LOS for the teamwork period was 16 min shorter than for nurse-led triage and 23 min shorter than for physician-led triage. The median TTP was shortest for physician-led triage, 56 min (95% Cl 54.5 to 56.6) compared with 116 min (95% Cl 114.4 to 117.5) for nurse-led triage and 74 min (95% Cl 72.7 to 74.8) for teamwork. The LWBS rate was 1.9% for nurse-led triage, 1.2% for physician-led triage and 3.2% for teamwork. All outcome measure differences had two-tailed p values< 0.01. Conclusions Interprofessional teamwork had the shortest length of stay, a shorter time to physician than nurse-led triage, but a higher LWBS rate. Interprofessional teamwork may be a useful approach to reducing ED throughput times.

Objective To compare two strategies, interprofessional teams versus fast track streaming, for orthopedic patients with limb injuries or back pain, the most frequent orthopedic complaints in an emergency department. Methods An observational before-and-after study at an adult emergency department from May 2012 to Nov 2015. Patients who arrived on weekdays from 8 am to 9 pm and presented limb injury or back pain during one year of each process were included, so that 11,573 orthopedic presentations were included in the fast track period and 10,978 in the teamwork period. Similarly, another 11,020 and 10,760 arrivals presenting the six most frequent non-orthopedic complaints were included in the respective periods, altogether 44,331 arrivals. The outcome measures were the time to physician (TTP) and length of stay (LOS). The LOS was adjusted for predictors, including imaging times, by using linear regression analysis. Results The overall median TTP was shorter in the teamwork period, 76.3 min versus 121.0 min in the fast track period (-44.7 min, 95% confidence interval (CI): -47.3 to -42.6). The crude median LOS for orthopedic presentations was also shorter in the teamwork period, 217.0 min versus 230.0 min (-13.0 min, 95% CI: -18.0 to -8.0), and the adjusted LOS was 22.8 min shorter (95% CI: -26.9 to -18.7). For non-orthopedic presentations, the crude median LOS did not differ significantly between the periods (2.0 min, 95% CI: -3.0 to 7.0). However, the adjusted LOS was shorter in the teamwork period (-20.1 min, 95% CI: -24.6 to -15.7). Conclusions The median TTP and LOS for orthopedic presentations were shorter in the teamwork period. For non-orthopedic presentations, the TTP and adjusted LOS were also shorter in the teamwork period. Therefore, interprofessional teamwork may be an alternative approach to improve the patient flow in emergency departments.

BackgroundEmergency department (ED) care of older patients is often complex. Geriatric ED guidelines can help to meet this challenge. However, training requirements, the use of time-consuming tools for comprehensive geriatric assessment (CGA), a lack of golden standard to identify the frail patients, and the weak evidence of positive outcomes of using CGA in EDs pose barriers to introduce the guidelines. Dedicating an interprofessional team of regular ED medical and nursing staff and an older-friendly ED area can be another approach. Previous studies of geriatrician-led CGA in EDs have reported a reduced hospital admission rate. The aim of this study was to investigate whether a dedicated interprofessional emergency team also can reduce the hospital admission rate without the resources required by the formal use of CGA.MethodsAn observational pre-post study at a large adult ED, where all patients 80years or older arriving on weekdays in the intervention period from 2016.09.26 to 2016.11.28 and the corresponding weekdays in the previous year from 2015.09.28 to 2015.11.30 were included.In the intervention period, older patients either received care in the geriatric module by the dedicated team or in the regular team modules for patients of mixed ages. In 2015, all patients received care in regular team modules. The primary outcome measure was the total hospital admission rate and the ED length of stay was the secondary outcome measure.ResultsWe included 2377 arrivals in the intervention period, when 26.7% (N=634) received care in the geriatric module, and 2207 arrivals in the 2015 period. The total hospital admission rate was 61.7% (N=1466/2377) in the intervention period compared to 64.8% (N=1431/2207) in 2015 (p=0.03). The difference was larger for patients treated in the geriatric module, 51.1% compared to 62.1% (95% CI: 56.3 to 68.0%) for patients who would have been eligible in 2015. The ED length of stay was longer in the intervention period.ConclusionsAn interprofessional team and area dedicated to older patients was associated to a lower hospital admission rate. Further studies are needed to confirm the results.

Background The need for interprofessional collaboration has been emphasized by health organizations. This study was part of a mixed-methods evaluation of interprofessional teamwork modules implementation in an emergency department (ED), where a major intervention was didactic training of team roles and behaviours in combination with practice scenarios. The aim of the study was to evaluate the implementation of interprofessional teamwork modules from a staff perspective and focus on how implementation fidelity may be sustained. Methods In this mixed-methods case study we triangulated staff data from structured observations, semi-structured interviews, and a questionnaire repeated at intervals over 5 years. A protocol of key team behaviours was used for the observations conducted in June 2016 and June 2018, 11/2 and 31/2 years after the initial implementation. A purposeful sample of central informants, including nursing and medical professionals and section managers, was interviewed from May to June 2018. The interview guide consisted of open-ended questions about the experiences of interprofessional teamwork modules and the implementation process. The questionnaire consisted of five statements about the perceived workload, interprofessional collaboration and patient satisfaction, where each was rated on a Likert scale. Results Good fidelity to four out of five key team behaviours was observed during the first year. However, fidelity was sustained only for one key team behaviour after 3 years. We conducted a qualitative content analysis of 18 individual interviews. The theme Enjoying working together, but feeling less efficient emerged of the interprofessional teamwork modules, despite shorter ED stays for the patients. Negative experiences of the staff included passive team leaders and slow care teams. The theme Stimulating to create, but challenging to sustain emerged of the implementation process, where barriers were not adressed and implementation fidelity not sustained. The staff questionnaire showed that the perceived work conditions was improved in periods of high fidelity, but deteriorated to pre-implementation levels as fidelity to the key team behaviours decayed in 2018. Conclusions Extensive planning and successful initial implementation were not enough to sustain the key behaviour changes in the study. The use of implementation frameworks can be helpful in future projects.

Italo Masiello, docent, universitetslektor och chef för Södersjukhusets Utbildnings- och innovationscenter, har tillsammans med Anna Mattsson, med dr, skrivit en artikel om medicinsk simuleringsträning.

In Self-Regulated Learning (SLR), the lack of a predefined, formal learning trajectory makes it more challenging to assess students’ progress (e.g. by comparing it to specific baselines) and to offer relevant feedback and scaffolding when appropriate. In this paper we describe a Visual Learning Analytics (VLA) solution for exploring students’ datasets collected in a Web-Based Learning Environment (WBLE). We employ mining techniques for the analysis of multidimensional data, such as t-SNE and clustering, in an exploratory study for identifying patterns of students with similar study behavior and interests. An example use case is presented as evidence of the effectiveness of our proposed method, with a dataset of learning behaviors of 6423 students who used an online study tool during 18 months.

Advanced medical education simulators are broadly used today to train both technical/procedural and team-based skills. While there is convincing evidence of the benefits of training technical skills, this is not the case for team-based skills. Research on medical expertise could drive the creation of a new regime of simulation-based team training. The new regime includes first the understanding of complex systems such as the hospital and the operating room; then the performance of work-place assessment; thirdly, the deliberate training of weaknesses and team performance skills; and lastly the understanding of the underlying mechanisms of team competence. A new regime of deliberate training proposed by the author, which would need to be evaluated and validated, could elucidate the underlying mechanisms of team competence while providing evidence of the effect of simulation-based team training.

Medical simulation training has become an important model for training of technical and non-technical clinical skills, aiming at preventing avoidable mistakes. The evidence for effects of simulation training is increasing, and several systematic reviews on the effect of medical simulation training have been published. This article summarizes the evidence for medical simulation training based on systematic reviews of medical simulation published in the last three years. There is a consistent finding in all systematic reviews that simulation training has a positive effect on learning and skills transfer, and small positive effects on patient-related outcomes. However, there is considerable uncertainty about the strength of evidence of this research, and all systematic reviews reported serious weaknesses in research methods of the included studies. We hope that the newly published guidelines for study design and reporting of medical simulation research can help create a stronger evidence base.

Background: The enhancement of–or even a shift from–traditional teaching and learning processes to corresponding digital practices has been rapidly occurring during the last two decades. The evidence of this ongoing change is still modest or even weak. However, the adaptation of implementation science in educational settings, a research approach which arose in the healthcare field, offers promising results for systematic and sustained improvements in schools. The aim of this study is to understand how the systematic professional development of teachers and schools principals (the intervention) to use digital learning materials and learning analytics dashboards (the innovations) could allow for innovative and lasting impacts in terms of a sustained implementation strategy, improved teaching practices and student outcomes, as well as evidence-based design of digital learning material and learning analytics dashboards.

Methods: This longitudinal study uses a quasi-experimental cluster design with schools as the unit. The researchers will enroll gradually 145 experimental schools in the study. In the experimental schools the research team will form a School Team, consisting of teachers/learning-technologists, school principals, and researchers, to support teachers’ use of the innovations, with student achievement as the dependent variable. For the experimental schools, the intervention is based on the four longitudinal stages comprising the Active Implementation Framework. With an anticipated student sample of about 13,000 students in grades 1–9, student outcomes data are going to be analyzed using hierarchical linear models.

Discussion: The project seeks to address a pronounced need for favorable conditions for children’s learning supported by a specific implementation framework targeting teachers, and to contribute with knowledge about the promotion of improved teaching practices and student outcomes. The project will build capacity using implementation of educational technology in Swedish educational settings.

Simulation-based training has seen an increased use of extended reality, that is, augmented reality (AR), virtual reality (VR) and mixed reality (MR) displays. The health professions have been using VR for simulation-based training more extensively than others. This method can offer the possibility of immediate feedback, which promotes more accurate training to self-correct mistakes in environments that are otherwise risky or provide unsafe conditions. The nuclear industry has attempted to seize the same digital and educational transformation to train their personnel to handle dangerous scenarios. We ran a pilot study with the aim of evaluating the VR training scenario developed for the specific target group and the acceptance of the VR technology itself for this kind of training. We used the Kirkpatrick framework to evaluate the training and the VR-HAM acceptance model to evaluate the acceptance of VR. A VR scenario was developed to test specific technical skills of nuclear power plant personnel. The 13 participants showed results within the basic level of the Kirkpatrick framework and held both positive reactions and concerns, that is, they enjoyed the training with VR and expressed concerns regarding the stability of the VR technology. The participants also showed positive attitudes towards the perceived ease of use and usefulness of the VR-HAM and its various constructs. Even though the COVID-19 pandemic limited our testing, we could show valuable data and positive attitudes and perceived ease by the participants. Simulation-based VR training could be an important complement to traditional training methods, especially where safety is a priority, but we still need to provide solid evidence.

This chapter discusses the trends and issues surrounding digital learning in K-12 schools in Sweden. It begins with an introduction to digital transformation in education and highlights its importance, both in Sweden and also more generally. The focus then shifts specifically to K-12 schools in Sweden and examines the current status of digital learning in this context, explaining the established physical IT infrastructure and broad use of digital tools at all levels of education. The challenges of COVID-19 were a catalyst to implement more goal-oriented activities for teachers and learners. This chapter identifies several trends in digital learning, including the integration of technology into the curriculum, the use of online resources and platforms, the implementation of personalized learning approaches, testbeds, programming and generative AI. It also highlights the challenges and issues associated with digital learning, such as the need for adequate infrastructure, technical support and teacher training, ensuring digital inclusion for all students, and addressing concerns regarding data privacy and security. In conclusion, this chapter emphasizes the need for continued efforts to foster digital learning in K-12 schools in Sweden, while also addressing the associated issues. It suggests that educators and stakeholders should collaborate to provide necessary resources and support for effective digital learning implementation in the classroom.

The promise of Learning Analytics Dashboards in education is to collect, analyze, and visualize data with the ultimate ambition of improving students’ learning. Our overview of the latest systematic reviews on the topic shows a number of research trends: learning analytics research is growing rapidly; it brings to the front inequality and inclusiveness measures; it reveals an unclear path to data ownership and privacy; it provides predictions which are not clearly translated into pedagogical actions; and the possibility of self-regulated learning and game-based learning are not capitalized upon. However, as learning analytics research progresses, greater opportunities lie ahead, and a better integration between information science and learning sciences can bring added value of learning analytics dashboards in education.

A dashboard that provides a central location to monitor and analyze data is an efficient way to track multiple data sources. In the educational community, for example, using dashboards can be a straightforward introduction into the concepts of visual learning analytics. In this paper, the design and implementation of Student Activity Visualization (SAVis), a new Learning Analytics Dashboard (LAD) using interactive visualization and Machine Learning (ML) is presented and discussed. The design of the dashboard was directed towards answering a set of 22 pedagogical questions that teachers might want to investigate in an educational dataset. We evaluate SAVis with an educational dataset containing more than two million samples, including the learning behaviors of 6,423 students who used a web-based learning platform for one year. We show how SAVis can deliver relevant information to teachers and support them to interact with and analyze the students’ data to gain a better overview of students’ activities in terms of, for example, their performance in number of correct/incorrect answers per each topic.

With the help of Visual Learning Analytics (VLA) tools, teachers can construct meaningful groups of students that can, for example, collaborate and be engaged in productive discussions. However, finding similar samples in large educational databases requires effective similarity measures that capture the teacher’s intent. In this paper we propose a web-based VLA tool called Similarity-Based Grouping (SBGTool), to assist teachers in categorizing students into different groups based on their similar learning outcomes and activities. By using SBGTool, teachers may compare individual students by considering the number of answers (correct and incorrect) in different question categories and time ranges, find the most difficult question categories considering the percentage of similarity to the correct answers, determine the degree of similarity and dissimilarity across students, and find the relationship between students’ activity and success. To demonstrate the tool’s efficacy, we used 10,000 random samples from the EdNet dataset, a large-scale hierarchical educational dataset consisting of student-system interactions from multiple platforms, at university level, collected over a period of two years. The results point to the conclusion that the tool is efficient, can be adapted to different learning domains, and has the potential to assist teachers in maximizing the collaborative learning potential in their classrooms.

Visual Learning Analytics (VLA) tools and technologies enable meaningful exchange of information between educational data and teachers. This allows teachers to create meaningful groups of students based on possible collaboration and productive discussions. VLA tools also allow to better understand students' educational demands. Finding similar samples in huge educational datasets, however, involves the use of effective similarity measures that represent the teacher's purpose. In this study, we conducted a user study and improved our web-based VLA tool, Similarity-Based Grouping (SBGTool), to help teachers categorize students into groups based on their similar learning outcomes and activities. SBGTool v2.0 differs from SBGTool due to design changes made in response to teacher suggestions, the addition of sorting options to the dashboard table, the addition of a dropdown component to group the students into classrooms and improvement in some visualizations. To counteract colour-blindness, we have also considered a number of color palettes. By applying SBGTool v2.0, teachers may compare the outcomes of individual students inside a classroom, determine which subjects are the most and least difficult over the period of a week or an academic year, identify the number of correct and incorrect responses for the most difficult and easiest subjects, categorize students into various groups based on their learning outcomes, discover the week with the most interactions for examining students' engagement, and find the relationship between students’ activity and study success. We used 10,000 random samples from the EdNet dataset, a large-scale hierarchical educational dataset consisting of student-system interactions from multiple platforms at the university level, collected over a two-year period, to illustrate the tool's efficacy. Finally, we provide the outcomes of the user study that evaluated the tool's effectiveness. The results revealed that even with limited training, the participants were able to complete the required analysis tasks. Additionally, the participants’ feedback showed that the SBGTool v2.0 gained a good level of support for the given tasks, and it had the potential to assist teachers in enhancing collaborative learning in their classrooms.

Learning Analytics (LA) involves a growing range of methods for understanding and optimizing learning and the environments in which it occurs. Different Machine Learning (ML) algorithms or learning classifiers can be used to implement LA, with the goal of predicting learning outcomes and classifying the data into predetermined categories. Many educational datasets are imbalanced, where the number of samples in one category is significantly larger than in other categories. Ordinarily, it is ML’s performance on the minority categories that is the most important. Since most ML classification algorithms ignore the minority categories, and in turn have poor performance, so learning from imbalanced datasets is really challenging. In order to address this challenge and also to improve the performance of different classifiers, Synthetic Minority Over-sampling Technique (SMOTE) is used to oversample the minority categories. In this paper, the accuracy of seven well-known classifiers considering 5 and 10-fold cross-validation and the F1-score are compared. The imbalanced dataset collected based on self-regulated learning activities contains the learning behaviour of 6,423 medical students who used a web-based study platform—Hypocampus—with different educational topics for one year. Also, two diagnostic tools including Area Under the Receiver Operating Characteristics (AUC-ROC) curves and Precision-Recall (PR) curves are applied to predict probabilities of an observation belonging to each category in a classification problem. Using these diagnostic tools may help LA researchers on how to deal with imbalanced educational datasets. The outcomes of our experimental results show that Neural Network with 92.77% in 5-fold cross-validation, 93.20% in 10-fold cross-validation and 0.95 in F1-score has the highest accuracy and performance compared to other classifiers when we applied the SMOTE technique. Also, the probability of detection in different classifiers using SMOTE has shown a significant improvement. 

There is a significant amount of data available about students and their learning activities in many educational systems today. However, these datasets are frequently spread across several different digital services, making it challenging to use them strategically. In addition, there are no established standards for collecting, processing, analyzing, and presenting such data. As a result, school leaders, teachers, and students do not capitalize on the possibility of making decisions based on data. This is a serious barrier to the improvement of work in schools, teacher and student progress, and the development of effective Educational Technology (EdTech) products and services. Data standards can be used as a protocol on how different IT systems communicate with each other. When working with data from different public and private institutions simultaneously (e.g., different municipalities and EdTech companies), having a trustworthy data pipeline for retrieving the data and storing it in a secure warehouse is critical. In this study, we propose a technical solution containing a data pipeline by employing a secure warehouse—the Swedish University Computer Network (SUNET), which is an interface for information exchange between operational processes in schools. We conducted a user study in collaboration with four municipalities and four EdTech companies based in Sweden. Our proposal involves introducing a data standard to facilitate the integration of educational data from diverse resources in our SUNET drive. To accomplish this, we created customized scripts for each stakeholder, tailored to their specific data formats, with the aim of merging the students’ data. The results of the first four steps show that our solution works. Once the results of the next three steps are in, we will contemplate scaling up our technical solution nationwide. With the implementation of the suggested data standard and the utilization of the proposed technical solution, diverse stakeholders can benefit from improved management, transportation, analysis, and visualization of educational data.

Learning Analytics Dashboards (LADs) can help provide insights and inform pedagogical decisions by supporting the analysis of large amounts of educational data, obtained from sources such as Digital Learning Materials (DLMs). Extracting requirements is a crucial step in developing a LAD, as it helps identify the underlying design problem that needs to be addressed. In fact, determining the problem that requires a solution is one of the primary objectives of requirements extraction. Although there have been studies on the development of LADs for K12 education, these studies have not specifically emphasized the use of a Human-Centered Design (HCD) approach to better comprehend the teachers’ requirements and produce more stimulating insights. In this paper we apply prototyping, which is widely acknowledged as a successful way for rapidly implementing cost-effective designs and efficiently gathering stakeholder feedback, to elicit such requirements. We present a three-step HCD approach, involving a design cycle that employs paper and interactive prototypes to guide the systematic and effective design of LADs that truly meet teacher requirements in primary/secondary education, actively engaging them in the design process. We then conducted interviews and usability testing to co-design and develop a LAD that can be used in classroom’s everyday learning activities. Our results show that the visualizations of the interactive prototype were easily interpreted by the participants, verifying our initial goal of co-developing an easy-to-use LAD.

Visual Learning Analytics (VLA) tools (such as dashboards) serve as a centralized hub for monitoring and analyzing educational data. Dashboards can assist teachers in data-informed pedagogical decision-making and/or students in following their own learning progress. However, the design of VLA tools should include features of trust in order to make analytics overt among its users. In this study, we propose a framework for the development of VLA tools from beginning to end that describes how we intend to develop the digital and technical infrastructure in our project for teachers. With that aim, we offer one scenario describing how data is managed, transferred, analyzed, and visualized by teachers. The suggested framework intends to make it easier for developers to understand the various steps involved in co-designing and developing a reliable VLA tool and to comprehend the importance of the teacher’s participation in design. VLA tools developed based on the proposed framework have the potential to assist teachers in understanding and analyzing educational data, monitoring students’ learning paths based on their learning outcomes and activities, simplifying regular tasks, and giving teachers more time to support teaching/learning and growth.

Visual Learning Analytics (VLA) uses analytics to monitor and assess educational data by combining visual and automated analysis to provide educational explanations. Such tools could aid teachers in primary and secondary schools in making pedagogical decisions, however, the evidence of their effectiveness and benefits is still limited. With this scoping review, we provide a comprehensive overview of related research on proposed VLA methods, as well as identifying any gaps in the literature that could assist in describing new and helpful directions to the field. This review searched all relevant articles in five accessible databases — Scopus, Web of Science, ERIC, ACM, and IEEE Xplore — using 40 keywords. These studies were mapped, categorized, and summarized based on their objectives, the collected data, the intervention approaches employed, and the results obtained. The results determined what affordances the VLA tools allowed, what kind of visualizations were used to inform teachers and students, and, more importantly, positive evidence of educational interventions. We conclude that there are moderate-to-clear learning improvements within the limit of the studies’ interventions to support the use of VLA tools. More systematic research is needed to determine whether any learning gains are translated into long-term improvements.

Background Clinical education is essential for students’ progress towards becoming registered nurses (RN) in Sweden. Assessment of caring skills in the Emergency Medical Services (EMS) is complex due to the ever-changing scenarios and the fact that multiple supervisors are involved in the student’s education. Currently, assessments of student’s skills are summative and occur twice during the six weeks of clinical education. A digitalized assessment tool (DAT) with an adaptation for formative assessment is a new approach to assessment of nursing skills in the EMS. Since new technologies and changes in procedures are likely to affect both students and supervisors, our aim in this study is to describe students’ and clinical supervisors’ experience of formative assessments using DAT in the EMS.

Method This study is qualitative, using semi-structured group interviews (N = 2) with students and semi-structured individual telephone interviews (N = 13) with supervisors. The data was analysed according to Graneheim and Landman’s method for content analysis. This analysis generated 221 codes organized into 10 categories within which three themes were identified. The students in this study were nursing students in their last semester and all supervisors were experienced RNs.

Results The results showed that students and supervisors had mainly positive views of the DAT and the formative assessment stating that the information they provided while using the DAT offered opportunities for reflection. The DAT supported the students’ learning by visualizing strengths and areas of improvement, as well as displaying progress using a Likert scale. The application improved communication, but additional features linking the assessment tool with the university were requested. The application contributed to transparency in the assessments and was seen as preferable to the traditional ‘pen and paper’ method.

Conclusion A digital system was described in a positive manner, and the assessment using the DAT facilitated reflection and formative assessment. The use of a Likert scale was considered positive in order to demonstrate progression which with advantage could be demonstrated visually.

Halfway through a four-year research project supported by implementation science and the Active Implementation Frameworks (AIF), this article reports on the status of the initial two implementation stages. Our research investigates the impact of systematically preparing educators and educational institutions to integrate digital learning materials and learning analytics dashboards to enrich teaching practices and improve student performance outcomes.

Furthermore, it seeks to establish a foundation for the use of innovative and validated educational technology (EdTech) through sustainable implementation strategies, evidence-based evaluation, and continuous redesign of digital learning materials. By adopting this comprehensive approach, we aim to enhance the knowledge base regarding effective digital innovation integration within educational environments.

We argue that applying implementation science in educational settings facilitates the adoption of effective innovations, promotes evidence-based decision-making, and helps identify and address obstacles to change. Our ongoing research underscores the transformative impact of implementation science in education. Thus far, we have highlighted the crucial role of teacher perspectives and the necessity of co-designing technology aligned with teaching and learning objectives.

This nuanced approach refutes the notion of a one-size-fits-all solution or a quick fix achievable in a single academic year. Instead, it advocates a dynamic, collaborative model that acknowledges the multifaceted nature of implementation. Our journey has reaffirmed the dedication of teachers, showcasing their readiness to invest time and effort when their professionalism is respected, and their input is genuinely valued and acted upon.

Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature.

Objectives: To explore changes in experienced simulation educators’ perceptions of their own teaching skills, practices, and understanding of teaching over time.

Methods: A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis.

Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor’s pedagogical development.

Conclusion: Experienced simulation educators’ pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.

Introduction

The generation and use of digital data and analyses in education comes with promises and opportunities, especially where digital materials allow use of Learning Analytics (LA) as a tool in Data-Based Decision-Making (DBDM). LA implies, analysing educational data to understand and optimise learning and learning environments (Siemens & Baker, 2012). In this paper we discuss LA as “a sophisticated form of data driven decision making” (Mandinach & Abrams, 2022, p. 196) as we explore how LA is used to support mathematics teaching and learning with digital materials in classroom practice. Data driven decision making or DBDM has been defined by Schildkamp and Kuiper (2010) as “systematically analyzing existing data sources within the school, applying outcomes of analyses to innovate teaching, curricula, and school performance, and, implementing (e.g., genuine improvement actions) and evaluating these innovations” (p. 482). DBDM is a key for the interpretation of LA, and can use any form of data, but in this review, the term DBDM is restricted to digital data. Using LA as a tool for DBDM could streamline data, making it more readily interpretable. However, questions remain about how usage can translate into practice (Mandinach & Abrams, 2022). 

Quality of technology integration is not merely about technology use, but also about pedagogical use (Ottestad & Guðmundsdottir, 2018), about transformation and amplification of teaching as well as learning through use of technology (Consoli, Desiron & Cattaneo, 2023). LA within Digital Learning Material (DLM) can offer learners adaptive functions seamlessly embedded in DLMs or, provide learners (and teachers) compiled student assessments in relation to learning goals extracted from learning activities (Wise, Zhao & Hausknecht, 2014). The role of the teacher in student learning is clearly of central importance (Hattie & Yates, 2013; Yackel & Cobb, 1996), and teachers have a key responsibility to make digital technology a recourse in teaching to support student learning (Scherer, Siddiq & Tondeur, 2019). 

This paper present findings from an exploratory systematic scoping review which was conducted regarding the use and impact of LA and DBDM in classroom practice to outline aspects related to Digital Learning Material (DLM), teacher usage, and student learning in the context of K-12 mathematics education. 

A scoping review was deemed most appropriate since it can be performed even if there is limited number of published primary research (Gough, Oliver & Thomas, 2017), fitting new research areas such as LA, as it provides “a technique to ‘map’ relevant literature in the field of interest” (Arksey & O’Malley, 2005, p. 20), as well as combine different kinds of evidence (Gough, et al., 2017).

Method

The methodology used the five-stage framework (Arksey & O’Malley, 2005), identifying the research question, identifying relevant studies, study selection, charting the data, collating, summarizing, and reporting the results. The databases ACM Digital Library, ERIC, PsycINFO, Scopus and Web of Science were chosen as they cover a wide range of topics within both technology and educational science to answer:

RQ1: How are analyses of digital data from DLM used in mathematics education?

RQ2: How do analyses of digital data from DLM impact teaching and learning?

The key elements of the research questions, Participants, Phenomena of Interest, Outcome, Context, Type of Source of Evidence (Arksey & O’Malley, 2005) were used to create the eligibility criteria. Publications that were included reported qualitative and/or quantitative data and were connected to the use of DLM and LA based on digital data involving students (between 6–19 years old) and teachers in mathematics K-12 education. The search was limited to papers published from 2000 up-to-date (March 2023) in English, Swedish or Norwegian. Exclusion criteria were developed to ensure consistency within the selection process.

Each record was screened by two reviewers and the relevance were coded according to the inclusion criteria. An independent researcher outside of the review group was consulted to design and validate the results of an inter-rater reliability test. The calculated inter-rater reliability score was 0.822, greater than 0.8, indicating a strong level of agreement (McHugh, 2012). After further screening 57 records were assessed to be eligible. At this stage the review pairs swapped batches and preformed data extraction showing, authors, year, title, location, aim, population, digital technology, method, intervention, outcomes, and key findings was performed for each record. 

The final selection of 15 articles was made by group discussion and consensus. Discussions mainly centred around four components (use, analysis, learning and teaching). The heterogeneity in our sample demanded a configurative approach to the synthesis to combine different types of evidence (Gough et al., 2017). A thematic summary provided the analysis with a narrative approach to answer RQ1. To explore RQ2 more deeply, a thematic synthesis was performed (Gough et al., 2017). The analysis focused on LA-usage based on digital data for student learning, for teaching, and for teachers’ DBDM. PRISMA Extension for Scoping Reviews (PRISMAScR) (Tricco, Lillie, Zarin, O'Brien, Colquhoun, Levac et al., 2018) was used as guidelines for reporting the results.

Preliminary results

3653 records were identified whereof 15 studies were included. Results show that LA-research is an emerging field, where LA-applications is used across many contents and curricula standards of K-12 mathematics education. LA were mainly based on continuously collected individual student log data concerning student activity in relation to mathematical content. Eight of the studies included embedded analytics and all 15 studies included extracted analytics, but accessibility varied for students and teachers. Overall, extracted analytics were mainly mentioned as a function for teacher-usage, available as tools for formative assessment, where analytics need to be translated by teachers into some kind of pedagogical action (i.e., into teaching).

LA-usage supports a wide variety of teachers’ data use, and while mathematics teachers seemed to have a positive attitude towards LA-usage, some teachers were unsure of how to apply it into their practice. The thematic synthesis yielded two themes regarding teaching, which showed that teaching by DBDM focused on Supervision and Guidance. Results indicate extracted analytics is more commonly used for Supervision than guidance. 

Results regarding learning suggest that LA-usage have a positive effect on student learning, where high-performing students benefit most. The included studies examine students’ digital learning behaviour, by describing sequences of actions related to LA, learning outcomes and student feelings. Hereby, through the thematic synthesis, we capture parts of students’ studying-learning process and how it can be affected by LA usage. Finally, we suggest a definition of an additional class of LA, which we introduce as Guiding analytics for learners.

Going forward, research on using LA and DBDM is essential to support teachers and school leaders to meet today’s demands of utilising data, to be aware of possible unwanted consequences, and to use technology to enhance active learners and students’ ownership of learning.

The generation, use, and analysis of educational data comes with many promises and opportunities, especially where digital materials allow usage of learning analytics (LA) as a tool in data-based decision-making (DBDM). However, there are questions about the interplay between teachers, students, context, and technology. Therefore, this paper presents an exploratory systematic scoping review to investigate findings regarding LA usage in digital materials, teaching, and learning in K–12 mathematics education. In all, 3,654 records were identified, of which 19 studies met all the inclusion criteria. Results show that LA research in mathematics education is an emerging field where applications of LA are used in many contexts across many curricula content and standards of K–12 mathematics education, supporting a wide variety of teacher data use. Teaching with DBDM is mainly focused on supervision and guidance and LA usage had a generally positive effect on student learning with high-performing students benefiting most. We highlight a need for further research to develop knowledge of LA usage in classroom practice that considers both teacher and student perspectives in relation to design and affordances of digital learning systems. Finally, we propose a new class of LA, which we define as guiding analytics for learners, which harnesses the potential of LA for promoting achievement and independent learning.

Amaç: Bu çalışmanın amacı günümüzde başarı ile sürdürülen mesleklerarası eğitim programlarının kurulma sürecine ilişkin anlayış geliştirmek ve ülkemizde mesleklerarası eğitim programlarını hayata geçirmek isteyen eğitimcilere, öncü eğitimcilerin deneyimlerden yararlanma fırsatı sunmaktır. Gereç ve Yöntem: Araştırma niteliksel desene sahip olup, verileri İsveç Stokholm’de mesleklerarası eğitim programının oluşturulmasında ve yürütülmesinde yer alan beş kurucu ile yapılandırılmış görüşmeler sonucunda elde edilmiştir. Çalışmadan elde edilen verilerin analizinde içerik analizi yönteminden yararlanılmıştır. Bulgular: Mesleklerarası eğitim programlarının başlatılmasında en önemli itici güçler, DSÖ’nün küresel boyuttaki çağrıları ve mesleklerarası eğitim etkinliklerinin sürdürüldüğü diğer üniversitelerin olumlu raporları olmuştur. Mesleklerarası eğitimin hayata geçirilmesi sürecinde; ortak bir anlayış geliştirme, değişime uyum sağlama, öğrenci programlarını planlanma, öğrenci izlemi ve finans konularında sorunlar yaşanmıştır. İstekli liderler ve savunucular ile öncü ekip, kurulum sürecinde hayati bir rol üstlenmiştir. Katılımcıların mesleklerarası eğitim programlarını kurmak isteyen eğiticilere ilişkin önerileri; ortak amaçların oluşturulması, yöneticilerin desteğinin alınması, başarılı mesleklerarası eğitim öncüleri ile işbirliği yapılması, iyi uygulama örneklerinin ziyaret edilmesi, mentörlerin eğitimine önem verilmesi ve sabırlı olunmasıdır.Sonuç: Mesleklerarası eğitim programlarının kurulması sürecinde pek çok sorun ile karşılaşmak kaçınılmazdır ancak bu programların kabul edilmesinde istekli liderler fark yaratabilmektedirler. Kurumun yöneticileri/karar vericileri sürecin sürdürülebilir olmasında oldukça önemli bir role sahiptir.

BACKGROUND:

Effective leadership is of prime importance in any organization and it goes through changes based on accepted health promotion and behavior change theory. Although there are many leadership styles, transformational leadership, which emphasizes supportive leadership behaviors, seems to be an appropriate style in many settings particularly in the health care and educational sectors which are pressured by high turnover and safety demands. Iran has been moving rapidly forward and its authorities have understood and recognized the importance of matching leadership styles with effective and competent care for success in health care organizations. This study aimed to develop the Supportive Leadership Behaviors Scale based on accepted health and educational theories and to psychometrically test it in the Iranian context.

METHODS:

The instrument was based on items from established questionnaires. A pilot study validated the instrument which was also cross-validated via re-translation. After validation, 731 participants answered the questionnaire.

RESULTS:

The instrument was finalized and resulted in a 20-item questionnaire using the exploratory factor analysis, which yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors (all above 0.6). Mapping these four measures of leadership behaviors can be beneficial to determine whether effective leadership could support innovation and improvements in medical education and health care organizations on the national level. The reliability measured as Cronbach's alpha was 0.84.

CONCLUSION:

This new instrument yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors which are applicable in health and educational settings and are helpful in improving self -efficacy among health and academic staff.

The objective structured examination is one of the most valid, reliable, and effective tools for assessing clinical and communication skills, often by use of standard patients (SPs). SPs can also be assessors of those skills. One of the crucial areas when utilizing SP-based assessment is the quality and consistency assurance of their portrayal of the case and their ability to fill in checklists in an adequate way. The aim of this study was to assess the validity and reliability of SPs' ability to assess students' communication skill via a Calgary-Cambridge checklist. This cross-sectional and correlational study was conducted at the Tehran University of Medical Science. We first analyzed validity; the criterion validity of the SPs' filling in the checklists was assessed through determining the correlation between the SPs' completed checklists and the checklists filled in by three physician raters individually and then reproducibility: it was assessed by a test-retest approach inter-rater reliability. The mean correlation for assessing the validity of SPs' completed checklists by individual SPs was 0.81. The inter-rater reliability was calculated by kappa coefficient, and the total correlation among the three raters was 0.85. The reliability of the test-retest approach showed no significant differences between the test and re-test results. The increased number of medical students and different faculties' responsibilities such as doing educational, research, and health services duties assessing medical student communication skills is a complex issue. The results of our study showed that trained SPs can be used as a valid tool to assess medical students' communication skills, which is also more cost effective and reduces work load of medical faculties.