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The present study investigated the relative contributions of experiential and ability factors to second language (L2) passage comprehension and L2 vocabulary retention. Participants included a cross section of 99 adult learners of Spanish as a foreign language enrolled in beginning through advanced level university Spanish courses. Participants completed a standardized reading proficiency test (Adult Basic Learning Examination, Spanish version) to verify a range in proficiency, a checklist and translation passage sight vocabulary test, and a written recall in the native language of the 4 passages that were read. Vocabulary retention was measured at 2 time intervals by a multiple-choice test of receptive retention of meaning of targeted vocabulary. Data were analyzed using structural equation modeling (SEM). Results revealed consistent support for the following model: (a) Language processing experience positively influenced L2 passage sight vocabulary; (b) L2 passage sight vocabulary positively influenced narrative passage comprehension; and (c) L2 comprehension positively influenced L2 vocabulary growth.

Background Integrated curricula reinforce student learning and retention of relevant knowledge. At Qatar University and Arabian Gulf University medical colleges, Problem-Based Learning (PBL) is the principal teaching and learning strategy to implement integrated multidisciplinary system-based curriculum. In addition, other initiatives include integrated assessment, logical organization of teaching and learning methods, as well as combined faculty effort in curriculum planning and delivery. This multicenter study aims to develop and validate a questionnaire for measuring the extent of medical curriculum integration in PBL programs. Methods Following an extensive literature review, the content validity of a questionnaire was tested through focus group discussion with subject matter experts ( n  = 20), followed by pilot testing with medical students ( n  = 20). The content-validated questionnaire (31 items) was distributed to students in the two colleges. To examine the construct validity and construct reliability of the questionnaire, exploratory factor analysis (EFA) was conducted with 330 students followed by confirmatory factor analysis (CFA) on 579 students. Results EFA supported a four-factor structure of the questionnaire which explained 62% of the variance; however, four items were deleted because of low factor loading (< 0.5) or cross-loading on multiple factors. Further CFA also supported the four-factor structure. Another three items were removed due to high modification indices. The most parsimonious model consisted of 24 items with good fitness indices (χ 2  = 512.23, df = 236, χ 2 /df = 2.17, CFI = 0.97, TLI = 0.97, RMSEA = 0.04, SRMR = 0.031, and AIC = 688.22). The four factors were: Planned Curriculum (3 items), Delivered Curriculum (10 items), Assessed Curriculum (4 items) and Learned Curriculum (7 items). The factor loadings of the items ranged from 0.61 to 0.84 with strong correlations between the four latent factors (constructs). The construct reliability of the total questionnaire was 0.97 and the four factors were between 0.94 and 0.97. In addition, there were strong significant correlations between curriculum integration scores and student satisfaction with the curriculum. Conclusions The developed questionnaire exhibits good evidence of construct validity and reliability. Further studies required to test the validity of this questionnaire in other settings.

Background Moulage is a technique used to simulate injury, disease, aging and other physical characteristics specific to a scenario, often used in health and emergency worker training, predominantly for simulation-based learning activities. Its use in allied health fields is unclear. Previous work has explored moulage as an adjunct for authentic simulations, however there is opportunity for broadening its scope. Aim To explore the effects of moulage interventions in simulation-based education and training, for learner experience. A secondary aim was to understand which pedagogical frameworks were embedded in moulage interventions. Method Four electronic databases (PubMed, CINAHL, EmBase, Proquest Central) were systematically searched to December 2022 for studies utilising moulage in simulation-based education experiences. Outcomes were focused on learner satisfaction, confidence, immersion, engagement, performance, or knowledge. Study quality was assessed using the Mixed Methods Appraisal Tool. Results Twenty studies ( n  = 11,470) were included. Studies were primarily conducted in medicine ( n  = 9 studies) and nursing ( n  = 5 studies) and less frequently across other health disciplines. The findings demonstrated greater learner satisfaction, confidence, and immersion when moulage was used against a comparator group. Minimal improvements in knowledge and performance were identified. One study underpinned the intervention with a pedagogical theory. Conclusion Moulage improves learner experience in simulation-based education or training, but not knowledge or clinical performance. Further research utilising moulage across a broader range of professions is needed. Interventions using moulage should be underpinned by pedagogical theories.

Background National Medical Licensing Examination (NMLE) is the entrance exam for medical practice in China, and its general medical knowledge test (GMKT) evaluates abilities of medical students to comprehensively apply medical knowledge to clinical practice. This study aimed to identify nonacademic predictors of GMKT performance, which would benefit medical schools in designing appropriate strategies and techniques to facilitate the transition from medical students to qualified medical practitioners. Methods In 1202 medical students, we conducted the deletion-substitution-addition (DSA) and structural equation model (SEM) analyses to identify nonacademic predictors of GMKT performance from 98 candidate variables including early life events, physical conditions, psychological and personality assessments, cognitive abilities, and socioeconomic conditions. The candidate variables were assessed using psychometrically or cognitively validated and accepted instruments. Results We identified seven nonacademic predictors for GMKT performance. Body mass index (BMI) and working memory reaction time showed direct negative effects on GMKT performance. Psychological and personality features (conscientiousness, state anxiety, and openness to experience) indirectly affected GMKT performance via BMI, while socioeconomic conditions (father’s education and mother’s occupation) indirectly affected GMKT performance by influencing psychological and personality features and further BMI. Conclusion The identified nonacademic predictors for GMKT performance and their pathways may be useful for improving medical education by strengthening favorable and weakening, rectifying, or compensating unfavorable factors that are modifiable.

Practice questions are highly sought out for use as a study tool among medical students in undergraduate medical education. At the same time, it remains unknown how medical students use and incorporate practice questions and their rationales into their studies. To explore this heavily relied upon study strategy, semi-structured interviews were conducted with second-year medical students to assess how they approach using practice questions. Qualitative thematic analysis revealed several recurrent themes: (1) Medical students use practice questions for primary learning, (2) Medical students place more importance on the rationale of a practice question versus selecting the right answer, and (3) Medical students view practice questions as being designed to be used once or having a single-use. Together, these themes provide insight into how medical students use practice questions to study, which may guide medical educators in their creation of practice questions with appropriate rationales and provide foundational data for future mixed methods analyses seeking to generalize these findings.

Objectives: The aim of this study was to determine whether college students build their vocabularies by playing a serious game that incorporates principles of learning and memory. Design: This study used a single-site, prospective, randomized trial with 2 branches--immediate and delayed treatment. Outcome measures were obtained after a 1-month intervention and, for the immediate group only, after a 1-month retention interval. Setting: College students from the University of Iowa were recruited via mass e-mail. The intervention took place in the participants' homes; the testing took place in a university laboratory. Participants: Forty undergraduates (32 women, 8 men) who planned to take the Graduate Record Examinations (GRE; Educational Testing Service, 2018) within the year following the treatment participated in the study. Participants were allocated to 1 of the 2 treatment branches via biased coin randomization. Intervention: The treatment consisted of vocabulary training on Vocabulary.com for a minimum of 20 min (dose) 4 times per week (frequency) for 4 weeks (treatment duration), for a total cumulative treatment intensity of 320 min. Outcome Measures: The prespecified primary outcome measures of word learning were the number of words mastered during Vocabulary.com play and the percentage of mastered words accurately defined. The depth of information included in the definitions was a secondary outcome. The prespecified primary outcome measure of functional impact was change in the verbal GRE practice test scores from pre- to posttreatment. The examiners scoring the definitions were blind to treatment assignment. All other outcomes were measured automatically by the relevant computer program so blinding was moot. Results: The participants averaged 5.33 hr of play during the treatment interval and mastered 124 words. Amount of play and mastery were highly correlated. Accuracy of definitions was 55% or 59% (depending on treatment branch) after treatment and 55% 1 month later, an insignificant decline. The game itself did not result in GRE gains, but participants who mastered more words per minute of play had higher GRE scores than other participants. Conclusion: Vocabulary.com, an evidence-based game, showed promise as a way to build vocabulary knowledge, but at the intensity of treatment provided, it did not result in gains in high-stakes test performance.

Background Currently, several studies have explored the LSPPDM teaching model and peer-assisted learning to enhance teaching outcomes. Nevertheless, no study has integrated the LSPPDM model with peer mutual learning to explore its possible beneficial effects. The present study aims to explore the role of peer-assisted learning under the LSPPDM mode in improving the clinical competency of residents. Methods A total of 129 residents of Zhongnan Hospital of Wuhan University were selected as study subjects, including 68 residents in Grade 2022 as the control group (traditional teaching mode) and 61 residents in Grade 2023 as the experimental group (peer-assisted learning under the LSPPDM mode). To compare the grades of the basic clinical skills course and the after-department examination performance of the two groups of residents and to analyze the residents’ evaluation of the effectiveness of their teaching, questionnaires were used. Results The experimental group achieved a significantly higher total score in the clinical basic skills course (90.62) compared to the control group (86.23, P  < 0.05). The average scores of theory, skills and case reports of the residents in the experimental group were 83.75, 90.98 and 89.74, respectively, which were higher than the 82.83, 89.11 and 87.41, respectively, in the control group. The difference between the skill score and case report score was statistically significant ( P  < 0.05), and the theoretical score difference was not statistically significant ( p  = 0.476). Residents in the experimental group were significantly satisfied with each teaching session compared with the test value (4 points = satisfaction) ( P  < 0.001). Conclusion Peer-assisted learning under the LSPPDM mode significantly improves residents’ clinical competency and achieves high satisfaction levels, offering valuable insights for optimizing clinical skill training in other hospitals.

Objective This study aimed to evaluate the effectiveness of combining the One-Minute Preceptor (OMP) and Flipped Classroom (FC) methods in clinical teaching for general medicine residents during their standardized training. Methods A total of 80 general medicine residents undergoing standardized training at our hospital between June 2023 and December 2024 were selected as study participants. These residents were randomly assigned to either an experimental group ( n  = 40) receiving the OMP/FC teaching method or a control group ( n  = 40) following traditional teaching methods. The effectiveness of the teaching methods and resident satisfaction were assessed through exit examinations and a questionnaire survey. Results There was no significant difference in gender, age and other general data between the two groups. The experimental group showed significantly higher performance in the exit examination compared to the control group, with superior scores in theoretical assessments, first-round medical record writing, major case documentation, and clinical reasoning ( P  < 0.05). Additionally, survey results indicated that the experimental group exhibited better abilities in disease history taking, physical examination, and interpreting auxiliary examinations ( P  < 0.05). While improvements in theoretical knowledge, medical record documentation, and clinical reasoning were statistically significant ( P  < 0.05), the size of the improvement for some measures, such as satisfaction ratings, were modest and may not be clinically meaningful. Conclusion The combination of the OMP and FC methods significantly improved the clinical training outcomes for general medicine residents. These methods enhanced key clinical skills, increased teaching effectiveness, and fostered higher levels of resident satisfaction, making them a promising approach for clinical education in primary care.

Background The American Board of Medical Specialties recognized Pediatric Hospital Medicine (PHM) for subspecialty certification in 2016, with the first certification exam in 2019. To address the need for exam preparatory materials, we designed and evaluated a novel PHM board review course that was offered both in-person and online. Methods Course content was based on the American Board of Pediatrics (ABP) PHM certifying exam outline. Course objectives were developed from published PHM core competencies and the 2012 ABP general pediatrics content objectives. National experts served as faculty, presenting didactic sessions, and contributing to a question bank for high-yield review. For program evaluation, we applied the Kirkpatrick Model, evaluating estimated exam pass rates (Level 4), participant learning (Level 2) via post-presentation practice questions, and participants’ ratings of presenters (via five-point Likert scale) and satisfaction (Level 1). Results There were 112 in-person and 144 online participants with estimated pass rates of 89 and 93%, respectively. The mean correct response for the post-presentation knowledge questions was 84%. Faculty effectiveness ratings ranged from 3.81 to 4.96 (median score 4.60). Strengths included the pace of the course, question bank, and printed syllabus. Suggestions for improvement included question bank expansion, focus on “testable” points rather than general information, and challenges with long days of didactic presentations. Conclusions This novel PHM board review course demonstrated effectiveness. Hospitalists preferred focused “testable” information, an active learning environment, and a robust question bank. Future preparatory courses should consider including more opportunities for practice questions, focused content review, and learner engagement.

Background Virtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training “on the patient”. However, there are no data comparing different commercially available high-end virtual reality simulators. Methods Trainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination. Results All trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination ( p  < 0.001), median time taken improved from 305 to 167 s ( p  < 0.001). Conclusions All Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.