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Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear. This study aimed to determine the cost-effectiveness of a face-to-face learning and blended learning approach for evidence-based medicine training within a medical program. The economic evaluation was conducted as part of a randomized controlled trial (RCT) comparing the evidence-based medicine (EBM) competency of medical students who participated in two different modes of education delivery. In the traditional face-to-face method, students received ten 2-hour classes. In the blended learning approach, students received the same total face-to-face hours but with different activities and additional online and mobile learning. Online activities utilized YouTube and a library guide indexing electronic databases, guides, and books. Mobile learning involved self-directed interactions with patients in their regular clinical placements. The attribution and differentiation of costs between the interventions within the RCT was measured in conjunction with measured outcomes of effectiveness. An incremental cost-effectiveness ratio was calculated comparing the ongoing operation costs of each method with the level of EBM proficiency achieved. Present value analysis was used to calculate the break-even point considering the transition cost and the difference in ongoing operation cost. The incremental cost-effectiveness ratio indicated that it costs 24% less to educate a student to the same level of EBM competency via the blended learning approach used in the study, when excluding transition costs. The sunk cost of approximately AUD $40,000 to transition to the blended model exceeds any savings from using the approach within the first year of its implementation; however, a break-even point is achieved within its third iteration and relative savings in the subsequent years. The sensitivity analysis indicates that approaches with higher transition costs, or staffing requirements over that of a traditional method, are likely to result in negative value propositions. Under the study conditions, a blended learning approach was more cost-effective to operate and resulted in improved value for the institution after the third year iteration, when compared to the traditional face-to-face model. The wider applicability of the findings are dependent on the type of blended learning utilized, staffing expertise, and educational context.

Early onset of behavioural problems has lasting negative effects on a broad range of lifetime outcomes, placing large costs on individuals, families and society. A number of researchers and policy makers have argued that early interventions aimed at supporting the family is the most effective way of tackling child behaviour problems. This study forms the economic component of a randomised evaluation of the Incredible Years programme, a programme aimed at improving the skills and parenting strategies of parents of children with conduct problems. Our results show that the programme provides a cost-effective way of reducing behavioural problems. Furthermore, our cost analysis, when combined with a consideration of the potential long-run benefits, suggests that investment in such programmes may generate favourable long-run economic returns.

Background Despite the widespread implementation of competency-based education, evidence of ensuing enhanced patient care and cost-benefit remains scarce. This narrative review uses the Kirkpatrick/Phillips model to investigate the patient-related and organizational effects of graduate competency-based medical education for five basic anesthetic procedures. Methods The MEDLINE, ERIC, CINAHL, and Embase databases were searched for papers reporting results in Kirkpatrick/Phillips levels 3–5 from graduate competency-based education for five basic anesthetic procedures. A gray literature search was conducted by reference search in Google Scholar. Results In all, 38 studies were included, predominantly concerning central venous catheterization. Three studies reported significant cost-effectiveness by reducing infection rates for central venous catheterization. Furthermore, the procedural competency, retention of skills and patient care as evaluated by fewer complications improved in 20 of the reported studies. Conclusion Evidence suggests that competency-based education with procedural central venous catheterization courses have positive effects on patient care and are both cost-effective. However, more rigorously controlled and reproducible studies are needed. Specifically, future studies could focus on organizational effects and the possibility of transferability to other medical specialties and the broader healthcare system.

Fundamental to planning, implementing, and sustaining a quality Doctor of Nursing Practice (DNP) program is access to the resources needed to foster a learning environment that prepares nurses for advanced practice and leadership in the future redesigned health care system. This creates formidable challenges for schools and colleges of nursing as they endeavor to address the nation’s need for an increased supply of advanced practice nurses to provide access to high-quality, cost-effective care for an aging population. This article describes the essential resources needed to support the delivery of a DNP program and the proposed strategies needed to address the resource challenges. [Fundamental to planning, implementing, and sustaining a quality Doctor of Nursing Practice (DNP) program is access to the resources needed to foster a learning environment that prepares nurses for advanced practice and leadership in the future redesigned health care system. This creates formidable challenges for schools and colleges of nursing as they endeavor to address the nation’s need for an increased supply of advanced practice nurses to provide access to high-quality, cost-effective care for an aging population. This article describes the essential resources needed to support the delivery of a DNP program and the proposed strategies needed to address the resource challenges. [ J Nurs Educ. 2013;52(8):449–452.]

In response to declining instruction in technical skills, the authors instituted a novel method to teach basic procedural skills to medical students beginning the surgery clerkship. Sixty-three medical students participated in a skills training laboratory. The first part of the laboratory taught basic suturing skills, and the second involved a cadaver with pig skin grafted to different anatomic locations. Clinical scenarios were simulated, and students performed essential procedural skills. Students learned most of their suturing skills in the laboratory skills sessions, compared with the emergency room or the operating room ( P = .01). Students reported that the laboratory allowed them greater opportunity to participate in the emergency room and operating room. Students also felt that the suture laboratory contributed greatly to their skills in wound closure. Finally, 90% of students had never received instruction on suturing, and only 12% had performed any procedural skills before beginning the surgery rotation. The laboratory described is an effective way of insuring that necessary technical skills are imparted during the surgery rotation.

Competency based education and training (CBET) helps to prepare graduates of medical laboratory science programs for the specific needs of the workforce. This is especially important in resource-limited countries where shortage of laboratory personnel creates a large demand for skilled graduates. Internet and other technology can be useful to teach specific tasks in CBET. Even in resource-limited countries, technology can be used in the implementation of competency based education and training curricula in medical laboratory programs.

This paper argues that micro-credentials are gig credentials for the gig economy. Micro-credentials are short competency-based industry-aligned units of learning, while the gig economy comprises contingent work by individual ‘suppliers’. Both can be facilitated by (often the same) digital platforms, and both are underpinned by social relations of precariousness in the labour market and in society. They are mutually reinforcing and each has the potential to amplify the other. Rather than presenting new opportunities for social inclusion and access to education, they contribute to the privatisation of education by unbundling the curriculum and blurring the line between public and private provision in higher education. They accelerate the transfer of the costs of employment preparation, induction, and progression from governments and employers to individuals. Micro-credentials contribute to ‘disciplining’ higher education in two ways: first by building tighter links between higher education and workplace requirements (rather than whole occupations), and through ensuring universities are more ‘responsive’ to employer demands in a competitive market crowded with other types of providers. Instead of micro-credentials, progressive, democratic societies should seek to ensure that all members of society have access to a meaningful qualification that has value in the labour market and in society more broadly, and as a bridge to further education. This is a broader vision of education in which the purpose of education is to prepare individuals to live lives they have reason to value, and not just in the specifics required of particular jobs.

Aim The study describes the fidelity of implementing a competency‐based nursing education (CBNE) programme during the COVID‐19 pandemic in a low‐resource setting. Design A descriptive case study research design integrating mixed methods underpinned by the fidelity of implementation framework was applied to assess teaching, learning and assessment during the COVID‐19 pandemic. Methods A survey, focus group and document analysis were applied to collect data from 16 educators, 128 students and eight administrators of a nursing education institution and accessing institutional documents. Data were analysed through descriptive statistics and deductive content analysis and packaging the outcome of the study according to the five elements related to the fidelity of implementation framework. Results The fidelity of implementing the CBNE programme was satisfactorily maintained as described in the fidelity of implementation framework. However, sequenced progression and programmatic assessments were not aligned with a CBNE programme within the context of the COVID‐19 pandemic. Patient or Public Contribution This paper proposes strategies to enhance the fidelity of implementing competency‐based education during educational disruptions.

Research in marketing has increasingly focused on building knowledge about how firms' marketing contributes to performance outcomes. A key precursor to accurately diagnosing the value firms' marketing creates is conceptualizing and operationalizing appropriate ways to assess performance outcomes. Yet, to date, there has been little conceptual development and no systematic examination of how researchers in marketing should conceptualize and measure the performance outcomes associated with firms' marketing. The authors develop a theory-based performance evaluation framework and examine the assessment of such performance outcomes in 998 empirical studies published in the top 15 marketing journals from 1981 through 2014. The results reveal a large number of different performance outcome measures used in prior empirical research that may be only weakly related to one another, making it difficult to synthesize findings across studies. In addition, the authors identify significant problems in how performance outcomes in marketing are commonly conceptualized and operationalized. They also reveal several theoretically and managerially important performance areas in which empirical knowledge of marketing's impact is limited or absent. Finally, they examine the implications of the results, provide actionable guidelines for researchers, and suggest a road map for systematically improving research practice in the future.