Data sharing and big data in health professions education: Ottawa consensus statement and recommendations for scholarship.

Changes in digital technology, increasing volume of data collection, and advances in methods have the potential to unleash the value of big data generated through the education of health professionals. Coupled with this potential are legitimate concerns about how data can be used or misused in ways that limit autonomy, equity, or harm stakeholders. This consensus statement is intended to address these issues by foregrounding the ethical imperatives for engaging with big data as well as the potential risks and challenges. Recognizing the wide and ever evolving scope of big data scholarship, we focus on foundational issues for framing and engaging in research. We ground our recommendations in the context of big data created through data sharing across and within the stages of the continuum of the education and training of health professionals. Ultimately, the goal of this statement is to support a culture of trust and quality for big data research to deliver on its promises for health professions education (HPE) and the health of society. Based on expert consensus and review of the literature, we report 19 recommendations in (1) framing scholarship and research through research, (2) considering unique ethical practices, (3) governance of data sharing collaborations that engage stakeholders, (4) data sharing processes best practices, (5) the importance of knowledge translation, and (6) advancing the quality of scholarship through multidisciplinary collaboration. The recommendations were modified and refined based on feedback from the 2022 Ottawa Conference attendees and subsequent public engagement. Adoption of these recommendations can help HPE scholars share data ethically and engage in high impact big data scholarship, which in turn can help the field meet the ultimate goal: high-quality education that leads to high-quality healthcare.

Undergraduate Students' Profiles of Cognitive Load in Augmented Reality-Assisted Science Learning and Their Relation to Science Learning Self-efficacy and Behavior Patterns.

Research evidence indicated that a specific type of augmented reality-assisted (AR-assisted) science learning design or support might not suit or be effective for all students because students' cognitive load might differ according to their experiences and individual characteristics. Thus, this study aimed to identify undergraduate students' profiles of cognitive load in AR-assisted science learning and to examine the role of their distinct profiles in self-efficacy together with associated behavior patterns in science learning. After ensuring the validity and reliability of each measure, a latent profile analysis confirmed that 365 Chinese undergraduates carried diverse dimensions of cognitive load simultaneously. The latent profile analysis findings revealed four fundamental profiles: Low Engagement, Immersive, Dabbling, and Organized, characterized as carrying various respective cognitive loads. The multivariate analysis of variance findings revealed different levels of the six AR science learning self-efficacy dimensions across profiles. Low Engagement students displayed the lowest self-efficacy among all dimensions. Organized students recorded better conceptual understanding and higher-order cognitive skills than Dabbling ones. Students with the Immersive profile had the highest science learning self-efficacy. The lag sequential analysis results showed significant differences in behavior patterns among profiles. Among them, profiles with social interaction, test, and reviewing feedback behavior had a significantly higher score for self-efficacy than those patterns mainly based on test learning and resource visits. This finding provides a unified consideration of students' diverse profiles and can inform interventions for effective design of AR-assisted science learning to match appropriate strategies to facilitate the science learning effect.

Laypeople's Online Health Information Search Strategies and Use for Health-Related Problems: Cross-sectional Survey.

BACKGROUND: With the increase in the use of the internet to search for health information about health-related problems, there is a need for health care professionals to better understand how their patients search for and use the online health information that may influence their medical decision making. OBJECTIVE: The aims of this study are to explore laypeople's online health information search strategies and examine the relationships between their search strategies and utilization behavior of online health information. METHODS: Two scales, namely match and elaboration, were used to measure patients' basic search strategies (ie, simple approach) and advanced search strategies (ie, integrative approach), respectively. In addition, the consultation scale was used to evaluate the participants' use of online health information to consult doctors and others. A total of 253 outpatients without university education were purposely selected and surveyed. The participants were outpatients at a university-affiliated teaching hospital. Partial least squares-structural equation modeling (PLS-SEM) was performed to analyze the measurement model to specify the measurement validation. In addition, the structure model of PLS-SEM was evaluated to examine the path correlations between variables and to execute interaction effect and curvilinear relationship analyses. RESULTS: The results of the path correlation analysis by PLS-SEM showed that both elaboration strategy (path coefficient=0.55, P<.001) and match strategy (path coefficient=0.36, P<.001) were positively correlated with consultation on online health information with doctors and others. In addition, interaction effect and curvilinear relationship analyses indicated that there was a significant interaction effect between elaboration and match on consultation (path coefficient=-0.34, P<.001) and a significant curvilinear relationship between match and consultation (path coefficient=-0.09, P=.046). CONCLUSIONS: Increasing patients' exposure to online health information through both a simple search approach (ie, match strategy) and a complex search approach (ie, elaboration strategy) may lead them to appropriately use the information to consult doctors and others. However, the results of interaction effect and curvilinear relationship analyses highlighted the essential role of the elaboration strategy to properly locate, evaluate, and apply online health information. The findings of this study may help health care professionals better understand how to communicate with their patients through the health information on the internet.

Massive Distance Education: Barriers and Challenges in Shifting to a Complete Online Learning Environment.

The global pandemic has dramatically changed how the world functions and impacted all sectors of society including all educational institutions. Government and educators respond with immediate online teaching and learning for all students. Massive distance education has been drawn into the picture to provide non-stop learning in most countries worldwide. This study focuses on examining different orders of barriers educators have encountered during the Covid-19 pandemic. The barriers to massive online teaching and learning included the first-order barrier (technological or external barrier), the second-order barrier (internal barrier or teachers' and parents' beliefs), the third-order barrier (design thinking barrier), and the 2.5th order barrier (the classroom management barrier). Both teachers and students are suffering from unstable or limited internet connectivity and it directly hinders students' rights in the massive online education. Teachers are facing the need for sudden pedagogical redesign while parents are enduring the burden of providing all kinds of support for their children's online learning at home. Some learners are experiencing videoconferencing fatigue and struggling with overwhelming resources and an excessive amount of technology time. This study also identifies a group of forgotten learners, the videoconferencing refugees, who have limited access to the Internet and lost their learning opportunities. From a global perspective, shifting to massive online education may be possible with all four orders of barriers being overcome.

A Systematic Review of MRI Neuroimaging for Education Research.

This study aims to disclose how the magnetic resonance imaging (MRI) neuroimaging approach has been applied in education studies, and what kind of learning themes has been investigated in the reviewed MRI neuroimaging research. Based on the keywords "brain or neuroimaging or neuroscience" and "MRI or diffusion tensor imaging (DTI) or white matter or gray matter or resting-state," a total of 25 papers were selected from the subject areas "Educational Psychology" and "Education and Educational Research" from the Web of Science and Scopus from 2000 to 2019. Content analysis showed that MRI neuroimaging and learning were studied under the following three major topics and nine subtopics: cognitive function (language, creativity, music, physical activity), science education (mathematical learning, biology learning, physics learning), and brain development (parenting, personality development). As for the type of MRI neuroimaging research, the most frequently used approaches were functional MRI, followed by structural MRI and DTI, although the choice of approach was often motivated by the specific research question. Research development trends show that the neural plasticity theme has become more prominent recently. This study concludes that in educational research, the MRI neuroimaging approach provides objective and empirical evidence to connect learning processes, outcomes, and brain mechanisms.

Internet-Specific Epistemic Beliefs in Medicine and Intention to Use Evidence-Based Online Medical Databases Among Health Care Professionals: Cross-sectional Survey.

BACKGROUND: Evidence-based medicine has been regarded as a prerequisite for ensuring health care quality. The increase in health care professionals' adoption of web-based medical information and the lack of awareness of alternative access to evidence-based online resources suggest the need for an investigation of their information-searching behaviors of using evidence-based online medical databases. OBJECTIVE: The main purposes of this study were to (1) modify and validate the internet-specific epistemic beliefs in medicine (ISEBM) questionnaire and (2) explore the associations between health care professionals' demographics, ISEBM, and intention to use evidence-based online medical databases for clinical practice. METHODS: Health care professionals in a university-affiliated teaching hospital were surveyed using the ISEBM questionnaire. The partial least squares-structural equation modeling was conducted to analyze the reliability and validity of ISEBM. Furthermore, the structural model was analyzed to examine the possible linkages between health professionals' demographics, ISEBM, and intention to utilize the evidence-based online medical databases for clinical practice. RESULTS: A total of 273 health care professionals with clinical working experience were surveyed. The results of the measurement model analysis indicated that all items had significant loadings ranging from 0.71 to 0.92 with satisfactory composite reliability values ranging from 0.87 to 0.94 and average variance explained values ranging from 0.70 to 0.84. The results of the structural relationship analysis revealed that the source of internet-based medical knowledge (path coefficient -0.26, P=.01) and justification of internet-based knowing in medicine (path coefficient 0.21, P=.001) were correlated with the intention to use evidence-based online medical databases. However, certainty and simplicity of internet-based medical knowledge were not. In addition, gender (path coefficient 0.12, P=.04) and academic degree (path coefficient 0.15, P=.004) were associated with intention to use evidence-based online medical databases for clinical practice. CONCLUSIONS: Advancing health care professionals' ISEBM regarding source and justification may encourage them to retrieve valid medical information through evidence-based medical databases. Moreover, providing support for specific health care professionals (ie, females, without a master's degree) may promote their intention to use certain databases for clinical practice.

Challenges and Future Directions of Big Data and Artificial Intelligence in Education.

We discuss the new challenges and directions facing the use of big data and artificial intelligence (AI) in education research, policy-making, and industry. In recent years, applications of big data and AI in education have made significant headways. This highlights a novel trend in leading-edge educational research. The convenience and embeddedness of data collection within educational technologies, paired with computational techniques have made the analyses of big data a reality. We are moving beyond proof-of-concept demonstrations and applications of techniques, and are beginning to see substantial adoption in many areas of education. The key research trends in the domains of big data and AI are associated with assessment, individualized learning, and precision education. Model-driven data analytics approaches will grow quickly to guide the development, interpretation, and validation of the algorithms. However, conclusions from educational analytics should, of course, be applied with caution. At the education policy level, the government should be devoted to supporting lifelong learning, offering teacher education programs, and protecting personal data. With regard to the education industry, reciprocal and mutually beneficial relationships should be developed in order to enhance academia-industry collaboration. Furthermore, it is important to make sure that technologies are guided by relevant theoretical frameworks and are empirically tested. Lastly, in this paper we advocate an in-depth dialog between supporters of "cold" technology and "warm" humanity so that it can lead to greater understanding among teachers and students about how technology, and specifically, the big data explosion and AI revolution can bring new opportunities (and challenges) that can be best leveraged for pedagogical practices and learning.

To examine the associations between medical students' conceptions of learning, strategies to learning, and learning outcome in a medical humanities course.

BACKGROUND: By learning medical humanities, medical students are expected to shift from handling the diseases only to seeing a whole sick person. Therefore, understanding medical students' learning process and outcomes of medical humanities becomes an essential issue of medical education. Few studies have been conducted to explore factors surrounding medical students' learning process and outcomes of medical humanities. The objectives were: (1) to investigate the relationships between medical students' conceptions of learning and strategies to learning; and (2) to examine the relationships between students' strategies to learning and learning outcomes for medical humanities. METHODS: We used the modified Approaches to Learning Medicine (mALM) questionnaire and Conceptions of Learning Medicine (COLM) questionnaire to measure the medical students' strategies to learning and conceptions of learning respectively. The learning outcome of medical humanities was measured using students' weighted grade in a medical humanities course. The confirmatory factor analysis (CFA) was used to validate the COLM and mALM questionnaires, in which construct validity and reliability were assessed. Pearson's correlation was used to examine the relationships among the factors of COLM, mALM, and the weighted grade. Path analysis using structural equation modeling technique (SEM) was employed to estimate the structural relationships among the COLM, mALM, and the weighted grade. RESULTS: Two hundred and seventy-five first-year medical students consented to participate in this study. The participants adopting surface strategies to learning were more likely to have unsatisfactory learning outcome (ß = - 0.14, p = .04). The basic-level conception of "Preparing for Testing" was negatively (ß = - 0.19, p < .01) associated with deep strategies of learning, and positively (ß = 0.48, p < .01) associated with surface strategies of learning (ß = 0.50, p < .01). The basic-level conception of "Skills Acquisition" was positively associated with deep strategies of learning (ß = 0.23, p < .01). CONCLUSION: Medical educators should wisely employ teaching strategies to increase students' engagement with deep and self-directed learning strategies, and to avoid using surface learning strategies in the medical humanities course in order to achieve better learning outcomes.

The relationships between the medical learners' motivations and strategies to learning medicine and learning outcomes.

BACKGROUND: One of the strongly theorized areas of research associated with learning outcomes has been the approaches to learning. Few studies have been focused on examining the relationship between the approaches to learning medicine (ALM) and learning outcomes. OBJECTIVES: The objectives were: (1) to conduct psychometric testing of the ALM questionnaire; and (2) to examine the association between medical learners' ALM and learning outcomes. DESIGN: We developed the ALM questionnaire which was a modification of the Revised Learning Process questionnaire. We defined the learning outcome of each house officer as the class rank in his/her graduating class. Exploratory factor analysis was used to examine the factor structure of the ALM questionnaire. We conducted Pearson's and Spearman's Rank correlation coefficients for examining the linear relationships between two continuous variables, and between a continuous variable and a categorical variable, respectively. Stepwise multivariate linear regression analysis with backward elimination was undertaken to examine the correlation between the ALM and the learning outcome. RESULTS: A house officer with deep strategies (relating multiple ideas and truly understanding the course content) or surface motivations (aim for qualification) was more likely to have a better learning outcome as indicated by a better class rank based on his/her academic performance. Furthermore, a house officer with surface learning strategies (minimizing the study scope to merely passing the examination) to learning medicine was more likely to have an unfavorable class rank. CONCLUSIONS: This study represents the first report of the correlation between house officers' ALM and learning outcomes. House officers with deep strategies were more likely to have better learning outcomes. In particular, house officers with a surface motive to learning medicine, i.e., aiming for qualification, were surprisingly correlated with better learning outcomes.

Health Information Obtained From the Internet and Changes in Medical Decision Making: Questionnaire Development and Cross-Sectional Survey.

BACKGROUND: The increasing utilization of the internet has provided a better opportunity for people to search online for health information, which was not easily available to them in the past. Studies reported that searching on the internet for health information may potentially influence an individual's decision making to change her health-seeking behaviors. OBJECTIVE: The objectives of this study were to (1) develop and validate 2 questionnaires to estimate the strategies of problem-solving in medicine and utilization of online health information, (2) determine the association between searching online for health information and utilization of online health information, and (3) determine the association between online medical help-seeking and utilization of online health information. METHODS: The Problem Solving in Medicine and Online Health Information Utilization questionnaires were developed and implemented in this study. We conducted confirmatory factor analysis to examine the structure of the factor loadings and intercorrelations for all the items and dimensions. We employed Pearson correlation coefficients for examining the correlations between each dimension of the Problem Solving in Medicine questionnaire and each dimension of the Online Health Information Utilization questionnaire. Furthermore, we conducted structure equation modeling for examining the possible linkage between each of the 6 dimensions of the Problem Solving in Medicine questionnaire and each of the 3 dimensions of the Online Health Information Utilization questionnaire. RESULTS: A total of 457 patients participated in this study. Pearson correlation coefficients ranged from .12 to .41, all with statistical significance, implying that each dimension of the Problem Solving in Medicine questionnaire was significantly associated with each dimension of the Online Health Information Utilization questionnaire. Patients with the strategy of online health information search for solving medical problems positively predicted changes in medical decision making (P=.01), consulting with others (P<.001), and promoting self-efficacy on deliberating the online health information (P<.001) based on the online health information they obtained. CONCLUSIONS: Present health care professionals have a responsibility to acknowledge that patients' medical decision making may be changed based on additional online health information. Health care professionals should assist patients' medical decision making by initiating as much dialogue with patients as possible, providing credible and convincing health information to patients, and guiding patients where to look for accurate, comprehensive, and understandable online health information. By doing so, patients will avoid becoming overwhelmed with extraneous and often conflicting health information. Educational interventions to promote health information seekers' ability to identify, locate, obtain, read, understand, evaluate, and effectively use online health information are highly encouraged.

Inhibition of human colorectal cancer metastasis by notoginsenoside R1, an important compound from Panax notoginseng.

Panax notoginseng (P. notoginseng) and its components are used as traditional Chinese medicine for cardiovascular disease, although studies concerning the anti-metastatic properties of these compounds are limited. The goal of this study was to investigate the effects of notoginsenoside R1 (NGR1), an important compound derived from P. notoginseng, on the metastasis of human colorectal cancer (CRC). The migratory, invasive, and adhesive abilities of cultured human CRC cells (HCT-116) treated with NGR1 and expression of metastasis­associated regulatory molecules were assessed. The migratory and invasive abilities of the HCT-116 cells were reduced after treatment with 75, 150 or 300 µM NGR1 for 24 h. When HCT-116 cells were incubated with 150 or 300 µM NGR1 for 24 h, matrix metalloproteinase (MMP)-9 expression was reduced compared with that of the control group. In the adhesion reaction assays, treatment with 150 or 300 µM NGR1 led to significantly decreased adhesion of the HCT-116 cells to endothelial cells (EA.hy926 cells). Levels of integrin-1 protein were significantly decreased in the HCT-116 cells following treatment with 75, 150 or 300 µM NGR1, and levels of E-selectin and intercellular adhesion molecule 1 (ICAM-1) proteins were significantly decreased in the EA.hy926 cells treated with 75, 150 or 300 µM NGR1. Scanning electron microscopy examination indicated that HCT-116 cells treated with lipopolysaccharide (LPS) combined with 300 µM NGR1 exhibited a less flattened and retracted shape compared with cells treated with LPS alone, and this change in shape is characteristic of extravasation. Additionally, the transepithelial electrical resistance of the EA.hy926 endothelial cell monolayer increased after incubation with 150 or 300 µM NGR1 for 24 h. Overall, these results demonstrated the anti-metastatic properties of 150 or 300 µM NGR1, a compound that affects CRC metastasis by inhibiting cell migration, invasion, and adhesion and by regulating expression of metastasis-associated signalling molecules.

The Association Between Internet Use and Ambulatory Care-Seeking Behaviors in Taiwan: A Cross-Sectional Study.

BACKGROUND: Compared with the traditional ways of gaining health-related information from newspapers, magazines, radio, and television, the Internet is inexpensive, accessible, and conveys diverse opinions. Several studies on how increasing Internet use affected outpatient clinic visits were inconclusive. OBJECTIVE: The objective of this study was to examine the role of Internet use on ambulatory care-seeking behaviors as indicated by the number of outpatient clinic visits after adjusting for confounding variables. METHODS: We conducted this study using a sample randomly selected from the general population in Taiwan. To handle the missing data, we built a multivariate logistic regression model for propensity score matching using age and sex as the independent variables. The questionnaires with no missing data were then included in a multivariate linear regression model for examining the association between Internet use and outpatient clinic visits. RESULTS: We included a sample of 293 participants who answered the questionnaire with no missing data in the multivariate linear regression model. We found that Internet use was significantly associated with more outpatient clinic visits (P=.04). The participants with chronic diseases tended to make more outpatient clinic visits (P<.01). CONCLUSIONS: The inconsistent quality of health-related information obtained from the Internet may be associated with patients' increasing need for interpreting and discussing the information with health care professionals, thus resulting in an increasing number of outpatient clinic visits. In addition, the media literacy of Web-based health-related information seekers may also affect their ambulatory care-seeking behaviors, such as outpatient clinic visits.

Exploring the relationships between epistemic beliefs about medicine and approaches to learning medicine: a structural equation modeling analysis.

BACKGROUND: Students' epistemic beliefs may vary in different domains; therefore, it may be beneficial for medical educators to better understand medical students' epistemic beliefs regarding medicine. Understanding how medical students are aware of medical knowledge and how they learn medicine is a critical issue of medical education. The main purposes of this study were to investigate medical students' epistemic beliefs relating to medical knowledge, and to examine their relationships with students' approaches to learning medicine. METHODS: A total of 340 undergraduate medical students from 9 medical colleges in Taiwan were surveyed with the Medical-Specific Epistemic Beliefs (MSEB) questionnaire (i.e., multi-source, uncertainty, development, justification) and the Approach to Learning Medicine (ALM) questionnaire (i.e., surface motive, surface strategy, deep motive, and deep strategy). By employing the structural equation modeling technique, the confirmatory factor analysis and path analysis were conducted to validate the questionnaires and explore the structural relations between these two constructs. RESULTS: It was indicated that medical students with multi-source beliefs who were suspicious of medical knowledge transmitted from authorities were less likely to possess a surface motive and deep strategies. Students with beliefs regarding uncertain medical knowledge tended to utilize flexible approaches, that is, they were inclined to possess a surface motive but adopt deep strategies. Students with beliefs relating to justifying medical knowledge were more likely to have mixed motives (both surface and deep motives) and mixed strategies (both surface and deep strategies). However, epistemic beliefs regarding development did not have significant relations with approaches to learning. CONCLUSIONS: Unexpectedly, it was found that medical students with sophisticated epistemic beliefs (e.g., suspecting knowledge from medical experts) did not necessarily engage in deep approaches to learning medicine. Instead of a deep approach, medical students with sophisticated epistemic beliefs in uncertain and justifying medical knowledge intended to employ a flexible approach and a mixed approach, respectively.

Improving Health Care Providers' Capacity for Self-Regulated Learning in Online Continuing Pharmacy Education: The Role of Internet Self-Efficacy.

INTRODUCTION: Although Internet-based learning is widely used to improve health professionals' knowledge and skills, the self-regulated learning (SRL) activities of online continuing education in pharmacy are seldom discussed. The main purpose of this study was to explore the relationships between pharmacists' Internet self-efficacy (ISE) and their SRL in online continuing education. METHODS: A total of 164 in-service pharmacists in Taiwan were surveyed with the Internet Self-Efficacy Survey, including basic ISE (B-ISE), advanced ISE (A-ISE) and professional ISE (P-ISE), as well as the Self-Regulated Learning Questionnaire consisting of preparatory SRL (P-SRL) and enactment SRL (E-SRL). RESULTS: Results of a 1-by-3 (educational levels: junior college versus bachelor versus master) analysis of variance and a 1-by-4 (institutions: community-based versus hospital versus clinic versus company) analysis of variance revealed that there were differences in ISE and SRL among different education levels and working institutions. The hierarchical regression analyses indicated that B-ISE and P-ISE were significant predictors of P-SRL, whereas P-ISE was a critical predictor of E-SRL. Moreover, the interaction of P-ISE × age was linked to E-SRL, implying that P-ISE has a stronger influence on E-SRL for older pharmacists than for younger pharmacists. However, the interactions between age and ISE (A-ISE, B-ISE, and P-ISE) were not related to P-SRL. DISCUSSION: This study highlighted the importance of ISE and age for increasing pharmacists' SRL in online continuing education.

The roles of social factor and internet self-efficacy in nurses' web-based continuing learning.

This study was conducted to explore the relationships among social factor, Internet self-efficacy and attitudes toward web-based continuing learning in a clinical nursing setting. The participants recruited were 244 in-service nurses from hospitals in Taiwan. Three instruments were used to assess their perceptions of social factor, Internet self-efficacy (including basic and advanced Internet self-efficacy) and attitudes toward web-based continuing learning (including perceived usefulness, perceived ease of use, affection and behavior). Structural equation modeling (SEM) was utilized to identify the hypothesized structural model. The results of this study support that social factor is a significant factor correlated to Internet self-efficacy and attitudes toward web-based continuing learning (including perceived usefulness, perceived ease of use and affection). In addition, nurses' basic Internet self-efficacy plays a key role in attitudes including perceived usefulness, perceived ease of use and affection. However, advanced self-efficacy was not correlated to any of the attitudes. The behavior dimension was not linked to social factor or Internet self-efficacy, but was linked to perceived ease of use and affection.

The relationships among nurses' job characteristics and attitudes toward web-based continuing learning.

The purpose of this study was to explore the relationships between job characteristics (job demands, job control and social support) and nurses' attitudes toward web-based continuing learning. A total of 221 in-service nurses from hospitals in Taiwan were surveyed. The Attitudes toward Web-based Continuing Learning Survey (AWCL) was employed as the outcome variables, and the Chinese version Job Characteristic Questionnaire (C-JCQ) was administered to assess the predictors for explaining the nurses' attitudes toward web-based continuing learning. To examine the relationships among these variables, hierarchical regression was conducted. The results of the regression analysis revealed that job control and social support positively associated with nurses' attitudes toward web-based continuing learning. However, the relationship of job demands to such learning was not significant. Moreover, a significant demands×job control interaction was found, but the job demands×social support interaction had no significant relationships with attitudes toward web-based continuing learning.

Effects of different forms of physiology instruction on the development of students' conceptions of and approaches to science learning.

The purpose of this study was to investigate students' conceptions of and approaches to learning science in two different forms: internet-assisted instruction and traditional (face-to-face only) instruction. The participants who took part in the study were 79 college students enrolled in a physiology class in north Taiwan. In all, 46 of the participants were from one class and 33 were from another class. Using a quasi-experimental research approach, the class of 46 students was assigned to be the "internet-assisted instruction group," whereas the class of 33 students was assigned to be the "traditional instruction group." The treatment consisted of a series of online inquiry activities. To explore the effects of different forms of instruction on students' conceptions of and approaches to learning science, two questionnaires were administered before and after the instruction: the Conceptions of Learning Science Questionnaire and the Approaches to Learning Science Questionnaire. Analysis of covariance results revealed that the students in the internet-assisted instruction group showed less agreement than the traditional instruction group in the less advanced conceptions of learning science (such as learning as memorizing and testing). In addition, the internet-assisted instruction group displayed significantly more agreement than the traditional instruction group in more sophisticated conceptions (such as learning as seeing in a new way). Moreover, the internet-assisted instruction group expressed more orientation toward the approaches of deep motive and deep strategy than the traditional instruction group. However, the students in the internet-assisted instruction group also showed more surface motive than the traditional instruction group did.

A pilot study on conducting mobile learning activities for clinical nursing courses based on the repertory grid approach.

In clinical nursing courses, students are trained to identify the status of the target patients. The mastery of such ability and skills is very important since patients frequently need to be cared for immediately. In this pilot study, a repertory grid-oriented clinical mobile learning system is developed for a nursing training program. With the assistance of the mobile learning system, the nursing school students are able to learn in an authentic learning scenario, in which they can physically face the target patients, with the personal guidance and supplementary materials from the learning system to support them. To show the effectiveness of this innovative approach, an experiment has been conducted on the "respiratory system" unit of a nursing course. The experimental results show that the innovative approach is helpful to students in improving their learning achievements. Moreover, from the questionnaire surveys, it was found that most students showed favorable attitudes toward the usage of the mobile learning system and their participation in the training program.

Nurses' Internet self-efficacy and attitudes toward web-based continuing learning.

OBJECTIVE: There are increasing opportunities for nurses to engage in continuing learning via the Internet; hence, it is important to explore nurses' attitudes toward web-based continuing learning. METHOD: This paper explores 267 Taiwanese clinical nurses' attitudes toward web-based continuing learning. In addition, the role of the nurses' Internet self-efficacy in their attitudes is investigated. This study utilizes two questionnaires to respectively survey the nurses' Internet self-efficacy and their attitudes toward web-based continuing learning. In particular, the Internet Self-efficacy Survey includes two scales: 'Basic self-efficacy' (the perceived confidence of using basic Internet functions, such as the confidence in using a web browser or searching for online information) and 'Advanced self-efficacy' (the perceived confidence of using advanced Internet functions, such as the confidence in online discussion or making online payments). RESULTS AND FINDINGS: Exploratory factor analyses indicated adequate reliability and validity of the two questionnaires. The regression analyses revealed that both nurses' basic and advanced Internet self-efficacy can positively explain the perceived usefulness, ease of use and friendly feeling when using web-based continuing learning environments, whereas nurses' advanced Internet self-efficacy was the only predictor to explain how they intend to use web-based continuing learning environments more.

Students' perceptions of constructivist Internet learning environments by a physics virtual laboratory: the gap between ideal and reality and gender differences.

The purpose of this study was to investigate the perceptions of Internet users of a physics virtual laboratory, Demolab, in Taiwan. Learners' perceptions of Internet-based learning environments were explored and the role of gender was examined by using preferred and actual forms of a revised Constructivist Internet-based Learning Environment Survey (CILES). The students expressed a clear gap between ideal and reality, and they showed higher preferences for many features of constructivist Internet-based learning environments than for features they had actually learned in Demolab. The results further suggested that male users prefer to be involved in the process of discussion and to show critical judgments. In addition, male users indicated they enjoyed the process of negotiation and discussion with others and were able to engage in reflective thoughts while learning in Demolab. In light of these findings, male users seemed to demonstrate better adaptability to the constructivist Internet-based learning approach than female users did. Although this study indicated certain differences between males and females in their responses to Internet-based learning environments, they also shared numerous similarities. A well-established constructivist Internet-based learning environment may encourage more female learners to participate in the science community.