Exploring the impact of digital concept mapping methods on nurse students' learning anxiety, learning motivation.

In involuntary distance education, like during epidemics and wars, students often feel heightened learning anxiety, impacting outcomes. Despite innovative teaching methods, many face hurdles in distance learning. We want to propose specific strategies to solve learning difficulties in distance education. AIM: This study explored whether using digital concept maps (DCM) in physiology courses can reduce learning anxiety among nursing students. DESIGN: The study was quasi-experimental, including a pre-and post-test control group. METHODS: 71 nursing students aged 16-18 enrolled in a physiology course were recruited in the study. DCM was the intervention as a tool for in-person learning (first 12 weeks) and distant learning (final six weeks). Each student was required to complete the assignments independently to compare learning outcomes. Questionnaires were administered, and an assignment evaluation was completed before and after the course's different formats. RESULTS: DCM using software using mobile vehicles (mobile, notebook, pad) is digital learning to help nursing students learn difficult subjects. DCM improved the students' learning motivation and effectiveness more in distance learning than in-person learning, decreasing learning anxiety in both face-to-face and distance learning. CONCLUSIONS: DCM promoted students' self-regulated learning and positively affected learning outcomes by increasing motivation and reducing stress. This study offers a tailored teaching framework for international settings to reduce student anxiety and improve learning effectiveness.

Promoting clinical reasoning in undergraduate Family Medicine curricula through concept mapping: a qualitative approach.

Clinical reasoning is a crucial skill for physicians, enabling them to bridge theoretical knowledge with practical application. The gap between basic sciences and clinical practice persists as a challenge, with traditional teaching methods yet to effectively bridge it. Concept maps (CMs), visual tools for organizing and connecting knowledge, hold promise for enhancing clinical reasoning in the undergraduate medical curriculum. However, further research is required to ascertain if CMs facilitate clinical reasoning development in medical students transitioning from basic sciences to clinical practice. This study aims to delineate how CMs can facilitate clinical reasoning in patients with multimorbidity within undergraduate Family Medicine curricula, as perceived by students and tutors, and to understand the implementation process and resources required. This exploratory qualitative study formed a part of an action research project. While introducing an educational intervention to 5th-year medical students, we conducted a qualitative evaluation. Subsequently, semi-structured group interviews were conducted with students, and a focus group was conducted with tutors. Three main educational impacts were identified: integration of clinical information, support for patient management and care plan, and collaborative learning. Key aspects for successful CM implementation included clear instructions for map construction, using user-friendly software, allocating sufficient time for the task, encouraging group discussion of CMs, and incorporating tutor feedback. CMs are pedagogical tools that facilitate clinical information integration and support management and treatment plans, helping students better understand multimorbidity patients and promoting some components of clinical reasoning in undergraduate medical education.

Effectiveness of using concept mapping by dental students in the radiographic interpretation of jaw diseases.

OBJECTIVES: Interpretation of dental radiographs is a difficult process, particularly for inexperienced students. This study introduced concept mapping for dental students to help in the radiographic interpretation of common jaw lesions. We aimed to analyze the efficacy of the concept map (CM) in radiographic interpretation, with a discussion of the diagnostic reasoning dilemma. METHODS: This study included 39 dental students. After a 1-h class for CM guidance and based on three group discussions and one-on-one feedback, the students completed and submitted CMs for three jaw diseases (ameloblastoma, odontogenic keratocyst, and simple bone cyst). All participants underwent a pretest and posttest of knowledge and diagnosis; all students but one completed an open-ended questionnaire regarding the use of CMs. RESULTS: Concept mapping effectively improved diagnostic accuracy. The participants' posttest scores were better than their pretest scores in both knowledge and diagnostic tests. Most of the students attempted radiographic interpretation through analytic reasoning. The time required for the students to draw a CM varied from student to student from 3-5 h to 1-3 days. CONCLUSION: This study shows that CMs can improve the radiographic diagnostic ability of dental students by providing a framework for analytic reasoning. Continuous research is warranted to improve the effectiveness of CM in oral radiographic interpretation in the dental student's class.

Comparing two teaching methods based on concept map and lecture on dental students' knowledge and performance of post-exposure prophylaxis to hepatitis B: A quasi-experimental study.

BACKGROUND: Dental students are at high risk of hepatitis B virus (HBV) infection during clinical activities. Therefore, preventive measures are essential after exposure to the HBV. This study aimed to compare the effectiveness of the concept map and the lecture methods on dental students' knowledge and performance regarding hepatitis B post-exposure prophylaxis (PEP) after possible exposure to the HBV. MATERIALS AND METHODS: This quasi-experimental study was conducted on 70 dental students at Shiraz University of Medical Sciences, Iran. Subjects were categorized into two groups, each receiving either the concept map or the traditional lecture methods. After the interventions, dental students' knowledge and performance were measured by a researcher-made questionnaire. RESULTS: The statistical analysis showed significantly higher knowledge and performance in the concept map group compared to the lecture group (P = 0.030 and P = 0.022, respectively). Although both groups' knowledge and performance decreased after the six-month intervention, the second group who received the lecture method showed more decline in knowledge and performance (P = 0.041 and P < 0.001, respectively). CONCLUSION: Both the concept map and lecture methods have proved to be effective ways of improving the knowledge and performance of dental students. However, the present study revealed that the concept method was more effective on dental students' knowledge and performance regarding preventive measures after exposure to HBV. Thus, the concept map method is recommended for informative and educational purposes.

The quality of first-year dental students' cognitive structures and the factors that influence it.

INTRODUCTION: In health professions education, it is widely recognised that concept mapping helps students organise their knowledge. This study aimed to investigate the quality of first-year dental students' cognitive structures and the factors that influence it. Two approaches (qualitative and descriptive) to analysing student concept maps are described in this article. The qualitative approach emphasises the distinct morphologies (structures) that are considered to indicate the level of understanding. The descriptive approach provides information on the content's richness in terms of concepts and key concepts. MATERIALS AND METHODS: A total of 31 first-year dental students participated in this study. In an introductory session, students drew their first concept map (CM) using Cmaptools software. Then, students created and submitted individualised CMs for four course topics. Qualitative and descriptive approaches to analysing concept maps are valuable because they highlight what students have learned and how they organise and structure knowledge through CMs. To determine students' cognitive structures and explore the evolution of their representations over the four course topics, two examiners analysed the CMs' morphology and content. RESULTS: Students presented various cognitive structures for the same topic. The quality of concept maps seemed to be influenced by the topic, as well as by familiarisation with making CM. CONCLUSION: Concept mapping revealed the organisation of students' knowledge. This study explored the structural (morphology) and content analyses of CMs. The quality of the CMs seems to be affected by the nature of the topic.

The impact of concept maps on academic achievement: A meta-analysis.

The present study aimed to review master's and doctoral theses, articles and proceedings on the impact of concept maps on academic achievement and published between 2005 and 2017, and to analyze the common effect size with the meta-analysis method. In the study, the effect sizes reported in 78 studies on the effect of concept maps on academic achievement and the overall effect size reported in these studies were analyzed. The Comprehensive Meta-Analysis software was employed in data analysis. In the study, interpretations were conducted based on the effect size index published by Cohen (1988) [1]. The studies included in the meta-analysis were combined and it was determined that the structure was heterogeneous. Thus, the calculations were conducted with the random effects model in the study. The analysis findings demonstrated that the impact of the concept maps was 1.08 on academic achievement; thus, the effect was categorized as strong and positive based on Cohen's (Cohen, 1988) [1] classification. It was concluded that the concept maps were quite effective in the improvement of the academic achievements of the students and could be employed in education.

Information-seeking process and clinical scenario solving: introduction of a new tool in nursing education.

BACKGROUND: Nursing education has recently undergone changes to improve care. These changes require innovative and transformative strategies in nursing education. Search as learning is one of the educational methods this study was conducted to determine the effect of the information searching process on scenario-based learning in nursing students. METHODS: This study is a single group semi-experimental study that was conducted on 38 nursing students in 2021. Students first drew a concept map according to their existing knowledge about two scenarios (diabetes and trauma). The students then searched the medical databases and drew another concept map after the search. Data were analyzed using descriptive statistics, paired mean tests and Pearson correlation coefficients. RESULTS: The results showed that the mean scores of the participants in the diabetes scenario before and after the search were 18.32 ± 5.50 and 19.13 ± 7.54, respectively, and those in the trauma scenario were 18.58 ± 7.69 and 29.61 ± 7, respectively (P < 0.01). The mean scores of the details of the conceptual map before and after the search in terms of themes, number of levels and relationships were statistically significant. In both scenarios, there was a positive correlation (p < 0.01) between learning and the number of correct webpages (r = 0.74 for trauma and r = 0.64 for diabetes), as well as between search time and the amount of learning (r = 0.77 for trauma and 0.64 for diabetes). CONCLUSIONS: The results showed that search as learning in nursing education scenarios led to student learning. It is recommended that nurse educators use this method as a tool in nursing education to increase students' awareness and develop their thinking skills. Further research is recommended to determine the effectiveness of this method with other educational methods.

The effectiveness of concept mapping as a tool for developing critical thinking in undergraduate medical education - a BEME systematic review: BEME Guide No. 81.

BACKGROUND: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are 1) What studies have been published on concept mapping in undergraduate medical education; 2) What was the impact of CMs on students' critical thinking; 3) How and why have these interventions had an educational impact? METHODS: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles and abstracts and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the STructured apprOach to the Reporting In healthcare education of Evidence Synthesis statement and BEME guidance. RESULTS: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students' knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both a teaching and a learning methods. CONCLUSIONS: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increases our confidence that the positive effects are consistent.

Advancing the Management of Long COVID by Integrating into Health Informatics Domain: Current and Future Perspectives.

The ongoing COVID-19 pandemic has profoundly affected millions of lives globally, with some individuals experiencing persistent symptoms even after recovering. Understanding and managing the long-term sequelae of COVID-19 is crucial for research, prevention, and control. To effectively monitor the health of those affected, maintaining up-to-date health records is essential, and digital health informatics apps for surveillance play a pivotal role. In this review, we overview the existing literature on identifying and characterizing long COVID manifestations through hierarchical classification based on Human Phenotype Ontology (HPO). We outline the aspects of the National COVID Cohort Collaborative (N3C) and Researching COVID to Enhance Recovery (RECOVER) initiative in artificial intelligence (AI) to identify long COVID. Through knowledge exploration, we present a concept map of clinical pathways for long COVID, which offers insights into the data required and explores innovative frameworks for health informatics apps for tackling the long-term effects of COVID-19. This study achieves two main objectives by comprehensively reviewing long COVID identification and characterization techniques, making it the first paper to explore incorporating long COVID as a variable risk factor within a digital health informatics application. By achieving these objectives, it provides valuable insights on long COVID's challenges and impact on public health.

Comparison lecture and concept map methods on the level of learning and satisfaction in puerperal sepsis education of midwifery students: a quasi-experimental study.

BACKGROUND: Education and training about emergency cases are necessary for different medical groups such as midwives. Teaching puerperal sepsis is important for midwives. The teaching method is one of the challenges of the educational system in universities. This study was conducted to compare lecture and concept map methods on the level of learning and satisfaction in puerperal sepsis education of midwifery students. METHOD: This semi-experimental study was conducted in 2022 at Ardabil Nursing and Midwifery School on 50 midwifery students. Students randomly were placed in lecture and concept map teaching groups. To collect data, a 23-question satisfaction questionnaire and a 15-question test taken from the WHO books on the management of puerperal sepsis were used to check students' knowledge and learning. The data were analyzed by using descriptive statistics and independent and paired t-test SPSS software. FINDINGS: The average learning score of the students after teaching in the concept map group was 10.28 ± 1.90 and the lecture group 9.20 ± 1.70, the difference was statistically significant (p = 0.04). The average satisfaction score in the concept map group was 107.92 ± 4.46 and in the lecture group 105.68 ± 6.84, this difference was statistically significant (p = 0.03). CONCLUSION: The teaching of puerperal sepsis with the concept map method had a greater effect on the learning and satisfaction of midwifery students. Therefore, it is recommended to use this educational method.

An integrated pre-clerkship curriculum to build cognitive medical schema: It's not just about the content.

Both physiology and pathophysiology are essential disciplines in health professional education however, clinicians do not use this knowledge in isolation. Instead, physicians use inter-disciplinary concepts embedded within integrated cognitive schema (illness scripts) established through experience/knowledge that manifest as expert-level thinking. Our goal was to develop a pre-clerkship curriculum devoid of disciplinary boundaries (akin to the physician's illness script) and enhance learners' clerkship and early clinical performance. As well as developing curricular content, the model considered non-content design elements such as learner characteristics and values, faculty and resources and the impact of curricular and pedagogical changes. The goals of the trans-disciplinary integration were to develop deep learning behaviors through, 1) developing of integrated, cognitive schema to support the transition to expert-level thinking, 2) authentic, contextualization to promote knowledge transfer to the clinical realm 3) allowing autonomous, independent learning, and 4) harnessing the benefits of social learning. The final curricular model was a case-based approach with independent learning of basic concepts, differential diagnosis and illness scripting writing, and concept mapping. Small-group classroom sessions were team-taught with basic scientists and physicians facilitating learners' self-reflection and development of clinical reasoning. Specifications grading was used to assess the products (written illness scripts and concept maps) as well as process (group dynamics) while allowing a greater degree of learner autonomy. Although the model we adopted could be transferred to other program settings, we suggest it is critical to consider both content and non-content elements that are specific to the environment and learner.

Zoom-sandwiched cross-chapter concept map: a novel model to optimize a concept map project in online STEM courses.

Although previous studies have confirmed the various benefits of concept maps, limited information is available regarding how to effectively employ the concept map in online courses. In this research, we have designed and assessed the effectiveness of the "Zoom-sandwiched cross-chapter concept map" model in an online biology course. The model has optimized the concept map project because it incorporates synchronous interaction as well as asynchronous communication among students, assigns required meetings with flexible schedules, endows students with intrinsic motivation, and is facilitated by indirect instructor intervention. Our results showed improved student skills in constructing the cross-chapter concept map and positive student perceptions of the model. In addition, this study provided an in-depth analysis of how students benefit from cross-chapter concept maps. Our findings could guide educators on how to optimize the concept map project and utilize concept maps effectively to overcome some primary learning challenges and enhance student learning in online education, especially in STEM fields.NEW & NOTEWORTHY This research aims to optimize the concept map project for STEM courses in the virtual delivery system and to explore its effectiveness. Specifically, we 1) established the "Zoom-sandwiched cross-chapter concept map" model in an online STEM course; 2) evaluated student performance on concept map construction; 3) distributed survey questions to investigate student perception toward the Zoom-sandwiched cross-chapter concept map model; and 4) further explored the mechanism of how this model promoted student learning.

Patient perspectives of positive messages from clinicians: a qualitative secondary analysis and conceptual model.

Background: A review and meta- analysis of empathic communication and patients' expectations of interventions has shown that if positive messages are delivered there is a small but measurable reduction of pain and anxiety and some improvements in physical outcomes. Aim: To identify elements of health messages that may have a positive impact on patient health outcomes to guide effective nurse-patient- communication. Methods: Data were extracted from each study in a qualitative analysis of a systematic review investigating the health effects of positive messages, and analysed following the principles of thematic analysis. Findings: Central to effective positive messages were good communication skills. Five key features were identified. Discussion: The non-treatment care categories such as cognitive care and emotional care can significantly influence health outcomes across a range of interactions. Conclusion: Strategies to facilitate positivity can be incorporated into nursing education programs designed to improve patient outcomes.

Investigating online learners' knowledge structure patterns by concept maps: A clustering analysis approach.

A deep understanding of the learning level of online learners is a critical factor in promoting the success of online learning. Using knowledge structures as a way to understand learning can help analyze online students' learning levels. The study used concept maps and clustering analysis to investigate online learners' knowledge structures in a flipped classroom's online learning environment. Concept maps (n = 359) constructed by 36 students during one semester (11 weeks) through the online learning platform were collected as analysis objects of learners' knowledge structures. Clustering analysis was used to identify online learners' knowledge structure patterns and learner types, and a non-parametric test was used to analyze the differences in learning achievement among learner types. The results showed that (1) there were three online learners' knowledge structure patterns of increasing complexity, namely, spoke, small-network, and large-network patterns. Moreover, online learners with novice status mostly had spoke patterns in the context of flipped classrooms' online learning. (2) Two types of online learners were found to have different distributions of knowledge structure patterns, and the complex knowledge structure type of learners exhibited better learning achievement. The study explored a new way for educators to analyze knowledge structures by data mining automatically. The findings provide evidence in the online learning context for the relationship between complex knowledge structures and better learning achievement while suggesting the existence of inadequate knowledge preparedness for flipped classroom learners without a special instructional design.

Clinical reasoning pattern used in oral health problem solving - A case study in Indonesian undergraduate dental students.

BACKGROUND: Health professionals are known to use various combinations of knowledge and skills, such as critical thinking, clinical reasoning, clinical judgment, problem-solving, and decision-making, in conducting clinical practice. Clinical reasoning development is influenced by knowledge and experience, the more knowledge and experience, the more sophisticated clinical reasoning will be. However, clinical reasoning research in dentistry shows varying results . AIMS: This study aims to observe the clinical reasoning pattern of undergraduate dental students when solving oral health problems, and their accordance with their knowledge acquisition. MATERIAL AND METHODS: This qualitative study employed the think-aloud method and the result was assessed through verbal protocol analyses. Five respondents from final year dental undergraduate students were agreed to participate. A unique hypothetical clinical scenario was used as a trigger. The audio data were transcribed, interpreted, and categorized as a clinical reasoning pattern; and the concept maps created were assessed by a Structure of Learning Outcomes (SOLO) taxonomy as knowledge acquisition. RESULTS: Observations on clinical reasoning patterns and the level of knowledge acquisition in five undergraduate dental students showed varying results. They applied clinical reasoning patterns according to their knowledge acquisition during didactical phase. Learners with inadequate knowledge relied on guessing, meanwhile learners with adequate knowledge applied more sophisticated reasoning pattern when solving problems. CONCLUSIONS: Various problem-solving strategies were encountered in this study, which corresponded to the level of knowledge acquisition. Dental institutions must set minimum standards regarding the acquisition of conceptual knowledge accompanied by improvement of clinical reasoning skills, as well as refinement of knowledge and procedural skills.

Weakly Supervised Concept Map Generation through Task-Guided Graph Translation.

Recent years have witnessed the rapid development of concept map generation techniques due to their advantages in providing well-structured summarization of knowledge from free texts. Traditional unsupervised methods do not generate task-oriented concept maps, whereas deep generative models require large amounts of training data. In this work, we present GT-D2G (Graph Translation-based Document To Graph), an automatic concept map generation framework that leverages generalized NLP pipelines to derive semantic-rich initial graphs, and translates them into more concise structures under the weak supervision of downstream task labels. The concept maps generated by GT-D2G can provide interpretable summarization of structured knowledge for the input texts, which are demonstrated through human evaluation and case studies on three real-world corpora. Further experiments on the downstream task of document classification show that GT-D2G beats other concept map generation methods. Moreover, we specifically validate the labeling efficiency of GT-D2G in the label-efficient learning setting and the flexibility of generated graph sizes in controlled hyper-parameter studies.

All together now - patient engagement, patient empowerment, and associated terms in personal healthcare.

BACKGROUND: Patients as active partners in their personal healthcare are key drivers to reducing costs, securing an effective usage of resources, and ensuring patient-provider satisfaction. Even though these benefits are acknowledged, a theoretical framework for the plethora of concepts used in this context, such as patient engagement, patient empowerment, or patient involvement is missing. Furthermore, the heterogeneous or synonymous usage of these terms leads to miscommunication, missing standard conceptual measures, and a deficiency in theory building and testing. Our objective is to show what the relationships and distinctions between concepts focussing on patients as active partners in their personal healthcare are. METHODS: A systematic literature review was conducted to consolidate terms related to patients' having an active role in their healthcare. From 442 articles screened in PubMed, a final set of 17 papers was included. Any articles conceptualising or presenting relationships between the concepts were included. Information was synthesised, and contradictions were unravelled systematically. The concepts and their relationships are structured and represented by employing a concept map. RESULTS: Patient-centredness is a concept dominantly influenced by health care providers and can enhance patients' competencies, attitudes, and behaviours towards their personal healthcare. Enabling patients to become more empowered can ultimately lead to their greater involvement and engagement. Fostering an active role of patients can also increase their adherence to the care pathway. In general, patient engagement seems to be the most conclusive and furthest developed concept in terms of turning patients into active partners in their personal healthcare. CONCLUSIONS: We plead for a stricter demarcation and therefore a terminological standardisation of the terms in the future to avoid further ambiguity and miscommunication. The concept map presents a basis for a uniform understanding and application of the concepts. Through a comprehensive understanding of the terms and their dimensions, relationships between the concepts can be utilised, measures can be derived, and theory building and testing can be enhanced, leading to better acceptance and utilisation of concepts in healthcare services. Furthermore, patient engagement is presented to be the most conclusive and furthest developed concept in the subject area.

Deciphering the Diversity of Mental Models in Neurodevelopmental Disorders: Knowledge Graph Representation of Public Data Using Natural Language Processing.

BACKGROUND: Understanding how individuals think about a topic, known as the mental model, can significantly improve communication, especially in the medical domain where emotions and implications are high. Neurodevelopmental disorders (NDDs) represent a group of diagnoses, affecting up to 18% of the global population, involving differences in the development of cognitive or social functions. In this study, we focus on 2 NDDs, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), which involve multiple symptoms and interventions requiring interactions between 2 important stakeholders: parents and health professionals. There is a gap in our understanding of differences between mental models for each stakeholder, making communication between stakeholders more difficult than it could be. OBJECTIVE: We aim to build knowledge graphs (KGs) from web-based information relevant to each stakeholder as proxies of mental models. These KGs will accelerate the identification of shared and divergent concerns between stakeholders. The developed KGs can help improve knowledge mobilization, communication, and care for individuals with ADHD and ASD. METHODS: We created 2 data sets by collecting the posts from web-based forums and PubMed abstracts related to ADHD and ASD. We utilized the Unified Medical Language System (UMLS) to detect biomedical concepts and applied Positive Pointwise Mutual Information followed by truncated Singular Value Decomposition to obtain corpus-based concept embeddings for each data set. Each data set is represented as a KG using a property graph model. Semantic relatedness between concepts is calculated to rank the relation strength of concepts and stored in the KG as relation weights. UMLS disorder-relevant semantic types are used to provide additional categorical information about each concept's domain. RESULTS: The developed KGs contain concepts from both data sets, with node sizes representing the co-occurrence frequency of concepts and edge sizes representing relevance between concepts. ADHD- and ASD-related concepts from different semantic types shows diverse areas of concerns and complex needs of the conditions. KG identifies converging and diverging concepts between health professionals literature (PubMed) and parental concerns (web-based forums), which may correspond to the differences between mental models for each stakeholder. CONCLUSIONS: We show for the first time that generating KGs from web-based data can capture the complex needs of families dealing with ADHD or ASD. Moreover, we showed points of convergence between families and health professionals' KGs. Natural language processing-based KG provides access to a large sample size, which is often a limiting factor for traditional in-person mental model mapping. Our work offers a high throughput access to mental model maps, which could be used for further in-person validation, knowledge mobilization projects, and basis for communication about potential blind spots from stakeholders in interactions about NDDs. Future research will be needed to identify how concepts could interact together differently for each stakeholder.

How the design and complexity of concept maps influence cognitive learning processes.

Concept maps are assumed to enhance learning as their inherent structure makes relations between information more salient. Nevertheless, research on how to design concept maps as conducive to learning as possible is still rare. In particular, the salience of spatial arrangement of thematically related concepts within the map as well as the complexity of the map were found to be central design elements that influence learning. This study aimed to examine how the structure (i.e., the salience of the spatial relationship between individual concepts) and the complexity (i.e., number of nodes per sub concept) influence learning. Accordingly, a 2 (low vs. high salience of map structure) × 2 (few vs. many nodes) between-subject design was used (N = 122) to examine cognitive processes while learning with a concept map. No significant learning performance differences were found. Concepts maps with a low salience of map structure increased perceptions of disorientation. A serial mediation with learning performances as dependent variable revealed that the salience of the map structure is significantly associated with disorientation and extraneous cognitive load perceptions. By this, current attempts to measure extraneous cognitive load are questioned.

Barriers to Accessing Mental Health Services by Migrant Youth.

The purpose of the study was to identify barriers to accessing mental health services by migrant youth in a middle-sized central Canadian city. We asked participants, "What would stop you from talking to someone about mental health stress?". We interviewed 30 youth aged 16 to 22 who migrated from 10 different countries and lived in Canada for an average of 29 months. The data was analyzed using group concept mapping. The participants identified five concepts: fear of being misunderstood or ignored, desire for confidentiality, lack of trust and understanding, talking about it as not appropriate, and fear of the disclosure process. We compare these results with the literature.