Using interactive digital notebooks for bioscience and informatics education.

Interactive digital notebooks provide an opportunity for researchers and educators to carry out data analysis and report the results in a single digital format. Further to just being digital, the format allows for rich content to be created in order to interact with the code and data contained in such a notebook to form an educational narrative. This primer introduces some of the fundamental aspects involved in using Jupyter notebooks in an educational setting for teaching in the bio/health informatics disciplines. We also provide 2 case studies that detail how we used Jupyter notebooks to teach non-coders programming skills on a blended Master's degree module for a Health Informatics programme and a fully online distance learning unit on Programming for a postgraduate certificate (PG Cert) in Clinical Bioinformatics with a more technical audience.

Impact of Colonoscopy Preparation Video on Boston Bowel Preparation Scale Score.

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and the second most common cancer among women. Early detection of localized adenocarcinoma and adenomatous polyps helps reduce the mortality related to colon cancer. According to the American Gastroenterological Association, colonoscopy (CSPY) is the gold standard in screening for CRC. To improve the results of screening, the CSPY preparation (prep) needs to be optimal. This study was undertaken to determine whether a supplemental standardized educational video on bowel preparation in the viewer's native language would improve bowel preparation at the time of CSPY. After institutional review board approval, the records of adult patients who presented to the gastroenterology clinic were reviewed. Patients who underwent a CSPY were assigned according to whether they watched a supplemental educational video on CSPY bowel preparation in their native language. This video reflects the same information provided in written and verbal form at the time of CSPY scheduling. Bowel prep was rated by the endoscopist using the Boston Bowel Preparation Scale (BBPS) and quantifies the adequacy of the preprocedure bowel prep. Participant characteristics and BBPS scores were statistically assessed for significant differences. We identified a total of 186 patients, 91 in March 2015 (pre-video intervention) and 95 in March 2016 (post-video intervention). Mean BBPS score was 7.9 and 8.54 for the March 2015 and 2016 group, respectively (p value of .0039). Although there was no statistical difference between the 2 groups with concern to gender and age, the racial makeup and BBPS score were statistically different. Multivariate analysis was performed. There was no interaction between gender or race and year effect to account for any difference in that factors' performance. Thus, it can be implied that there is not a consistent race effect but there is a consistent gender effect with females having higher success rates, regardless of video intervention (p value of .003). After controlling for both gender and race, the year effect is modestly significant (p value of .025), with the post-video subjects having higher prep success rates. A supplemental educational video incorporated into precolonoscopy teaching may provide a standardized method of effectively conveying simple bowel prep instructions in an efficient manner. This study demonstrated that using such a video produced significant results in improving the quality of bowel preparation.

Contextual attributes promote or hinder self-regulated learning: A qualitative study contrasting rural physicians with undergraduate learners in Japan.

BACKGROUND AND OBJECTIVES: Previous studies support the notion that East Asian medical students do not possess sufficient self-regulation for postgraduate clinical training. However, some East Asian physicians who are employed in geographically isolated and educationally underserved rural settings can self-regulate their study during the early phase of their postgraduate career. To explore the contextual attributes that contribute to self-regulated learning (SRL), we examined the differences in self-regulation between learning as an undergraduate and in a rural context in East Asia. METHODS: We conducted interviews and diary data collection among rural physicians (n = 10) and undergraduates (n = 11) in Japan who undertook self-study of unfamiliar diseases. We analyzed three domains of Zimmerman's definition of SRL: learning behaviors, motivation, and metacognition using constructivist grounded theory. RESULTS: Rural physicians recognized their identity as unique, and as professionals with a central role of handling diseases in the local community by conducting self-study. They simultaneously found themselves being at risk of providing inappropriate aid if their self-study was insufficient. They developed strategic learning strategies to cope with this high-stakes task. Undergraduates had a fear of being left behind and preferred to remain as one of the crowd with students in the same school year. Accordingly, they copied the methods of other students for self-study and used monotonous and homogeneous strategies. CONCLUSIONS: Different learning contexts do not keep East Asian learners from being self-regulated. Awareness of their unique identity leads them to view learning tasks as high-stakes, and to initiate learning strategies in a self-regulated manner. Teacher-centered education systems cause students to identify themselves as one of the crowd, and tasks as low-stakes, and to accordingly employ non-self-regulated strategies.

Evaluation of a flipped classroom approach to learning introductory epidemiology.

BACKGROUND: Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model. METHODS: One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated. RESULTS: There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers. CONCLUSIONS: There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.

[Impact of an e-learning program regarding patients' harmful alcohol consumption on the knowledge, attitudes and perceived competencies of nurses from an acute care hospital: a pretest-posttest-study]. / Auswirkungen eines E-Learning zum gesundheitsschädigenden Alkohol-konsum auf Wissen, Einstellung und Kompetenzen von Pflegefachpersonen im Akutspital ­ Eine Prätest-Posttest-Studie.

Impact of an e-learning program regarding patients' harmful alcohol consumption on the knowledge, attitudes and perceived competencies of nurses from an acute care hospital: a pretest-posttest-study Abstract. BACKGROUND: Harmful alcohol consumption is associated with approximately 1600 deaths in Switzerland annually, and is the third-largest risk factor for various diseases worldwide. It has been shown that through early identification of problematic drinking behaviours along with preventive intervention, alcohol-related illnesses and mortality can be reduced. Therefore, nurses play a crucial role for patients with alcohol problems. However, the most common reasons for nurses not providing preventive intervention are a lack of knowledge, personal attitudes and uncertainty. Learning programs hold the potential for influencing these factors. AIM: The aim of this study was to assess the impact of an e-learning program regarding patients' harmful alcohol consumption on the knowledge, attitudes and perceived competencies of nurses in an acute care hospital. METHOD: A pretest-posttest-study was conducted with 33 registered nurses prior to and upon completion of the e-learning program. Data was collected from December 2013 to March 2014 using a literature-based questionnaire. RESULTS: It was shown that knowledge and perceived competencies significantly improved from pre-test to post-test. No significant differences were measured with regard to the attitudes. CONCLUSIONS: The results suggest that the alcohol e-learning program could be used to enhance nurses' knowledge and perceived competencies, both of which are related to the reduction of uncertainty and improvement of confidence. To foster non-judgemental attitudes towards affected people, classroom courses are recommended in addition to the e-learning program and the implementation of directives.

The Value of Internet Tools in Undergraduate Surgical Education: Perspective of Medical Students in a Developing Country.

OBJECTIVE: Advances in information technology (IT) in the past decade present opportunities and challenges in undergraduate surgical education. There may be need to evaluate the knowledge base and the use of Internet tools among medical students in settings where traditional mode of education is preeminent. This may help to establish a conceptual framework for integrating e-learning into the traditional teaching to enhance learning experience. In this study, we evaluated the medical students' knowledge and use of Internet tools, and their opinion on the application of these tools in surgical education. METHODS: We undertook a cross-sectional survey of 2013 and 2014 graduating medical class of College of Medicine University of Nigeria, Enugu using structured self-administered questionnaire. The survey assessed the knowledge, utility, and application of Internet tools in surgical education using 5-point Likert scale. RESULTS: Overall response rate was 78% (227/291) comprising 151 (66.5%) males and 76 (33.5%) females. The median age was 24 years (range 20-33 years). Although 106 (46.7%) had formal training on information technology, 223 (98.2%) can access Internet, and 162 (71.4%) use one or more of the Internet tools, 90.6% (96/106) of those trained on ICT use Internet for education/learning compared to 88.4% (107/121) of those without ICT training (p = 0.76). Google™ search tool had the highest rating in terms of familiarity and utility for education/learning (mean rating 4.3 on a scale of 5.0), while Skype™ had the least rating (mean 2.0). Overall, 89% of respondents (mean rating 4.5 on a scale of 5.0) indicated that Internet tools could be effectively applied in surgical education specifically in areas of lectures, assignments, real-time procedure demonstration, case discussion, and interaction with surgical experts. The key benefits are utility as a regular self-assessment tool (mean rating = 4.6) and offer of flexible learning schedule (mean rating = 4.0). Fifty-two percent (118/227) strongly agree that combination of the use of Internet tools with the traditional teaching may give better learning outcome (mean rating 4.44). The major challenges were cost of accessing Internet (n = 126; 55.5%), lack of facility with the technology (n = 115; 50.7%), and network availability (n = 96; 42.3%). Availability of affordable Internet (n = 205; 90.3%), improvement of training on ICT (n = 135; 59.5%), and encouragement of the use of these tools by faculty (n = 107; 47.1%) were the major suggestions to address the challenges. CONCLUSION: In our setting, a substantial number of undergraduate medical students are familiar with and use Internet tools for learning and believe that the tools may have utility in surgical education. However, to further consolidate and enhance learning experience, it may be useful to integrate this learning modality with the traditional mode of teaching through a well thought out curriculum modification.

Randomized controlled trial of self-directed versus in-classroom teaching of narrow-band imaging for diagnosis of Barrett's esophagus-associated neoplasia.

BACKGROUND AND AIMS: Previous studies have shown that narrow-band imaging (NBI) can be taught to inexperienced gastroenterologists. However, it is unknown whether in-person training is more effective than self-directed training. The objective of this study was to compare the accuracy of diagnosing Barrett's esophagus (BE)-associated neoplasia by trainees with no prior NBI experience between in-classroom and self-directed didactic training programs. METHODS: This was a randomized controlled trial that took place at 2 tertiary-care medical centers, involving 33 participants--12 second-year medical students, 8 first-year gastroenterology fellows, 7 second-year gastroenterology fellows, and 6 third-year gastroenterology fellows. A teaching module was developed for all participants to review. Half of the participants were taught in a classroom setting by an endoscopist with expertise in NBI, whereas the other participants were in a self-directed group that received an automated version of the presentation with audio commentary. Participants completed a test of 40 randomized NBI images, predicting the histology and indicating their confidence levels in the diagnosis. RESULTS: There was no difference in accuracy between the in-classroom and self-directed groups (57.5% vs 57.2%; P = 1.0). The in-classroom group had a significantly higher percentage of high-confidence answers (57.2% vs 41.1%; P ≤ .01), but there was no significant difference in accuracy with these high-confidence answers (60.7% vs 66.4%; P = .34). There was no significant difference in overall accuracy or accuracy with high-confidence predictions between the 2 study sites (57.4% vs 55.9%, P = .58; 63.1% vs 61.4%, P = .69) or between gastroenterology fellows and medical students (57.8% vs 54.6%, P = .27; 62.8% vs 60.8%, P = .62). CONCLUSIONS: The overall accuracy of predicting NBI patterns in BE were modest in our study participants, and there was no difference between self-directed and in-classroom didactic training. Self-directed learning of NBI is adequate for teaching NBI to trainees.

Emotion regulation training to reduce problematic dietary restriction: An experimental analysis.

Evidence suggests that emotion regulation may be a process relevant to problematic dietary restriction. However, emotion regulation has not been evaluated as an intervention target across a range of restriction severity. This study utilized an experimental design to examine whether targeting emotion regulation reduced problematic dietary restriction. Within a self-identified restrictive sample (n = 72), the effects of an emotion regulation condition (i.e., emotion regulation training) were compared to those of a control condition (i.e., nutrition information training) on dietary restriction indices (i.e., effort to reduce intake on a progressive ratio task, work towards an alternate reinforcer on a progressive ratio task, intake by dietary recall) following a stressor. Exploratory analyses of potential moderators (i.e., restraint, BMI, binge eating and purging status, emotion regulation difficulties) were conducted to examine whether these factors affected the impact of training on dietary restriction. No significant main effects of condition were detected on any outcome measure. However, results were moderated by BMI status. Participants with lower BMIs exerted less effort towards dietary restriction following the emotion regulation condition versus the control condition (p = 0.02). Results suggest that targeting emotion regulation may help to reduce problematic dietary restriction among lower weight individuals.

Using concept maps and goal-setting to support the development of self-regulated learning in a problem-based learning curriculum.

Problem-based learning (PBL) in medical education focuses on preparing independent learners for continuing, self-directed, professional development beyond the classroom. Skills in self-regulated learning (SRL) are important for success in PBL and ongoing professional practice. However, the development of SRL skills is often left to chance. This study presents the investigated outcomes for students when support for the development of SRL was embedded in a PBL medical curriculum. This investigation involved design, delivery and testing of SRL support, embedded into the first phase of a four-year, graduate-entry MBBS degree. The intervention included concept mapping and goal-setting activities through iterative processes of planning, monitoring and reflecting on learning. A mixed-methods approach was used to collect data from seven students to develop case studies of engagement with, and outcomes from, the SRL support. The findings indicate that students who actively engaged with support for SRL demonstrated increases in cognitive and metacognitive functioning. Students also reported a greater sense of confidence in and control over their approaches to learning in PBL. This study advances understanding about how the development of SRL can be integrated into PBL.

Self-directed simulation-based training of emergency cricothyroidotomy: a route to lifesaving skills.

The emergency cricothyroidotomy (EC) is a critical procedure. The high cost of failures increases the demand for evidence-based training methods. The aim of this study was to present and evaluate self-directed video-guided simulation training. Novice doctors were given an individual 1-h simulation training session. One month later, an EC on a cadaver was performed. All EC's were video recorded. An assessment tool was used to rate performance. Performance was compared with a pass/fail level for the EC. We found a high reliability, based on Pearson's r (0.88), and a significant progression of skill during training (p < 0.001). Eleven out of 14 succeeded in creating an airway on the cadaver in 64 s (median, range 39-86 s), but only four achieved a passing score. Our 1-h training protocol successfully raised the competence level of novice doctors; however, the training did not ensure that all participants attained proficiency.

An evaluation of UK foundation trainee doctors' learning behaviours in a technology-enhanced learning environment.

BACKGROUND: Technology-Enhanced Learning (TEL) can be used to educate Foundation Programme trainee (F1 and F2) doctors. Despite the advantages of TEL, learning behaviours may be exhibited that are not desired by system developers or educators. The aim of this evaluation was to investigate how learner behaviours (e.g. time spent on task) were affected by temporal (e.g. time of year), module (e.g. word count), and individual (e.g. knowledge) factors for 16 mandatory TEL modules related to prescribing and therapeutics. METHODS: Data were extracted from the SCRIPT e-Learning platform for first year Foundation trainee (F1) doctors in the Health Education England's West Midland region from 1(st) August 2013 to 5(th) August 2014. Generalised Estimating Equation models were used to examine the relationship between time taken to complete modules, date modules were completed, pre- and post-test scores, and module factors. RESULTS: Over the time period examined, 688 F1 doctors interacted with the 16 compulsory modules 10,255 times. The geometric mean time taken to complete a module was 28.9 min (95% Confidence Interval: 28.4-29.5) and 1,075 (10.5%) modules were completed in less than 10 min. In February and June (prior to F1 progression reviews) peaks occurred in the number of modules completed and troughs in the time taken. Most modules were completed, and the greatest amount of time was spent on the learning on a Sunday. More time was taken by those doctors with greater pre-test scores and those with larger improvements in test scores. CONCLUSIONS: Foundation trainees are exhibiting unintended learning behaviours in this TEL environment, which may be attributed to several factors. These findings can help guide future developments of this TEL programme and the integration of other TEL programmes into curricula by raising awareness of potential behavioural issues that may arise.

Can Individualized Learning Plans in an advanced clinical experience course for fourth year medical students foster Self-Directed Learning?

BACKGROUND: Residency programs have utilized Individualized Learning Plans (ILPs) to customize resident education while undergraduate medical education has not done so in a meaningful way. We discuss the use of ILPs within a fourth year medical school course to facilitate self-directed learning (SDL). METHODS: At Stony Brook University School of Medicine, an ILP component was added to the Advanced Clinical Experience (ACE) course for fourth year students. Each completed an ILP outlining personal learning goals and strategies to achieve them. An adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ) (Duncan T and McKeachie W, Educ Psych 40(2):117-128, 2005 and Cook DA et al., Med Ed 45:1230-1240, 2011) was used to measure success of ILPs in improving SDL. Qualitative data analysis was conducted on the ILPs and self-reflections. RESULTS: Forty-eight students participated. Two of the four SDL sub-domains identified on the MSLQ showed improvement; self-efficacy (p = .001) and self-regulation (p = .002). 'Medical Knowledge' was the competency most frequently identified as an area of concentration (90 %) and professionalism was selected least frequently (4 %). A higher percentage (83 %) of students who reported complete achievement of their ILP goals also reported feeling better prepared for entering residency. CONCLUSIONS: ILPs improve SDL strategies among medical students and may serve as useful tools to help shape future learning goals as they transition to residency training.

GP supervisors' experience in supporting self-regulated learning: a balancing act.

Self-regulated learning is essential for professional development and lifelong learning. As self-regulated learning has many inaccuracies, the need to support self-regulated learning has been recommended. Supervisors can provide such support. In a prior study trainees reported on the variation in received supervisor support. This study aims at exploring supervisors' perspectives. The aim is to explore how supervisors experience self-regulated learning of postgraduate general practitioners (GP) trainees and their role in this, and what helps and hinders them in supervising. In a qualitative study using a phenomenological approach, we interviewed 20 supervisors of first- and third-year postgraduate GP trainees. Supervisors recognised trainee activity in self-regulated learning and adapted their coaching style to trainee needs, occasionally causing conflicting emotions. Supervisors' beliefs regarding their role, trainees' role and the usefulness of educational interventions influenced their support. Supervisors experienced a relation between patient safety, self-regulated learning and trainee capability to learn. Supervisor training was helpful to exchange experience and obtain advice. Supervisors found colleagues helpful in sharing supervision tasks or in calibrating judgments of trainees. Busy practice occasionally hindered the supervisory process. In conclusion, supervisors adapt their coaching to trainees' self-regulated learning, sometimes causing conflicting emotions. Patient safety and entrustment are key aspects of the supervisory process. Supervisors' beliefs about their role and trainees' role influence their support. Supervisor training is important to increase awareness of these beliefs and the influence on their behaviour, and to improve the use of educational instruments. The results align with findings from other (medical) education, thereby illustrating its relevance.

Outcomes of Irish graduate entry medical student engagement with self-directed learning of clinical skills.

BACKGROUND: Existing literature is mixed as to whether self-directed learning (SDL) delivers improvements in knowledge, skills or attitudes of medical students compared with traditional learning methods. This study aimed to determine whether there is an association between engagement in SDL and student performance in clinical examinations, the factors that influence student engagement with SDL in clinical skills, and student perceptions of SDL. METHODS: A retrospective analysis of electronic records of student bookings of SDL sessions from 2008 to 2010 was performed for students in the pre-clinical years of an Irish Graduate Entry Medical programme to assess their level of engagement with SDL. The extent to which this engagement influenced their performance in subsequent summative examinations was evaluated. A cross-sectional survey of students across the four years of the programme was also conducted to determine student perceptions of SDL and the factors that affect engagement. RESULTS: The level of engagement with SDL decreased over time from 95% of first years in 2008 to 49% of first years in 2010. There was no significant difference between the median exam performance for any clinical skills tested by level of engagement (none, one or more sessions) except for basic life support in first year (p =0.024). The main reason for engaging with SDL was to practice a clinical skill prior to assessment and the majority of respondents agreed that SDL sessions had improved their performance of the specific clinical skills being practised. CONCLUSION: Students viewed SDL as an opportunity to practise skills prior to assessment but there were no significant differences in subsequent summative assessment by the level of engagement for most clinical skills.

[Tempora mutantur... et nos? The future of the Hungarian anatomy teaching in reflection of the German trends]. / Tempora mutantur et nos? A magyar anatómiaoktatás jövoje a német trendek tükrében.

The traditional four-semester anatomy is a subject to change: next to the external pressure, there is an intrinsic need to shift the emphasis. The mapping of the strengths, weaknesses and threats of the Hungarian anatomy teaching helps to formulate the directions of possible development. Current trends in the German medical education should be carefully followed. Nowadays, nearly 25% of the medical students in Germany are studying according to the new, integrated "Modellstudiengang", i.e. all the conventional subjects are reorganised into organ system thematic blocks. The unified German written final exam system provides an objective assessment parameter: to rank the 36 German medical schools according to the results of the anatomy exams. The homepage-published data, the number of semesters or teaching hours, or the thematic concept of the subject alone cannot explain the rankings of the medical schools according to the anatomy exam results. The greatest challenges of the Hungarian anatomy teaching today are: the development of an outcome-oriented, unified, practical system of requirements, the redefinition of the subject, the more effective interaction with the clinical colleagues, solving the problems of faculty recruitment and establishing the vertical integration of anatomy.

"Walk with me " : A journey of self-directed holistic cancer education by medical students.

Cancer education offers an ideal opportunity to inspire and initiate medical students in life-long, self-directed learning. Early and innovative out-of-the-box learning experiences, tailored to appeal to a multi-media savvy generation of medical students, form the theme of these reflections. Students never fail to surprise teachers when the seed of an idea appeals and motivates their minds. 'Walk with me…' is the story of a journey together of students, mentors, patients, and the manifold professionals who manage breast cancer.

Study guide usability survey: perception of students and teachers of an undergraduate medical college.

OBJECTIVES: To explore the perception about usability of study guide from students and teachers of an undergraduate medical college. METHODS: The cross-sectional study was done at Bahria University Medical and Dental College, Karachi, in May 2012 and comprised 2nd, 3rd and 4th year medical students and faculty members. Data was analysed on SPSS 16. Analysis of variance was used for looking at differences in perceptions of the three groups of students and among different cadres of faculty, while tukeys test was used for individual differences. RESULTS: Of the 300 students initially enrolled, 257 (85.6%) represented the final study sample. There were 147 (57.2%) females and 110 (42.8%) males. Reliability of the questionnaire by Cronbach's alpha was 0.889. Besides, 150 (58.3%) students agreed that layout and content of the study guide helped in self-directed learning, while 128 (50%) said that information about books and resources was not mentioned in it. The faculty overall appreciated the study guide except on information about identification of resources in it. CONCLUSION: The perception about the usability of study guide was well appreciated by both students and teachers Their content will be reviewed and improved based on the results of this study.

A comparison of online versus workbook delivery of a self-help positive parenting program.

A noninferiority randomized trial design compared the efficacy of two self-help variants of the Triple P-Positive Parenting Program: an online version and a self-help workbook. We randomly assigned families of 193 children displaying early onset disruptive behavior difficulties to the online (N = 97) or workbook (N = 96) interventions. Parents completed questionnaire measures of child behavior, parenting, child maltreatment risk, personal adjustment and relationship quality at pre- and post-intervention and again at 6-month follow up. The short-term intervention effects of the Triple P Online program were not inferior to the workbook on the primary outcomes of disruptive child behavior and dysfunctional parenting as reported by both mothers and fathers. Both interventions were associated with significant and clinically meaningful declines from pre- to post-intervention in levels of disruptive child behavior, dysfunctional parenting styles, risk of child maltreatment, and inter-parental conflict on both mother and father report measures. Intervention effects were largely maintained at 6-month follow up, thus supporting the use of self-help parenting programs within a comprehensive population-based system of parenting support to reduce child maltreatment and behavioral problems in children.

Effectiveness of a poverty simulation in Second Life®: changing nursing student attitudes toward poor people.

Social justice is a fundamental value of the nursing profession, challenging educators to instill this professional value when caring for the poor. This randomized controlled trial examined whether an interactive virtual poverty simulation created in Second Life® would improve nursing students' empathy with and attributions for people living in poverty, compared to a self-study module. We created a multi-user virtual environment populated with families and individual avatars that represented the demographics contributing to poverty and vulnerability. Participants (N = 51 baccalaureate nursing students) were randomly assigned to either Intervention or Control groups and completed the modified Attitudes toward Poverty Scale pre- and post-intervention. The 2.5-hour simulation was delivered three times over a 1-year period to students in successive community health nursing classes. The investigators conducted post-simulation debriefings following a script. While participants in the virtual poverty simulation developed significantly more favorable attitudes on five questions than the Control group, the total scores did not differ significantly. Whereas students readily learned how to navigate inside Second Life®, faculty facilitators required periodic coaching and guidance to be competent. While poverty simulations, whether virtual or face-to-face, have some ability to transform nursing student attitudes, faculty must incorporate social justice concepts throughout the curriculum to produce lasting change.

Assessing the effect of self instructional module on knowledge of menopause & hormone replacement therapy for menopausal women in Moradabad (UP).

Objectives of the study were to identify the problems faced by menopausal women and to find out the remedial measures adopted by them, to assess the knowledge of menopausal women regarding menopause & hormone replacement therapy (HRT) before and after administration of self-instructional module (SIM) and to find out the acceptability and utility of the SIM. An evaluative research approach, with pre-experimental one group pre-test post-test design was adopted. Purposive sampling technique was used to obtain an adequate size of the sample. The sample comprised of 100 menopausal women living in selected community of Moradabad (UP). A knowledge questionnaire and opinionnaire were administered, and SIM on menopause and HRT administered. It was found that there was deficit in knowledge of menopausal women regarding menopause and HRT. Mean post-test knowledge scores were significantly higher than mean pre-test knowledge scores. SIM was found highly acceptable and useful by menopausal women.