Machine-learning-optimized Cas12a barcoding enables the recovery of single-cell lineages and transcriptional profiles.

The development of CRISPR-based barcoding methods creates an exciting opportunity to understand cellular phylogenies. We present a compact, tunable, high-capacity Cas12a barcoding system called dual acting inverted site array (DAISY). We combined high-throughput screening and machine learning to predict and optimize the 60-bp DAISY barcode sequences. After optimization, top-performing barcodes had ∼10-fold increased capacity relative to the best random-screened designs and performed reliably across diverse cell types. DAISY barcode arrays generated ∼12 bits of entropy and ∼66,000 unique barcodes. Thus, DAISY barcodes-at a fraction of the size of Cas9 barcodes-achieved high-capacity barcoding. We coupled DAISY barcoding with single-cell RNA-seq to recover lineages and gene expression profiles from ∼47,000 human melanoma cells. A single DAISY barcode recovered up to ∼700 lineages from one parental cell. This analysis revealed heritable single-cell gene expression and potential epigenetic modulation of memory gene transcription. Overall, Cas12a DAISY barcoding is an efficient tool for investigating cell-state dynamics.

Unproctored online exams provide meaningful assessment of student learning.

In the United States, the onset of COVID-19 triggered a nationwide lockdown, which forced many universities to move their primary assessments from invigilated in-person exams to unproctored online exams. This abrupt change occurred midway through the Spring 2020 semester, providing an unprecedented opportunity to investigate whether online exams can provide meaningful assessments of learning relative to in-person exams on a per-student basis. Here, we present data from nearly 2,000 students across 18 courses at a large Midwestern University. Using a meta-analytic approach in which we treated each course as a separate study, we showed that online exams produced scores that highly resembled those from in-person exams at an individual level despite the online exams being unproctored-as demonstrated by a robust correlation between online and in-person exam scores. Moreover, our data showed that cheating was either not widespread or ineffective at boosting scores, and the strong assessment value of online exams was observed regardless of the type of questions asked on the exam, the course level, academic discipline, or class size. We conclude that online exams, even when unproctored, are a viable assessment tool.

Renewable risk assessment of heterogeneous streaming time-to-event cohorts.

The analysis of streaming time-to-event cohorts has garnered significant research attention. Most existing methods require observed cohorts from a study sequence to be independent and identically sampled from a common model. This assumption may be easily violated in practice. Our methodology operates within the framework of online data updating, where risk estimates for each cohort of interest are continuously refreshed using the latest observations and historical summary statistics. At each streaming stage, we introduce parameters to quantify the potential discrepancy between batch-specific effects from adjacent cohorts. We then employ penalized estimation techniques to identify nonzero discrepancy parameters, allowing us to adaptively adjust risk estimates based on current data and historical trends. We illustrate our proposed method through extensive empirical simulations and a lung cancer data analysis.

The association between online learning, perceived parental relationship, anxiety, and depression symptoms among secondary school students: insight from symptom network and cross-lagged panel network approach.

INTRODUCTION: Anxiety and depression often co-occur in adolescents, with factors from family and school playing a significant role in the comorbidity. However, network analysis has not examined and clarified the detailed bridge and central symptoms of this comorbidity caused by online learning and perceived parental relationships across different COVID-19 times. METHODS: Over four months, 2,356 secondary school students completed the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7. Participants were divided into harmonious and disharmonious groups based on their answers to a question about parental conflicts. RESULTS: The results indicated that adolescents perceiving more parental conflicts showed a denser comorbidity network after four months of online learning. Significant bridge symptoms decreased from three to two across two waves in the harmonious group, while in the disharmonious group, they increased from two to three. The number of central symptoms increased from one in wave 1 to three in wave 2 for the harmonious group, while four in wave 1 decreased to two in wave 2 for the disharmonious group. Furthermore, the CLPN analysis revealed that the strongest positive cross-lagged edge intensity between symptoms was anhedonia-energy in the harmonious group, with anhedonia being the most trigger symptom. In contrast, for the disharmonious group, guilt-suicide and trouble relaxing-excessive worry were the strongest cross-lagged edge, and trouble relaxing was the most trigger symptom. CONCLUSION: These findings may have implications for interventions designed to promote adolescent mental health in the context of online learning and parental conflicts.

School learning modes during the COVID-19 response and pre- to during pandemic mental health changes in a prospective cohort of Canadian adolescents.

PURPOSE: Considerable debate centered on the impact of school closures and shifts to virtual learning on adolescent mental health during the COVID-19 pandemic. We evaluated whether mental health changes differed by school learning modes during the pandemic response among Canadian adolescents and whether associations varied by gender and perceived home life. METHODS: We used prospective survey data from 7270 adolescents attending 41 Canadian secondary schools. Conditional change linear mixed effects models were used to examine learning mode (virtual optional, virtual mandated, in-person, and blended) as a predictor of change in mental health scores (depression [Centre for Epidemiologic Studies - Depression], anxiety [Generalized Anxiety Disorder-7], and psychosocial well-being [Flourishing scale]), adjusting for baseline mental health and covariates. Gender and home life happiness were tested as moderators. Least square means were calculated across interaction groups. RESULTS: Students learning in a blended learning mode had greater anxiety increases relative to their peers in other learning modes. Females learning fully in-person and males learning virtually when optional reported less of an increase in depression scores relative to their gender counterparts in other learning modes. Learning virtually when optional was associated with greater declines in psychosocial well-being in students without happy home lives relative to other learning modes. CONCLUSION: Findings demonstrate the importance of considering gender and home environments as determinants of mental health over the pandemic response and when considering alternative learning modes. Further research is advised before implementing virtual and blended learning modes. Potential risks and benefits must be weighed in the context of a pandemic.

On-demand mobile hypertension training for primary health care workers in Nigeria: a pilot study.

BACKGROUND: Only one out of every ten Nigerian adults with hypertension has their blood pressure controlled. Health worker training is essential to improve hypertension diagnosis and treatment. In-person training has limitations that mobile, on-demand training might address. This pilot study evaluated a self-paced, case-based, mobile-optimized online training to diagnose and manage hypertension for Nigerian health workers. METHODS: Twelve hypertension training modules were developed, based on World Health Organization and Nigerian guidelines. After review by local academic and government partners, the course was piloted by Nigerian health workers at government-owned primary health centers. Primary care physician, nurse, and community health worker participants completed the course on their own smartphones. Before and after the course, hypertension knowledge was evaluated with multiple-choice questions. Learners provided feedback by responding to questions on a Likert scale. RESULTS: Out of 748 users who sampled the course, 574 enrolled, of whom 431 (75%) completed the course. The average pre-test score of completers was 65.4%, which increased to 78.2% on the post-test (P < 0.001, paired t-test). Health workers who were not part of existing hypertension control programs had lower pre-test scores and larger score gains. Most participants (96.1%) agreed that the training was applicable to their work, and nearly all (99.8%) agreed that they enjoyed the training. CONCLUSIONS: An on-demand mobile digital hypertension training increases knowledge of hypertension management among Nigerian health workers. If offered at scale, such courses can be a tool to build health workforce capacity through initial and refresher training on current clinical guidelines in hypertension and other chronic diseases in Nigeria as well as other countries.

How Has High School Learned from the Global Pandemic?

The study focuses on the consequences of the pandemic for the further development of higher education. The purpose of the article is to summarize the main consequences of the pandemic, which have become the result of scientific analysis and the object of many scientific studies. These are the degree of students' satisfaction with online learning, technological readiness of universities, the impact of new learning conditions on the psychological and emotional sphere, the problem of cheating at examinations, the problem of quality of education. Analysis of studies shows that in the academic environment there are different estimates of the pandemic period, sometimes they are of opposite nature. In spite of possibilities of online education universities tend to return to the full-time form of education. The study emphasizes that there are long-term consequences of the pandemic that are on the periphery of researchers' attention. These are the legal and economic consequences for universities, as the online form of learning has acquired a different legal status. In addition, the introduction of online learning is inevitably associated with additional hardware and software costs. Another important consequence is the impact of the pandemic on academic culture. Under the pandemic, students were isolated from the traditional academic environment, which affected the transformation of social rituals and academic ethics. Academic Values. Since there has been no complete return to previous conditions and the threat of a global pandemic exists, the new experience is integrated into the existing system of academic values and serves as a trigger for change in the long term.

Pandemic response policies' democratizing effects on online learning.

The COVID-19 pandemic has changed peoples' lives in unexpected ways, especially how they allocate their time between work and other activities. Demand for online learning has surged during a period of mass layoffs and transition to remote work and schooling. Can this uptake in online learning help close longstanding skills gaps in the US workforce in a sustainable and equitable manner? We answer this question by analyzing individual engagement data of DataCamp users between October 2019 and September 2020 (n = 277,425). Exploiting the staggered adoption of actions to mitigate the spread of COVID-19 across states, we identify the causal effect at the neighborhood level. The adoption of nonessential business closures led to a 38% increase in new users and a 6% increase in engagement among existing users. We find that these increases are proportional across higher- and lower-income neighborhoods and neighborhoods with a high or low share of Black residents. This demonstrates the potential for online platforms to democratize access to knowledge and skills that are in high demand, which supports job security and facilitates social mobility.

A Quarter-Century of Online Informatics Education: Learners Served and Lessons Learned.

The value and methods of online learning have changed tremendously over the last 25 years. The goal of this paper is to review a quarter-century of experience with online learning by the author in the field of biomedical and health informatics, describing the learners served and the lessons learned. The author details the history of the decision to pursue online education in informatics, describing the approaches taken as educational technology evolved over time. A large number of learners have been served, and the online learning approach has been well-received, with many lessons learned to optimize the educational experience. Online education in biomedical and health informatics has provided a scalable and exemplary approach to learning in this field.

Dignity during work-integrated learning: Piloting an online learning resource for placement students and supervisors.

What was the educational challenge?Medical student abuse within work-integrated learning (WIL) is well-reported, with negative consequences for wellbeing, motivation, and learning. Conversely, workplace dignity, described as respecting the worth of others and self, has positive impacts on wellbeing, learning, and relationships for WIL students and supervisors. Stakeholders often struggle to articulate what workplace dignity means, and can downplay or do nothing in the face of WIL indignities.What was the solution and how was this implemented?We created an innovative research-informed online learning resource about WIL dignity to improve stakeholders' understandings and help them get the best from WIL placements ensuring these are dignified, safe, and educationally productive. The resource included three topics: (a) workplace dignity and why it matters; (b) upholding dignity; and (c) strengthening dignity.What lessons were learned?We conducted a pilot qualitative evaluation involving 13 semi-structured interviews with students and supervisors to elicit their views and experiences of the resource. Our key findings across three overarching categories were: (1) perceived benefits (motivations to complete the resource; content of the resource; online pedagogies); (2) potential applications of learning (reinforcing existing knowledge; developing new knowledge; promoting reflection; changing workplace practices); and (3) suggested improvements (barriers to resource use; resource content; online pedagogies; timing of resource implementation; embedding the resource in broader learning).What are the next steps?Although we identified numerous perceived benefits, and applications of learning, the findings suggested opportunities for further development, especially improving the resource's social interactivity. We recommend that further resource implementation includes student-educator and student-peer interactivity to maximise learning, and longitudinal evaluation of the resource.

Online learning in health professions education. Part 2: Tools and practical application: AMEE Guide No. 163.

Part 1 of the AMEE Guide Online learning in health professions education focused on foundational concepts such as theory, methods, and instructional design in online learning. Part 2 builds upon Part 1, introducing technology tools and applications of these foundational concepts by exploring the various levels (from beginner to advanced) of utilisation, while describing how their usage can transform Health Professions Education. This Part covers Learning Management Systems, infographics, podcasting, videos, websites, social media, online discussion forums, simulation, virtual patients, extended and virtual reality. Intertwined are other topics, such as online small group teaching, game-based learning, FOAM, online social and collaboration learning, and virtual care teaching. We end by discussing digital scholarship and emerging technologies. Combined with Part 1, the overall aim of Part 2 is to produce a comprehensive overview to help guide effective use online learning in Health Professions Education.

Online learning in Health Professions Education. Part 1: Teaching and learning in online environments: AMEE Guide No. 161.

Online learning in Health Professions Education (HPE) has been evolving over decades, but COVID-19 changed its use abruptly. Technology allowed necessary HPE during COVID-19, but also demonstrated that many HP educators and learners had little knowledge and experience of these complex sociotechnical environments. Due to the educational benefits and flexibility that technology can afford, many higher education experts agree that online learning will continue and evolve long after COVID-19. As HP educators stand at the crossroads of technology integration, it is important that we examine the evidence, theories, advantages/disadvantages, and pedagogically informed design of online learning. This Guide will provide foundational concepts and practical strategies to support HPE educators and institutions toward advancing pedagogically informed use of online HPE. This Guide consists of two parts. The first part will provide an overview of evidence, theories, formats, and educational design in online learning, including contemporary issues and considerations such as learner engagement, faculty development, inclusivity, accessibility, copyright, and privacy. The second part (to be published as a separate Guide) focuses on specific technology tool types with practical examples for implementation and integration of the concepts discussed in Guide 1, and will include digital scholarship, learning analytics, and emerging technologies. In sum, both guides should be read together, as Guide 1 provides the foundation required for the practical application of technology showcased in Guide 2.Please refer to the video abstract for Part 1 of this Guide at https://bit.ly/AMEEGuideOnlineLearning.

Anodal transcranial direct current stimulation does not enhance the effects of motor imagery training of a sequential finger-tapping task in young adults.

When applied over the primary motor cortex (M1), anodal transcranial direct current stimulation (a-tDCS) could enhance the effects of a single motor imagery training (MIt) session on the learning of a sequential finger-tapping task (SFTT). This study aimed to investigate the effect of a-tDCS on the learning of an SFTT during multiple MIt sessions. Two groups of 16 healthy young adults participated in three consecutive MIt sessions over 3 days, followed by a retention test 1 week later. They received active or sham a-tDCS during a MIt session in which they mentally rehearsed an eight-item complex finger sequence with their left hand. Before and after each session, and during the retention test, they physically repeated the sequence as quickly and accurately as possible. Both groups (i) improved their performance during the first two sessions, showing online learning; (ii) stabilised the level they reached during all training sessions, reflecting offline consolidation; and (iii) maintained their performance level one week later, showing retention. However, no significant difference was found between the groups, regardless of the MSL stage. These results emphasise the importance of performing several MIt sessions to maximise performance gains, but they do not support the additional effects of a-tDCS.

Adapting to change: Undergraduate nursing students' sense of belonging transitioning from online to in-person learning environments.

AIM: To examine undergraduate nursing students' sense of belonging as they transitioned from online to in-person learning. DESIGN: A mixed-method design employing a Sense of Belonging Survey and three open-ended questions. METHODS: Participants were first-year undergraduate nursing students who were back to in-person learning after 3 years of online learning during the pandemic. The survey was administered online in April 2023 using Qualtrics survey software. The survey data were analysed using descriptive statistics, and the open-ended questions were analysed by deductive thematic analysis. RESULTS: Seventy-five (48%) of the 155 potential participants responded to the survey. The mean score on the Sense of Belonging Survey was 74%, a positive finding suggesting that many participants feel that they 'belong' in the classroom. Three overarching themes were identified in response to the open-ended questions: factors supporting students' sense of belonging, factors hindering students' sense of belonging and strategies for faculty, administrators and students to increase a sense of belonging. CONCLUSION: Understanding the factors that contribute to or hinder nursing students' sense of belonging during this transition will assist in developing strategies to mitigate challenges, foster a positive learning environment and enhance the overall sense of belonging among nursing students. IMPACT: The first year of a nursing programme is crucial for student retention as students require tailored programmes and strategies to support their success. Examining and analysing the transition from online to in-person classroom settings is crucial to identifying strategies to enhance and support first-year students' sense of belonging and academic success. Exploring nursing students' experiences of belonging during transitions contributes to a more inclusive and equitable educational experience, fostering an environment where all students can thrive and succeed. PATIENT OR PUBLIC CONTRIBUTION: Not applicable.

Assigned group work is associated with increased student motivation and perceptions of belonging in an asynchronous online physiology laboratory course.

With the rise of online instruction, a better understanding of the factors that contribute to belonging and motivation in these contexts is essential to creating optimal learning environments. Although group work is known to be beneficial to student success, few studies have investigated its role in the context of asynchronous online courses. The present study addresses this gap through a survey of 146 undergraduate students in an asynchronous online physiology lab over two semesters, one with required group work and one without group work. Students were surveyed to evaluate the influence of group work on their motivation and sense of belonging, as well as their perceptions of inclusive and exclusive features of the course. Students assigned to groups had a higher sense of belonging (P = 0.006) and beliefs about their competence (P = 0.002) and perceived lower effort and psychological costs associated with the course (P = 0.04 and 0.04, respectively) compared to students not assigned to groups. Students assigned to groups reported that peer interactions made them feel included in the course (70% of coded responses) while those not assigned to groups valued instructor interactions (51% of coded responses) as inclusive. Negative peer interactions were commonly reported as exclusive by students assigned to groups (28% of coded responses) while a lack of peer interactions (23% of coded responses) made students not assigned to groups feel excluded. These data indicate that assigning groups in asynchronous online courses is an effective way to increase student motivation and perceptions of belonging.NEW & NOTEWORTHY This study explores the effect of assigned group work in an asynchronous online physiology laboratory course on student motivation and belonging. Students' perceptions of belonging and competence-related beliefs were higher, and effort and psychological costs were lower, when assigned to groups compared to students not assigned to groups. Students assigned to groups noted peer interactions as the most inclusive aspect of the course, whereas instructor interactions were noted as inclusive by those not assigned group work.

E-learning in medical education: a perspective of pre-clinical medical students from a lower-middle income country.

BACKGROUND: Many of the educational institutions in developed countries have shifted to online learning. While transition from traditional to electronic learning (e-learning) has remained a great challenge in low-middle income countries, where limited resources for teaching and learning are important factors. Medical education involves not only lecturing but also deep understanding through laboratories and patient exposure. The debate about the effectiveness of e-learning in medical education is still in contradiction due to its limitations. This cross-sectional survey was conducted to assess pre-clinical undergraduate medical students' perception of their first online learning in a lower-middle income country. METHODOLOGY: The survey was conducted among the students who had participated in online learning during COVID-19 for at least a year. A total of 824 preclinical medical students who completed the survey from public and private medical universities in Sindh, Pakistan were included in the study. We used a validated online-based questionnaire, distributed through E-mail and social media platforms to assess the perception of students regarding their first online learning experience. RESULTS: The response rate of the survey was 87.9%. The mean age of students was 20.7 ± 3.8 years. 392/824 (47%) were males and 57% were females. Our study indicated that 613/824 (75%) of students were experiencing online learning for the very first time while 631/824 (77%) were facing technical issues like internet accessibility and lack of IT-related skills. 381/824 (46%) were not satisfied with the institute's readiness for online teaching. However, 79% (654/824) of participants were of the idea that traditional learning is more effective in developing their practical skills as compared to e-learning. Of note, 668/824 (81%) showed overall dissatisfaction with e-learning. CONCLUSION: Based on our study findings, we concluded that most students have a negative perception of e-learning. Difficulty in connectivity, electricity issues, less interaction with colleagues and teachers, and issues with the structure of online courses were the most frequently reported problems by the students.

Factors affecting medical students' satisfaction with online learning: a regression analysis of a survey.

BACKGROUND: Medical education requires the implementation of different teaching methods and strategies for future doctors to achieve broad learning objectives. This wide range of methods and strategies includes the use of Information Technologies. For a long time, there was a call for a change in medical education for blending new teaching approaches to lessen medical students' class time. The COVID-19 pandemic then sped up the transition to the new way of medical education and classroom lectures were quickly moved to a virtual environment. We expect that these changes will continue, and online learning will be one of the main teaching strategies in medical education. Therefore, educational experiences during the COVID-19 pandemic will improve our understanding of online learning and will help to develop blended medical school curricula in the future. For this reason, we aimed to determine students' overall satisfaction with their online learning experience and to define the main factors affecting students' satisfaction with their online learning program at Cerrahpasa Medical Faculty. METHODS: A cross-sectional survey study was conducted to determine medical students' overall satisfaction with online learning methods and to identify factors associated with positive and negative satisfaction levels. A questionnaire, consisting of 24 questions to collect demographic characteristics, factors associated with online education experience and overall satisfaction levels was developed and distributed to 1600 medical students. Multivariable linear regression analysis was used to determine the factors associated with positive and negative satisfaction levels. RESULTS: Regression analysis showed that being familiar with online teaching techniques (ß = 0.19, 95% CI [0.07, 0.30], faculty members' higher online teaching skill levels (ß = 0.42, 95% CI [0.32, 0.51], interactive online teaching approaches (ß = 0.54, 95% CI [0.41, 0.67], having a personal workspace (ß = 0.43, 95% CI [0.19, 0.67], and a self-reported longer attention span (ß = 0.75, 95% CI [0.57, 0.92] were associated with higher overall satisfaction with online learning. The occurrence of technical problems (ß = -0.19, 95% CI [-0.26, -0.12] was associated with lower overall satisfaction. CONCLUSIONS: Higher online teaching skills of faculty members, use of interactive approaches, students' familiarity with online teaching techniques, provision of a personal workspace, and self-reported longer attention spans positively contributed to higher levels of student satisfaction with online learning. Considering the increasing significance of online educational methods, our study identified key components that affect students' level of satisfaction. This information might contribute to the development of online educational programs in the future.

Investigating the learning self-efficacy of a fully online teaching environment among undergraduate Chinese medical students: a cross-sectional study.

BACKGROUND: Fully online learning has become a common option in many universities worldwide in the post-COVID-19 era. The study aimed to evaluate the dimensions and characteristics of the fully online learning self-efficacy among Chinese undergraduate medical and nonmedical students. METHODS: A cross-sectional study was conducted from January to August 2023 at Xihua University in China. A stratified cluster sampling method was used to enroll participants of undergraduate students. The Chinese version of the online learning self-efficacy scale (OLSES) was used to collect the demographic information. Cronbach's alpha coefficient, exploratory factor analyses, confirmatory factor analyses, and linear regression analyses were conducted in the study. RESULTS: A total of 203 college students were included in the study. One hundred and twenty (59.1%) of the participants were medical students and 83 (40.9%) were nonmedical students, and most of them (64.5%) were from rural areas. The Cronbach's alpha coefficients were determined to be 0.90, 0.86, 0.87, and 0.95 for the learning in a fully online environment, time management, technology use subscales, and the whole scale, respectively. Exploratory factor analysis revealed the justifiability of factor analysis. In the confirmatory factor analysis, the majority of the goodness-of-fit indices reached an acceptable threshold (χ2/df = 3.14, RMR = 0.06, RMSEA = 0.10, NFI = 0.84, RFI = 0.80, IFI = 0.89, TLI = 0.85, CFI = 0.90). More than half of the students reported insufficient self-efficacy for learning in a fully online environment and time management, whereas 55.7% showed good self-efficacy for technology use. Although more medical students than non-medical students had higher self-efficacy scores in the three domains of self-efficacy, the proportion of students with good self-efficacy was slightly lower among medical students than non-medical students, with no significant differences between the medical students and nonmedical students. CONCLUSIONS: Most Chinese university students' that participated to our study found self-efficacy for fully online learning as insufficient (results on the three domains, ranging from 36.5 to 55.7%) and had a good level of fully online learning self-efficacy. Medical students and nonmedical students are not differences in the self-efficacy of fully online learning. Thus, pedagogues should take measures to help students including medical and nonmedical improve their self-efficacy in online environment learning, time management and technology use, ultimately enhancing their academic success.

Patients as teachers: a within-subjects randomized pilot experiment of patient-led online learning modules for health professionals.

PURPOSE: Many health professions education programs involve people with lived experience as expert speakers. Such presentations may help learners better understand the realities of living with chronic illness or experiencing an acute health problem. However, lectures from only one or a small number of people may not adequately illustrate the perspectives and experiences of a diverse patient cohort. Additionally, logistical constraints such as public health restrictions or travel barriers may impede in-person presentations, particularly among people who have more restrictions on their time. Health professions education programs may benefit from understanding the potential effects of online patient-led presentations with a diverse set of speakers. We aimed to explore whether patient-led online learning modules about diabetes care would influence learners' responses to clinical scenarios and to collect learners' feedback about the modules. METHOD: This within-subjects randomized experiment involved 26 third-year medical students at Université Laval in Quebec, Canada. Participation in the experiment was an optional component within a required course. Prior to the intervention, participating learners responded to three clinical scenarios randomly selected from a set of six such scenarios. Each participant responded to the other three scenarios after the intervention. The intervention consisted of patient-led online learning modules incorporating segments of narratives from 21 patient partners (11 racialized or Indigenous) describing why and how clinicians could provide patient-centered care. Working with clinical teachers and psychometric experts, we developed a scoring grid based on the biopsychosocial model and set 0.6 as a passing score. Independent evaluators, blinded to whether each response was collected before or after the intervention, then scored learners' responses to scenarios using the grid. We used Fisher's Exact test to compare proportions of passing scores before and after the intervention. RESULTS: Learners' overall percentage of passing scores prior to the intervention was 66%. Following the intervention, the percentage of passing scores was 76% (p = 0.002). Overall, learners expressed appreciation and other positive feedback regarding the patient-led online learning modules. DISCUSSION: Findings from this experiment suggest that learners can learn to provide better patient-centered care by watching patient-led online learning modules created in collaboration with a diversity of patient partners.

Utilising massive open online courses to enhance global learning dissemination in cleft lip and palate: a case report of penta helix collaboration.

BACKGROUND: Educating and raising awareness in cleft lip and palate future generations is one vital effort to ensure the improvement of cleft care and research in the future. This study reported the overview in organising and evaluating the Massive Open Online Course (MOOC) in Cleft Lip and Palate as the alternative way for students' capacity building outside their study program whilst also earning credits towards their studies. METHODS: Smile Train cleft charity generously donated recorded lectures from cleft experts around the world in which each of the experts agreed to provide one-hour live discussion sessions. The learning activities ranging from lectures, pre- and post-course evaluation, forum, live discussion sessions, virtual visits to Indonesian Cleft Centre, self-reflection assignments and final project. A survey was released to the participants to collect their feedback. RESULTS: The course mainly attracted dental students, and several allied health professional students. In total, 414 out of 717 participants registered for this MOOC managed to finish the course and received a certificate of completion which was run between August-October 2021. In general, participants positively received the course. CONCLUSIONS: The MOOC model and its objective of disseminating widespread information across geographical boundaries to enhance learning about cleft lip and palate treatment was achieved. This report serves as an example for other educational institutions and stakeholders who plan to use online educational engagement platforms to provide high-quality education and capacity building to participants in lower-middle income countries.