Factors Influencing Medical Students' Experiences and Satisfaction with Blended Integrated E-Learning.

OBJECTIVES: Blended learning has been presented as a promising learner-centred model that emphasises the learning outcome rather than the process of education, but it can negatively affect learners' engagement with learning. SUBJECT AND METHODS: Using a mixed-methods approach, this study aimed to determine the significant predictors of learning satisfaction and to evaluate the experiences of medical students with the different domains of an introduced blended integrated learning approach. RESULTS: The survey was administered to 92 respondents with a mean age of 20.5 years. Male students had significantly higher computer self-efficacy and overall learner satisfaction ratings than their female counterparts. Multiple regression analysis showed that gender (student characteristics), performance expectations (cognitive factors), and learning climate (social environment) were predictors of the perceived satisfaction of learners. CONCLUSION: Wider integration of blended learning into pre-clinical undergraduate medical education could enhance the shift towards competency-based education and life-long learning among medical students. However, effective implementation would depend largely on student characteristics, as well as environmental and cognitive components of the delivery method.

Effect of supervised integrated exercise on heart rate variability in type 2 diabetes mellitus.

BACKGROUND: Heart rate variability (HRV) reflects autonomic nervous system modulation of cardiac activity. There is a relationship between degrees of physical activity, HRV changes and the risk of cardiovascular disease. AIM: To study the effect of a supervised integrated exercise programme on HRV in type 2 diabetes mellitus (DM). METHODS: The study group consisted of 48 patients (27 males, mean age 62+/-7 years) with type 2 diabetes, of whom 28 underwent a special exercise programme whereas the remaining 20 did not and served as the control group. The supervised integrated exercise programme was applied for a period of 9 months. Deep breathing time domain HRV (difference between the shortest and the longest R-R interval over one minute) was measured at baseline and after 3, 6 and 9 months. RESULTS: A significant improvement in the HRV values was observed with increasing duration of exercise (13.03+/-1.08 beats/min at baseline versus 16.5+/-1.11 beats/min at 9 months, p <0.001) whereas HRV decreased in the control group (14.85+/-1.15 beats/min at baseline vs. 14.30+/-1.75 at 9 months, p <0.05). Favourable changes in HRV in the exercise group were gender-dependent and were significant in males (12.4+/-1.76 beats/min at baseline vs. 16.18+/-1.91 at 9 months, p <0.001) whereas in females only a trend towards HRV improvement was observed. The HRV changes were also age-dependent and were more pronounced in younger patients than in the elderly. The metabolic parameters of diabetes control (blood glucose and glycosylated haemoglobin levels) significantly improved in the exercise group and significantly worsened in the control group. CONCLUSIONS: Regular supervised integrated exercise significantly improves HRV in patients with type 2 DM, which may favourably influence their long-term prognosis.