Search Results (449)

Cognitive load theory-informed curriculum design in health sciences education refers to the purposeful organisation of teaching strategies and learning materials based on the principles of Cognitive Load Theory (CLT), a framework developed by John Sweller in the late 1980s. CLT is grounded in cognitive psychology and recognises that the working memory has a limited capacity for processing new information. It identifies three types of cognitive load: intrinsic load, which refers to the inherent complexity of the material being learned; extraneous load, which results from ineffective instructional design or irrelevant information; and germane load, which reflects the mental effort directed toward understanding, integrating, and organising information into long-term memory. In health sciences education, students frequently engage with tasks that require the simultaneous processing of multiple interacting elements, placing high demands on working memory at specific points in time. This includes foundational biomedical sciences such as anatomy, physiology, and pathophysiology extending to applied clinical skills, diagnostic reasoning under uncertainty, health service management within complex systems, and ethically grounded decision-making. Without thoughtful instructional design, learners may be overwhelmed by excessive information and cognitive demands, which can hinder understanding, retention, and performance. Applying CLT-informed strategies, educators can reduce unnecessary cognitive burden, sequence learning activities to align with learners’ cognitive capacity, and promote deeper learning. This approach supports more effective knowledge acquisition and transfer and is particularly valuable in content dense academic environments such as medicine, nursing, allied health education, public health and health service management education. Therefore, integrating CLT-informed principles into curriculum design can help optimise learning experiences and support the development of competent health professionals. Full article

Despite growing recognition that organizational culture shapes nursing practice, the linking of ethical climate to sustainable environmental health literacy (SEHL) remains poorly understood. This study examined whether moral courage statistically mediates the relationship between perceived ethical climate and self-reported environmental health literacy among Egyptian nurses, rather than observed competencies or clinical actions. A cross-sectional correlational design was employed with 743 nurses recruited from government, private, and university-affiliated hospitals. Participants completed the Hospital Ethical Climate Survey, the Nurses’ Moral Courage Scale, and the Environmental Health Literacy Scale. Mediation analysis used Hayes’ PROCESS macro with 5000 bootstrap samples. Ethical climate demonstrated strong positive associations with moral courage (r = 0.81) and SEHL (r = 0.86), while moral courage and SEHL were also strongly correlated (r = 0.82). Ethical climate explained 74% of variance in SEHL and 66% of variance in moral courage. Moral courage was associated with partial statistical mediation of the ethical climate–SEHL relationship, accounting for 33.4% of the total effect (β = 0.31, 95% CI [0.26, 0.37]), while the direct effect remained substantial (66.6%). These findings suggest that supportive ethical climates may be associated with nurses’ environmental health literacy via two statistical pathways: one directly linked to environmental learning and another indirectly linked to moral courage. Healthcare organizations should prioritize ethical climate development alongside moral courage training as potentially promising approaches to advance climate-responsive nursing practice. Full article

Autonomy and trust are central concepts in sociology and psychology and are particularly relevant to the study of hybrid societies in which human and artificial agents interact. Trust is essential for effective collaboration across a wide range of contexts, and the benefits of interacting with autonomous agents for facilitating goal achievement are well established. However, the complex interplay between trust and autonomy remains insufficiently understood, especially in sensitive domains such as healthcare, where ethical values, patient safety, and inter-agent dependencies must be carefully managed. In this work, we employ a multi-agent simulation to investigate the roles of autonomy and trust in relation to patient satisfaction. Our results show that higher levels of autonomy—enabling agents to modify delegations and exploit dependencies—effectively support implicit goal discovery and can enhance explicit goal achievement. Nevertheless, such autonomy may be detrimental compared to lower levels of autonomy that only allow dependency exploitation. This effect is particularly evident in contexts with large pools of partners who lack sufficient competence but are willing to accept multiple concurrent delegations. Conversely, in environments characterized by heterogeneous trustworthiness, higher autonomy proves advantageous, as it enables agents to more effectively discover and leverage dependencies. Full article

The rapid expansion of Generative Artificial Intelligence (GAI) is transforming higher education systems, particularly public institutions seeking to advance toward smart governance models and digital transformation. In this context, digital teaching competence emerges as a strategic factor for the effective, ethical, and pedagogically sound adoption of these technologies. This study assesses the level of digital competence among public higher education faculty in Paraguay and examines its predictive capacity regarding the adoption of GAI tools using machine learning models. A nationwide quantitative study was conducted with a sample of 800 faculty members from public universities across Paraguay. Data were collected through a structured questionnaire based on international digital competence frameworks, incorporating additional variables such as attitudes toward GAI, technological experience, institutional infrastructure, and perceived organizational support. Data analysis involved the application of machine learning techniques, including Logistic Regression, Random Forest, and Gradient Boosting, to identify the variables with the strongest predictive power regarding faculty readiness and willingness to integrate GAI into teaching practices. Model performance was evaluated using metrics such as accuracy, F1-scores, and the AUC-ROC. The findings identify key predictors of technological readiness and structural gaps within Paraguay’s public higher education system. This research provides empirical evidence from Latin America on the factors influencing GAI adoption in public sector educational contexts and contributes to the design of educational policies aimed at fostering smart universities and digitally sustainable academic ecosystems. Full article

Higher Education Institutions (HEIs) are increasingly called upon to integrate sustainability across curricula and to prepare students to respond critically and responsibly to complex environmental challenges. While sustainability education is often associated with scientific, technological, or policy-oriented disciplines, the contribution of the humanities remains underexplored, particularly in digitally mediated university teaching. This paper argues that ancient texts, approached through the lens of the Environmental Humanities and supported by digital pedagogy, can offer a valuable framework for fostering sustainability literacy in higher education. Drawing on a humanities-based pedagogical model, this article explores how practices such as collaborative close reading, ecocritical discussion, narrative mapping, reflective writing, and digital storytelling can help students connect classical representations of nature, fragility, order, and human responsibility with contemporary ecological concerns. These activities encourage the development of sustainability-related competencies—including critical thinking, ethical reflection, interpretive complexity, and ecological awareness—while also supporting Inner Development Goals such as self-awareness, empathy, relational thinking, and responsible action. Based on a conceptual pedagogical model supported by exploratory qualitative evidence from a small-scale higher education course, this paper suggests that digital pedagogy can make sustainability learning in the humanities more dialogic and reflective. In doing so, this article proposes a practice-based pedagogical framework that may help Higher Education Institutions explore ways of embedding sustainability meaningfully beyond traditionally environmental fields. This article’s primary contribution is therefore pedagogical: it presents a humanities-based model for sustainability education while using exploratory qualitative evidence from one course context to illustrate how such a model may support interpretive, ethical, and sustainability-oriented learning. Full article

Globalization refers to the increasing density of economic, social, and technological interconnections on a global scale. In the healthcare industry, it simultaneously accelerates innovation and increases systemic vulnerabilities. This study aims to review and conceptually synthesise the main channels of impact: (1) pharmaceuticals, clinical development, and regulation; (2) supply chains and resilience; (3) service mobility (health tourism); (4) human resources and competencies; (5) digitalization, artificial intelligence (AI), and data governance; (6) ethics, law, and public policy; and (7) sustainability and climate change. The COVID-19 pandemic highlighted the risks associated with global interdependencies, particularly in supply chains, while also demonstrating the innovation-accelerating effects of knowledge sharing and international cooperation. Particular attention is given to artificial intelligence and digital health, which open up new potential for efficiency and quality improvement from research and development through diagnostics to healthcare organization, while simultaneously intensifying concerns related to data protection, cyber security, and liability. Telemedicine, platform-based systems, and real-world data may contribute to addressing the care needs of ageing societies, but only when supported by appropriate competencies and sound data governance. As global data flows intensify, the importance of data protection, bias mitigation, transparency, and accountability correspondingly increases. Through the cultural channels of globalization, health-conscious lifestyles and complementary approaches are also spreading, which we address in a brief, separate subsection. The guidelines of international organizations foster standardization; however, due to differences in local capacities and institutional environments, the effects are not homogeneous. In conclusion, the study emphasises the dual nature of globalization; it expands access and accelerates innovation, while at the same time creating new vulnerabilities—in supply chains, labour mobility, and data security—and, together with climate-related risks, generating complex adaptive pressures for the healthcare industry. Full article

The digital transformation of healthcare requires stronger digital competencies among pharmacists, yet evidence on the effectiveness of structured training remains scarce. This study examines the impact of a blended digital health training programme delivered to practicing pharmacists in Bihor County, Romania, as part of the Romanian pilot of the EU-funded European Health Professionals’ and the DigitAl team SkillS (H-PASS) project. A single-group pre–post educational design was applied to pharmacists from Bihor County, Romania, participating in a modular digital health training programme delivered between May and July 2025. A total of 84 pharmacists completed both pre-training and post-training self-reported competency assessments comprising 18 items across three modules: digital innovation and change management, communication and collaboration, and data management and digital literacy. Paired samples t-tests, Cohen’s d effect sizes, Cronbach’s alpha, moderator analyses, and ceiling effect analyses were conducted using Python-based statistical workflows. Statistically significant improvements were observed across all three modules (all p < 0.0001), with large effect sizes (d = 1.04–1.30). Post-training internal consistency increased substantially, with overall Cronbach’s alpha reaching 0.74. The greatest item-level gains were recorded in adaptive communication, cultural adaptation of care, and data protection ethics. No significant moderation effects were found for age, gender, or years of experience. Course satisfaction showed a moderate positive correlation with competency gains (r = 0.528), while perceived improvement was not significantly associated with observed score change. A ceiling effect indicated greater gains among participants with lower baseline competencies. The Romanian implementation of the H-PASS training programme was associated with improved self-reported digital health competencies among practicing pharmacists, high-lighting its potential as a scalable model for digital upskilling in healthcare. Full article

Generative AI (GenAI) is reshaping second language (L2) writing not only by altering how learners generate, revise, and refine text but also by changing how writers justify, disclose, and remain accountable for AI-mediated decisions. Yet much prompt-literacy work still treats prompting as output optimization or leaves it under-theorized as a general ability to “use AI well.” This conceptual article addresses that gap by reconceptualizing Fine-Tuned Prompt Literacy (FTPL) as an interaction-first learning-and-accountability framework for GenAI-mediated L2 writing. We argue that prompt literacy should be understood not simply as better prompting, but as the trained ability to set communicative and genre constraints, interrogate provisional AI outputs, corroborate claims, revise prompts and texts iteratively, and document accountable uptake decisions. To clarify FTPL’s theoretical distinctiveness, we position it in relation to AI literacy, critical GenAI literacy, and prompt literacy research, and define four interlocking dimensions—learner empowerment, prompt optimization, critical evaluation, and ethical responsibility. We further operationalize the framework through observable interactional indicators, process evidence, and assessment/accountability implications relevant to instructional and institutional contexts. By reframing prompt literacy as a genre-sensitive and ethically accountable interactional competence, this article offers a conceptual model for studying and designing GenAI-mediated writing beyond product improvement alone. Full article

Doping remains a major threat to athlete health and sport integrity. Although anti-doping efforts have traditionally focused on athletes, increasing attention has turned to Athlete Support Personnel (ASP) due to their influence on athletes’ decisions, behaviors and involvement in anti-doping rule violations. This narrative review aimed to synthesize the existing literature on the role of ASP (including coaches, physicians, pharmacists, sport psychologists, nutritionists, physiotherapists, parents and other family members) in anti-doping, with particular attention to their influence on athletes’ knowledge, attitudes, behaviors, education and decision-making related to doping. Coaches, physicians, and pharmacists are among the ASP groups most frequently examined in the literature, although substantial knowledge gaps remain across all groups. Coaches shape motivational climates and ethical norms but often lack adequate understanding of anti-doping regulations and supplement risks. Physicians and pharmacists play key roles in medication management and Therapeutic Use Exemptions procedures, though incomplete regulatory knowledge may contribute to inadvertent violations. Nutritionists are central in preventing supplement-related doping, while research on sport psychologists and physiotherapists remains limited despite their preventive potential. Parents significantly shape athletes’ moral development and susceptibility to doping, acting as protective or risk factors depending on family dynamics. Overall, anti-doping education for ASP remains inconsistent. In conclusion, ASP plays an essential yet heterogeneous role in influencing doping-related behaviors. Strengthening role-specific and interdisciplinary anti-doping education, particularly within university programs and professional development, appears critical for enhancing ASP competence and promoting a sustainable culture of clean sport. Full article

The incorporation of digital technologies has transformed Social Work, generating new demands in terms of professional competencies. It is worth questioning whether, in contexts as sensitive as social services, the mere acquisition of instrumental mastery of these tools is sufficient to ensure safe practice. Considering that the level of proficiency with these tools is influenced by age, the aim of this study is to conduct a comparative analysis of the digital competence levels of social work professionals and students in order to contrast the skills and shortcomings of both groups. To achieve this, a quantitative methodological design was employed using questionnaires based on the European DigComp 2.2 framework. The sample included 451 professionals from Spain and 171 students from the University of Huelva, whose data were processed using statistical software (SPSS 27). The results show that students display a higher overall level of digital competence, particularly in the creation of digital content and the use of artificial intelligence tools. Professionals, on the other hand, demonstrate stronger competencies in digital security and data literacy. The findings reveal a clear complementarity between the two groups, highlighting an opportunity for mutual feedback and learning that can help combine technological efficiency with ethical responsibility and respect for human rights. Full article

Background: Cultural competence is essential in nursing, enabling the delivery of ethical, patient-centered, and respectful care that respects diverse cultural backgrounds in an increasingly diverse healthcare setting. Improving cultural competence can substantially reduce stereotyping, time pressure, and distress among nurses. Objective: This study aimed to examine the relationship between cultural competence and loneliness among nurses working at a university medical city in Saudi Arabia and to identify associated demographic and psychological factors. Methods: A descriptive cross-sectional study was conducted using a convenience sample of 184 nurses. Data were collected via an online questionnaire that included the Cultural Capacity Scale, the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire-4 between April and May 2024. Descriptive statistics, Spearman’s correlation, and multiple linear regression were used in the data analysis. Result: Findings indicate high cultural competence (mean score: 78.82) but moderate loneliness (mean score: 11.9). Notably, a strong negative correlation exists between cultural competence and feelings of loneliness (r = −0.777) and anxiety/depression (r = −0.818), suggesting that increased cultural competence is associated with lower loneliness and mental health issues. Conclusions: Both cultural knowledge and sensitivity emerged as significant predictors of lower anxiety and depression levels. These findings highlight the association between cultural competence and reduced loneliness and psychological distress among nurses, suggesting the need for targeted training interventions to improve nurses’ well-being and the quality of patient-centered care in culturally diverse healthcare settings. Full article

Background: Evidence-based practice (EBP) is a cornerstone of high-quality and safe nursing care. However, undergraduate nursing students often experience cognitive, methodological, and contextual barriers to learning and applying EBP. Active teaching strategies, such as the flipped classroom, may support the development of EBP competencies, yet qualitative evidence exploring students’ learning experiences remains limited. Objectives: To explore nursing students’ perceptions and experiences of learning evidence-based practice through a flipped classroom model. Methods: A qualitative descriptive study was conducted at the Faculty of Nursing of the University of Murcia (Spain). Purposeful maximum variation sampling was used to recruit undergraduate nursing students from the second and fourth academic years who had completed an EBP course delivered using a flipped classroom approach supported by an online learning platform. Twenty semi-structured interviews were conducted via videoconference. Data were transcribed verbatim and analyzed using reflexive thematic analysis with independent coding by two researchers and consensus procedures. Ethical approval and confidentiality were ensured. Results: Three main themes were identified: (1) transformation of the meaning of EBP learning and professional role, (2) cognitive and metacognitive processes in EBP learning, and (3) the learning experience as a catalyst for deep learning. Students described a shift from initial fear and perceived difficulty toward recognizing the practical value of EBP, accompanied by increased critical thinking, autonomous learning, and a growing evidence-informed professional identity. The flipped classroom model facilitated engagement and understanding, while the transfer of learning to clinical practice was influenced by contextual facilitators and barriers. Conclusions: Learning EBP through a flipped classroom was experienced as a transformative process that fostered critical thinking, self-regulated learning, and the construction of an evidence-oriented professional identity among nursing students. Strengthening information literacy skills and improving alignment between academic and clinical environments may enhance the sustainable application of EBP in clinical practice. Full article

As artificial intelligence (AI) becomes increasingly embedded in organizational processes, questions about its implications for leadership have gained growing relevance. However, the existing literature remains fragmented, often addressing strategy, leadership capabilities, governance structures, or ethical concerns in isolation, without explaining how these dimensions interact to shape leadership effectiveness in AI-driven environments. This study conducts a PRISMA-guided systematic review of 33 peer-reviewed articles to examine how AI-embedded leadership is conceptualized across contexts. By synthesizing findings across strategic, human, and governance domains, the analysis identifies recurring patterns and structural relationships in the literature. The results indicate that effective leadership in AI-intensive settings is not determined solely by technological adoption or digital competencies, but by the alignment between the depth of AI integration in decision-making processes, leaders’ capacity to interpret and oversee algorithmic outputs, and the presence of governance mechanisms that ensure transparency, accountability, and trust. While some studies highlight potential opportunities associated with AI, these remain less systematically developed compared to the extensive focus on challenges and emerging risks. On this basis, the study introduces the AI-Leadership Configurational Framework (ALCF), a multi-level model that conceptualizes leadership effectiveness as the outcome of systemic alignment. The framework integrates previously disconnected debates and provides a coherent foundation for future empirical research on leadership in the algorithmic age. Full article

This study explores how incorporating generative artificial intelligence into the Collaborative Online International Learning (COIL) framework can enhance internationalisation for home and social entrepreneurship education in multilingual settings. A four-week AI-supported COIL programme was conducted with 30 postgraduate students from Russian and Spanish programmes. Students collaborated in intercultural teams to develop bilingual social innovation projects. Data were collected before and after the intervention using validated scales measuring intercultural competence, social entrepreneurship skills, AI literacy and ethics, and linguistic self-efficacy. Repeated-measures ANOVA indicated statistically significant improvements across all domains, with moderate-to-large effect sizes. The most pronounced gains were observed in mixed intercultural groups, which may suggest a potential synergistic effect between authentic intercultural exchanges and AI-mediated language support. Additionally, notable improvements were observed in ethical awareness of AI use and linguistic self-efficacy. Overall, these findings suggest that the AI-COIL model may represent a practical and potentially scalable approach for integrating language learning, intercultural competence, social innovation, and responsible AI use to advance internationalisation in higher education. Full article

Autonomous robots are increasingly integrated into social contexts, making affective human–robot interaction (HRI) critical for their effectiveness and acceptance. However, existing research remains dispersed across domains and techniques, lacking a unified framework to characterize core robotic capabilities. To address this gap, we adopt a capability-oriented perspective and conduct a comprehensive literature review, through which we propose a structured taxonomy of capabilities for robots in affective HRI. The taxonomy comprises five core dimensions: perception (recognizing human internal states), strategy (planning responses based on human states and context), expression (conveying robot lifelikeness and social presence), sustainability (maintaining effective and reliable operation over time), and ethics (ensuring behavior within ethical constraints). By organizing diverse research efforts into a structured framework, this taxonomy provides a systematic foundation for designing socially competent robots and guiding future research. Full article