Search Results (209)

This exploratory descriptive-correlational study analyses the perceptions of 257 adult students (doctoral, master’s, and teachers) at DPPD, USV Iași, during the 2025–2026 academic year regarding hybrid education, teaching quality, and environmental sustainability. Using a structured Likert-scale questionnaire, the analysis indicates good-to-excellent internal consistency, with Cronbach’s alpha values ranging between 0.886 and 0.901, and a high overall global average score of 4.64. The findings reveal strong support for the hybrid model. Perceived teaching quality received the highest subscale rating (M = 4.80), closely followed by the perceived ecological impact (M = 4.65). The analysis indicates strong Pearson correlations, specifically between the hybrid learning experience and perceived teaching quality (r = 0.818), as well as between the perceived ecological impact and pro-sustainability attitudes (r = 0.809). Regarding academic mobility, the estimate indicates 81,283 km of avoided commuting travel and approximately 12,295 kg of avoided commuting-related CO₂ emissions, based on self-reported distance, means of transport, and number of physical attendances replaced by online activities. These findings suggest that hybrid learning may represent a relevant managerial option for university sustainability policies. The model appears well suited to postgraduate programmes addressed to employed adults, although the ecological benefits should be read as partial and do not displace perceived teaching quality as the central factor. Full article

Background/Objectives: Pelvic floor dysfunctions (PFDs) are highly prevalent chronic conditions associated with substantial functional and psychosocial burden. Although multidisciplinary pelvic floor rehabilitation is recommended as first-line management, its effectiveness depends not only on intervention efficacy but also on care delivery, communication, patient engagement, and long-term adherence. This study applied the Delphi-Dialogue Patients–Professionals (DDPP) framework to quantify patient–professional alignment and translate identified patient–professional perceptual differences into candidate service-improvement strategies. Methods: A two-phase observational study incorporating parallel stakeholder surveys and a modified Real-Time Delphi feasibility-assessment process was conducted under the auspices of the Spanish Society of Physical Medicine and Rehabilitation (SERMEF). In Phase 1, parallel online questionnaires were completed by 225 patients with PFD and 164 rehabilitation professionals. Shared items were rated on a six-point Likert scale, and patient–professional divergence was quantified using an operational composite index integrating standardized differences in mean ratings and high-agreement responses. In Phase 2, the implementation feasibility of 10 improvement recommendations was evaluated by a Delphi panel comprising 35 PM&R physicians and two representatives of the Spanish Incontinence Association (ASIA). Results: Patient–professional agreement was domain-specific. The greatest divergences concerned digital competence, timing of patient education, bladder and bowel diary use, and adherence to prescribed rehabilitation programmes. Professionals attributed greater value to bladder and bowel diaries and selected group-based interventions, whereas patients reported higher digital competence, more timely information delivery, and better adherence. Comparatively similar response patterns were observed regarding hybrid rehabilitation models, educational resources, app-supported follow-up, and overall satisfaction with rehabilitation care. The Delphi process identified structured home exercise programmes, adherence-monitoring strategies, and improved visibility of rehabilitation pathways as the recommendations with the highest perceived implementation feasibility. Conclusions: The findings suggest that important challenges in pelvic floor rehabilitation may arise from implementation-related factors in addition to the effectiveness of available interventions. The DDPP framework provides a structured, stakeholder-informed methodology for translating patient–professional divergence into candidate organizational recommendations with comparatively higher perceived implementation feasibility. Full article

The rapid proliferation of social media has transformed political communication, public diplomacy, and citizens’ digital attitudes across the MENA region—a context marked by hybrid political systems, intensive disinformation, and accelerating digital transformation. This study examines how social media use and media literacy are associated with five key constructs—institutional trust, trust in media and digital sources, attitudes toward political narratives, attitudes toward digital diplomacy, and security and disinformation perceptions—among 250 citizens of Egypt, Jordan, Tunisia, and Kuwait, alongside generational and educational differences across all constructs. Using a quantitative cross-sectional design, data were collected via an online questionnaire between January and March 2025 and analyzed through simple linear regression (H₁–H₁₀) and Kruskal–Wallis tests (H₁₁–H₂₄). Twenty-one of twenty-four hypotheses were confirmed. Social media use was a strong negative predictor of institutional trust (β = −0.750, R² = 0.562) and a strong positive predictor of political narrative awareness, digital diplomacy attitudes, and security perceptions; media literacy showed a parallel pattern. Educational level was the strongest differentiating factor in media literacy competencies (χ² = 175.874), far exceeding generational effects. Notably, trust in media and digital sources showed no significant association with either predictor or demographic variable across four independent tests, suggesting that—unlike the other constructs examined—media trust in the MENA region is shaped less by individual competencies or behaviors and more by structural and political factors. These findings support extending formal, curriculum-based media literacy education and point to the need for media trust research grounded in non-Western political contexts. Full article

Background/Objectives: The digital transition in school settings is reshaping children’s learning, writing practices, and mental health trajectories. This narrative review examines whether handwriting still matters in contemporary hybrid educational environments from a multidisciplinary perspective. Methods: Evidence from neuroscience, developmental psychology, educational sciences, pediatrics, and child psychiatry was narratively synthesized, with attention to handwriting, digital exposure, learning, emotional regulation, and vulnerable populations. Results: Handwriting uniquely integrates fine motor control, visuomotor coordination, orthographic processing, attention, and embodied cognition, supporting early literacy, memory consolidation, conceptual learning, and reflective writing. Conversely, excessive or poorly mediated digital exposure may interact with attentional fragmentation, sleep disruption, online stressors, problematic use, and internalizing symptoms, particularly in vulnerable children and adolescents. Digital tools remain essential for personalization, accessibility, and compensatory support, especially for students with neurodevelopmental or learning difficulties. Conclusions: Handwriting and digital technologies should not be framed as competing educational paradigms. A developmentally sensitive hybrid model is needed, preserving handwriting during key stages of literacy and self-regulation while integrating digital tools as purposeful, individualized resources for learning, inclusion, and school mental health promotion. Full article

This paper presents the design, implementation, and assessment approach of the Blended Intensive Program (BIP) “Towards Enhanced Pedestrian Safety”, developed under the Erasmus+ framework at the University of Beira Interior in collaboration with four partner universities from Slovenia, Poland, and Croatia. The study applies the EPIC framework (Embedded, Pluralistic, Internationalized, and Connected) to the design and evaluation of a short-term, hybrid, and international learning format in Civil Engineering, addressing a gap in the literature regarding the limited availability of structured and empirically grounded approaches for the design and assessment of Blended Intensive Programs in engineering education. The research presents an applied case study design in higher education supported by a mixed-methods approach, combining quantitative and qualitative data from a cohort of 25 participants across different academic levels. Data collection includes performance-based assessment (tests and project evaluation), structured surveys, and qualitative feedback. The program combined digital technologies, including GIS, machine learning, and video image analysis, with problem-based and collaborative learning in a hybrid format comprising 7 h online and 35 h in person. The BIP fostered both technical competences, such as road safety diagnosis and data-driven modelling, and transversal skills, including teamwork, communication, leadership, and intercultural competence. Results from student assessment and satisfaction surveys indicate high levels of engagement, motivation, and learning achievement. The findings provide empirical support for the applicability of the EPIC framework in the design and implementation of BIPs, demonstrating its adaptability to short-term, hybrid, and international learning contexts. The study highlights the pedagogical value of integrating international collaboration, digital tools, and active learning strategies, while aligning with SDG 3 (Good Health and Well-being) and SDG 11 (Sustainable Cities and Communities). Full article

While existing curricula often focus on theoretical aspects of sustainability, they frequently fail to equip students with practical design skills required by the green industry. To address this disconnect, this study seeks to answer: How can a structured pedagogical framework effectively enhance students’ ability to translate abstract sustainability principles into concrete technical solutions? This study introduces a comprehensive CDIO-based framework reform for Embedded Intelligent Systems education, weaving sustainability throughout every phase. We put forward a “Sustainable CDIO Capability Model” that charts a progressive pathway—starting from basic resource awareness and advancing through to sophisticated sustainable system innovation. Our four-dimensional teaching strategy brings this model to life: first, project-based learning driven by real sustainability challenges; second, a hybrid ecosystem blending online resources, hands-on practice, and immersion in green industry contexts; third, hierarchical team-based pedagogy backed by personalized support mechanisms; and fourth, a multi-dimensional assessment system that weights energy efficiency, resource stewardship, and social value creation alongside conventional metrics. We implemented this approach with Intelligent Science and Technology majors at Wuhan Institute of Technology. The results show the model effectively bridges the persistent gap between dry technical content and the practical demands of green industry. Students made substantial gains not merely in core engineering capabilities—system architecture, hardware-software co-development—but crucially in sustainable design awareness and their capacity to untangle complex sustainability challenges. This work offers a readily transferable framework for embedding Education for Sustainable Development (ESD) into engineering curricula worldwide. It provides practitioners with a concrete, tested model for cultivating the next generation of engineers who naturally think and act with sustainability in mind. Full article

Introduction: Remote education is increasingly used in ostomy care, but its components, timing, governance, and evaluation remain inconsistently defined. This study aimed to develop practice-oriented recommendations for implementing remote patient education for people living with an ostomy. Methods: An Italian expert consensus using a modified Delphi method and reported according to the ACCORD guidelines was conducted. An expert panel (n = 11), recruited nationally, included stomatherapists (n = 6) and people living with an ostomy (n = 5). Round 1 comprised a remotely conducted focus group to generate and refine statements informed by a targeted literature search. Rounds 2 and 3 were anonymous online surveys in which panelists rated statements on a four-point Likert scale and could provide comments or propose additional items. Consensus was predefined as ≥75% agreement. Results: Response rates were 100% across the three rounds (October–November 2025). The panel achieved consensus on 8 definitions and 14 statements, organized into six domains: (1) model of care and eligibility; (2) privacy and data protection; (3) program structure, outcomes, and evaluation; (4) educational content and teaching strategies; (5) timing, intensity, follow-up, and caregiver involvement; and (6) dignity, relational quality, and professional and organizational requirements. Recommendations supported a hybrid-by-default model with eligibility criteria, privacy-by-design using secure platforms and traceable documentation, structured programs with tailored multimodal content, staged pathways lasting 2–6 months after an initial in-person foundation, dignity-preserving options during remote encounters, professional training in communication and digital empathy, and integration into clinical planning and records. Conclusions: This consensus provides the first ostomy-specific, implementation-focused recommendations for standardizing remote patient education in Italy, with an emphasis on equity, privacy, dignity, evaluation, and workforce competencies. Full article

This article presents a Q-methodological approach to capturing the relational structure of teacher beliefs regarding education for sustainable development (ESD). It reports on the development and pilot testing of a Q-sample designed to assess the suitability of Q-methodology with a pilot sample of pre-service primary teachers. Research on ESD emphasizes the field’s normative complexity and conceptual ambiguity, which pose challenges for empirically investigating professional beliefs. Current approaches often conceptualize beliefs as isolated dimensions or thematically reconstructed individual constructions, which provides limited insight into their relational organization as structured configurations of meaning. The Q-sample was constructed through a structured selection from a hybrid concourse, drawing on international empirical studies, student reflections, and theory-derived statements. The Q-sample was administered via an online Q-sorting procedure using a forced quasi-normal distribution and analyzed using by-person factor analysis to examine structural differentiation and interpretability. The pilot study produced an interpretable two-factor solution, demonstrating the instrument’s ability to generate distinguishable belief configurations. Overall, the findings suggest that Q-methodology is a conceptually coherent and methodologically robust approach for capturing the relational structure of ESD-related belief configurations in teacher education research. Full article

Background: Digital health technologies are increasingly integral to healthcare delivery worldwide; however, successful adoption depends on more than technological availability. In nursing, readiness is particularly important because digital systems increasingly shape documentation, communication, decision support, and care delivery. Within the context of Saudi Arabia’s healthcare transformation, doctoral nursing students are positioned as future educators, clinicians, and leaders whose perceptions can provide insight into digital health readiness and preparation. Aim: This study aimed to explore doctoral nursing students’ perceptions of their readiness to adopt digital health technologies in Saudi Arabia, guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). Methods: This exploratory, qualitative, descriptive study recruited 9 doctoral nursing students from a public university in Saudi Arabia using purposive sampling based on predefined eligibility criteria. Individual semi-structured interviews were conducted online and audio-recorded. Data were analyzed using a hybrid inductive–deductive thematic approach. UTAUT2 informed the deductive component of the analysis, while inductive coding and cross-case comparison supported theme generation. Results: Four interrelated themes were identified. First, readiness was positive but conditional, shaped by movement from openness to professional necessity, familiarity, workflow fit, and caution about the possible weakening of foundational or manual competence. Second, adoption depended on practical value and system credibility, including access, convenience, efficiency, safety, documentation integrity, accuracy, privacy, and reliability. Third, adoption was organizationally mediated through leadership, peer culture, infrastructure, implementation conditions, training, follow-up, and academic preparation. Fourth, digital health was understood as supporting, not substituting for, nursing work by reducing avoidable burden and creating more space for direct care while preserving human presence, communication, and clinical judgment. Conclusions: In this sample of doctoral nursing students, digital health readiness was positive but conditional. The findings suggest that readiness reflects a context-sensitive professional judgment shaped by educational preparation, organizational support, system credibility, workflow compatibility, and the perceived ability of digital technologies to enhance nursing work rather than replace it. Implications: The findings suggest that nursing education and practice should strengthen applied digital health competencies through simulation-based preparation, electronic documentation training, privacy and ethics education, workflow-aligned implementation, and sustained organizational support. Full article

The rapid growth of programming education and online learning environments has increased the demand for scalable and reliable assessment methods. Although many automated grading approaches exist, the literature spans traditional test-based methods and recent solutions based on artificial intelligence, making it difficult to obtain a coherent overview of the field. This study conducts a systematic literature review on automated programming assessment, analysing grading approaches, the use of artificial intelligence techniques, educational contexts, and comparisons between automated and human grading. The review synthesises evidence from 39 primary studies to identify technological trends and research gaps. The results show a shift from execution-based grading toward deep learning and large language model approaches, with most systems applied in higher education and limited research on visual programming assessment. Automated grading is evolving into an intelligent educational support tool, but challenges remain with regard to reliability and pedagogical impact. Future work should prioritise empirical validation, hybrid grading models, and broader educational applications. Full article

Non-consumptive wildlife tourism serves as a vital vehicle for promoting ecological conservation and nature education. Understanding visitors’ perceptions of wildlife behavior and how these perceptions translate into long-term pro-environmental behavioral intentions is crucial for balancing visitor recreational experiences with ecological management in nature reserves. This study developed a hybrid analytical method integrating Latent Dirichlet Allocation (LDA) and Structural Equation Modeling (SEM). Based on 62,557 online reviews and 351 questionnaires collected from 33 macaque tourism sites in China, we identified three dimensions of perceived macaque behavior: food-driven approach (FDA), co-presence experience (CPE), and natural habitat-based behavior (NHB). SEM results revealed that all three dimensions significantly influenced Perceived Ecological Value (PEV) and Positive Emotional Arousal (PEA). NHB and FDA exert a stronger influence on PEV, while CPE primarily drives PEA. Furthermore, both PEV and PEA significantly promote PEBI, with PEV having a stronger effect. These findings indicate that PEBI formation relies more heavily on understanding ecological significance than on immediate positive emotions alone. These findings refine the “experience-to-conservation support” mechanism and suggest that managers should optimize ecological interpretation and regulate food interactions to foster sustainable wildlife tourism. Full article

The integration of virtual museums into education has emerged as an innovative approach embraced by both teachers and learners, reflecting the broader impact of virtual reality (VR) applications in education. This study puts forward a pedagogical framework for utilizing virtual museums in teaching art history and investigating their impact on the art history curriculum. In this context, two free online museums are used as teaching materials, representing 3D interactive learning environments that enable immersive exploration of cultural heritage. Grounded in the Theory of Technology-Mediated Learning, this research adopts a hybrid methodological approach to track the art history courses of 75 Chinese undergraduates through experiments, questionnaires, and structured interviews over a four-week period. The findings demonstrate that virtual museum-integrated instruction significantly enhances learning effectiveness over sustained use, actively promotes learner engagement, and fosters greater autonomy. Importantly, learners prioritize educational value and authenticity in virtual museum features, while also expressing a strong preference for technologically mature platforms. This research contributes to understanding the impact of VR on digital transformation in the educational sector by providing a validated instructional model that integrates virtual museums into art history curricula, offering educators a replicable framework for implementation. Future studies should investigate the relationship between emotional engagement and academic performance within virtual museums to further refine both pedagogical strategies and educational virtual reality design. Full article

The COVID-19 pandemic transformed healthcare education, increasing the shift to digital tools and establishing a hybrid curriculum blending online learning with traditional clinical practice. This study aims to understand how this shift impacts the educational growth and skill building of nursing students. A qualitative approach was conducted to understand the experience of Hong Kong nursing students adapting to online learning during the pandemic and beyond. Fifty nursing students were interviewed, and Colaizzi’s phenomenological method revealed key themes in their learning narratives. The analysis revealed four distinct themes characterizing the students’ experiences: (i) Learning on their terms: the mandated shift in healthcare reflecting a lack of agency during the educational transition; (ii) Knowledge without touch: the perceived incompetence of the COVID-19 nursing cohort, highlighting anxieties regarding a lack of hands-on clinical proficiency; (iii) Words left unsaid: The weight of insecurity, indicating a decline in interpersonal skills due to isolation; and (iv) Beyond the perfect algorithm: the unrehearsed art of care, describing the difficulty in translating digital simulations to complex, human-centric patient care. Findings show that while digital progress ensured continuity in education, it also contributed to reduced clinical confidence, weaker communication skills, and shifts in how nursing students approached their learning. Consequently, the post-COVID environment demands that training programs evolve to address these specific deficits. Advancing the existing pandemic-era nursing literature, this study emphasizes the need for diverse, targeted teaching methods to mitigate these gaps. By intentionally bridging theoretical knowledge with hands-on clinical practice, educators can better support student wellbeing and help restore the confidence and competence required of future graduates. Full article

Background/Objectives: Alcohol and tobacco use in adolescence are major public health concerns that shape long-term health trajectories and undermine healthy behaviour development. Schools are key settings for health promotion, offering structured environments to foster self-regulation, social skills, and protective behaviours. This scoping review mapped recent school-based educational strategies designed to prevent alcohol and tobacco use among adolescents and to examine whether the included studies reported any involvement of school nurses. Methods: Review followed Arksey and O’Malley’s framework and adhered to JBI guidance and PRISMA-ScR. Searches were conducted in PubMed and Web of Science (2019–2024) to identify school-based educational interventions targeting alcohol and/or tobacco use among primary or secondary school children. The primary search targeted prevention strategies, complemented by nursing-related terms to identify nurse involvement. A standardised charting form captured study characteristics, intervention formats, theoretical foundations, implementation factors, and any reported participation of health professionals. Data extraction was performed independently by two reviewers. Results: Eleven studies met the inclusion criteria. Most were randomised controlled trials (81.8%). Educational strategies included online (45.5%), hybrid (27.3%), and face-to-face (27.3%) formats. Programs focused on social skills, self-regulation, harm reduction, or resilience. Digital formats were cost-effective but showed challenges in engagement and sustained participation, while face-to-face or hybrid approaches offered relational support but were vulnerable to implementation drift. No study reported nurse involvement. Conclusions: School-based prevention strategies can contribute to healthier behaviours related to substance use by reinforcing socioemotional competencies and reducing early exposure to substances. However, persistent barriers such as low engagement, inconsistent delivery, and the absence of health professionals limit their impact. The role of school nurses could be considered in future school-based prevention programmes. Full article

This scoping review maps AI-based approaches used to infer or measure attention and emotion in technology-enhanced learning (TEL), with a particular focus on tertiary (higher) education and learning analytics-enabled digital environments supporting online and hybrid instruction. Although artificial intelligence (AI) promises personalized digital education, many systems still respond poorly to students’ attentional and emotional fluctuations. We therefore examined the extent to which the literature converges on jointly measuring attention and emotion through AI in educational contexts, especially in virtual and distance-learning settings. Following PRISMA-ScR, we searched Scopus and Web of Science and identified 39 eligible studies. We conducted a methodological quality appraisal using Joanna Briggs Institute tools, a keyword co-occurrence bibliometric analysis, and a narrative synthesis. The evidence shows a rapidly expanding field and a wide range of AI-based techniques, but emotion and attention are typically operationalized and modelled in isolation. Both the bibliometric and narrative results indicate persistent conceptual fragmentation and limitations in the validity of measurement metrics. Overall, the field has not yet established a unified paradigm that integrates attention and emotion within AI-driven educational systems, constraining their adaptive potential. This evidence highlights the need for theory-informed and operational frameworks that enable genuinely holistic, student-centred pedagogical adaptation. Full article