Search Results (870)

This study examined the instructional effects of integrating a game-based learning system into a programming course, focusing on how tool-supported practice influences students’ learning outcomes and learning experiences. A quasi-experimental design was employed, involving an experimental group that used a game-based learning system for programming practice and a control group that completed traditional programming assignments. Both groups were taught by the same instructor using identical instructional content over an eight-week period. Pre-tests and post-tests were administered to assess learning performance. Baseline-adjusted and conditional effect analyses were conducted to examine whether the instructional effect varied according to students’ prior programming knowledge. The results showed that students in the experimental group achieved higher post-test performance than those in the control group, and the Group × Pre-test interaction indicated that the learning effect was conditional on learners’ baseline programming competence. In addition, students in the experimental group completed questionnaires on system use perceptions and flow experience. The findings indicated generally positive perceptions of the game-based learning system and a significantly positive level of flow during programming practice. The findings suggest that the GBPLS can support programming practice when it is embedded within a coherent instructional design. However, the observed benefits should be interpreted as conditional rather than universal. The educational value of the system appears to depend on the alignment among programming tasks, feedback, game-based engagement, generative AI-supported question generation, and teacher guidance. Full article

This qualitative study examines how culturally responsive pedagogy (CRP) and transformative learning are fostered in higher education when structured reflection, dialogic engagement, and feedback are intentionally embedded in teacher education coursework. Drawing on data from two university courses—one undergraduate course for preservice teachers and one graduate course for in-service educators (n = 44)—the study explores how equity-focused instructional design supports development toward inclusive, globally informed practice. Data sources included student reflective writing, an anonymous pre- and post-semester survey aligned with InTASC dispositions, instructor reflexive journals, peer observation reports, and course feedback artifacts. Of the 44 enrolled participants, 39 completed the pre-survey and 19 completed the post-survey; survey results were analyzed descriptively at the group level because responses were anonymous and could not be matched across time. Analysis followed Braun and Clarke’s thematic analysis procedures, with trustworthiness strengthened through triangulation, peer debriefing, member checking with a subset of participants, and reflexive journaling. Findings revealed seven interconnected themes demonstrating how reflective writing, critical scholarship, multimedia exemplars, dialogic feedback, and iterative course design supported movement from awareness toward equity-oriented pedagogical praxis. Four overarching outcomes were especially salient: (a) expanded understandings of CRP as justice-oriented praxis; (b) increased capacity to identify and interrogate personal and systemic bias; (c) stronger connections between global and intercultural perspectives and locally grounded teaching commitments; and (d) reported pedagogical shifts toward more inclusive, equity-centered practice. Survey findings indicated a group-level shift from Agree toward Strongly Agree across equity-oriented dispositions, suggesting strengthened professional commitments while warranting cautious interpretation given unmatched responses and post-survey attrition. Comparative analysis also highlighted cohort-differentiated developmental trajectories, underscoring the importance of scaffolded, context-responsive approaches in equity-focused teacher education. Overall, the study demonstrates how intentional instructional design can position reflection as an ethical and professional stance that supports equity, inclusion, and global readiness across educator career stages. Full article

Background: Human papillomavirus (HPV) causes nearly all cervical cancers and a growing share of HPV-related malignancies in both sexes, yet HPV vaccine knowledge and acceptance among medical students in Saudi Arabia, the next generation of clinicians shaping recommendations, remain poorly characterized across the full training continuum. Methods: We conducted a cross-sectional online survey of 300 medical students at the College of Medicine, Qassim University. A pre-validated questionnaire captured sociodemographic data, HPV knowledge (14 items), vaccine awareness, attitudes and behavioral intent (4 items), and barriers. Multivariable logistic regression assessed independent predictors of awareness, personal willingness, and intent to recommend the vaccine to family members and future patients. Results: A total of 91.7% of students had previously heard of HPV, and 79.3% had heard of the HPV vaccine. However, only 44.3% reached the predefined threshold for good knowledge, and 56.3% reported personal willingness to receive the vaccine. Willingness to recommend the vaccine to future patients was the most frequently endorsed intent (78.3%), followed by recommending it to a family member (73.3%), with male gender reported as the leading reason among decliners. After adjustment, each one-point increase in the knowledge score independently raised the adjusted odds of vaccine awareness (aOR 1.40, 95% CI 1.22 to 1.61), of recommending the vaccine to a future patient (aOR 1.28, 95% CI 1.13 to 1.45), of recommending it to a family member (aOR 1.19, 95% CI 1.06 to 1.33), and of personal willingness (aOR 1.16, 95% CI 1.04 to 1.29). Female gender was associated with higher odds of personal willingness (aOR 2.31, 95% CI 1.37 to 3.88), and senior training phase predicted vaccine awareness (aOR 2.71, 95% CI 1.33 to 5.52). Conclusions: Human papillomavirus vaccine knowledge independently predicted both awareness and behavioral intent among medical students at Qassim University. However, personal willingness to receive the vaccine lagged behind willingness to recommend it, particularly among male students. Embedding HPV prevention more explicitly into the medical curriculum, with particular emphasis on its relevance to male health, may help narrow this gap. Full article

Background: Violence against healthcare professionals constitutes a global and persistent problem, with significant consequences for professionals’ physical and mental health, organisational climate, and the quality of care provided to patients. Objective: To evaluate the impact of a training activity on the prevention and management of aggression in healthcare settings among fourth-year undergraduate nursing students. Materials and Methods: The study was conducted at the Nuestra Señora de Candelaria School of Nursing, University of La Laguna. An intervention study with a quasi-experimental design without a control group was conducted through the implementation of a training workshop. A pre- and post-intervention questionnaire was administered to a sample of 59 fourth-year nursing students. In addition, two questionnaires were distributed at the end of the session to assess satisfaction with the training received and students’ self-perceived acquisition of knowledge. This research complied with the TREND statement. Results: Descriptive analysis showed higher post-test scores than pre-test scores. The Wilcoxon test indicated a statistically significant difference between the pre-test and post-test scores. Mean knowledge scores increased from 3.16 to 7.58 following the intervention, with a statistically significant difference (p < 0.001) and a very large effect size (r = 0.87). Conclusions: The training workshop was associated with a significant immediate improvement in knowledge, high levels of satisfaction, and enhanced self-perceived learning. Full article

The study investigated the tensile strength and elongation properties of abaca fiber-reinforced polymer (AFRP) composites after varying durations of seawater soaking, with a focus on their potential for reinforcing fiber-optic cables. It aims to bridge industrial technology education, experiential learning, and green technology by evaluating abaca fiber as a sustainable alternative to synthetic aramid yarn. Conducted at Caraga State University, Cabadbaran Campus (CSUCC), the research utilized a quasi-experimental product development design involving industrial technology students and instructors. Tensile strength testing and comparative analysis were performed on abaca fiber samples (A, B, and C) subjected to different seawater soaking durations. Results show that soaking time significantly affects the fiber strength, with Sample A achieving the highest tensile strength (5631.5 MPa) and Sample C the lowest (1679.8 MPa). Findings indicate that prolonged exposure to seawater weakens abaca fiber, emphasizing the need for controlled treatment to optimize its industrial applications. This study emphasizes the importance of hands-on learning in industrial technology education, promoting critical thinking and technical skills while underscoring sustainability. The research advocates for eco-friendly materials in industrial applications and highlights the potential of abaca fiber composites. Future studies should investigate pre-treatment methods to enhance fiber durability, assess the long-term environmental performance, and conduct large-scale pilot testing to evaluate commercial viability. By integrating sustainable innovations into industrial technology education, this study contributes to advancing natural fiber composites for manufacturing and telecommunications infrastructure. Full article

This study aimed to analyze the observed variations in the research competencies of first-year nursing students following the implementation of a pedagogical problem-solving strategy based on Polya’s method and integrated with STEM technological resources. The study was conducted within the context of higher education, where strengthening research skills in the early stages of academic training continues to represent a formative challenge. A pre-experimental pretest–posttest design with a single group was employed, involving 69 students enrolled in an introductory research course. The intervention was implemented over 16 weeks and structured according to the four phases of Polya’s method—understanding the problem, planning, execution, and review—while also integrating the use of a STEM educational kit and visual programming tools. The results showed descriptive increases across all evaluated dimensions. The overall mean score increased between the pretest and posttest, revealing statistically significant differences in research competencies (p < 0.001) and a large effect size (r = 0.896). Likewise, significant differences were identified in the dimensions related to research background and objectives, development of research activities, and evaluation of results. In contrast, the dimension concerning problem identification and formulation did not show statistically significant differences, suggesting that this competency may require longer formative processes and greater academic support. Although the results suggest favorable associations between the implemented strategy and the observed variations in research competencies, these findings should be interpreted with caution due to the limitations inherent to the pre-experimental design employed. In this sense, the study provides preliminary evidence regarding the pedagogical potential of integrating problem-solving and STEM technological resources to promote the early development of research competencies in university students in the health sciences. Full article

Background/Objectives: Given the complexity of current healthcare, working in highly cohesive teams is essential. Clinical simulation can promote group cohesion among healthcare teams. There are different learning methodologies in simulated environments capable of developing group cohesion in healthcare teams. The objective of this study was to compare group cohesion outcomes between two clinical simulation learning models—self-directed (Self-Learning Methodology in Simulated Environments, MAES©) and non-self-directed (Simulation-Based Learning, SBL)—in nursing student teams. Methods: A quasi-experimental pre–post study with a control group was conducted among 311 fourth-year nursing students from two Spanish universities. The primary outcome was group cohesion, assessed using the Spanish short version of the Group Environment Questionnaire (GEQ) total score and its dimensions. The questionnaire was administered twice, before and after participation in clinical simulation sessions. The experimental group used the MAES© methodology, while the control group used SBL. Between-group differences were analyzed using analysis of covariance (ANCOVA), adjusting post-intervention scores for baseline values. Within-group pre-post changes were explored as a secondary analysis using the Wilcoxon signed-rank test. Results: No significant differences in baseline group cohesion were found. After the intervention, both methodologies were associated with improvements in group cohesion over time. Adjusted analyses (ANCOVA) showed statistically significant between-group differences favoring MAES© across all dimensions, with small-to-medium effect sizes (ηp² = 0.036–0.138). Conclusions: Both simulation methodologies were associated with improvements in group cohesion among nursing students. Adjusted between-group differences were observed across all dimensions, associated with higher adjusted scores in the MAES© group. However, given the non-randomized design these findings should be interpreted as associations rather than evidence of causality. Further randomized controlled trials are needed to confirm these results. Full article

Objectives: Food insecurity (FI) among college students is an emerging global public health concern. While the burden is international in scope, this systematic review evaluates the prevalence of FI in college populations in the United States (U.S.) and examines the suitability of commonly used FI assessment tools for this population. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted (up to April 2026) in accordance with the PRISMA 2020 Abstracts checklist. Eligible studies were peer-reviewed research articles published between 2005 and 2026, conducted in the U.S., written in English, and including college or university students with sample sizes ≥ 30. Studies were required to use validated FI assessment tools developed by the United States Department of Agriculture (USDA) or Health Watch. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools and only studies rated as moderate or high quality were included. Results were synthesized by grouping studies according to the FI assessment tools used. Results: Thirty studies met the inclusion criteria (total n = 213,624 students surveyed). FI prevalence among U.S. college students ranged from 14% to 72.9%. Variability in estimates was influenced by the assessment tool used, demographic characteristics, institutional settings, and regional socioeconomic differences. Shorter screening instruments, including the USDA six-Item Household Food Security Survey Module (HFSSM) Short Form and Hunger Vital Sign, demonstrated greater variability in reported FI prevalence (47% and 41%, respectively) compared with longer assessment measures. Higher FI prevalence was also more frequently reported among students of color, those from lower socioeconomic backgrounds, and female students. Conclusions: Findings demonstrate FI is prevalent among college students. Limitations of the current study include restriction to three databases, exclusion of pre-2005 studies, and inclusion of only U.S.-based studies. Variability in assessment methods, as well as consideration of confounding variables (e.g., socioeconomics, demographics and institutional settings), underscores the need for context-specific tools tailored to this population to inform effective interventions and policies globally. Full article

Values are cultural tools that pre-service teachers can use in situations that require discernment and integrity. Promoting an axiological framework in the training of future educators is an urgent necessity for coexistence in today’s world. This study aimed to understand the preferences and meanings that third-year students studying to become primary school teachers of mathematics, Spanish, and English as a foreign language attribute to values, as well as how values are transmitted in degree programs and at selected universities. An exploratory case study was used as the research design. Thirty-two students were selected using purposive sampling until theoretical saturation was reached. Data were collected through semi-structured interviews with the participants. Reflective thematic analysis was used to analyze the data. The findings revealed three themes: students’ value preferences are conditioned by their pedagogical training; values, as constructions of shared meaning, are conceived as normative guidelines that orient human action in all its dimensions; and teacher educators transmit values linked to the pedagogical role and teacher identity, while universities emphasize moral values oriented toward professional development, thus articulating two complementary levels of training. The study provides an empirical framework for moving from spontaneous value education to intentional communication, both in teacher training curricula and in the educational activities of each university. Full article

This study examines failure in introductory programming courses, commonly known as CS1, in Chilean higher education by combining academic trajectory analysis with early-risk prediction models. We analyzed a cohort of 994 students from a Chilean technical university enrolled during the first academic semester of 2025, with a 46% failure rate, integrating pre-university academic and admission variables (e.g., mathematics and language indicators, as well as baseline diagnostic measures when available), sociodemographic information, and within-semester performance indicators. Group differences were assessed using non-parametric tests, and predictive performance was evaluated under two realistic information-availability scenarios: (i) pre-university variables only and (ii) variables available up to the first major written examination (C1). The results show statistically significant differences between students who passed and those who failed, with indicators of quantitative preparedness and, most notably, C1 performance emerging as the strongest signals of risk. In the pre-university scenario, models achieved acceptable discrimination (AUC ≈ 0.77), whereas incorporating C1 substantially improved discriminative performance (AUC ≈ 0.92) and increased precision in identifying at-risk students while reducing false positives. These findings support a staged institutional strategy: broad, low-cost preventive support before the semester begins, followed by more targeted and intensive interventions after C1, thereby enabling more efficient early-warning systems in high-stakes first-year courses. Full article

Introduction: Nasal colonization plays a pivotal role in Methicillin-resistant Staphylococcus aureus (MRSA) carriage and transmission, especially in healthcare settings. Asymptomatic carriers amongst healthcare workers (HCWs) may serve as an important source for inner-hospital transmission, besides personal increased risks of endogenous infections. Medical students are an often-overlooked part of medical staff which, while not typically included in statistics concerning HCWs, are associated with increased patient contact and exposure to healthcare-associated pathogens. This study aimed to assess MRSA carriage rate amongst clinical-year medical students in the largest Romanian medical university, in addition to identifying potential risk factors. Nonetheless, a methodological aim was incorporated, in order to evaluate the effect of nasal swab pre-moistening with sterile saline on MRSA retrieval rate. Materials and Methods: A cross-sectional study was conducted among clinical-year students from the ‘Carol Davila’ University of Medicine and Pharmacy in Bucharest, Romania. Participants completed a survey regarding potential risk factors and underwent nasal swab sampling, being randomly assigned to the two swab collection methods—dry swab or pre-moistened swab with sterile saline, randomization ensuring comparable baseline characteristics. Samples were inoculated on chromogenic MRSA agar media and incubated for 24–48 h at 35–37 °C. Isolates exhibiting characteristic growth further underwent coagulase testing, bacterial identification and methicillin resistance confirmation. Results: The study comprised 156 medical students, with an overall prevalence of asymptomatic MRSA nasal carriage of 5.76% (n = 9, 95% CI: 3.05–10.58%). No statistically significant associations were identified between MRSA carriage and hospital exposure. The prevalence of MRSA positive cultures was 5.00% (n = 4/80) among the conventional dry swab sampling subgroup, while the subgroup undergoing pre-moistened swab collection presented a 6.57% prevalence (n = 5/76), revealing no statistical significance (p = 0.74). Conclusions: Asymptomatic MRSA carriage among medical students in this cohort suggests the potential role of this population in intra-hospital transmission. In addition, pre-moistening the nasal swab for collection of the sample showed no statistically significant impact on MRSA recovery rates, correlating with existing literature on the topic. These findings further emphasize the need for strict adherence to infection prevention and control measures in hospitals. Full article

This study examines how learning input quality shapes students’ trust, perceived learning value, and post-exposure behavioural intentions, and whether AI-supported instructional content contributes to conceptual learning. Grounded in the Technology Acceptance Model, trust theory, and the Cognitive Theory of Multimedia Learning, the study proposes the Learning Input Quality, Belief, User Learning Experience, and Continuance (LBUC) model. Data were collected from 320 university students in Türkiye via an online survey. To evaluate the proposed framework in an authentic instructional setting, participants watched NotebookLM-generated instructional videos in Turkish and completed pre-test and post-test knowledge measures together with Likert-type scales assessing Audio and Narration Quality, Perceived Visual Design Quality, AI Trust and Persuasion, Instructional Design Effectiveness, Perceived Learning Value, Using Intention, and Recommendation Intention. Learning gains were assessed using paired-samples t-tests, and the proposed LBUC model was evaluated using Partial Least Squares Structural Equation Modelling. The findings showed a significant within-group increase in post-test scores, suggesting short-term conceptual gains after exposure to the videos. In the structural model, Audio and Narration Quality strongly predicted AI Trust and Persuasion, whereas Perceived Visual Design Quality significantly predicted Instructional Design Effectiveness but did not directly predict trust. Both AI Trust and Persuasion and Instructional Design Effectiveness positively influenced Perceived Learning Value, which in turn strongly predicted Using Intention and Recommendation Intention. The results suggest that students’ immediate post-exposure Using Intention and Recommendation Intention are associated less with visual appeal alone than with pedagogically coherent narration, AI Trust and Persuasion, and Perceived Learning Value in the context of NotebookLM-generated instructional videos. Full article

Background: Proximal lower-extremity muscle strengthening is an important conservative intervention for patellofemoral pain syndrome (PFPS), as these muscle groups play critical roles in femoral stabilization and knee valgus control. However, evidence remains limited regarding the effectiveness of muscle strengthening in improving lower-extremity axial alignment through modulation of femoral neck anteversion, femoral internal rotation, and tibial external rotation. Therefore, the present study aimed to determine whether a strengthening protocol targeting the quadriceps and hip external rotator and hip abductor muscles could improve knee alignment and reduce bone torsion in young adults with patellofemoral pain syndrome. Methods: This prospective interventional cohort study implemented a muscle strengthening protocol in ten university students with PFPS. Outcomes included femoral neck anteversion angle (FNA), tibial tubercle–trochlear groove distance (TT–TG), tibial external torsion angle (TET), and the knee Q-angle, assessed via 3D reconstruction of computed tomography (3D-CT) images. Pre- and post-intervention data were analyzed using the Shapiro-Wilk test for normality and repeated-measures ANOVA (p < 0.05; 95% confidence interval). Results: Muscle strengthening improved lower-limb axial alignment, with reductions observed across all measures post-intervention. Mean changes were 0.68 ± 1.26° for FNA (p = 0.0626); 1.51 ± 0.97 mm for TT–TG (p = 0.0001); 1.38 ± 3.36° for TET (p = 0.2231); and 1.14 ± 1.52° for the Q-angle. Statistically significant improvements were observed for TT–TG and the Q-angle. Conclusions: Proximal muscle strengthening improved knee valgus and axial lower-limb alignment, as evidenced by significant reductions in Q angle and TT–TG distance. Reductions in femoral neck anteversion (FNA) and tibial external torsion angle (TET) were observed. However, these differences were not statistically significant. These findings support muscle strengthening as a noninvasive strategy for improving lower-limb alignment in individuals with patellofemoral pain syndrome. Full article

Background: In March 2026, a meningococcal cluster centred on the University of Kent, England, caused two deaths and resulted in over 20 reported cases within the first week, including confirmed and suspected invasive cases. Subsequent UKHSA updates in early April 2026 reported 21 laboratory-confirmed MenB cases (18 linked to the outbreak strain) and two deaths, with the outbreak subsequently spreading to a second Canterbury university, Canterbury Christ Church University, and confirmed as Neisseria meningitidis serogroup B (MenB). Sub-Saharan Africa (SSA) bears a disproportionate global burden of meningococcal disease, yet university settings remain a critically understudied outbreak amplifier. This narrative review extracts epidemiological and policy lessons from the Kent event and applies them to the SSA context. Methods: We conducted a narrative review following the SANRA criteria, searching PubMed, Embase, Scopus, Google Scholar, and African Journals Online (2000–2026), with supplementary grey literature retrieved from World Health Organisation (WHO), Africa Centre for Disease Control, and United Kingdom Health Security Agency (UKHSA). Outbreak data were drawn from official UKHSA public-health statements (grey literature, archived), the University of Kent communications, and peer-reviewed expert commentary. Results: The Canterbury outbreak exposed six reproducible vulnerabilities: unprotected serogroup circulation (confirmed MenB, not covered for the current university-age cohort), nightlife-linked transmission amplification, delayed serogroup identification, poor student symptom-recognition, inadequate institutional response capacity, and, critically, multi-institutional spread via shared nightlife venues (confirmed extension to Canterbury Christ Church University within five days). Each vulnerability is demonstrably more severe in SSA universities, which face a broader multi-serogroup threat environment (NmA, B, C, W, X), virtually no university-entry vaccination requirement, and critical evidence gap of campus-specific meningococcal evidence in the published literature. Conclusions: This review proposes a five-pillar preparedness framework for SSA tertiary institutions, derived from a synthesis of the Kent outbreak and broader epidemiological evidence, intended to inform policy discussion and future research. Moreover, these should be embedded within a broader age-linked prevention strategy that begins before university entry, particularly during the transition into secondary school in high-risk settings. Priority measures include meningococcal vaccination at key educational transition points, prophylactic antibiotic pre-positioning, serogroup-capable surveillance, symptom-recognition training, and pan-continental alert A predominantly reactive response may carry substantial risk in SSA settings. Full article

Alcohol is one of the most commonly consumed psychoactive substances worldwide, with university students representing a subgroup characterized by elevated consumption rates. The COVID-19 pandemic triggered significant behavioral shifts across the general population, with students particularly vulnerable to its psychosocial impacts. In this context, the present study aimed to assess alcohol consumption patterns among university students and to examine the influence of the early stages of the COVID-19 pandemic on these behaviors. A cross-sectional study was conducted between July and November 2020 using a structured, self-administered online questionnaire. Alcohol consumption was assessed through self-reported measures of use (yes/no), frequency of intake (e.g., weekly consumption), and perceived changes in consumption compared to the pre-pandemic period. The instrument also collected data on sociodemographic characteristics, health status, and COVID-19 diagnosis. A total of 1553 valid questionnaires (i.e., fully completed responses meeting inclusion criteria) were analyzed. The prevalence of self-reported alcohol consumption was 99.93%, reflecting the inclusion of individuals with any level of consumption (including occasional use). Weekly consumption was the most frequently reported pattern. Regarding changes during the pandemic, 248 students reported an increase in alcohol intake, which was considered the main outcome of the study. Students reporting a perceived decline in overall health were less likely to report increased consumption, whereas those with a confirmed COVID-19 diagnosis were more likely to report increased use. The findings reveal a high prevalence of alcohol consumption among university students and suggest that periods marked by abrupt behavioral and routine changes, such as the COVID-19 pandemic, may significantly influence substance use patterns within this population. Full article