Search Results (1,710)

Background: Digital health technologies have reshaped continuing professional development (CPD) in healthcare. However, learning in digitally mediated programs is often assumed rather than explicitly designed and assessed. Project ECHO^® (Extension for Community Healthcare Outcomes), a globally implemented telementoring model, expands access to specialized expertise through videoconferencing-based, case-oriented learning. While prior literature has documented program reach, implementation, and clinical outcomes, comparatively less attention has been paid to the interactional mechanisms through which learning unfolds within ECHO sessions. Objectives: This article conceptualizes Project ECHO as a structured learning environment and proposes a theoretically grounded framework for examining and assessing learning processes in digital CPD. Methods: Using situated learning, communities of practice, and cognitive apprenticeship as analytical lenses, this conceptual analysis examines participation structures, distributed expertise, facilitation practices, and case-based dialogue in ECHO sessions. Principles of constructive alignment inform a process-oriented assessment approach aligned with CPD evaluation models such as Moore’s framework. Conceptual framework: This article develops a theory-informed framework that conceptualizes Project ECHO as a structured learning architecture for digital continuing professional development. The framework identifies how participation, distributed expertise, facilitation, and case-based dialogue support learning processes during ECHO sessions. It also proposes process-oriented indicators to make learning dynamics more visible alongside outcome-based evaluation approaches. Conclusions: By foregrounding learning processes, this analysis offers a conceptual foundation to strengthening pedagogical alignment, faculty development, and assessment design in ECHO programs. The framework contributes to digital CPD scholarship by clarifying how learning develops within telementoring environments and by guiding future research and program refinement. More specifically, the article contributes a process-oriented evaluation perspective that helps make learning quality more visible within telementoring environments, thereby complementing dominant outcome-focused CPD models. Full article

Background: Breakpoints in the pre-examination processes and at organizational interfaces are a significant source of failures in specimen identification and tracking in anatomic pathology. While ISO 15189 emphasizes end-to-end traceability and risk-based quality management, implementing these principles in complex, multi-actor specimen pathways remains challenging. This study explores expert perspectives on specimen process chains, tracking mechanisms, and ISO 15189-oriented quality and risk management in pathology. Methods: We conducted 10 semi-structured expert interviews across three settings. Interviews were audio-recorded, transcribed, pseudonymized, and analyzed using structured qualitative content analysis (Mayring) supported by MAXQDA. A deductive category system derived from the theoretical framework and interview guide comprised six main categories and twelve subcategories. Results: Across 512 coded text segments, participants identified several factors as critical for effective implementation, including: (i) interface management along the specimen pathway, with recurrent vulnerabilities at handovers between operating theater/ward/transport and accessioning; (ii) the central role of barcode-based identification and the need for closed-loop traceability; (iii) the importance of measurable quality indicators and incident learning systems to operationalize risk management; (iv) persistent paper–digital handoffs and heterogeneous IT landscapes that undermine data integrity; (v) the need for clearly assigned responsibilities, training, and SOP governance; and (vi) implementation barriers including resources, change management, and vendor integration, alongside practical enablers such as incremental roll-out and cross-professional governance. Conclusions: Experts converge on a pragmatic ISO 15189-aligned roadmap: prioritize interface risks, standardize identifiers and handover rules, define a minimal KPI set for tracking and misidentification events, and reduce paper–digital handoffs by interoperable IT. Future work should quantify baseline error rates and evaluate the impact of digital tracking interventions on patient safety and turnaround times. Full article

Background: Recent evidence suggests the potential role of fetal cardiac function parameters in the assessment of different obstetrical conditions. Despite this evidence, the application of cardiac function parameters to routine fetal cardiac evaluation is limited. Among other reasons, the lack of accessibility to a simple, practical instrument offering tips on how to carry out a fetal cardiac functional assessment could explain this restricted application. Methods: A narrative review of the available literature on how to practically carry out a fetal cardiac function assessment was reviewed and summarized to offer an instrument to assess fetal cardiac function alongside the classical morphological evaluation. Results: The contents of this guide are focused exclusively on the practical details to carry out a fetal cardiac function assessment and voluntarily exclude the definition of and indications for the parameters assessed. The guide includes the assessment of fetal cardiac morphometry, valvular evaluation and cardiac contractility. Conclusions: The aim of this guide is to make fetal cardiac functional parameters more accessible to maternal and fetal medicine health professionals with a good background knowledge of fetal cardiology. Full article

Sports have progressively incorporated technological advances, yet while the impact on performance and broadcasting is remarkable, the application of Artificial Intelligence (AI) in sports refereeing appears residual. A closer examination of prior research suggests that this limited development reflects deeper conceptual patterns within the field. While existing research on AI in sports officiating has predominantly conceptualized the field under an accuracy-optimization paradigm (focusing on decision precision, visual attention patterns, referee fatigue, and performance enhancement), there is a systematic lack of theoretical and empirical work that frames officiating as a broader socio-technical ecosystem. In particular, the literature does not provide conceptual models addressing (i) AI-assisted risk prevention and athlete safety as a core officiating function, (ii) human–AI task redistribution in cognitively overloaded and hybrid evaluative environments (e.g., disciplines such as artistic gymnastics or bodybuilding, where technical execution and aesthetic judgment are simultaneously assessed), and (iii) the redefinition of the referee’s role when AI operates as an anticipatory or real-time alert system rather than merely as a post hoc verification tool. Thus, the gap is not only one of application but of knowledge production: the dominant paradigm optimizes decision accuracy, yet it leaves the question of how AI can transform refereeing responsibilities, cognitive load distribution, and safety governance within competitive ecosystems under-theorized. This exploratory study adopts a Human–Computer Interaction (HCI) perspective to contrast existing initiatives with the practical expectations of professional referees. The methodology comprises two pillars: a systematic literature review following PRISMA guidelines and qualitative experimentation involving professional referees using focus groups and affinity diagrams techniques. From an initial total of 1251 records retrieved across five academic databases (2019–2025), 1122 articles were analyzed after applying strict inclusion/exclusion criteria. The findings provide preliminary support for our hypothesis of a significant underutilization gap, showing that research is concentrated on accuracy systems, while high-potential areas identified as critical by experts, such as athlete safety, represent only 0.6% of the analyzed literature. The study contributes a conceptual framework based on five categories established by experts, according to the identified use cases, providing guidance for future AI integration and interdisciplinary research in the sports officiating ecosystem. Based on the results, we point to future applications and lines of research aimed at integrating AI as a tool for sports refereeing. Full article

Background: Depression remains a major global health burden, yet fragmented care often leads to waiting times and unmet needs. Therefore, the Belgian collaborative Integrated Depression Care (IDECA) project strengthened primary care depression management by introducing a Reference Person Mental Wellbeing (RPMW) who functions as a case manager, supported by shared-care tools, structured psychoeducation modules, and targeted training for general practitioners (GPs). This study examines normalization in primary care practice. Methods: A single-arm, mixed-method study was implemented over 18 months in two Flemish Primary Care Zones (PCZ). Implementation outcomes were assessed every four months using the NoMAD questionnaire and analyzed using Wilcoxon signed-rank tests. Peer review sessions with professionals and interviews with patients were analyzed thematically. Caseload and service delivery were assessed using process evaluation logs. Results: Twenty-two professionals (17 GPs, two RPMWs, and three PCZ staff members) completed the NoMAD questionnaire. Intervention familiarity increased during the first eight months (T0–T1: p < 0.001; T1–T2: p = 0.022) and continued to rise thereafter (T3–T4: p = 0.008). Integration into daily practice and perceived impact on professional work improved progressively, reaching near-ceiling scores. Peer review sessions highlighted the RPMW’s central role in trust-building and care coordination. Over 12 months, one full-time equivalent RPMW supported 175 patients (mean age 40.7 years; 75% female), with an average of five consultations per patient. Patients reported high satisfaction, emphasizing accessibility, empathy, and practical support. Conclusions: Sustained results suggest successful normalization and support the potential of collaborative, low-threshold depression care. Future work will assess clinical and economic outcomes. Full article

Living Wall Systems (LWS) are vertical vegetated building façade systems that offer environmental and social benefits; however, their adoption in South Africa, particularly within the Western Cape (WC), remains limited due to high capital and maintenance costs and the absence of regionally adapted design and cost models. This study investigates the viability and design development of LWS in the WC from a Quantity Surveying (QS) perspective, with the aim of developing a context-specific system utilising indigenous plant species and assessing its economic feasibility over the building life cycle. This study employed a mixed method research approach comprising a literature review, semi-structured interviews with industry professionals, thematic analysis, cost modelling, and the preparation of a detailed Bill of Quantities (BOQ). Life cycle costing (LCC) techniques were applied to evaluate long-term cost implications. The study resulted in the development of a criteria-led, context-adapted LWS model, termed Viridis 5045, which satisfies environmental, technical, and contextual requirements for the WC. The BOQ and LCC analyses provide projected capital and operational cost benchmarks for the proposed system. This study demonstrates that the Viridis 5045 model is technically feasible and contextually appropriate for application within the WC, supporting its consideration in sustainable construction practice when evaluated beyond conventional life cycle financial indicators. Future research should focus on the monetisation of long-term benefits, greywater integration, and Whole Life Costing. Full article

Legal decision-making is expected to meet high standards of consistency and rationality, yet human judgments in this domain are known to be influenced by procedural factors such as evidence order and intermediate evaluations. Recent work has shown that even legal professionals, including judges, are susceptible to such biases when assessing criminal cases. This raises a critical question: do large language models, which are increasingly proposed as decision-support tools in legal contexts, exhibit similar procedural biases—and if so, can these biases be mitigated? To address this question, we tested GPT-4o and GPT-5.2 using a controlled legal judgment task adapted from prior human research. The task involved simplified criminal cases in which we systematically manipulated (i) the order of incriminating and exonerating evidence and (ii) whether an intermediate guilt judgment was required before a final decision. Model responses were directly compared to human judgments from the original study. We additionally examined whether prompt engineering strategies, based on current best-practice recommendations, could reduce observed biases. GPT-4o exhibited robust order effects and a form of evaluation bias, although the latter differed in structure from the human pattern. GPT-5.2 showed similar but attenuated effects. Across both models, prompt engineering had limited and inconsistent impact, failing to reliably eliminate procedural sensitivity. These findings suggest that even advanced large language models remain vulnerable to normatively irrelevant procedural influences. More broadly, they advise caution in treating large language models as inherently rational or bias-resistant decision-support systems in high-stakes professional domains such as law. Full article

The combination of Artificial Intelligence (AI) and Formative Assessment (FA) in Teacher Education explores how emerging technologies can enhance teaching practices and professional development. AI tools can provide personalized feedback, identify learning needs, and support reflective practice among educators. Integrating AI-driven formative assessment methods allows for continuous evaluation of teaching competencies, promoting adaptive learning, data-informed decision-making, and improved instructional quality in teacher education programs. The purpose of this study was to conduct a systematic review of the use of Formative Assessment (FA) and Artificial Intelligence (AI) in Teacher Education (TE) during the period 2020–2025 (inclusive). The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, which ensures a rigorous, transparent, and reproducible process in the selection and analysis of studies. To this end, scientific articles published in the Scopus, Web of Science and Dialnet databases were reviewed, considering publications in English and Spanish. The objective was to identify trends, methodological approaches, results, and research gaps that show how AI is being integrated, or not, into FA processes in TE. The review also sought to analyze the impact of AI on student participation in assessment, feedback, decision-making, and the learning and assessment process itself, synthesizing the current evidence on the relationship between AI and FA in TE. Full article

Background/Objectives: Pain is highly prevalent among hospitalized patients, and suboptimal pain assessment and management remain common in clinical practice. Nurses are central to timely pain recognition and intervention, yet knowledge and attitudinal gaps can hinder evidence-based pain care. Therefore, this study aimed to evaluate the impact of an evidence-based instructional program on nurses’ knowledge and attitudes toward pain management at a tertiary hospital in Saudi Arabia. Methods: A one-group pretest–posttest quasi-experimental study was conducted at King Fahad Military Medical Complex, Dhahran, Saudi Arabia (January–July 2025). Registered nurses providing direct patient care (N = 226) completed a researcher-developed questionnaire assessing pain management knowledge (30 items) and attitudes (10 items, 5-point Likert scale) immediately before and one week after a structured three-hour evidence-based educational program. Data were analyzed using descriptive statistics, paired-sample t-tests, and Pearson correlation coefficients (SPSS v30), with p < 0.05 considered statistically significant. Results: Baseline findings indicated moderate knowledge (mean of total scores = 15.54 ± 4.32) and generally positive attitudes toward pain management (mean = 3.83 ± 0.60). Knowledge scores increased significantly after the intervention to become moderate to high (pretest: 15.54 ± 4.32 vs. posttest: 18.65 ± 3.83; p < 0.001). Attitude scores also improved significantly following the program (p < 0.001). Knowledge and attitudes showed a significant positive correlation both preintervention (r = 0.241, p < 0.001) and postintervention (r = 0.435, p < 0.001). Conclusions: A brief evidence-based educational program yielded measurable improvements in nurses’ pain management knowledge and attitudes. Integrating structured pain education into continuing professional development may strengthen patient-centered pain care and support more consistent evidence-based practice in tertiary settings. Full article

This qualitative study examines the organizational structures shaping the experience of 18 women assistant heads working at K-12 independent, co-educational, day schools serving students of 700 students or more. Specifically, we were interested in better understanding the disproportionate representation of women in the assistant headship and whether, and to what degree, this may be a function of the role. We wondered if gendered structural elements shaping the role and specifically feminization (e.g., gendered expectations, role elasticity, diminished professional autonomy, and compensation structures that devalue care work) may hamper these women’s overall success and well-being. We found that the structures shaping their role did appear to be feminized, such that while many participants felt a sense of purpose in their work, the expansive and seemingly endless nature of their responsibilities; the emotional labor the role necessitated; the limited guidance, autonomy, and feedback they received; and their frequent perception that their efforts were under-compensated contributed to diminished well-being. The implications of this study include the need for training in, and implementation of, best practices for evaluation, mentorship, and mitigating gender bias and discrimination in all aspects of school operations. Full article

Generative artificial intelligence (GenAI) has rapidly emerged as a transformative educational technology, raising questions about how educators and pre-service teachers critically engage with AI-produced content. This case study investigates how WebQuests, a long-established, inquiry-based pedagogical model, can foster critical engagement with GenAI tools. Situated within an initial teacher education programme, a WebQuest, incorporating GenAI sources, was implemented with 24 pre-service language teachers, who engaged with curated resources alongside ChatGPT and Copilot to produce infographics for secondary school audiences. Data were collected through semi-structured interviews and were analysed using Braun and Clarke’s thematic analysis. Findings indicate that scaffolded engagement with GenAI encouraged participants to compare AI-generated outputs with trusted sources, critically evaluate accuracy and reliability, and reflect on integration into their future practice. Whilst pre-service teachers valued GenAI’s accessibility and efficiency, they expressed concerns about clarity, verbosity, and trustworthiness. The WebQuest model effectively supported synthesis of multiple information sources, fostering functional AI engagement and critical evaluation of its affordances and limitations. This case study concludes that integrating GenAI within structured, inquiry-based pedagogies advances digital and AI literacy in initial teacher education, whilst highlighting the need for institutional guidance, professional development, and further research in this area. Full article

Today, university counselling services play a crucial role in creating places where personal and professional skills can be developed. Universities provide an environment where people can grow as individuals and improve their quality of life. The aim of the study was to evaluate the impact of a counselling service that uses positive psychology as a theoretical and practical framework on students’ well-being and positive resources. Methods: Seventy students aged between 19 and 54 (M = 24.2; SD = 5.87), of whom 68.6% were women and 31.4% were men, participated in 10 psychological counselling sessions. The sessions focused on academic and general well-being, non-intellectual skills related to academic performance and satisfaction (e.g., academic self-efficacy, motivation, reaction to failure, time management), as well as positive resources (e.g., hope, resilience, courage). Participants completed a questionnaire protocol on these variables before and 6 months after the intervention. Results: The results show a significant increase in almost all indices of general and domain-specific well-being and in positive psychosocial resources. The participants themselves stated that the counselling intervention produced significant changes in their lives in general and as university students. Conclusions: The results seem to suggest that structuring counselling programmes with a positive, well-being-oriented perspective can promote students’ professional and personal development. Building psychological support environments can guide everyone on the path to maximising their potential in life and professional trajectories. The university services must pay constant attention not only to student performance but, above all, to improving their quality of life, preventing distress and promoting well-being. Full article

The recent revision of the European Energy Performance of Buildings Directive (EPBD) introduces mandatory whole-life global warming potential (GWP) reporting, creating practical challenges for building life-cycle assessment due to incomplete life-cycle phase coverage in conventional Environmental Product Declarations (EPDs). This study develops and validates an integrated BIM–LCA framework for structured whole-building GWP evaluation through harmonized life-cycle module alignment and cross-tool comparison, with emphasis on the early design stages. The workflow combines rapid BIM-based screening with detailed external LCA validation, establishing a tiered assessment strategy that enables iterative material optimization within the BIM environment prior to expert review. The methodology is applied to two residential construction systems (masonry and timber), and three functional units are evaluated: total whole-building GWP, area-normalized GWP, and material-level contributions. Five comparative scenarios are analyzed, including reference, nationally representative, optimized low-carbon, and European benchmark configurations. The results show progressive GWP reductions ranging from 5% to 30% across scenarios. Although substantial absolute deviations are observed between BIM-integrated and professional LCA tools, scenario-level rankings remain fully consistent across all functional units, confirming the robustness of the screening approach for comparative decision-making. Cross-tool validation focuses on an aligned embodied-carbon scope (A1–A3 plus selected end-of-life modules) to ensure screening robustness, while full whole-life LC-GWP (including B-modules and services) is positioned as the regulatory context for subsequent expert-stage assessment. The framework provides an efficient and transferable decision-support methodology that supports early-stage carbon optimization while preserving methodological transparency for regulatory reporting. Full article

Background: Professional identity and ethical integrity are foundational to nursing practice and are shaped in part by educational experiences. This study evaluated an online Holocaust and genocide educational seminar delivered to fourth-year Bachelor of Science in Nursing (BSN) students and explored how students linked seminar content to professional identity formation, ethical vigilance, and patient advocacy. Methods: We conducted a descriptive mixed-methods educational evaluation. Students completed an anonymous pre-seminar survey (demographics, motivations for studying nursing, self-identified desirable professional qualities, and self-rated knowledge of the Holocaust and other genocides) and an anonymous post-seminar feedback survey with four open-ended questions. Quantitative items were summarized descriptively; qualitative data were analyzed using inductive qualitative content analysis. Results: Of the 205 students who attended the seminar, 133 completed the pre-seminar survey, and 110 completed the post-seminar survey. Students reported high baseline knowledge of the Holocaust but limited knowledge of the Armenian and Rwandan genocides. The five themes that emerged are as follows: (1) ethical judgment and the influence of nurses; (2) patient advocacy and social justice; (3) the effect of historical and contemporary trauma on students’ learning experience; (4) genocide awareness and prevention; and (5) approaches to education and content presentation. Conclusions: Carefully facilitated Holocaust and genocide education, delivered through interactive online pedagogy and structured debriefing, may support late-stage nursing students’ reflection on ethical integrity and professional identity during the transition to professional practice. Full article

Background: The use of physical restraints in hospital settings remains a controversial practice due to its ethical, legal, and safety implications. Although restraints are intended to prevent falls or manage agitation, their inappropriate use may compromise patient dignity, autonomy, and quality of care. Current healthcare policies emphasize restraint reduction, appropriate documentation, and professional training as key elements of humanized and safe care. Methods: A descriptive cross-sectional study based on an anonymous self-administered survey was conducted in a tertiary university hospital as the diagnostic phase of a quality improvement project aimed at evaluating healthcare professionals’ knowledge, perceptions, and documentation practices related to physical restraint use. A structured ad hoc questionnaire was distributed to registered nurses and nursing assistants working in adult inpatient units using a non-probabilistic convenience sampling strategy. The survey explored training, clinical decision-making, communication with patients and families, awareness of institutional protocols, and use of the electronic health record (EHR). Descriptive analyses and Pearson’s chi-square tests were performed using IBM SPSS Statistics. Results: A total of 241 professionals participated. More than half of respondents (54.8%) reported no formal training in physical restraint use, and only 27.4% considered their training sufficient. Although 86.3% stated they were familiar with restraint indications, only 53.5% were aware of the existence of a structured EHR restraint registry, and just 31.0% consistently completed it. Documentation of restraint removal was particularly low (32.9%). Furthermore, significant discrepancies were observed between regulatory definitions of restraints and professionals’ perceptions regarding practices requiring formal documentation. Statistically significant associations were identified between professional category, perceived training adequacy, and knowledge of physical restraint indications. Conclusions: This diagnostic phase identified substantial gaps between regulatory requirements, professional knowledge, and real-world documentation practices related to physical restraint use. The findings highlight the need for competency-based training strategies, standardized documentation processes, and strengthened institutional leadership to promote patient safety, regulatory compliance, and the humanization of hospital care. Full article