Search Results (63)

Wearable technologies, such as smartwatches, are increasingly used by people with Chronic Obstructive Pulmonary Disease (COPD) for health monitoring and self-management. However, there is limited evidence-informed guidance available to help patients and healthcare practitioners use these tools effectively in everyday life. Objectives: This study aimed to co-create a digital resource for people with COPD and healthcare practitioners to support the use of smartwatches for self-management. Methods: A participatory co-creation methodology was used, based on the Three Co’s Framework (co-define, co-design, co-refine). Participants included people with COPD, carers, family, or friends of people with COPD; healthcare practitioners; and researchers who attended workshops and individual think-aloud interviews to develop a website and video resource. The resource was refined based on real-time feedback. Data were analysed using rapid qualitative analysis. Results: Twenty-one participants engaged and identified key informational needs, including understanding smartwatch features, interpreting health data, and setting personalised goals. The co-created website and video resource were positively received. Participants valued the inclusion of real-life experiences and practical guidance tailored to both patients and healthcare practitioners. Conclusions: This study presents the first co-created resource for COPD and healthcare practitioners on using smartwatches. The co-creation process was successfully delivered online and face-to-face, demonstrating a robust, inclusive approach to managing multiple stakeholders. The resource offers practical value for patients and practitioners and contributes to the growing field of remote interventions for chronic respiratory conditions. Future research is needed to evaluate its effectiveness. Full article

This study aims to explore teachers’ perceptions and students’ strategies when integrating AI-mediated informal digital learning of English tools (AI-IDLE) into career ESL writing instruction. This case study involved six university instructors and over 300 students in an English writing course. Although AI-IDLE has broadened English access beyond classrooms, existing research on writing skills often neglects students’ diverse strategies that correspond to their professional aspirations, as well as teachers’ perceptions. The data included a demographic questionnaire, think-aloud protocols for real-time assessment of cognitive processes during the task, and semi-structured interviews for teachers’ validation. Findings reveal three major student strategies: (1) explicit genre understanding, (2) student-driven selection of digital multimodal tools—such as Grammarly, ChatGPT, Canva with Magic Write, and Invideo—to integrate text with images, sound, and layout for improved rhetorical accessibility, and (3) alignment with students’ post-graduation career needs. Students’ work with these AI tools demonstrated that when they created projects aligned with professional identities and future job needs, they became more aware of how to improve their writing; however, the teachers expressed hopes and doubts about the tools’ effectiveness and authenticity of the students’ work. Suggestions to use AI-IDLE to improve writing were provided. Full article

The electrostatic potential in certain types of boundary value problems can be found by solving Laplace’s Equation (LE). It is important for students to develop the ability to recognize the utility of LE and apply the method to solve physics problems. To develop students’ problem-solving skills for solving problems that can be solved effectively using Laplace’s equation in an upper-level electricity and magnetism course, we developed and validated a tutorial focused on finding electrostatic potential in a Cartesian coordinate system. The tutorial was implemented across three instructors’ classes, accompanied by scaffolded pretest (after traditional lecture) and posttest (after the tutorial). We also conducted think-aloud interviews with advanced students using both unscaffolded and scaffolded versions of the pretest and posttest. Findings reveal common student difficulties that were included in the tutorial as a guide to help address them. The difference in the performance of students from the pretest after lecture to the posttest after the tutorial was similar on the scaffolded version of the tests (in which the problems posed were broken into sub-problems) for all three instructors’ classes and interviewed students. Equally importantly, interviewed students demonstrated greater differences in scores from the pretest and posttest on the unscaffolded versions in which the problems were not broken into sub-problems, suggesting that the scaffolded version of the tests may have obscured evidence of actual learning from the tutorial. While a scaffolded test is typically intended to guide students through complex reasoning by breaking a problem into sub-problems and offering structured support, it can limit opportunities to demonstrate independent problem-solving and evidence of learning from the tutorial. Additionally, one instructor’s class underperformed relative to others even on the pretest. This instructor had mentioned that the tests and tutorial were not relevant to their current course syllabus and offered a small amount of extra credit for attempting to help education researchers, highlighting how this type of instructor framing of instructional tasks can negatively impact student engagement and performance. Overall, in addition to identifying student difficulties and demonstrating how the tutorial addresses them, this study reveals two unanticipated but critical insights: first, breaking problems into sub-parts can obscure evidence of students’ ability to independently solve problems, and second, instructor framing can significantly influence student engagement and performance. Full article

Computer-Aided Design (CAD) software has long served as a foundation for planning and modeling in Architecture, Engineering, and Construction (AEC). In recent years, the introduction of Augmented Reality (AR) and Virtual Reality (VR) has significantly reshaped the CAD landscape, offering novel interaction paradigms that bridge the gap between digital prototypes and real-world spatial understanding. These technologies have enabled users to engage with 3D architectural content in more immersive and intuitive ways, facilitating improved decision making and communication throughout design workflows. As digital design services grow more complex and span multiple media platforms—from desktop-based modeling to immersive AR/VR environments—evaluating usability and User Experience (UX) becomes increasingly challenging. This paper presents a longitudinal usability and UX study of a multiplatform house design pipeline (i.e., structured workflow for creating, adapting, and delivering house designs so they can be used seamlessly across multiple platforms) comprising a web-based application for initial house creation, a mobile AR tool for contextual exterior visualization, and VR applications that allow full-scale interior exploration and configuration. Together, these components form a unified yet heterogeneous service experience across different devices and modalities. We describe the iterative design and development of this system over three distinct phases (lasting two years), each followed by user studies which evaluated UX and usability and targeted different participant profiles and design maturity levels. The paper outlines our approach to cross-platform UX evaluation, including methods such as the Think-Aloud Protocol (TAP), standardized usability metrics, and structured interviews. The results from the studies provide insight into user preferences, interaction patterns, and system coherence across platforms. From both participant and evaluator perspectives, the iterative methodology contributed to improvements in system usability and a clearer mental model of the design process. The main research question we address is how iterative design and development affects the UX of the heterogeneous service. Our findings highlight important considerations for future research and practice in the design of integrated, multiplatform XR services for AEC, with potential relevance to other domains. Full article

This study investigates urban–remote disparities in the science performance of Taiwanese eighth-grade students, particularly in matter-related domains, using an explanatory–sequential mixed-methods design. For the quantitative phase, we applied differential item functioning (DIF) analysis with Mantel–Haenszel statistics and logistic regression to the TIMSS 2019 science assessment, while in the qualitative phase, we employed think-aloud interviews and the repertory grid technique (RGT) with 12 students (6 urban, 6 remote) to explore cognitive structures. The quantitative phase identified 26 items (12.3% of 211) disadvantaging remote students, with DIF most pronounced in constructed-response formats and matter-related domains: “Composition of Matter”, “Physical States and Changes in Matter”, and “Properties of Matter”. The follow-up qualitative analyses revealed fragmented, associative cognitive structures in remote learners, marked by reliance on observable (macroscopic) properties rather than microscopic explanations, terminological confusion, microscopic gaps, and misconceptions, contrasting with urban students’ hierarchical integration. Triangulation suggests that the observed disparities are linked to experiential constraints, potentially accounted for by hindered micro–macro connections. Our findings suggest that resource inequities may play a role in sustaining certain biases, indicating that targeted measures could help to make science education more inclusive. Based on these results, we tentatively outline possible educational interventions to improve equity in science education. Full article

When nurses encounter people in institutional settings who are living with dementia and self-neglecting their hygiene, they are challenged to provide care that respects autonomy while upholding the ethical principles of beneficence and non-maleficence. This study aimed to understand how nurses respond when confronted with patients who decline assistance with personal hygiene and then became physically aggressive. Methods: A qualitative descriptive study employing think-aloud interviewing to explore nurses’ clinical reasoning about how they would proceed with the care of a patient living with dementia who self-neglects their hygiene. Results: Nurses describe many creative ways that they would work with patients to accomplish personal hygiene care in an ideal world. Participants also share the many barriers they experience to providing desired care and instances where they would force care with people who self-neglect their hygiene. Thematic analysis revealed six key themes: non-preferred approaches to care; preferred approaches to care; barriers to actualizing preferred approaches; responding to continued resistance to care; justified use of force; and efforts to minimize harm. Conclusions: This study highlights that ethical nursing practice in dementia care is not simply a matter of following through with best practices. It is an ongoing negotiation, carried out in environments that are often misaligned with nurses’ values. Full article

In Industry 5.0 it is essential that humans are in the loop of technology integration of industry processes. With the advancements of Generative Artificial Intelligence (GenAI), a lot of new opportunities and challenges for learning and teaching are present. Many students already use publicly available AI Digital Assistants (p-AIDA) like ChatGPT for academic purposes. However, there are concerns around the use of such p-AIDA tools, particularly in terms of academic integrity, data privacy, intellectual property, and the impact on the quality of education. Furthermore, many higher education institutions have substantial learning materials and data about students that they may not want to share with p-AIDA. Therefore, using the Technology Acceptance Model (TAM) and following a Design-Based Research (DBR) approach, we explored the perspectives and experiences of a beta-test of an institutionally developed AIDA (i-AIDA) with 18 UK students using multiple methods and data sources (including pre-post-test, interviews, think-aloud, and prompt analysis). Our research underscores the potential benefits and limitations of in-house i-AIDA in enhancing learning experiences without compromising academic integrity or privacy, and how higher education institutions can prepare themselves for Industry 5.0. Full article

Reviews of literacy coaching show positive outcomes for teaching and learning, yet also that coaching’s impact varies widely, especially at increased scale. Thus, some scholars argue the quality of coaching interactions may matter more than broad coaching actions (e.g., co-planning, observing). Situated within Habermas’s notion of “public sphere”, we used discourse analysis to examine video-recorded pre- and post-interviews, coaching meetings, and coach retrospective think-aloud protocols of a literacy coach and elementary school teacher who described their partnership as “successful”. We examined participants’ values expressed about coaching; how each participant positioned themselves, each other, and the coaching context; and the nature of the coach–teacher discourse therein to answer the following question: what occurs in the interactional space between a coach and teacher when engaged in coaching meetings? We found four categories of values focused on participatory choice, their sense of connectedness, knowledge development, and their approach to working with/as a coach. Further, participants’ positionings signified agency for both the coach and teachers in the interactional space. While bracketing and leveraging their own authority, the coach’s language choices promoted teachers’ agency within the interactional space, providing insight into how language functions to shape the “public sphere” of coaching interactions. Full article

Background/Objectives: Neonatal intubation is a complex procedure, often associated with low first-pass success rates and a high incidence of complications. Video laryngoscopes provide several advantages, including higher success rates, especially for novice clinicians, a magnified airway view that can be shared with supervisors, and the ability to record still or video images for debriefing and education. However, video laryngoscope devices vary, raising the possibility of differences in usability. Methods: The study used mixed methodology, including observations, semi-structured interviews, think-aloud techniques, high-fidelity simulations, function tests, and questionnaires to assess usability, defined by the clinician satisfaction, efficacy, and efficiency of six video laryngoscope devices; (1) C-MAC^® with Miller blade, (2) GlideScope^® Core^TM with Miller blade, (3) GlideScope^® Core^TM with hyperangle LoPro blade, (4) Koala^® Vision Ultra with Miller blade, (5) Koala^® Handheld with Miller blade, and (6) Parker Neonatal with Miller blade. Clinician satisfaction was determined by the System Usability Scale (SUS), National Aeronautics and Space Administration Task Load Index (NASA-TLX), and clinician preference. Device efficacy was determined by first-pass success, number of attempts, and overall success. Efficiency was assessed by time to successful intubation and function test completion rates. Results: Neonatal video laryngoscopes varied considerably in design, impacting usability. All devices were deemed suitable for neonatal intubation, with the Koala^® Handheld, C-MAC^®, and GlideScope^® Core ^TM Miller demonstrating the highest usability. Conclusions: This simulation-based study highlights substantial variability in neonatal video laryngoscope usability, indicating the need for further research into usability in the clinical setting. Full article

Background: Clinical guidelines for physiotherapy following total hip and knee arthroplasty (THA/TKA) recommend using Patient-Reported Outcome Measures (PROMs) like the Hip disability and Knee injury Osteoarthritis Outcome Score (HOOS/KOOS). However, it remains unclear how physiotherapists use these PROMs in daily clinical practice. Objective: To explore primary care physiotherapists’ experiences with the HOOS/KOOS in daily clinical practice following THA and TKA. Methods: Thirteen physiotherapists in the Netherlands were recruited via convenience sampling. Data were collected through semi-structured interviews, which explored HOOS/KOOS use in clinical practice, administrative regulations, and applications beyond patient care, as well as think-aloud interviews to capture perceptions of the content of these PROMs and interpretations of hypothetical patient scores. Interviews were analysed using reflexive thematic analysis. Results: The physiotherapists’ ages ranged from 25 to 54y, with annual THA/TKA volumes from 5 to 50 patients. Three themes emerged, as follows: (1) “Physiotherapists use the HOOS/KOOS for various purposes in daily clinical practice”, including complementing history taking and monitoring patient progress; (2) “Perceptions of the relevance of the HOOS/KOOS for daily clinical practice vary per item, domain, and version,” with items related to daily life activities and psychosocial factors being perceived as more valuable; and (3) “Practical aspects of HOOS/KOOS administration influence their use in daily clinical practice,” with electronic health records (EHRs) that facilitate PROM administration enhancing their use, while administrative regulations limit this. Conclusions: Physiotherapists experience HOOS/KOOS items related to daily life activities and psychosocial factors useful for history-taking and monitoring patient progress, particularly when embedded in EHRs that facilitate PROM administration. Full article

Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young people’s and their caregivers’ own words. Here, we aimed to develop a hope assessment tool to facilitate the future evaluation of interventions to support wellness and health for young people growing up with chronic health conditions; Methods: We developed Likert-type scale questions using the young people’s and caregivers’ definitions of hope and applied the think-aloud cognitive interview method to assess understanding and to inform sequential iteration. Interviews were recorded and insights from participant interviews were analyzed thematically. Results: In total, 11 youth (age 12–16 years) with various chronic health conditions completed surveys and interviews over three iteration cycles. Responses to the six-point Likert-scale questions ranged from 1 (none of the time) to 6 (all of the time) (median 5). All of the young people (n = 11) reported that they do things they enjoy, either all of the time or most of the time. In contrast, only 36% felt energetic, either all or most of the time. Three themes were identified: my body and hope; my identity, self-image, and hope; and my world and hope. Conclusions: In addition to gaining important feedback that allowed us to improve item word choice to maximize assessment tool understanding, we gained valuable insights into the multidimensional construct of hope. Thematic analysis revealed the importance of physical symptoms and identity to the meaning of hope in the context of a young person’s life. Our new hope assessment tool derived from the young people’s own definition of hope has face and content validity for use in clinical and research settings to evaluate hope among pediatric patients living with chronic health conditions. Full article

While it is common for blind and visually impaired (BVI) users to use mobile devices to search for information, little research has explored the accessibility issues they encounter in their interactions with information retrieval systems, in particular digital libraries (DLs). This study represents one of the most comprehensive research projects, investigating accessibility issues, especially help-seeking situations BVI users face in their DL search processes. One hundred and twenty BVI users were recruited to search for information in six DLs on four types of mobile devices (iPhone, iPad, Android phone, and Android tablet), and multiple data collection methods were employed: questionnaires, think-aloud protocols, transaction logs, and interviews. This paper reports part of a large-scale study, including the categories of help-seeking situations BVI users face in their interactions with DLs, focusing on seven types of help-seeking situations related to visual interactions on mobile platforms: difficulty finding a toggle-based search feature, difficulty understanding a video feature, difficulty navigating items on paginated sections, difficulty distinguishing collection labels from thumbnails, difficulty recognizing the content of images, difficulty recognizing the content of graphs, and difficulty interacting with multilayered windows. Moreover, corresponding design recommendations are also proposed: placing meaningful labels for icon-based features in an easy-to-access location, offering intuitive and informative video descriptions for video players, providing structure information about a paginated section, separating collection/item titles from thumbnail descriptions, incorporating artificial intelligence image/graph recognition mechanisms, and limiting screen reader interactions to active windows. Additionally, the limitations of the study and future research are discussed. Full article

The T1DCoach mobile application is designed to educate patients—children with type 1 diabetes (T1D) and their caregivers and diabetes educators. The idea behind the mobile application is that its users perform actions that the patient needs to perform in real life. These include measuring blood glucose levels, operating the insulin pump, meal calculation, bolus administration, etc. These in-application activities are performed on the patient’s digital twin. To increase user engagement, gamification elements have been implemented in the application. An important element of the T1DCoach mobile application is its interface, which should be adapted to very different groups of users: children, their caregivers and educators. In addition to presenting the T1DCoach application, the paper presents the stage examining the quality of the interface using three research groups: children, their caregivers and educators. The research was conducted using the scenario method, using eye-tracking, recording activities and thinking aloud. After the application testing sessions, surveys were carried out using the System Usability Scale method and focus group interviews were conducted. The research results are presented in the article along with the most important recommendations for improving the application interface. Full article

Currently, there are no resources to support culturally and linguistically diverse (CALD) women with breast cancer to make decisions about undergoing breast reconstruction (BR). This study evaluated the usability and acceptability of decision aids (DAs) for Vietnamese- and Arabic-speaking women. This two-phase qualitative recruited Vietnamese- (Phase 1) and Arabic-speaking (Phase 2) adult (age ≥ 18 years) women who were diagnosed with breast cancer and could read Vietnamese/Arabic. Women participated in either think-aloud telephone interviews (Phase 1) or semi-structured telephone interviews (Phase 2) and provided feedback on the DA. Interviews were audio-recorded, translated, and transcribed from Vietnamese/Arabic to English, and inductive thematic analysis was undertaken. Additionally, Arabic-speaking women completed the Preparation for Decision Making (PrepDM) scale in Round 2. Twenty-five women were recruited in two phases (Phase 1: Vietnamese-speaking women, n = 14; Phase 2: Arabic-speaking, n = 11). Three themes were developed in Phase 1: (1) DA content and reception; (2) linguistic attributes and cultural appropriateness; and (3) factors that improve the DAs’ impact. Three themes were developed in Phase 2: (1) varying perceptions of DA content; (2) linguistic and cultural suitability of information; and (3) impact of DA on decision making. Women from both phases identified areas for improvement: minimising the use of medical terminology, considering the cultural taboos associated with the word ‘breast’, and addressing remaining information gaps. Both language DAs were generally perceived as acceptable and useful in providing information about BR options and prompting women’s reflections about the suitability of BR as part of their treatment. The mean PrepDM score for Arabic-speaking women in Round 2 was 4.8/5 (SD = 0.3). Further work is needed to ensure that culturally adapted DAs take into account the myriad of information needs and health literacy levels. The key role of healthcare professionals in shared decision making among CALD populations should also be considered. Full article

With the evolution of traditional production towards smart manufacturing, humans and machines interact dynamically to handle complex production systems in semi-automated environments when full automation is not possible. To avoid undesirable side effects, and to exploit the full performance potential of experts, it is crucial to consider the human perspective when developing new technologies. Specifically, human sub-tasks during machine operation must be described to gain insights into cognitive processes. This research proposes a cognition-based framework by integrating a number of known psychological concepts. The focus is on the description of cognitive (team) processes in the resolution of anomalies within a manufacturing process with interdisciplinary experts working together. An observational eye tracking study with retrospective think-aloud interviews (N = 3) provides empirical evidence for all cognitive processes proposed in the framework, such as regular process monitoring and—in case of a detected anomaly—diagnosis, problem solving, and resolution. Moreover, the role of situation awareness, individual expertise and (cognitive) team processes is analyzed and described. Further, implications regarding a human-centered development of future production systems are discussed. The present research provides a starting point for understanding and supporting cognitive (team) processes during intelligent manufacturing that will dominate the production landscape within Industry 5.0. Full article