薄弱学生的医学统计学 “故事化解读” 教学实践

文章主要探讨了计算科学助力叙事医学人才培养的实践路径。随着计算科学的快速发展，自然语言处理、生成式AI等计算科学的技术为叙事医学教育提供了许多智能化工具和量化 ...

目的：叙事医学是人文落地和实践的工具，BOPPPS模型是一种以学生为中心的模块化教学模式，可提高教学效果。本研究的主要目的是探讨BOPPPS融合叙事医学在全科医学实习教学 ...

项目聚焦线上思政教育模式创新，系统性构建“行医故事”主题资源库，依托叙事医学理论，以浸润式策略促进医学生职业价值观塑造。通过整合历史文献与临床案例，形成多媒体数据库， ...

叙事教育通过叙述、解释和重构教育者和学生的故事、经历，记录反思日记等形式，并使专业教育与人文教育相融合，重视理论人文和交流沟通，有助于人文关怀品质的培养与提高，达到 ...

精细阅读与写作是叙事医学教学的主要方法[3]。通过精细阅读来培养学生的故事倾听与理解能力，从病人的表述里察觉出与疾病相关的重要信息；通过写作构建自我身份、提升自我 ...

通过挖掘《医药数理统计》课程的思想政治元素,将思政理念融于《医药数理统计》课程教学中,恰到好处地将学科知识与思想政治教育内容结合起来,不仅可以让课程内容变得更加有 ...

本文基于布鲁姆认知领域教育目标分类理论，融合课程思政育人要求，构建AI赋能的“思政引领–认知进阶”双螺旋教学模式。该模式通过AI技术重构教学资源、创新教学互动、优化评价 ...

传统教学注重学生对理论的掌握和软件操作的训练，但对学生理论应用实践及分析问题、解决问题的能力培养有所欠缺。例如，在方差分析检验中，生物技术系生物2311级和2312级共65 ...

在概率论与数理统计教学内容中挖掘马克思主义哲学的认识论、唯物论和辩证法方面的思政元素[2]。在讲授概率论产生的背景和来源时可以从实践观的角度进行思政挖掘，比如在赌博 ...

具有叙事能力的医学，即为叙事医学[2]。护理学作为人文属性鲜明的医学学科，人文医学走向叙事是培养医护人员人文素养的有效途径，也是使医学真正转向生物–心理–社会模式的一种 ...

针对统计计算课程教学中存在理论抽象、实践性强、学生参与度低等问题，本文基于BOPPPS模型构建了线上线下混合式的教学模式。通过整合微课、虚拟仿真等数字化资源， ...

基于应用统计系学生对专业核心课程学习心态的调查研究,对应用统计专业核心课程的教学内容,教学方法和教学模式等方面进行探讨改进,使其更有利于学生保持良好学习心态,有利于 ...

结果：进行叙事教育后，护理研究生人文关怀品质总体得分为123.34 ± 21.16，明显高于学习前的得分77.52 ± 11.28；且学习后其人文关怀能力得分为193.17 ± 23.22，同样高于学习前的 ...

目的:通过分析预防医学专业卫生统计学课程成绩,探讨混合教学模式对卫生统计学教学效果的影响.方法:采用形成性评价方式,得到预防医学专业2018级和2019级学生过程性评价 ...

BACKGROUND: Memorization involves storing and retrieving learned information, and effective teaching methods are crucial for this process. This study compared the effects of storytelling and interactive lecturing on the long-term memory of Anesthesia Technology students, highlighting the importance of memory in medical science education. MATERIALS AND METHODS: This quasi-experimental study used a pretest and two post-test designs. An immediate post-test followed weekly teaching sessions for 1 month to evaluate short-term retention, while a delayed post-test assessed long-term memory 3 weeks later. In 2023, a study with 52 undergraduate Anesthesia Technology students at Iran and Tehran University of Medical Sciences compared two teaching methods: storytelling (n = 31) and interactive lecturing (n = 21). Three tests were conducted: a preliminary test, an immediate post-test for short-term evaluation, and a delayed post-test for long-term evaluation 3 weeks later. This study utilized descriptive statistics (mean, standard deviation, frequency) to summarize demographic data and applied inferential tests (paired t-tests, independent t-tests, repeated measures tests) to evaluate research hypotheses and relationships between variables. RESULTS: Statistical analysis revealed no significant demographic differences between groups. The findings indicated a significant difference in long-term memory retention, with the storytelling method leading to higher scores in delayed post-tests compared to the interactive lecturing approach (t = 3.388, P < 0.001). These results demonstrate that storytelling is more effective in enhancing long-term memory retention among students. CONCLUSION: The storytelling approach greatly improves long-term memory retention among Anesthesia Technology students in comparison to the interactive lecturing method. It is recommended to implement this approach to promote meaningful learning and improve patient management in both medical and paramedical disciplines.

The COVID-19 pandemic accelerated the shift to online veterinary education, posing challenges for teaching practical skills. Although instructional videos have long supported medical and veterinary education, the impact of video storytelling (VST) using specific content-creation techniques for student engagement and achieving success for learning outcomes remains underexplored. Our research compared traditional lecturer-generated Brightspace videos (BSVs) with VST content to evaluate their effect on student experience and grades in a practical task. Students were assessed on their performance, and they used standardised questionnaires to evaluate their perceptions of the online material and the impact it had on practical skill acquisition. In both phases, students answered questionnaires using Likert scales. Responses were analysed using descriptive and inferential statistics. Comparison between groups for qualitative data were conducted using binomial or chi-square tests, with multiple comparisons controlled for using the Bonferroni correction method. For quantitative data, comparisons between groups were performed using the Mann-Whitney U test. In Phase 1 (2020), 106 final-year students were provided with BSV content ahead of a simulated assessment. All students in the year enrolled voluntarily in this observational study. However, 33/106 students (31.1%) did not view the content. No significant performance differences were observed between those who watched the videos and those who did not (p = 0.711). In Phase 2 (2023), 148 preclinical stage 3 students voluntarily participated in a randomised, blinded, controlled trial comparing BSV (75 students) with VST (73 students). The VST group reported significantly lower stress and anxiety levels (p = 0.002), felt better prepared for Directly Observed Practical Skill (DOPS) assessments (p < 0.001), and achieved higher practical assessment scores (p = 0.001). As online and blended learning continue to expand, veterinary programs should consider investing in high-quality VST to support student well-being, promote deeper learning, and more effectively prepare students for clinical practice.

To captivate students by employing an engaging, innovative, and collaborative approach using the creative storytelling and jigsaw technique for student-centered learning in a large group environment. The student-centric educational intervention was conducted in 2023 for 2nd phase MBBS (n = 153) students in large groups to enhance student engagement. Competencies of microbiology and pharmacology were integrated using a combination of story writing in the form of an autobiography of helminths and collaborative learning using a jigsaw as a student-centric approach used as a teaching-learning method. Facilitators assessed the written autobiographies using an assessment framework and model answers to see the learning by the students together with the storyline. Students’ perceptions were assessed using an anonymous feedback form. Descriptive, Chi-square statistics (<0.05 as significant), and Cramer’s V value were calculated to analyze data and study the association between storyline and learning. Out of 146 students, 33% scored >20/30 in the knowledge component, among which the majority were female. For the story part, the majority were able to write interesting to very interesting storylines, with female predominance. Overall, the students perceived this innovative teaching-learning activity as enjoyable that stimulated their interest in the topic as well as helping them enhance their communication skills and students also expressed their agreement in favor of using this intervention frequently in classrooms. The study concludes the importance of using innovative teaching-learning activities to enhance students learning, engagement, and interest in large classrooms.

Storytelling is a powerful form of communication which can improve attention and lead to lasting behavioural changes. Addressing the need to incorporate patient safety teaching into undergraduate medical curricula, it was hypothesized that medical students could benefit from hearing clinician stories of medical error. The medium of animation was considered to be a potentially engaging means of presenting stories of error to a large audience. Three animated videos were developed to accompany audio recordings of junior doctors describing their experiences of a serious incident or near-miss event. The videos were delivered to 200 final-year medical students with a subsequent large-group discussion directed at understanding contributory factors. An evaluative questionnaire exploring learners’ reactions and modification of beliefs and perception was distributed. The questionnaire included questions rated on a modified Likert scale and a free-text box. A mixed-methods analysis was conducted with descriptive statistics and qualitative content analysis of the free-text responses. Of the 200 students who attended, 104 completed the questionnaire and 83 completed free-text feedback. Most students responded positively to hearing stories of medical error and felt that the animated videos improved their engagement while the voice recordings helped bring the cases to life. The majority of students agreed the session would impact on their future practice. This pilot study confirmed that undergraduate students consider animated, personal stories of medical error an effective, engaging means of learning about patient safety. Longitudinal studies are required to confirm if measurable behaviour change is achieved.

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Background: Storytelling is a powerful educational method that encourages reflection and deeper understanding of complex concepts. Storytelling as a learner is commonly used in other disciplines, yet its application in medical education is limited. This study sought to evaluate the use of storytelling as a pedagogical approach in a workshop with medical students and assess its impact on students’ knowledge and attitudes towards core concepts of medical education. Methods: Interactive workshops were implemented using a storytelling approach based on a fictional diary of a dental student. Participants engaged in story-based discussions in a book-club format, followed by introduction of the main educatio by the facilitator. A pre-post questionnaire was used to assess students’ knowledge and attitudes. Quantitative data were analyzed with paired t-tests, and Cronbach’s alpha was used to assess internal consistency. Participants’ open-ended feedback was reviewed thematically to better understand perceptions of students regarding the storytelling method. Results: Out of 80 participants, 76 finished the pre- and post-tests (95 percent response rate). Post-workshop scores showed notable improvements in knowledge (Mean±SD: 12.9±2.3 to 17.8±1.9; P<0.001) and attitudes (Likert mean score: 3.4±0.6 to 4.2±0.5; P<0.001). The internal consistency of the questionnaire was acceptable (Cronbach’s α=0.82). participants gave positive comments, and emphasized how memorable and captivating the workshops were. Conclusion: Storytelling is a powerful teaching method in medical education that can increase students’ emotional and cognitive engagement. It encourages reflection, active learning, and higher levels of learner satisfaction.

I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984: Objectives Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this. This study evaluates a curriculum developed to foster the sharing of faculty medical error stories, practice of constructive coping strategies, and growth in resident confidence in managing error. Methods Researchers identified factors related to effective physician error management and recovery to develop a targeted intervention for family medicine residents. The intervention consisted of three one hour didactic sessions in a medium-sized midwestern, urban family medicine residency program over the course of 6 months. Instructional methods included guided reflection after mentor storytelling, small group discussion, role play, and self-reflection. Results Of the 30 residents, 22 (73%) completed the preintervention survey, and 15 (50%) completed the postintervention survey. While most residents reported having experienced error (55%), fewer than half of the residents reported they knew what to do when faced with medical errors (46%). This increased to 93% after intervention. Personal error stories from mentors were the most desired type of training reported by residents preintervention, but this was surpassed by legal and malpractice concerns in the postintervention survey. Rates of reported error story sharing increased after the intervention. Residents reported self-efficacy (I can be honest about errors) and self-awareness (I acknowledge when I am at increased risk for error) also increased with intervention. However, these changes did not reach statistical significance. Conclusions Family medicine residents are receptive to learning from peers and mentors about error management and recovery. A brief intervention can impact the culture around disclosure and support. Future research should focus on the impact of targeted interventions on patient-oriented outcomes related to medical error.

Storytelling events in medical education settings are a powerful way to share stories, build community, promote resilience, and foster well-being, but many educators are unsure how to go about creating an event. This paper outlines practical tips to empower readers to plan and carry out a successful, impactful storytelling event.

Background Empathy for patients is now internationally accepted as one of the competencies of physicians for patient-centered medical practice and an essential component of medical education. Recently, “patient storytelling” has attracted attention in empathy education for medical students to understand patients’ experiences, feelings, and perspectives. This study aimed to quantitatively evaluate how patient storytelling enhanced undergraduate medical students’ empathy in Japan to the extent that they sustained it for six months. Methods Participants were 159 fourth-year undergraduate medical students in Tokyo in academic years 2018 and 2019. The questionnaire surveys were conducted three times: at the beginning of the class, immediately after the class, and six months after the class. The Japanese version of the Jefferson Scale of Empathy-Student Version was used in this study. Gender, age, and clinical orientation were also obtained through the self-reported questionnaire. We invited a male patient storyteller who was diagnosed with chronic kidney disease to the classes on “Professionalism.” The title of his storytelling was “The Power of Medical Professionals’ Words.” Results JSE-S scores improved significantly immediately after listening to patient storytelling. The scores remained improved six months after the class. Interest of specialty was significantly positively associated with an immediate change in JSE-S scores. However, gender had no significant association with changes in JSE-S scores either immediately or six months after education. Conclusions Our findings may suggest that patient storytelling would be useful to cultivate empathy among undergraduate medical students. It is to be expected that more medical schools will use patient storytelling to educate medical students in humanistic and communication education.

Background Constructivism theory has suggested that constructing students’ own meaning is essential to successful learning. The erroneous example can easily trigger learners’ confusion and metacognition, which may “force” students to process the learning material and construct meaning deeply. However, some learners exhibit a low level of elaboration activity and spend little time on each example. Providing instructional scaffolding and elaboration training may be an efficient method for addressing this issue. The current study conducted a randomized controlled trial to examine the effectiveness of erroneous example elaboration training on learning outcomes and the mediating effects of metacognitive load for Chinese students in medical statistics during the COVID-19 pandemic. Methods Ninety-one third-year undergraduate medical students were randomly assigned to the training group ( n  = 47) and the control group ( n  = 44). Prerequisite course performance and learning motivation were collected as covariates. The mid-term exam and final exam were viewed as posttest and delayed-test to make sure the robustness of the training effect. The metacognitive load was measured as a mediating variable to explain the relationship between the training and academic performance. Results The training significantly improved both posttest and delayed-test performance compared with no training ( F posttest  = 26.65, p  < 0.001, Partial η 2  = 0.23; F delayed test  = 38.03, p  < 0.001, Partial η 2  = 0.30). The variation trend in metacognitive load in the two groups was significantly different ( F  = 2.24, p  < 0.05, partial η 2  = 0.20), but metacognitive load could not explain the positive association between the treatment and academic performance ( β  = − 0.06, se  = 0.24, 95% CI  − 0.57 to 0.43). Conclusions Erroneous example learning and metacognitive demonstrations are effective for academic performance in the domain of medical statistics, but their underlying mechanism merits further study.

With growing interest in storytelling as a pedagogy for students learning university introductory statistics, a need has arisen to develop appropriate research methodologies. This paper presents methodological insights from a study involving 31 university introductory statistics students who wrote contextualised stories about sampling distributions and the normal distribution. Data was generated using sound recordings of student interviews that captured reflections of their story writing experiences. An assumption-based, reflective analysis produced conjectures that generated preliminary research findings, which were then tested using the theoretical ideas of presupposition, subjectification, and multiple perspectives. The study’s findings suggest there is value in undertaking additional research into storytelling as a pedagogy. The methodology developed offers insights not only for future researchers in statistics education but also for other educational settings.

Generative artificial intelligence (AI) is reshaping the way statistics is taught and applied in medical research. This paper explores the use of AI tools, with a focus on Julius AI, to support hypothesis testing and statistical reasoning among medical students and researchers. Using a practical example and comparative analysis of prompting strategies, we demonstrate how AI can assist in performing t‐tests and interpreting results. However, we also highlight the risks of misapplication and the importance of validating AI outputs. A structured framework is proposed to guide educators in integrating AI into the curriculum, emphasizing assumption testing, stepwise analysis, and critical evaluation. By embedding AI within a pedagogically sound approach, this work aims to enhance statistical literacy, promote responsible use of technology, and improve the quality of data analysis in medical education.

Despite the widespread inclusion of statistics in medical school curricula as per the Liaison Committee on Medical Education requirements, the statistical competency among medical students and clinicians remains low. A 2007 study of 277 medical residents revealed only 41.1% scored correctly on a statistical knowledge survey, with minimal understanding of key concepts such as confidence intervals and adjusted odds ratios. A more recent 2023 study of 898 clinicians showed similar deficiencies in understanding efficacy, p-values, and discrimination metrics despite high confidence. This perspective argues for a paradigm shift from teaching statistical applications to focusing on statistical communication. We believe current statistics instruction lacks emphasis on communicating statistical results to patients. Teaching statistical concepts as tools for patient communication, rather than extensions of mathematics, can enhance understanding and ensure patients make informed decisions. Reframing statistical education to focus on communication could potentially address traditionally perceived learning barriers, improve understanding, and foster confidence. In this article, we outline several example reframings of teaching classical statistical concepts emphasizing interpretation and communication. Future strategies such as aligning statistics education closer to residency, revising exam content, updating accreditation requirements, and developing standardized communication primers can help ensure future clinicians are well-equipped to practice evidence-based medicine and effectively communicate statistical information in our increasingly data-driven world.

Among Chinese medical students, medical statistics is often perceived as a formidable subject. While existing research has explored the attitudes of Chinese postgraduate medical students towards statistics and its impact on academic performance, there is a scarcity of studies examining the attitudes of Chinese medical undergraduates on this subject. This study endeavors to scrutinize the attitudes of Chinese medical undergraduates towards statistics, assessing their ramifications on learning achievements, and delving into the influence of demographic factors. 1266 medical undergraduates participated in this study, completing a questionnaire that included SATS-36 and additional queries. Furthermore, an examination was administered at the end of the medical statistics course. The analysis encompassed the SATS score and exam scores, examining both the overall participant population and specific demographic subgroups. Undergraduate medical students generally exhibit a favorable disposition towards statistics concerning Affect, Cognitive Competence, and Value components, yet harbor less favorable sentiments regarding the Difficulty component of SATS-36, aligning with previous research findings. In comparison to their postgraduate counterparts, undergraduates display heightened enthusiasm for medical statistics. However, they demonstrate a lower cognitive capacity in statistics and tend to underestimate both the value and difficulty of learning statistics. Despite these disparities, undergraduate medical students express a genuine interest in statistics and exhibit a strong dedication to mastering the subject. It is noteworthy that students’ attitudes toward statistics may be influenced by their major and gender. Additionally, there exists a statistically significant positive correlation between learning achievement and the Affect, Cognitive Competence, Value, Interest, and Effort components of the SATS-36, while a negative correlation is observed with the Difficulty component. Educators should carefully consider the influence of attitudes toward statistics, especially the variations observed among majors and genders when formulating strategies and curricula to enhance medical statistics education.

Despite the numerous advantages of mastering biostatistics, medical students generally perceive biostatistics as a difficult and challenging subject and even experience anxiety during the courses. Evidence for the correlation between students’ academic achievements and their attitudes, indicating that attitudes at the beginning of the biostatistics course may affect cognitive competence at the end of the course and subsequently influence student academic performance. However, there are current disagreements regarding the measurement and evaluation of attitudes related to statistics. Thus, there is a need for standard instruments to assess them. This study was conducted to develop a Chinese version of the Survey of Attitudes Toward Statistics (SATS-36) in order to acquire a valid instrument to measure medical students’ attitudes toward biostatistics under Chinese medical educational background. The Chinese version SATS-36 was developed through translation and back-translation of the original scale, with subsequent revisions based on expert advice to ensure the most appropriate item content. The local adaption was performed with a cohort of 1709 Chinese-speaking medical undergraduate and graduate students enrolled in biostatistics courses. And then, the reliability, validity and discrimination of the questionnaires were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods. The Chinese version SATS-36 consisted of 36 items and loaded a five-factor structure by factor analysis, which offered an alternative similar but not equal to that original six-factor structure. The cumulative variance contribution rate was 62.20%, the Cronbach’s α coefficient was 0.908, the Guttman split-half reliability coefficient was 0.905 and the test–retest reliability coefficient was 0.752. Discriminant analysis revealed small to large significant differences in the five attitude subscales. The Chinese version SATS-36 with good validity and reliability in this study can be used to evaluate the learning framework of Chinese medical students.

Statistics education is essential for evidence-based medical practice, yet many medical students face challenges in achieving statistical proficiency. While attitudes, anxiety, and self-efficacy are known to influence learning, the sequential pathways through which they interact remain unclear. This study examines a chain mediation model to clarify how attitudes towards statistics forecast proficiency through statistics anxiety and self-efficacy among medical students. A cross-sectional study was conducted with 576 medical students from Shandong University. Participants completed validated Chinese versions of the Statistics Anxiety Rating Scale (STARS) and the Current Statistics Self-Efficacy (CSSE) scale. Statistical proficiency was measured via final examination scores of the medical statistics course. Data were analyzed using structural equation modelling (SEM) with bootstrapping to test the direct and indirect effects within the proposed model. The SEM model demonstrated good fit. Negative attitudes towards statistics were associated with both lower proficiency directly (direct effect=-0.120, 95% CI: -0.224 to -0.027) and indirectly through two significant pathways: an independent mediation involving reduced self-efficacy (indirect effect = -0.035, 95% CI:-0.069 to -0.008), and a chain mediation where negative attitudes were positively correlated with higher anxiety, which in turn was associated with diminished self-efficacy, ultimately linked to lower proficiency (indirect effect = -0.007, 95% CI: -0.017 to -0.001). Crucially, the direct association between statistics anxiety and proficiency was non-significant (-0.018, 95% CI: -0.049 to 0.033), indicating that the relationship between anxiety and proficiency is fully mediated by self-efficacy. The findings validate a chain mediation model, highlighting self-efficacy as the critical cognitive link connecting both emotional factors like anxiety and academic performance. This suggests a “confidence crisis” as a central feature in the learning process. Consequently, medical statistics teaching may benefit from moving beyond just managing anxiety to actively building students’ confidence. Using practical, relevant tasks helps students feel more capable, which can enhance learning resilience and improve their performance. Finally, it should be noted that causal interpretations require confirmation through longitudinal or experimental designs.

Blended learning that combines a modular object-oriented dynamic learning environment (Moodle) with face-to-face teaching was applied to a medical statistics course to improve learning outcomes and evaluate the impact factors of students’ knowledge, attitudes and practices (KAP) relating to e-learning. The same real-name questionnaire was administered before and after the intervention. The summed scores of every part (knowledge, attitude and practice) were calculated using the entropy method. A mixed linear model was fitted using the SAS PROC MIXED procedure to analyse the impact factors of KAP. Educational reform, self-perceived character, registered permanent residence and hours spent online per day were significant impact factors of e-learning knowledge. Introversion and middle type respondents’ average scores were higher than those of extroversion type respondents. Regarding e-learning attitudes, educational reform, community number, Internet age and hours spent online per day had a significant impact. Specifically, participants whose Internet age was no greater than 6 years scored 7.00 points lower than those whose Internet age was greater than 10 years. Regarding e-learning behaviour, educational reform and parents’ literacy had a significant impact, as the average score increased 10.05 points (P < 0.0001). This educational reform that combined Moodle with a traditional class achieved good results in terms of students’ e-learning KAP. Additionally, this type of blended course can be implemented in many other curriculums.

Introduction: The importance of retaining content in the long-term memory of medical students is well-documented. Given the narrative structure of medical disciplines, digital storytelling is an effective educational tool. This study investigates the effect of digital storytelling on the learning and satisfaction of nursing and midwifery students. Methods: This quasi-experimental study included 20 third-semester midwifery students (intervention group, digital storytelling) and 50 first-semester nursing students (control group, traditional lectures), all enrolled in an undergraduate psychology course. Both groups participated in five initial lecture-based sessions. Thereafter, the intervention group received six weekly digital storytelling sessions, each featuring a 3–8 minute narrative followed by instructor-led discussions, while the control group continued with standard lectures and question–and–answer sessions. Learning outcomes were measured using pre- and post-tests, and student satisfaction was assessed using a validated questionnaire. Statistical analyses were performed, adjusting for baseline scores and demographic confounders. Results: The digital storytelling group showed significantly higher post-test scores in learning outcomes (75.21±17.75 vs. 54.97±23.40, p=0.001) and satisfaction (38.15±6.45 vs. 31.22±4.59, p=0.0003) compared to the traditional lecture group. The potential effect of baseline values, as well as non-homogeneous demographic variables across groups, was removed using non-parametric ANCOVA. The result confirmed that gender had no confounding effects on either learning outcomes or satisfaction. Additionally, the differences between the two groups in terms of learning and satisfaction remained significant (p<0.001). Conclusion: Digital storytelling offers a meaningful and learner-centered approach that extends beyond content delivery. By fostering active engagement and deeper cognitive involvement, it transforms traditional instruction into a more personalized and reflective learning experience. This approach is recommended in healthcare education to improve instructional effectiveness and student satisfaction.

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Introduction Statistics helps medical students understand research. Without understanding statistics, students can’t choose the proper analysis in their research. We aimed to assess the attitude toward statistics, usage of statical software and associated factors for using statistical analysis software in Sudan. Method A cross-sectional online survey was distributed among undergraduate medical students across ten Sudanese universities. The study aimed to measure their attitude towards statistics using Survey of Attitudes Toward Statistics (SATS-36) scale. Results In total, 489 students were participated with a mean age of 21.94 ± 1.61 and a slight female preponderance (52%, n  = 256). The overall attitude towards statistics was 4.64 ± 0.91. The mean attitude scores for the components of SATS-36 scale was higher for students who were using statistical analysis software demonstrating significant difference in affect ( p  = 0.002), cognitive competence ( p  = 0.002), value ( p  = 0.002), Interest ( p  = 0.004) and Effort ( p  = 0.029). Almost half of the students (47%) had attended a biostatistics workshop with only 26% of them reported using statistical analysis software. Of the latter group, 72% ( n  = 91) used SPSS while 50% ( n  = 64) used excel. Univariate logistic regression showed students who had previously used an statistical software were more likely to be studying in their sixth year compared with second year (OR: 12.652, CI 95% 4.803– 33.332; p  < 0.001), older age (OR: 1.224, CI 95% 1.079– 1.388; p  = 0.002), attended a course in research methodology (OR: 3.383, CI 95% 2.120– 5.398; p  < 0.001) or biostatistics (OR: 1.886, CI 95% 1.252– 2.841; p  = 0.002), initiated or participated in a research project (OR:4.349, CI 95% 2.839 – 6.661; p  < 0.001) or published a paper (OR: 8.271, CI 95% 3.542 – 19.312; p  < 0.001). Conclusions The study showed an average attitude towards statistics among medical students. Being at higher years, participating or publishing research and attending research workshop are associated with the usage of statistical software. Also, few students were using statistical software.

Knowledge of statistics is highly important for research scholars, as they are expected to submit a thesis based on original research as part of a PhD program. As statistics play a major role in the analysis and interpretation of scientific data, intensive training at the beginning of a PhD programme is essential. PhD coursework is mandatory in universities and higher education institutes in India. This study aimed to compare the scores of knowledge in statistics and attitudes towards statistics among the research scholars of an institute of medical higher education in South India at different time points of their PhD (i.e., before, soon after and 2–3 years after the coursework) to determine whether intensive training programs such as PhD coursework can change their knowledge or attitudes toward statistics. One hundred and thirty research scholars who had completed PhD coursework in the last three years were invited by e-mail to be part of the study. Knowledge and attitudes toward statistics before and soon after the coursework were already assessed as part of the coursework module. Knowledge and attitudes towards statistics 2–3 years after the coursework were assessed using Google forms. Participation was voluntary, and informed consent was also sought. Knowledge and attitude scores improved significantly subsequent to the coursework (i.e., soon after, percentage of change: 77%, 43% respectively). However, there was significant reduction in knowledge and attitude scores 2–3 years after coursework compared to the scores soon after coursework; knowledge and attitude scores have decreased by 10%, 37% respectively. The study concluded that the coursework program was beneficial for improving research scholars’ knowledge and attitudes toward statistics. A refresher program 2–3 years after the coursework would greatly benefit the research scholars. Statistics educators must be empathetic to understanding scholars’ anxiety and attitudes toward statistics and its influence on learning outcomes.

The development of graduate education in biostatistics and medical statistics is discussed in the context of training within a medical center setting. The need for medical researchers to employ a wide variety of statistical designs in clinical, genetic, basic science and translational settings justifies the ongoing integration of biostatistical training into medical center educational settings and informs its content. The integration of large data issues are a challenge.

Introduction: Gamification is the use of game design elements in non-game contexts. It is considered a student-centered instructional design to motivate student learning and academic behavior. In this study, the effects of gamification on learning statistics (hypothesis testing issue) and attitude toward statistics in comparison with the common e-learning approach were investigated. The students’ experience and critical elements of gamification on learning statistics were assessed, too. Methods: In a before and after trial, in a census manner, 64 health faculty students of Guilan University of Medical Sciences, Rasht, Iran, non-randomly were assigned to the intervention (n=42) and control (n=22) groups. Learning activities were gamified in the intervention group, while the control group received traditional problem-solving in the learning management system. Narrative, avatar, level, point, progress bar, scoreboard, challenge and feedback elements were used in the game experience. The implementation of gamification was applied based on Landers’ theory of gamified content. Valid and reliable Persian version of the Survey Attitude toward Statistics questionnaire measured the students’ attitude before and after the intervention. The EGameFlow questionnaire and a valid and reliable researcher-made exam measured the users’ experience of gamified content and learning hypothesis testing after the intervention. The independent samples T-test, analysis of covariance and the partial eta-squared effect size were calculated by SPSS software, version 26. Results: Compared to the control group, the intervention group had a more positive attitude toward learning difficulty (moderate partial eta-squared 0.099), value and cognitive competency (weak partial eta-squared=0.01 and 0.05). Learning between the two groups was not different (P=0.522). There was a significant correlation between learning and the students’ perceived experience with feedback (r=0.583, P<0.001), concentration (r=0.509, P=0.005), and challenge (r=0.421, P=0.023) of the gamified content. Conclusion: It suggests using gamification on learning statistics while optimizing the design with more focus on the feedback, challenge and concentration elements.

The increasing focus on technical skills and efficiency in medical education often overshadows humanistic aspects, creating gaps in preparing clinicians for holistic patient care. Narrative Medicine, integrating storytelling and reflective practices, offers a promising approach to addressing these challenges.

The landscape of public health education is transforming, and online learning technologies are rapidly being adopted. This narrative review examines how public health education has evolved by comparing traditional and online learning environments, focusing on how smart learning environments can enhance educational outcomes. The analysis is grounded in the community of inquiry framework, Gardner’s theory on multiple intelligences, and the theory of self-regulated learning. This review first outlines the key competencies required by public health professionals, including epidemiology, health policy, and biostatistics, and then discusses how these competencies are taught traditionally. This description is followed by an exploration of online learning environments and the unique challenges faced by learners, such as the need for self-regulation and motivation. Smart learning environments should integrate adaptive learning technologies and personalized learning pathways to address these challenges and provide a more engaging and supportive learning experience. These technologies enable real-time feedback and customization of learning materials, allowing students to monitor their progress and adjust their learning strategies. Smart learning environments can also contribute to community and collaborative learning in online environments. Integrating smart learning environments into public health curricula can enhance student learning outcomes and prepare future public health professionals to navigate a rapidly changing digital world. The purpose of this review is to contribute to the ongoing discourse on the modernization of public health education by proposing a conceptual community of inquiry framework for smart learning environments, suggesting a balanced approach that leverages the strengths of traditional and online learning methods.

This full, innovative practice paper explores the use of narrative pedagogy for effectively teaching biology to engineering students. Biology is often seen as a fact-heavy, memorization-intensive subject, making it unappealing to many Indian engineering undergraduates, especially those who opted out of biology in high school. However, as biological solutions gain prominence in technology, engineers must engage with biological concepts. To bridge this gap, innovative pedagogical approaches are needed. We argue that narrative pedagogy, which aligns with engineers' problem-solving mindset, can enhance their engagement with biology. Narratives also offer the scope of creating an emotional connection. A biology course titled Nature's Machines was taught to Freshmore engineering students using a narrative-based approach. Both in-person sessions and take-home assignments incorporated various aspects of a narrative pedagogy such as storytelling, designing lesson plans with a plot structure as well as enacting real-world scenarios. Performance data and student feedback indicated high engagement with the subject. Students found that linking biology to real-world problems made learning more enjoyable and relevant. Narrative-driven teaching and case studies were highlighted as making the learning process more effective. Two key pedagogical insights emerged: (1) Engineering students' problem-solving tendencies could be effectively leveraged for pedagogical design, and (2) fact-heavy subjects like biology can be successfully taught using a narrative approach. This method offers a compelling way to bridge the gap between engineering and biology, making biological concepts more intuitive and applicable for future engineers.

This study evaluates the pedagogical impact of integrating the documentary I Am Shakespeare: The Henry Green Story into an undergraduate public health course focused on structural health inequities. Through narrative-based learning, students examined how social determinants, such as racism, poverty, educational access, and neighborhood disinvestment, shape individual and population health outcomes. The documentary provided an emotionally resonant entry point for applying frameworks like the Social Determinants of Health (SDOH) and the Social-Ecological Model (SEM), while also engaging students in complex themes such as hypermasculinity, trauma, and resilience. The study draws on student reflections, final papers, and survey data to assess how narrative-centered instruction supports systems thinking, cultural humility, and advocacy-oriented learning. In addition to these public health competencies, the analysis incorporates developmental psychology perspectives, emphasizing how late adolescence and emerging adulthood, critical periods for identity formation, emotional regulation, and cognitive growth, are shaped by exposure to structural violence and chronic stress. Students demonstrated increased awareness of the psychological toll of inequity, including its impact on self-efficacy, executive function, and interpersonal trust. Findings suggest that narrative-based learning promotes both conceptual mastery and personal growth, helping students integrate academic content with evolving ethical and professional identities. By bridging public health theory with lived experience, and aligning instruction with developmental and psychological milestones, this approach offers a multidimensional framework for preparing equity-minded public health professionals. The study highlights the value of interdisciplinary pedagogy in fostering critical reflection, empathy, and a deeper commitment to social transformation.

This study explores the impact of integrating The Short and Tragic Life of Robert Peace into the undergraduate public health course PBHL 2950: Disparities in Health as a pedagogical tool to enhance student understanding of systemic inequities. Traditional lecture-based methods often fail to effectively convey complex concepts such as social determinants of health (SDOH), systemic racism, and economic disparities. Narrative-based learning, however, has been shown to deepen student engagement by humanizing statistical data and theoretical constructs. Using a mixed-methods approach, this study assesses how engagement with Robert Peace’s life story influences students’ comprehension of public health frameworks, including the Social-Ecological Model (SEM) and SDOH, and their ability to critically analyze structural inequities. Findings indicate that students demonstrated significant improvement in their ability to identify systemic health disparities, apply public health theories, and engage in policy discussions. Qualitative analysis of student reflections revealed increased empathy, enhanced systems thinking, and a stronger motivation for public health advocacy. However, students faced challenges in developing actionable, multi-tiered public health interventions, underscoring the need for structured guidance on intervention design. The study suggests that integrating real-world narratives into public health curricula can bridge the gap between theory and lived experience, preparing students with the critical thinking skills necessary for addressing health disparities. These findings contribute to ongoing discussions on innovative teaching strategies that cultivate cultural competence, policy awareness, and advocacy-oriented thinking in future public health professionals.

Undergraduate nursing students develop their training in a real context, where they are frequently confronted with clinical cases of clients in the end-of-life process but feel uncomfortable with palliative and end-of-life care. This pre–post study with a pre-experimental design evaluated the impact of an educational intervention on nursing students and their compassion levels, spiritual preparedness, and attitudes toward death. A total of 62 students participated in a training program consisting of 25 contact hours based on narrative pedagogy (theoretical and practical classes). The results showed that educational intervention positively impacted different dimensions, particularly self-compassion and spirituality, as well as reduced fear of death and increased neutral acceptance. Nursing education should prioritize the inclusion of death, dying, and end-of-life care across the nursing curriculum’s fundamental courses.

BACKGROUND As Abraham Maslow asserts, belonging is essential to achieving self-esteem and self-actualization. With increasing numbers of novice nurse burnout and a perceived education-practice gap, promoting a sense of belonging is important to nurses' growth and psychological well-being and should start in nursing school. METHOD An elective course, Belonging in Nursing, was developed to assist undergraduate nursing students in understanding the importance of belonging through narrative pedagogy. Course topics include the concept of belonging, managing moral distress, professional identity and boundaries, and readiness for practice. RESULTS Student feedback was positive, including the promotion of belonging in the class through hearing others express their fears and doubts and an increased awareness of moral distress and professional boundaries. CONCLUSION Teaching Belonging in Nursing through narrative pedagogy aids in integrating this vital concept into the undergraduate nursing curriculum. Promoting belonging should start in nursing school and continue into novice nurse practice. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Background Biostatistics is an increasing focus in current medical school curricula. This study evaluated the statistical methods utilized in a high-impact factor medical Journal to develop a guide to those statistics that can be applied to facilitate the interpretation of data for practicing physicians, fellows, residents, and medical students. Methods In Part 1 of our tandem manuscripts, the 100 most recent primary articles from February 2021 to December 2021 were analyzed from the Journal of Intensive Care Medicine. The evaluation consisted of study temporality, study design, types of descriptor variables, and types of statistical tests. Results Retrospective studies were most common (75/100, 75%), followed by prospective studies (23/100, 23%). The most popular designs were cohort (82/100, 82%), followed by case series (9/100, 9%), randomized control trials (4/100, 4%), and case-control (3/100, 3%). The most commonly utilized descriptor variables were frequency and proportion (100/100, 100%), followed by median (74/100, 74%) and mean (71/100, 71%). The chi-square test was the most frequently used statistical test (59/100, 59%), while logistic regression (48/100, 48%), Mann-Whitney-U (46/100, 46%), and two-sample independent t-test (40/100, 40%) also were popular. Conclusion This review revealed that retrospective and cohort studies were utilized most frequently. The chi-square test was used in the majority of studies, while logistic regression was also popular. This information can help determine areas in which supplemental training will be most beneficial to improve the understanding of statistical methods in medical journals by practicing physicians, fellows, residents, and medical students. As an outgrowth of this study, we have developed a practical guide to relevant statistical methods, serving as Part 2 of these tandem manuscripts.

Background Death education has been confirmed to be an effective method to enhance nursing students’ attitudes and coping abilities toward death. However, integrated Narrative Pedagogy into the death education to explore educational effectiveness is still limited. The study aimed to evaluate the effects of a death education based on Narrative Pedagogy in a palliative care course on the attitude toward death, coping with death, and attitude toward caring for the dying among undergraduate nursing students in China. Methods The study was designed as a pre-post intervention study with a quasi-experimental design. All the participants received 6 class hours of death education which was designed in a palliative care course. The death education includes preparation, presentation, discussion, reflection, and practice of the narrative materials. Death Attitude Profile-Revised (DAP-R), Coping with Death Scale (CDS), and Frommelt Attitude Toward Care of the Dying-Form B (FATCOD-Form B) were used to measure outcomes. Results Sixty undergraduate nursing students who consented. There were statistically significant increases in the mean score of neutral acceptance and approach acceptance in the DAP-R, CDS, and FATCOD-Form B before and after the intervention. Conclusion This death education integrated Narrative Pedagogy which indicated to improve attitude toward death, competence to cope with death, and attitude toward the care of dying patients. The findings assist teachers in understanding the importance and urgency of death education, as well as providing a favorable approach to death education. However, the long-term effectiveness still needs to study in further.

Background The development of nursing students’ ability to care for children is an important part of their nursing education. However, nursing students’ understanding of children’s experiences in healthcare is vague. The traditional lecture approach is not conducive to the cultivation of humanistic care competencies for hospitalized children. Objectives This study aimed at exploring the effectiveness of narrative pedagogy on developing nursing students’ ability to care for hospitalized children. Design A quasi-experimental non-equivalent control group pre-test and post-test design. Setting and participants: A purposive sampling method was used for this study. The study participants included 588 first-year nursing students in four classes at a university in western China. The students enrolled in a nursing humanistic curriculum were divided into an experimental group (295 students) and a control group (293 students). Methods During the 5 weeks of hospitalized children’s care program, the experimental group received narrative pedagogy, while the control group received traditional teaching with 2 credit hours per week. Data were collected quantitatively using the Caring Ability Inventory (CAI), as well as qualitatively through individual interviews and reflective diaries. Results The average scores on the CAI and subscales significantly improved for both groups. As a result of controlling for the effect of pre-test scores, the experimental group had significantly higher post-test scores on the CAI than the control group. Qualitative content analysis demonstrated that narrative pedagogy enhanced nursing students’ emotional experiences and facilitated their understanding of the caring practice for sick children. Conclusion Narrative pedagogy has positive implications for improving students’ care competencies for hospitalized children.

AIM This study aims to discuss how narrative pedagogy of improving the positive attitude toward older people among nursing students and increasing students' willingness to practice older people's care. BACKGROUND Considering the progress of population aging, the requirement for nursing manpower in older people care is on the rise. However, related studies have demonstrated that nursing students generally have a negative attitude toward older people, which affects students' willingness to engage in older people's care in the future. DESIGN This study applied mixed method research design. For the quantitative study design, we have adopted a quasi-experimental study, pretest-posttest design. METHODS The study adopted purposive sampling. A total of 87 nursing students in two classes of five-year junior college program in northern Taiwan were selected as the study subjects. The students were randomly allocated into an experimental group of 43 subjects and a control group of 44 subjects. The experimental group received narrative pedagogy of geriatric care course for 18 weeks with 2 h per week, the control group received general lectures. This study was conducted between October 2019 and February 2020. The quantitative data were collected using the structured questionnaire. The qualitative data were collected by individual interviews and students' reflective writing. RESULTS The average scores of the older people's attitude (F=4.60, p < 0.05) and the willingness to care for the older people (F=4.19, p < 0.05) in the experimental group increased significantly, reaching a statistically significant level. According to the adjusted post-test score averages of the two groups, under the control of the pre-test, the Older Adults Attitude Scale (64.02 >60.22) and the post-test of the Older Adults Care Willingness Scale (11.63 >9.93) in the experimental group were significantly higher than those in the control group. In the qualitative analysis, four themes were emerged, which were negative stereotypes about the older people, myth-breaking for prejudice against the older people, new older people impression for replacement and rethinking for older people care. CONCLUSION Narrative pedagogy is an effective teaching method, which can improve nursing students' older people's positive attitudes and increase students' willingness to practice older people's care.

Abstract This pilot study explored graduate nurse educator students’ perceptions of the application of narrative pedagogy in an online environment. Four major themes were identified in 15 student discussion posts: adapting challenges, increasing digital human interactions, enabling strategies, and creating a partnership for learning. Results illustrate how integrating narrative pedagogy into online classes enables a transformation of student thinking and learning by providing alternate ways for nurse educators to promote active learning.

This paper examines the pedagogical value of using narrative digital learning practices (NDLP) in instructional design. Through a thematic review of the literature, the authors illustrate that NDLP, which are the intentional use of storytelling techniques to inform and enhance the student experience within digital learning environments, can increase student engagement and help them meet the outcomes and goals for instruction. It discusses the different ways in which NDLP can be used to support such practices as course mapping, digital storytelling, adaptive and/or differentiated learning, scenario-based and case-based learning, gameful learning, and the application of universal design for learning principles. Additionally, the authors present backward design as a way to ensure that narrative structures used in courses are supportive of learning objectives. The future of learning is discussed, including the role of NDLP in facilitating more personalized and immersive learning experiences. The paper concludes by noting that NDLP is a valuable tool for instructional designers and educators and has the potential to transform teaching and learning through the unique affordances of narrative structure and digital tools.

1PhD Candidate in Human Relations Sciences, University of Bari “Aldo Moro”, Bari, Italy 2UNESCO Chair on Health Education and Sustainable Development, University Federico II School of Medicine, Naples, Italy 3Euro Mediterranean Scientific Biomedical Institute (ISBEM), Bruxelles, Belgium 4Italian Society of Environmental Medicine (SIMA), Milan, Italy 5Department of Environmental Science and Policy, University of Milan, Milan, Italy 6Department of History, Society and Human Studies, University of Salento, Lecce, Italy

To use narrative medicine as a means for action towards social justice in medical education, we need a renewal of our pedagogical methods that grapples not just with the worlds concocted within a text, but also our own world beyond the text. We propose a model for narrative medicine pedagogy that is oriented towards abolition. First, the composition of the classroom and syllabus must employ radical inclusion through recruitment of diverse voices and selection of diverse texts. After a traditional close reading is initiated, conscious expansion should take place through introduction of a text’s context and current social structures. Whenever internal and external conflicts arise, active self-interrogation should be encouraged through José Esteban Muñoz’s ‘disidentification’. We present relevant critiques of narrative medicine, case studies from workshop experiences, and close readings of selected narrative medicine texts to unmask limitations in the standard narrative medicine workshop format and illustrate the utility of our abolitionist model. The model we propose offers methods for disrupting long-standing patterns of inclusion (and exclusion) and radically transforming the structure of spaces and ideas produced within them. When new texts are added to the syllabus, they should be accompanied by hermeneutics that can adequately attend to them. Abolitionist narrative medicine pedagogy should stimulate practitioners to examine their own role in social structures that surround the text and the setting of close reading and, ultimately, to dismantle harmful structures. We offer strategies for confronting discomfort without requiring an abandonment of identity, context or content. Instead, holding complexity works towards the long-term aim of transforming practitioners to think critically about structural violence that prevents universal and equitable access to compassionate healthcare. Using this model for abolition, we hope practitioners of narrative medicine will be equipped with more dynamic tools to engage with texts and patients within and beyond the scope of the narrative medicine workshop.

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One of the essential skills required in nursing students is empathetic communication and communication skills. Communication skills refer to a set of potential and actual abilities that help achieve acceptable and informative behavior, leading to a level of emotional connection. This interpersonal skill facilitates the establishment and strengthening of the nurse-patient relationship. Therefore, researchers aimed to conduct a study to determine the impact of narrative writing based on Gibbs’ reflective model on the empathy and communication skills of nursing students. This quasi-experimental research was conducted using two groups and before-after design. The statistical population consisted of all third and fourth-year nursing students at Zabol University of Medical Sciences in 2023, among whom 80 students were selected by the census. The data collection tools included a demographic information form and reliable and valid questionnaires for empathy and communication skills. In the intervention group, Gibbs’ reflective thinking was taught through workshops. Students in this group were asked to engage in narrative writing-reflection sessions for 8 weeks, producing at least 8 narratives (one at the end of each week). The empathy and communication skills questionnaires were completed again at the end of the 8th week. The obtained data were analyzed using SPSS software (version 22), applying descriptive statistics and inferential statistics at a significance level of p ≤ 0.05 and a 95% confidence interval. The results of this study indicate that narrative writing based on Gibbs’ reflective model can positively impact nursing students’ empathy and communication skills. Specifically, the mean empathy score in the intervention group increased from 63.35 ± 6.61 to 70.20 ± 10.43, which was statistically significant according to the paired t-test (P = 0.000). In contrast, the control group showed no significant change in empathy, with scores changing from 62.70 ± 8.20 to 62.72 ± 7.92 (P = 0.760). Similarly, the mean communication skill in the intervention group improved from 183 ± 16.15 to 211.75 ± 9.30, with this change also being statistically significant (P = 0.000). In the control group, communication skills changed minimally from 186.27 ± 16.07 to 187.60 ± 15.44, which was not statistically significant (P = 0.215). Furthermore, when comparing the changes in empathy and communication skill scores according to demographic and educational variables, no significant differences were found (P > 0.05). Narrative writing helps students establish a more appropriate relationship with patients by fostering a deeper understanding of their issues and enhancing their empathy, leading to better patient care during their treatment. This suggests that incorporating narrative writing into nursing education could be beneficial for developing essential skills in future healthcare professionals.

Educational statistics is a crucial course that students of Islamic Education Management must master. However, students whose majors are not directly related to mathematics often face difficulties in learning educational statistics. Therefore, it is necessary to develop a learning model that can improve students' understanding and is applicable to practical courses such as educational statistics. One promising alternative is the Project-Based Learning (PjBL) model. This study was conducted at IAIN Takengon Aceh and involved 23 fourth-semester Islamic Education Management students in the 2023/2024 academic year. The research data were collected in the form of video recordings, photos, and final project reports. The data were analyzed using qualitative techniques and presented through narrative description. The results showed that the PjBL model is effective in promoting an understanding of descriptive statistics, fostering collaboration, and providing opportunities for students to develop problem-solving skills

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Although active learning methodologies promote students' creativity and motivation regarding learning objectives, traditional unidirectional teaching methods remain more common. The objective of this study was to determine nursing students' perceptions regarding the efficacy of narrative photography as a learning method, including self-perceived satisfaction. Narrative photography is an art-based technique inspired by Photovoice that promotes empathy, creativity, and reflection. A cross-sectional study was conducted using a non-probabilistic sample of 66 nursing students from a public university in Barcelona (Spain). Quantitative and qualitative data were collected anonymously using an electronic tool. Descriptive statistics and thematic analyses were used to analyze the data. Sixty valid questionnaires were returned. The respondents found narrative photography's ability to promote creativity and assist understanding of theory to be its most satisfying aspect (>95% somewhat/totally agree). Meanwhile, narrative photography's usefulness, ability to foster self-criticism, and the associated workload was the least satisfactory aspect (>55% somewhat/totally agree). Significant differences regarding satisfaction levels were found for both age and sex. Narrative photography is a helpful and satisfactory learning method, especially for promoting creativity and understanding theoretical concepts.

This research attempts to better understand how students in Saudi Arabia benefit from narrative and story aspects in gamified learning environments. Data from a sample of 500 persons with varying levels of education are analyzed using quantitative methods such as descriptive statistics, correlation analysis, and multiple regression analysis. The findings point to strong positive correlations between the use of gamification in education, the influence of storytelling, narrative variables, and the acquisition of new skills. There has been a significant shift toward the use of narrative variables as measures of mastery in gamified classrooms. This study's results show that using gamified learning with story elements may increase students' interest, motivation, and knowledge retention. Efforts are now being made by Saudi Arabia to update its educational system and provide its youth with the tools they'll need to succeed in the country's emerging knowledge-based economy. The use of game-based learning and narrative-rich experiences has promising results in this setting.

University students increasingly face mental health challenges, including anxiety, depression, and stress, yet most higher education environments lack proactive systems for emotional monitoring and support. This study aimed to design, implement, and evaluate a hybrid teaching management system that integrates narrative simulation with visual artificial intelligence (AI) to promote mental health literacy and emotional resilience among students. The system includes a narrative decision-making module simulating stress scenarios and an AI-powered emotion recognition tool (based on facial expression detection) embedded in classroom settings. A mixed-methods design was employed with 332 undergraduate students and 15 faculty members from multiple universities. Pre- and post-intervention surveys, usage logs, and real-time emotional data from visual AI were collected. Quantitative data were analyzed using descriptive statistics, paired t-tests, ANOVA, and multiple linear regression. Results indicated statistically significant improvements in students' mental health scores (p < 0.01), emotional awareness, and decision-making confidence. This integrated approach demonstrates both usability and scalability, offering instructors early emotional insight and students a reflective learning environment. The method is best suited for institutions equipped with AI-capable classrooms and trained ethical oversight.

Higher education students’ attitudes toward statistics are of great importance as these may affect student performance and achievement in statistics learning. Despite some interest in attitude towards statistics among higher education students in language-related fields and the broader area of tertiary-level education, the different types of existing attitudes toward statistics might remain uncovered. Applying the Attitude system as an analytical framework, this study explores how higher education students use linguistic resources to indicate statistics-related attitude before, during and after learning. The narratives of learning statistics were obtained from a group of MA TEFL students (n=25) who participated in an introductory course on basic statistical concepts and procedures, among others. The study makes visible a great variety and a considerable variation of linguistic means which students use to express statistics-related attitude as Judgement, Appreciation and Affect, emerging over time. As such, this study advances methodological practices and training in the field.

In a move bridging the science-humanities gap, Al-Nahrain University Medical College in Iraq integrated storytelling, arts, and ethical reflection into their first-year English course, fostering empathy and cultural sensitivity in future doctors. This experiment, despite challenges like large class size, received overwhelmingly positive student feedback, highlighting the value of engaging content, creative methods, and skill development for well-rounded healthcare professionals. This pioneering effort offers valuable insights and challenges for educators seeking to implement similar medical humanities programs.

Introduction: Storytelling of lived experience could be an effective educational intervention to enhance empathic communication during medical training. The aim of this study is to describe women’s experiences of participating in a storytelling intervention for medical students, consisting of live online and recorded stories about their lived experience of abnormal uterine bleeding. Methods: Semi-structured interviews were conducted with women who had lived experience of abnormal uterine bleeding and who participated in a storytelling intervention for medical students. Interviews were recorded and transcribed verbatim. A reflexive thematic analysis approach was used for analysing the data. Results: Eight women participated in interviews, five online, two by telephone and one responding to interview questions by email. The analysis produced five themes: (1) empowered by opportunity to provide guidance to students, (2) empowered by advocating for women, (3) therapeutic to share and hear lived experiences, (4) preference for a pragmatic online format and (5) safe and comfortable setting for sharing experiences. Conclusion: Women had a meaningful and therapeutic experience of participating in the storytelling intervention. Storytelling interventions for health professional education may work well for people with lived experience when a practical or flexible online format is offered, which contributes to a safe and comfortable environment.

Objective: The study intended to use narrative medicine study for interdisciplinary collaboration to let medical and healthcare students have a chance to interact with one another and listen to patients’ stories to enhance students’ reflective thinking, communication, empathy, and narrative medicine writing skills. Methods: A fifteen-week quasi-experimental design was used to examine the learning outcomes of the intervention. Two groups of students were randomly assigned as the experimental group (33 students) and the control group (32 students). Before and after the intervention, both groups had to fill in a Reflective Thinking Scale for Healthcare Students and Providers (RTS-HSP), Patient–Healthcare Provider Communication Scale (P-HCS), Empathy Scale in Patient Care (ES-PC), and Analytic Narrative Medicine Writing Scoring Rubric (ANMWSR). Results: The findings showed that on the reflective thinking scale, experimental group students had significantly higher reflective thinking posttest scores in “reflective skepticism,” “empathetic reflection,” and “critical open-mindedness,” but not in “self-examination.” As for patient–healthcare provider communication, they had significantly higher posttest scores in all “perception of trust and receptivity,” “patient-centered information giving,” “rapport building,” and “facilitation of patient involvement” factors. As for empathy, they had significant higher posttest scores in “behavioral empathy” and “affective empathy,” but not in “intelligent empathy.” In narrative medical writing skills, they had significant higher posttest scores in the “attention → representation → affiliation,” “depth of reflection,” “focus and context structure,” and “ideas and elaboration” sections, but not in the “language and conventions” section. Conclusion: The findings suggest that narrative medicine is worth recommending for interdisciplinary collaboration for healthcare education.

Prolonged conflict can severely impact medical education systems. In Syria, the effects on students’ research training and academic development remain poorly explored. The study examines how the Syrian conflict affected research training, educational barriers, and career intentions among medical students and recent graduates. An online, English-language questionnaire was distributed to students and trainees from Syrian medical universities. Domains included research exposure, institutional barriers, psychological well-being, and emigration intent. Of 211 individuals who accessed the survey, 208 responded (98.5%). Among them, 87 (42%) were males. Only 80 participants (38%) had received formal research training. Prior research experience was higher in males (53%) than females (40%, p = 0.09; 95% CI: 0.3–3.3). Graduate-level participation was more common in females (61%) than males (30%, p = 0.04; 95% CI: 1.1–4.2). Motivation for research was higher among males (74% vs. 60% strongly agreed, p = 0.05; 95% CI: 0.9–2.8), and males reported more confidence interpreting statistics (mean 2.3 vs. 2.0, p = 0.01; 95% CI: 1.9–5.9). Psychological distress was reported by 160 respondents (77%). 147 (71%) respondents perceived career migration in future, estimating peer emigration intent over 40%. The Syrian conflict has negatively affected medical students’ research training and academic confidence, particularly through infrastructure disruption and limited mentorship. Targeted support and international collaboration will be essential to rebuilding capacity in conflict-impacted medical education systems, for the benefit of both the healthcare professionals of the future, and their patients.

This paper examines the integration of creative writing into medical education as a means to foster empathy, self-reflection, and resilience among medical students. While traditional medical curricula focus heavily on scientific knowledge and clinical skills, they often lack training that addresses emotional well-being and patient-centered care. Creative writing, used in conjunction with narrative medicine, offers an avenue for students to explore and express the human dimensions of medical practice. Through reflective journaling, collaborative storytelling, and engagement with medical literature, students can cultivate emotional awareness and enhance their observational and interpersonal skills. This paper discusses seven practical strategies for implementing creative writing in the curriculum and offers insights from case studies where medical programs have successfully employed creative writing exercises. The goal is to develop a more holistic educational model that prepares future physicians to handle the complexities of patient care while maintaining their well-being. Keywords: Medical education, Creative writing, Empathy, Narrative medicine, Reflective practice.

Background: Introduced in 2010, the sub-discipline of gerontologic biostatistics (GBS) was conceptualized to address the specific challenges in analyzing data from research studies involving older adults. However, the evolving technological landscape has catalyzed data science and statistical advancements since the original GBS publication, greatly expanding the scope of gerontologic research. There is a need to describe how these advancements enhance the analysis of multi-modal data and complex phenotypes that are hallmarks of gerontologic research. Methods: This paper introduces GBS 2.0, an updated and expanded set of analytical methods reflective of the practice of gerontologic biostatistics in contemporary and future research. Results: GBS 2.0 topics and relevant software resources include cutting-edge methods in experimental design; analytical techniques that include adaptations of machine learning, quantifying deep phenotypic measurements, high-dimensional -omics analysis; the integration of information from multiple studies, and strategies to foster reproducibility, replicability, and open science. Discussion: The methodological topics presented here seek to update and expand GBS. By facilitating the synthesis of biostatistics and data science in gerontology, we aim to foster the next generation of gerontologic researchers.

Programming is ubiquitous in applied biostatistics; adopting software engineering skills will help biostatisticians do a better job. To explain this, we start by highlighting key challenges for software development and application in biostatistics. Silos between different statistician roles, projects, departments, and organizations lead to the development of duplicate and suboptimal code. Building on top of open-source software requires critical appraisal and risk-based assessment of the used modules. Code that is written needs to be readable to ensure reliable software. The software needs to be easily understandable for the user, as well as developed within testing frameworks to ensure that long term maintenance of the software is feasible. Finally, the reproducibility of research results is hindered by manual analysis workflows and uncontrolled code development. We next describe how the awareness of the importance and application of good software engineering practices and strategies can help address these challenges. The foundation is a better education in basic software engineering skills in schools, universities, and during the work life. Dedicated software engineering teams within academic institutions and companies can be a key factor for the establishment of good software engineering practices and catalyze improvements across research projects. Providing attractive career paths is important for the retainment of talents. Readily available tools can improve the reproducibility of statistical analyses and their use can be exercised in community events. [...]

A saddlepoint approximation of the Student's t-statistic was derived by Daniels and Young [Biometrika 78 (1991) 169-179] under the very stringent exponential moment condition that requires that the underlying density function go down at least as fast as a Normal density in the tails. This is a severe restriction on the approximation's applicability. In this paper we show that this strong exponential moment restriction can be completely dispensed with, that is, saddlepoint approximation of the Student's t-statistic remains valid without any moment condition. This confirms the folklore that the Student's t-statistic is robust against outliers. The saddlepoint approximation not only provides a very accurate approximation for the Student's t-statistic, but it also can be applied much more widely in statistical inference. As a result, saddlepoint approximations should always be used whenever possible. Some numerical work will be given to illustrate these points.

In this paper, we derive valid Edgeworth expansions for studentized versions of a large class of statistics when the data are generated by a strongly mixing process. Under dependence, the asymptotic variance of such a statistic is given by an infinite series of lag-covariances, and therefore, studentizing factors (i.e., estimators of the asymptotic standard error) typically involve an increasing number, say, $\ell$ of lag-covariance estimators, which are themselves quadratic functions of the observations. The unboundedness of the dimension $\ell$ of these quadratic functions makes the derivation and the form of the expansions nonstandard. It is shown that in contrast to the case of the studentized means under independence, the derived Edgeworth expansion is a superposition of three distinct series, respectively, given by one in powers of $n^{-1/2}$, one in powers of $[n/\ell]^{-1/2}$ (resulting from the standard error of the studentizing factor) and one in powers of the bias of the studentizing factor, where $n$ denotes the sample size.

During the past several years the authors have developed a new approach to the teaching of Physical Science, a general education course typically found in the curricula of nearly every college and university. This approach, called `Physics in Films', uses scenes from popular movies to illustrate physical principles and has excited student interest and improved student performance. The analyses of many of the scenes in `Physics in Films' are a direct application of Fermi calculations -- estimates and approximations designed to make solutions of complex and seemingly intractable problems understandable to the student non-specialist. The intent of this paper is to provide instructors with examples they can use to develop skill in recognizing Fermi problems and making Fermi calculations in their own courses.

For many students, introductory college science courses are often the only opportunity in their formal higher education to be exposed to science, shaping their view of the subject, their scientific literacy, and their attitudes towards their own ability in STEM. While science writing instruction has been demonstrated to impact attitudes and outlooks of STEM majors in their coursework, this instructional strategy has yet to be explored for non-majors. In this work, we investigate student attitudes towards STEM before and after taking a writing-intensive introductory astronomy course. We find that students cite writing about science as beneficial to their learning, deepening their understanding of science topics and their perspective on science as a field and finding writing to be a "bridge" between STEM content and their focus on humanities in their majors. Students also report increased perceptions of their own ability and confidence in engaging with STEM across multiple metrics, leaving the course more prepared to be informed, engaged, and science literate citizens.

The teaching of statistics in higher education in the UK is still largely lecture-based. This is despite recommendations such as those given by the American Statistical Association's GAISE report that more emphasis should be placed on active learning strategies where students take more responsibility for their own learning. One possible model is that of collaborative learning, where students learn in groups through carefully crafted `problems', which has long been suggested as a strategy for teaching statistics. In this article, we review two specific approaches that fall under the collaborative learning model: problem- and team-based learning. We consider the evidence for changing to this model of teaching in statistics, as well as give practical suggestions on how this could be implemented in typical statistics classes in Higher Education.

This paper's main contention is that some basically methodological developments in science which are apparently distant and unrelated can be seen as part of a sequential story. Focusing on general inferential and epistemological matters, the paper links occurrences separated by both in time and space, by formal and representational issues rather than social or disciplinary links. It focuses on a few limited aspects of several cognitive practices in medical and biological contexts separated by geography, disciplines and decades, but connected by long term transdisciplinary representational and inferential structures and constraints. The paper intends to show a given set of knowledge claims based on organizing statistically empirical data can be seen to have been underpinned by a previous, more familiar, and probably more natural, narrative handling of similar evidence. To achieve that this paper moves from medicine in France in the late eighteenth and early nineteenth century to the second half of the nineteenth century in England among gentleman naturalists, following its subject: the shift from narrative depiction of hereditary transmission of physical peculiarities to posterior statistical articulations of the same phenomena. Some early defenders of heredity as an important (if not the most important) causal presence in the understanding of life adopted singular narratives, in the form of case stories from medical and natural history traditions, to flesh out a special kind of causality peculiar to heredity. This work tries to reconstruct historically the rationale that drove the use of such narratives. It then shows that when this rationale was methodologically challenged, its basic narrative and probabilistic underpinings were transferred to the statistical quantificational tools that took their place.

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With little or no evidence-based information to back up claims of vaccine danger, anti-vaccine activists have relied on the power of storytelling to infect an entire generation of parents with fear of and doubt about vaccines. These parent accounts of perceived vaccine injury, coupled with Andrew Wakefield's fraudulent research study linking the MMR vaccine to autism, created a substantial amount of vaccine hesitancy in new parents, which manifests in both vaccine refusal and the adoption of delayed vaccine schedules. The tools used by the medical and public health communities to counteract the anti-vaccine movement include statistics, research, and other evidence-based information, often delivered verbally or in the form of the CDC's Vaccine Information Statements. This approach may not be effective enough on its own to convince vaccine-hesitant parents that vaccines are safe, effective, and crucial to their children's health. Utilizing some of the storytelling strategies used by the anti-vaccine movement, in addition to evidence-based vaccine information, could potentially offer providers, public health officials, and pro-vaccine parents an opportunity to mount a much stronger defense against anti-vaccine messaging.

Being able to draw accurate conclusions from childhood obesity trials is important to make advances in reversing the obesity epidemic. However, obesity research sometimes is not conducted or reported to appropriate scientific standards. To constructively draw attention to this issue, we present 10 errors that are commonly committed, illustrate each error with examples from the childhood obesity literature, and follow with suggestions on how to avoid these errors. These errors are as follows: using self-reported outcomes and teaching to the test; foregoing control groups and risking regression to the mean creating differences over time; changing the goal posts; ignoring clustering in studies that randomize groups of children; following the forking paths, subsetting, p-hacking, and data dredging; basing conclusions on tests for significant differences from baseline; equating "no statistically significant difference" with "equally effective"; ignoring intervention study results in favor of observational analyses; using one-sided testing for statistical significance; and stating that effects are clinically significant even though they are not statistically significant. We hope that compiling these errors in one article will serve as the beginning of a checklist to support fidelity in conducting, analyzing, and reporting childhood obesity research.

'Transfer' is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential. This review systematically identifies interventions described in the health professions education (HPE) literature that document the transfer of basic science knowledge to clinical reasoning, and considers teaching and assessment strategies. A systematic search of the literature was conducted. Articles related to basic science teaching at the undergraduate level in HPE were analysed using a 'transfer out'/'transfer in' conceptual framework. 'Transfer out' refers to the application of knowledge developed in one learning situation to the solving of a new problem. 'Transfer in' refers to the use of previously acquired knowledge to learn from new problems or learning situations. Of 9803 articles initially identified, 627 studies were retrieved for full text evaluation; 15 were included in the literature review. A total of 93% explored 'transfer out' to clinical reasoning and 7% (one article) explored 'transfer in'. Measures of 'transfer out' fostered by basic science knowledge included diagnostic accuracy over time and in new clinical cases. Basic science knowledge supported learning - 'transfer in' - of new related content and ultimately the 'transfer out' to diagnostic reasoning. Successful teaching strategies included the making of connections between basic and clinical sciences, the use of commonsense analogies, and the study of multiple clinical problems in multiple contexts. Performance on recall tests did not reflect the transfer of basic science knowledge to clinical reasoning. Transfer of basic science knowledge to clinical reasoning is an essential component of HPE that requires further development for implementation and scholarship.

Integrating basic science and clinical concepts in the undergraduate medical curriculum is an important challenge for medical education. The health professions education literature includes a variety of educational strategies for integrating basic science and clinical concepts at multiple levels of the curriculum. To date, assessment of this literature has been limited. In this critical narrative review, the authors analyzed literature published in the last 30 years (1982-2012) using a previously published integration framework. They included studies that documented approaches to integration at the level of programs, courses, or teaching sessions and that aimed to improve learning outcomes. The authors evaluated these studies for evidence of successful integration and to identify factors that contribute to integration. Several strategies at the program and course level are well described but poorly evaluated. Multiple factors contribute to successful learning, so identifying how interventions at these levels result in successful integration is difficult. Evidence from session-level interventions and experimental studies suggests that integration can be achieved if learning interventions attempt to link basic and clinical science in a causal relationship. These interventions attend to how learners connect different domains of knowledge and suggest that successful integration requires learners to build cognitive associations between basic and clinical science. One way of understanding the integration of basic and clinical science is as a cognitive activity occurring within learners. This perspective suggests that learner-centered, content-focused, and session-level-oriented strategies can achieve cognitive integration.

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The OMERACT Composite Working Group hosted a workshop at OMERACT 2023 to explore the complexities of weighting components in the development of composite outcomes. This study presents the methodology and findings of this workshop, exploring the complexities of weighting the individual components of composite outcome measures. The workshop featured a multifaceted program, beginning with a plenary session that introduced the concept of composite outcomes, shared a patient's journey with rheumatic disease through a narrative, illustrated a composite outcome for Osteoarthritis Flares, and outlined the five domains selected for this composite outcome. A breakout exercise engaged participants in ranking and assigning weights to these domains, followed by group discussions to reach a consensus on weights. The workshop concluded with another plenary session that discussed various weighting approaches, including discrete choice and conjoint analysis from the ANCA-Associated Vasculitis working group, and outlined future directions for research on composite outcome methods. The breakout exercise revealed the challenges in assigning relative importance to different domains, highlighting the variability in participant perspectives. Consensus discussions highlighted the diversity in approaches to weighting, the need for appropriate methods to determine domain weights and the impact of such weights on the interpretation of composite scores. The OMERACT 2023 workshop underscored the significance of a systematic approach to weighting components in composite outcome development. It highlighted the complexity of achieving consensus on the importance of domains and the role of incorporating the perspectives of patient research partners in this process. Future research directions include refining weighting methodologies, moving composites through the OMERACT Filter and enhancing understanding of their implications for clinical trials. The findings contribute to the ongoing discourse on optimizing composite outcome measures in rheumatology and beyond, advocating for a balanced integration of scientific rigour and patient-centeredness in their development.

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