Self-directed learning about normal birth with web-based support for nurse-midwife students in Thailand: A mixed methods study

ObjectivesThe study aimed to determine the following four differences between students in the fields of nursing and health systems management: (a) attitudes towards web-based learning, (b) online course anxiety, (c) online course self-efficacy, and (d) intentional use of technology for learning and find factors that influence students’ intentional learning with technology.MethodsThe study utilized an explanatory sequential mixed methods design. The study was performed according to the checklist for assessment and reporting of document analysis for mixed methods design and research in health professions education. We included students from the School of Health Sciences, including those studying nursing and health systems management. There were 304 students included in our study. ResultsStudents from health systems management had more positive attitudes toward web-based learning than nursing students. Health science students’ years of study, online course self-efficacy, and web-based learning influence intentional learning with technology among students. The qualitative finding corresponds only with the qualitative result demonstrated that online course self-efficacy predicts the intentional use of technology for learning.ConclusionsIt is needed to consider factors for designing effective online learning experiences in health science, enabling educators to enhance intentional technology-based learning for nursing and health systems management students through web-based learning optimization.

As the number of participants in online distance learning courses increases, peer assessment is becoming a popular strategy for evaluating open assignments and for breaking the social isolation surrounding distance education. Yet, the quality and characteristics of peer assessment in massive online courses has received little attention. Hence, this study was set to examine peer feedback quality and grading accuracy in a project-based course. The study applied a sequential exploratory mixed methods design. It included 339 participants who studied the same engineering course, but in three different modes: on-campus (n = 77), small private online course (n = 110), and massive open online course (MOOC) (n = 152). Content analysis of feedback comments identified four categories: reinforcement, statement, verification and elaboration, arranged in an ascending scale of cognitive ability. The findings indicated that the MOOC participants provided more feedback comments and volunteered to assess more projects than their counterparts did. However, the on-campus students provided higher quality feedback and their peer grading was better correlated with the grades assigned by the teaching assistants.

This study aims to investigate the impact of mastery goal orientation (MGO) and self-directed learning (SDL) on academic performance via academic self-efficacy (ASE). As a learning medium, computer-based training (CBT) attempts to boost student confidence. The study used a quantitative approach, with 142 merchant marine school students serving as participants. The questionnaire was used as a research tool to collect data. To assess and measure variable relationships, research data was examined using structural equation modeling. According to the findings of the study, MGO and SDL have a direct impact on ASE and academic achievement. The study revealed that ASE mediated MGO and SDL in relation to academic achievement. Individual ambition to acquire information and competence results in ASE, which indicated students' confidence. CBT allows students to broaden their learning interests. SDL and CBT complement each other in a mutually beneficial way. CBT is a learning tool; nevertheless, without SDL, it will be ineffective in improving academic achievement. SDL without CBT is less effective since students are unable to explore a broader range of information and expertise. When students use CBT as a learning medium, they frequently study and practice, gaining more knowledge and expertise. CBT is thought to be an effective learning medium for increasing student academic confidence and performance.

COVID-19 and the subsequent closure of the schools across Bhutan, to check the spread of the virus forced the Ministry of Education and Skills Development to transition to online teaching and learning. Teachers were mandated by emergency policies to teach students online through the use of technology, social media, and other social network platforms. Technology integration is influenced by both first and second-order barriers and the quality of technology integration ranges from low-quality integration to high-quality integration. Using survey data from a sample of 110 teachers and interviews with 26 teachers in five districts of Bhutan, this research attempted to identify and delineate teachers technological pedagogical content knowledge and the draw its relation to the quality of technology integration. Sequential explanatory mixed-methods design, which enables researchers to first collect quantitative data and analyze the data to draw first set of findings was used. The findings of the survey were used to guide the interviews conducted during the second phase of the research. Results indicate that teacher are neither proficient in the various dimensions of TPACK nor required too much assistance to navigate the challenges to technology integration. The interview data did not reveal high-quality technology integration in the teaching learning process. Recommendations for policy and practices are provided.

Assessing Social Media Preferences and Developing Digital Health Care Transition Education Materials for Emerging Adults with Sickle Cell Disease: A Mixed Method Pilot Study

BackgroundPrimary Health Care Integration (PHCI) is part of Indonesia’s health transformation initiated in 2022. After two years, not all districts/cities have implemented the change, especially related to Health Posts (HP). The study aims to assess the HP’s readiness to implement this transformation.MethodA sequential exploratory mixed-method design was used. The first stage was explorative using a qualitative design and developing a quantitative research instrument. The second stage conducted a survey. Qualitative data collection through in-depth interviews and focus group discussions involving 42 informants: health cadres, health care workers, and City Health Office representatives. The qualitative data was processed with the ScreenQ software, and content analysis was carried out. Afterward, quantitative research instruments were built using predetermined theory, and validity and reliability tests were carried out. The quantitative survey involved 139 health cadres and 128 health care workers. The data obtained is transformed first using Rasch modeling (Winsteps 37). Then it was analyzed using SPSS software (SPSS 20), with readiness levels categorized into “not ready”, “moderately ready”, and “ready”. A comparison of readiness was performed between groups of respondents.ResultsQualitative analysis identified Facilitators including health cadres enthusiasm, collaboration, and commitment. Barriers included human resource, facilities, data synchronization, and digital reporting. Quantitative results showed that 83.5% of Health Posts were classified as “moderately ready”, meaning they had some essential elements in place but still faced gaps requiring further strengthening before full implementation could succeed. No statistically significant differences were found in readiness perceptions between health cadres and health care workers (3.19 logit, CI: -12.91–19.27, p = 0.697).ConclusionThis study provides baseline data for future research and policy development, offering insights into how to strengthen PHCI readiness in similar contexts, particularly by addressing the serious barriers that may hinder successful implementation.

This study examines the effect of item order (random, increasingly difficult, and decreasingly difficult) on student performance, test parameters, and student perceptions in multiple-choice tests administered in a paper-and-pencil format after online learning. In the research conducted using an explanatory sequential mixed methods design, quantitative data were first analyzed and then qualitative data were collected to examine these findings in depth. 2131 freshman university students participated in the quantitative part of the study and 312 students participated in the qualitative part. After 14 weeks of online foreign language education, tests with different item orders were applied to measure the academic achievement of the students. The findings revealed that item order did not significantly affect academic achievement of students. Item order was found to not affect test parameters such as test difficulty and reliability. The most striking finding the difficulty level of the items changes depending on the item ordering. Findings regarding student perceptions show that encountering difficult questions at the beginning of the test reduces motivation, increases anxiety, and creates a negative perception of the assessment process. Additionally, students emphasize that the assessment process should be compatible with the pedagogical structure of online learning. These findings indicate that students' perceptions as well as test statistics should be taken into account in test design. In this context, conducting the assessment of education provided through online learning in an online environment can eliminate many discussions regarding the item order. Based on these findings, it is recommended that future research be expanded to include different courses, item order method, and individual student differences.

The nexus between employability, lifelong learning (LL), and leadership development has emerged as a defining priority for organizations and individuals navigating rapid technological disruption and shifting labor market demands. This study examines the career readiness outcomes of 1,800 professionals across five primary learning modalities — formal education, online courses, workplace training, mentorship and coaching, and self-directed learning — using a structured dataset. Three machine learning models were applied to predict employability readiness: Logistic Regression, Gradient Boosting, and Random Forest. Logistic Regression achieved the highest performance, with an accuracy of 81.50% and a Macro-AUC of 0.924, while Gradient Boosting and Random Forest achieved accuracies of 76.25% and 75.83%, respectively — all surpassing the 70% benchmark. Feature importance analysis identified the Lifelong Learning Index, Leadership Program Hours, and Mentor Support Score as the most influential predictors of employability readiness. Inferential statistical analysis confirmed significant differences in readiness levels across learning mode groups (p < 0.001). Participants engaged in online courses and mentorship-based learning reported the highest average employability readiness scores (74.2 and 71.8, respectively) and the lowest burnout rates (4.82% and 3.94%). These findings suggest that passive or isolated learning modes are insufficient for building career resilience. Rather, organizations and policymakers must adopt integrated, active learning ecosystems that combine digital upskilling, mentorship, and structured leadership development to produce measurable improvements in workforce employability.

To evaluate the outcomes and acceptability of the Community-based Participatory Occupational Well-being Intervention for Educators. This pilot study used a sequential explanatory mixed-method intervention study design in which the post-intervention qualitative data were embedded in the quasi-experimental pre-test-post-test data to explain and expand the intervention outcomes and to evaluate intervention acceptability. This study received an ethical statement from the UEF Committee on Research Ethics (7/2021 15.4.2021) and followed the ethical principles of the Declaration of Helsinki. The quantitative pre-and post-test data were collected using an electronic questionnaire among health care educators (intervention n = 19, comparison n = 22). The 1-year intervention included (i) an online course, formation of (ii) an occupational well-being development team, which (iii) planned and (iv) implemented community-specific development actions. Qualitative interview data were collected from participants (n = 9) 3 months post-intervention. The quantitative data were analysed statistically and the qualitative data by deductive-inductive content analysis. The main results were merged into a joint display as mixed-method meta-inferences. Positive changes were found in occupational well-being, promoting activities and workplace support. Educators experienced improvements in work organisation processes and reflection on occupational well-being issues. The study found no significant change in the overall self-assessed level of occupational well-being. The intervention framework was considered functional, with workload issues as the main barriers. The main limitations of this study were a small sample size and a long intervention period, which challenged participant engagement and outcome evaluation. The intervention enables community-level occupational well-being development, and it can be applied in health care educators' work communities. The study suggests refining the intervention in terms of information provision, time resources and community-level orientation and discussion.

Purpose Goal orientation (GO) describes an individual’s approach to different achievement situations. Understanding the motivations and approach to achieving goals of medical students is vital with the increasing emphasis on self-directed learning. The purpose of this study was to identify themes in self-improvement reflections that relate to each GO dimension (learning, performance-prove, and performance-avoid). Methods A sequential explanatory mixed methods design was used. GO data was used to categorize students into groups aligning with the GO dimension identified in the previous stage of quantitative analysis. Individualized learning plans (ILPs) for each GO dimension group were coded inductively to identify emergent themes related to goal setting and achievement. Results The learning GO group was the largest of the three GOs. Five themes were identified from inductive analysis: importance of practice, identifying elements that helped, identifying structural barriers, opportunities for improvement, and acknowledging experience. While these themes occur across GO, patterns exist within their ILPs based on GO. Conclusions We identified common themes for motivations of medical students, and these motivations might differ depending on their GO. Further exploration into the themes over the course of their training will provide additional insights on what factors may be involved in student motivations towards learning and achievement. Educators can use this information to individualize feedback and students can better understand their motivations towards achieving goals.

Purpose The purpose of this study is to explore how different forms of social support, namely, family, friends and teachers enhance students’ computer internet self-efficacy (CIS) and its subsequent impact on learning satisfaction. By understanding these relationships, this study aims to provide insights into how social interactions influence digital competency and self-directed learning (SDL). In addition, it seeks to assess the significance of course clarity (CC) in promoting a positive learning experience. These findings aim to guide educators and policymakers in improving online education by integrating effective social support structures and clear instructional strategies. Design/methodology/approach This study uses a structural equation modelling (SEM) approach to examine the role of social support in enhancing self-efficacy and learning satisfaction among secondary school students in India. Data were collected from a diverse sample of urban secondary school students across six major cities. The study investigates how social support from family, friends and teachers influences students’ CIS, subsequently impacting CC, SDL and overall learning satisfaction in online education settings. The analysis highlights key relationships between these factors, offering insights into the dynamics of digital learning experiences. Findings This study reveals that family and friend support significantly influence students’ CIS, which in turn enhances their confidence and ability to navigate digital learning tools. Peer support emerged as the most influential factor in fostering digital confidence, whereas teacher support (TS) was particularly crucial in online learning settings. Furthermore, CC was strongly associated with perceived satisfaction, highlighting the need for well-structured digital curricula. Students with higher self-efficacy were more likely to engage in SDL, emphasizing the importance of digital competency in fostering independent study habits and overall learning satisfaction. Research limitations/implications This study is limited to urban secondary school students in six major Indian cities. Future research should explore rural and international contexts to understand how social support influences self-efficacy and learning satisfaction in different educational settings. In addition, the study focuses on current digital learning environments and does not account for emerging technologies that may further impact student experiences. Expanding the research to include newer digital learning tools and platforms can provide a more comprehensive understanding of these dynamics. Practical implications The findings highlight the need for educational institutions to strengthen social support mechanisms, particularly peer and TS, to enhance students’ digital confidence. In addition, ensuring CC is essential for improving learning satisfaction. Schools and educators should focus on structured, well-organized course designs that facilitate easy navigation and comprehension. Training programmes for teachers on effective digital pedagogies and the role of social support in online education can also be beneficial. These insights can help shape policies aimed at improving student engagement and satisfaction in digital learning environments. Social implications This study underscores the importance of social interactions in online education, emphasizing the role of peer and TS in enhancing digital learning experiences. The findings suggest that fostering a supportive learning community can significantly improve students’ self-efficacy and engagement with digital tools. By promoting strong social networks in online learning, educators can help bridge digital divides and create inclusive learning environments. In addition, recognizing the role of family support in education can encourage policies that involve parents in their children’s digital learning experiences, ultimately contributing to better academic outcomes. Originality/value This research contributes to the literature by providing a nuanced understanding of how social support, self-efficacy and CC collectively influence learning satisfaction in online education. Although previous studies have examined these factors in isolation, this study integrates them to offer a more comprehensive perspective. The findings provide valuable insights for designing effective, supportive online learning environments. By emphasizing the significance of peer and TS, as well as structured course design, this research informs educational policies and practices that aim to improve digital learning experiences for secondary school students in India and beyond.

The importance of teacher performance in improving achievement to determine the quality of education and school performance, This study is an Exploratory Sequential mixed method design study. aims to influence leadership, work motivation, and organizational culture on teacher performance and achievement, both partially and simultaneously with Exploratory Sequential Design . This approach combines qualitative and quantitative methods, starting with an in-depth exploration of the factors that influence the effectiveness of teacher work performance, followed by testing the quantitative model. This research was conducted at SMP Negeri 3 Numfor Barat in a remote area. To achieve the objectives of this study, the researcher applied Exploratory Sequential mixed method design research with a case study approach . In the qualitative stage, the research data was collected through observation, in-depth interviews with 1 head of educational unit and 10 subject teachers, and document analysis to identify needs, challenges, and best practices in management. The research data was processed through the stages of data collection, data presentation, data reduction, and data conclusion drawing. To ensure the validity of the research data, the researcher conducted data confirmation and credibility by involving the Education Office for the development of educational resources and school supervisors. The results of the study indicate that: (1) the teacher training management model in improving work performance that has been implemented in remote areas consists of the planning, organizing, implementing and evaluating stages. (2) The function of the teacher training management model in improving work performance that has been implemented in remote areas runs effectively and efficiently. The results of this study provide important information for the government, school supervisors, principals and teachers. leadership, work motivation, and organizational culture simultaneously have a positive and significant effect on teacher work performance.

The COVID-19 epidemic caused a huge change in higher education, forcing schools all over the world to quickly switch from traditional in-person classes to online learning environments. At first, this change was made in reaction to an emergency, but now online learning is a permanent and strategic part of higher education in the post-COVID era. As a result, students' preparation for online learning has become a key factor in how well, fairly, and sustainably education works. This study examines students' preparedness for online learning in post-COVID higher education, concentrating on four fundamental dimensions: technology preparation, self-directed learning, learner motivation, and online communication efficacy. Using a quantitative survey study design, data were gathered from 420 undergraduate and postgraduate students attending public and private universities. An organized questionnaire, modified from established online learning preparation tools, was distributed electronically. We used descriptive statistics and inferential analysis to look at overall preparedness levels and how they changed based on demographic factors. The results show that students are fairly technologically ready, which is likely due to more time spent online during the pandemic. Nevertheless, moderate to low levels of preparation were noted in self-directed learning, motivation, and online communication, indicating ongoing difficulties that extend beyond technical proficiency. There were big variances in preparation based on how much online learning someone had done before and their socioeconomic background. These findings emphasize that successful online learning in the post-COVID era necessitates more than just technological access; it requires extensive institutional support that encompasses cognitive, motivational, and social aspects of learning. The study adds real-world data to studies on higher education after the pandemic and gives useful information for making policies, designing courses, and providing student support services that will help create inclusive and strong online learning environments.

This study aims to examine the effects of different online learning formats on academic achievement and perceived learning. Another aim of the study is to examine the effects of online learning formats, online learning readiness and self-directed learning with technology on achievement and perceived learning. In the study, a quasi-experimental design was used. Two groups were involved in the study. While hybrid (synchronous and asynchronous) online applications were applied in the first experimental group, asynchronous online applications were applied in the second experimental group. The participants of this study are 73 students who are enrolled in the “Open and Distance Learning” course, which is one of the common elective courses of the faculty of education. To analyze the data, independent sample t-tests, Pearson correlation analysis, and hierarchical regression analysis were used. According to the results of the study, it was concluded that there was a significant difference in achievement according to the online learning format used and that the achievement scores of the students were higher in the asynchronous online learning format. When the perceived learning of the students was analyzed according to the online learning format used in the study, it was concluded that there was no significant difference. As a result of the hierarchical regression analysis, it was seen that the online learning format used in the study (hybrid or asynchronous) was a predictor of academic achievement. Finally, it was concluded that the online learning method and self-directed learning with technology variables did not significantly predict perceived learning, but online learning readiness was a significant predictor of perceived learning.

<p>This article describes the rationale for pedagogical, technological and organizational choices in the design of a web-based and open virtual learning environment (VLE) promoting and sustaining self-directed language learning. Based on the last forty years of research on learner autonomy at the CRAPEL according to Holec's definition (1988), we designed a global VLE for researchers working on language learning autonomy, teachers with various degrees of practice and experience in self-directed learning, and language learners. The VLE is thus divided into three spaces for the different types of participant, each offering dedicated social networking possibilities and resources to enrich the others.</p><p>Our study focuses on the space dedicated to teacher training, the main objective being to help them build knowledge and skills for a new educational role in the paradigm of language learning autonomy (LLA). This space contains specially created Web-TV resources and audio podcasts of self-directed learning advising sessions, is based on reflective analysis and relies on a professional social network, following the principles of the “community of practice” (Wenger, 1998). In line with the principles of self-directed learning, teachers acting as trainers in the VLE mainly enact supportive and facilitative functions as advisers do in face-to-face interactions. We explore how training for advisers is organized in this online environment characterized by a high degree of openness (Jézégou, 2010). We report on findings from the way teachers within their dedicated space, using quantitative and qualitative data collected from interviews, questionnaires and analysis of logs. We look at the tensions that emerge as teachers conceive their new role and engage in new training practices given the opportunities afforded by the environment. The data provide insights to how the VLE can support training practices based on reflection, participation and collaboration.</p>