Background and objectives Interactive digital tools such as smartboards are increasingly being used in education, yet robust evidence from low- and middle-income countries (LMICs) is limited. This study compared Smartboard- and PowerPoint-based teaching in undergraduate paediatrics and assessed their impact on knowledge retention and learner engagement. Methods A single-centre, open-label, parallel-group randomised controlled trial was conducted among 360 MBBS students (second, third, and final years). Participants were stratified by academic year and baseline test scores, then randomly assigned to Smartboard or PowerPoint groups. Identical paediatric topics were taught using standardised lesson plans. The primary outcome was knowledge retention, assessed through objective structured clinical examinations (OSCEs) immediately, and at 1- and 2-month follow up. Secondary outcomes included student and faculty feedback. The trial was prospectively registered with the Clinical Trials Registry-India (CTRI/2025/04/083965). Results Immediate pooled OSCE performance was comparable (Smartboard: 47.2% Grade A vs. PowerPoint: 41.1%, P=0.29). At 1-month follow-up (primary outcome), Smartboard students achieved higher Grade A scores across all years combined (46.1% vs. 40.3%, P=0.028). Smartboard participants also showed superior retention at 2 months in third- (P=0.002) and final-year (P=0.049) cohorts. Students reported greater engagement (66.1% vs. 51.9%; absolute difference 14.2% points), attention (68.1% vs. 33.9%; difference 34.2% points), and recall (46.1% vs. 22.8%; difference 23.3% points). Faculty rated Smartboards higher for engagement (100% vs. 33.3%; difference 66.7% points), but preferred PowerPoint for ease of preparation (83.3% vs. 33.3%; difference 50.0% points). Interpretation and conclusions Smartboard-based teaching improved long-term knowledge retention, engagement, and attention compared with PowerPoint, particularly at 1 month and among senior students. Interactive digital tools may enhance learning outcomes in LMIC settings.
The application of established principles from multimedia learning, education, and cognitive psychology can help maintain audience attention during PowerPoint presentations. Slide design should adhere to key cognitive principles, including dual-channel theory, cognitive load theory, and the principles of redundancy, coherence, signalling, and segmenting. Slides generated by AI tools are often overly complex, with redundant text, intricate visuals, and multiple arrows depicting relationships; such slides also cannot be animated. Practical workarounds for these limitations are discussed. Default templates and Design Suggestions frequently use small font sizes that require correction. PowerPoint features such as animation, Draw and Highlight can be used to emphasise key information, while SmartArt facilitates clear representation of relationships between elements. Features such as slide transitions and WordArt are best avoided. Tools such as Pointer, Zoom, and Presenter View help guide the presentation and focus attention. For online presentations, larger fonts and higher contrast are recommended, along with the inclusion of interactive elements such as polls. AI add-ons integrated within PowerPoint offer useful functionality but should be used with care. Narration remains central to effective presentations; slides should support and complement it. The Rehearse with Coach feature may help improve delivery. Supplementary files provide detailed examples of the use of SmartArt and shapes in psychiatric presentations.
3D teaching, including various types of mixed and virtual reality, are increasingly being used in anatomy, including on veterinary programs. In this study we compared the use of 3D mixed reality holographic technology and a 2D PowerPoint teaching resource to investigate the proof of concept of the usability and efficacy of the 3D technology. The anatomical area of the equine sinuses was the subject matter. The study design involved a series of questionnaires and tests delivered before and after the students used the learning resource. First-year veterinary students were randomly allocated to either the 3D or 2D group. Spatial ability and cognitive load were measured before, and cognitive load, task load, a 10-question spot test, and motion sickness (3D group only) were measured after. All students provided feedback via a short survey. The 2D group performed better in the spot test than the 3D group (t16.33 = -3.19, p < .05). No differences were noted for task load (p > .05) nor in the overall cognitive load (3D: V = 31.5, p = .2767, 2D: V = 23.5, p = .706); however, more participants in the 3D group exhibited a reduced cognitive load. Limited motion sickness symptoms were reported by participants in the 3D group. Qualitative findings from the survey demonstrated that the 2D group indicated difficulty in converting from 2D to 3D, and that the 3D group enjoyed the possibility of moving around the hologram. These findings demonstrate that the 3D mixed reality holographic technology had reasonable usability as a teaching resource, but future work is required into the efficacy of such technology for learning.
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Medical education is evolving toward interactive teaching methods, and small group teaching (SGT) is increasingly being adopted. While lecture-based teaching using PowerPoint (LBTP) remains common, its effectiveness in fostering student engagement, retention, and critical thinking is being questioned. To compare students' perceptions of SGT versus LBTP among Indian medical undergraduates. A cross-sectional, within-subject, comparative pilot study was conducted among 100 undergraduate medical students at Sheikh Bhikhari Medical College, Hazaribagh, India. The same topic was taught using two approaches: SGT (15-17 students per group, divided into six groups) and LBTP (a whole-class PowerPoint lecture). Feedback was collected via a semistructured questionnaire using Google Forms. Responses were analyzed using descriptive statistics and Chi-square tests (P < 0.05 was considered statistically significant). Of the 100 students, 98 completed the questionnaire. Most students (85%) rated SGT as more effective, particularly for understanding and engagement. Knowledge retention was higher with SGT (62.2%) compared to LBTP (11.2%). Strengths of SGT included better interaction, clarity, peer learning, and personalized feedback. SGT was perceived as more effective than LBTP. These findings support the integration of interactive, learner-centered methods in resource-limited medical education contexts, such as those found in many parts of Sub-Saharan Africa and South Asia. Résumé Contexte:L’enseignement médical évolue vers des méthodes pédagogiques interactives, et l’enseignement en petits groupes (EPG) est de plus en plus adopté. Alors que l’enseignement basé sur des cours magistraux utilisant PowerPoint (CM-PP) reste courant, son efficacité à favoriser l’engagement, la rétention et la pensée critique des étudiants est remise en question.Objectif:Comparer les perceptions des étudiants concernant l’EPG et le CM-PP parmi des étudiants en médecine indiens de premier cycle.Méthodes:Une étude pilote transversale, comparative, intra-sujets a été menée auprès de 100 étudiants en médecine de premier cycle au Sheikh Bhikhari Medical College, Hazaribagh, Inde. Le même sujet a été enseigné à l’aide de deux approches : EPG (15–17 étudiants par groupe, répartis en six groupes) et CM-PP (un cours magistral PowerPoint pour l’ensemble de la classe). Les retours ont été collectés via un questionnaire semi-structuré utilisant Google Forms. Les réponses ont été analysées à l’aide de statistiques descriptives et de tests du Chi-carré (P < 0,05 considéré comme statistiquement significatif).Résultats:Parmi les 100 étudiants, 98 ont complété le questionnaire. La plupart des étudiants (85 %) ont jugé l’EPG plus efficace, en particulier pour la compréhension et l’engagement. La rétention des connaissances était plus élevée avec l’EPG (62,2 %) qu’avec le CM-PP (11,2 %). Les points forts de l’EPG incluaient une meilleure interaction, une plus grande clarté, l’apprentissage par les pairs et un retour personnalisé.Conclusion:L’EPG a été perçu comme plus efficace que le CM-PP. Ces résultats soutiennent l’intégration de méthodes interactives centrées sur l’apprenant dans les contextes d’enseignement médical disposant de ressources limitées, tels que ceux observés dans de nombreuses régions d’Afrique subsaharienne et d’Asie du Sud.
Compared to the general population, persons with intellectual disability (ID) have a similar cancer rate, but cancer is often discovered at a later stage. Adults with ID show lower participation in organized screenings for breast, cervical, and colorectal cancer. Here we tested an intervention to increase cancer screening knowledge and intention to participate among persons with ID. An open-label cluster randomized controlled trial was co-constructed with people having ID. Participants with ID underwent interventions about cancer screening or oral hygiene, using PowerPoint presentations, booklets, dice games, workshops, films, and discussions. Both groups completed a questionnaire two weeks before the intervention and at 15 min, three months, and one year after the intervention, which evaluated their knowledge gain and intention to participate in cancer screenings. At 15 min, three months, and one year after the intervention, participants in the cancer group showed significantly improved cancer screening knowledge (p < 0.001). The intention to participate in screenings was increased on the intervention date (p < 0.001), but this change was non-significant three months later, and observed as a trend at one year (p = 0.068). A steering group of persons with ID gave advice regarding participant recruitment, conducting sessions, and modifying the film scenario, PowerPoint presentation, and questionnaire. Persons with ID co-constructed the booklet on cancer screening and acted in the film. Participation of persons with ID greatly improved the study efficacy. This research provides strong evidence supporting direct interventions for people with intellectual disability to increase their participation in organized cancer screening. RéSUMé: OBJECTIFS: Les personnes qui ont une déficience intellectuelle (DI) développent autant de cancers que les personnes dans la population générale. Ces cancers sont souvent découverts à un stade avancé. Les adultes atteints de DI participent peu au dépistage organisé des cancers du sein, du col de l’utérus et colorectal. Nous avons testé une intervention visant à accroître les connaissances sur le dépistage des cancers et l’intention d’y participer chez les personnes qui ont une DI. MéTHODES: Un essai contrôlé randomisé en grappes en ouvert a été co-construit avec des personnes DI. Les participants atteints de DI ont bénéficié d’une intervention sur le dépistage, ou bien sur l’hygiène bucco-dentaire. Elle comportait une présentation par diaporama, un livret, un jeu de dés, des ateliers, un film et des discussions. Un questionnaire évaluant d’une part les connaissances, d’autre part les intentions de participer au dépistage des cancers a été complété deux semaines avant l’intervention, puis 15 min, trois mois et un an après l’intervention. RéSULTATS: Quinze minutes, trois mois et un an après l’intervention, les participants du groupe cancer avaient significativement amélioré leurs connaissances sur le dépistage des cancers (p < 0,001). L’intention de participer au dépistage a augmenté le jour de l’intervention (p < 0,001), cette modification n’était plus significative trois mois plus tard, mais subsistait cependant à un an comme une tendance (p = 0,068). Un comité de pilotage incluant des personnes DI a donné des conseils pour le recrutement des participants, la conduite des séances, pour modifier le scénario du film, les présentations par diaporamas et le questionnaire. Des personnes avec DI ont co-construit le livret de dépistage du cancer et ont été acteurs dans le film. CONCLUSION: La participation de personnes qui ont une DI a grandement amélioré l’efficacité de l’étude. Cette étude fournit des arguments solides pour développer des interventions directes auprès de ces personnes afin d’accroître leur participation au dépistage organisé des cancers.
Despite increased integration of digital technologies in higher education, nursing students face major barriers in resource-limited settings. The study investigated the utilisation of digital educational technologies amongst undergraduate nursing students in the Western Cape. The study was conducted at the school of nursing at a higher education institution in the Western Cape. A descriptive cross-sectional survey design with a self-administered questionnaire was used to collect data from a sample of 253 participants. Descriptive analysis was conducted to determine the frequencies and percentages; the mean score and Chi-square test were conducted to determine the association between the variables. Nearly 90% of participants had experience in the use of digital educational technology, 94.5%, learning management system and Facebook, and 93.7% used PowerPoint, communication and collaboration tools. The gender differences in technology use are consistent with the literature. The results suggest female respondents' frequent use of social networks. Male respondents reported more frequent use of bibliographic and web conferencing technologies. Although overall use was very low, gender remains an important factor in understanding technology use. In contrast, blogs, discussion forums and immersive technologies were amongst the least utilised educational technologies. Most nursing students use basic digital tools like learning management systems, Facebook and PowerPoint, but advanced tools such as blogs, forums and immersive technologies are underused, revealing a gap in digital competence that limits collaborative learning and clinical simulation. This study provides evidence on digital technology use amongst undergraduate nursing students, showing frequent use of basic tools but limited engagement with advanced, interactive technologies.
Obtaining, Evaluating, and Communicating Information is one of the eight Science and Engineering Practices in the National Research Council framework that underlies Next Generation Science Standards (NGSS). Scientific inquiry requires evaluation and communication of research findings. These skills are part of scientific inquiry itself. The goal of this study was to characterize the communication practices students used during Science and Engineering Fairs (SEFs). To examine these practices, we included the following question in our online anonymous and voluntary national high school SEF surveys carried out during 2021-22 and 2022-23, "What types of communication and presentation skills did you use in your science fair project?" The possible answers were literature review; research notebook; software to prepare tables, graphs, or images; written report; poster board preparation; PowerPoint presentation; and interview with the judges . Literature review and research notebook are part of developing research questions and data collection. Software to prepare tables, graphs, or images, and PowerPoint presentation contribute to analyzing research and developing a presentation. Written reports, poster board preparation, and interviews with the judges provide the opportunity to present the findings. Overall, 1789 students answered the question. The percentage of students utilizing these skills ranged from 17.3% doing a literature review to 67.6% preparing a poster board. On average, students indicated the use of three skills. Poster board preparation and interview with the judges were selected by students more than twice as frequently as literature review and research notebook. More positive SEF outcomes were associated with a greater number of skills used by students. Among the different skills, use of a research notebook showed the strongest association. In this paper, we present the findings and discuss implications regarding use of notebooks and other communication and presentation skills in students' SEF experiences and engagement with scientific inquiry.
Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in older adults. This study aimed to assess the effectiveness of an educational intervention in improving nursing students' knowledge and attitudes toward AMD. A quasi-experimental pretest-posttest design was conducted with 144 nursing students from M. M. Institute of Nursing, Haryana. A structured knowledge questionnaire and attitude scale were used to assess the students before and after the intervention. The educational intervention, delivered via PowerPoint presentation, covered AMD's definition, prevalence, risk factors, clinical features, management, and the nursing role in AMD care. The results indicated that in the pretest, 44.4% of the students demonstrated good knowledge, which increased to 79.2% in the posttest. Positive attitude improved from 77.8% to 85.4%, while neutral attitude decreased from 22.2% to 14.6%. In terms of knowledge, the mean score improved from 21.78 ± 6.29 in the pretest to 26.34 ± 5.07 in the posttest, showing a statistically significant improvement (P = 0.001). For attitude, the mean score increased from 54.09 ± 6.00 in the pretest to 55.73 ± 5.98 in the posttest, with a statistically significant improvement (P = 0.021). Therefore, the educational intervention significantly enhanced nursing students' knowledge and attitudes toward AMD. The educational intervention significantly improved nursing students' knowledge and attitudes toward AMD. These findings emphasize the need to integrate eye health education into nursing curricula to enhance the effective management of AMD so that nursing students can manage patients with AMD in the community as well as in hospitals. Résumé Introduction:La dégénérescence maculaire liée à l’âge (DMLA) est l’une des principales causes de perte de vision irréversible chez les adultes âgés. Cette étude visait à évaluer l’efficacité d’une intervention éducative pour améliorer les connaissances et les attitudes des étudiants en soins infirmiers vis-à-vis de la DMLA.Matériels et Méthodes:Un plan quasi-expérimental avec prétest-posttest a été utilisé avec 144 étudiants en soins infirmiers de l’Institut de Soins Infirmiers M.M., Haryana. Un questionnaire structuré sur les connaissances et une échelle d’attitude ont été utilisés pour évaluer les étudiants avant et après l’intervention. L’intervention éducative, présentée par PowerPoint, couvrait la définition de la DMLA, sa prévalence, ses facteurs de risque, ses caractéristiques cliniques, sa prise en charge, et le rôle des infirmiers dans les soins aux patients atteints de DMLA.Résultats:Les résultats ont indiqué que, lors du prétest, 44,4% des étudiants ont montré de bonnes connaissances, ce qui a augmenté à 79,2% lors du posttest. L’attitude positive est passée de 77,8% à 85,4%, tandis que l’attitude neutre est passée de 22,2% à 14,6%. En termes de connaissances, le score moyen est passé de 21,78 ± 6,29 au prétest à 26,34 ± 5,07 au posttest, montrant une amélioration statistiquement significative (P = 0,001). Concernant l’attitude, le score moyen est passé de 54,09 ± 6,00 au prétest à 55,73 ± 5,98 au posttest, avec une amélioration statistiquement significative (P = 0,021). Par conséquent, l’intervention éducative a considérablement amélioré les connaissances et les attitudes des étudiants en soins infirmiers concernant la DMLA.Conclusion:L’intervention éducative a significativement amélioré les connaissances et les attitudes des étudiants en soins infirmiers envers la DMLA. Ces résultats soulignent la nécessité d’intégrer l’éducation à la santé oculaire dans les programmes de soins infirmiers afin d’améliorer la gestion efficace de la DMLA, permettant ainsi aux étudiants en soins infirmiers de prendre en charge les patients atteints de DMLA tant dans la communauté que dans les hôpitaux.
Active learning in face-to-face courses is superior to traditional lecturing, especially for women and marginalized students in STEM. Activities can be delivered using a broad variety of techniques, such as concept mapping, think-pair-share, and clickers. Concept modeling is particularly impactful for undergraduate biology courses, as they help students model microscopic organisms and processes that are otherwise impossible to visualize without microscopes or that occur on the molecular level. Generation Z, also known as iGen, is becoming one of the largest, most diverse demographics of students. iGen students grew up with technology and expect devices to be part of the learning experiences, which may begin to push hands-on manipulatives into a virtual format. However, it is unclear if the virtual format is universally beneficial for students. Thus, we investigated changes to students' performance, perceived knowledge, and confidence with the integration of eLearning activities, compared to interactive PowerPoint or hands-on activities. We sampled students in three sections of general microbiology over a semester as they completed six activities on historically difficult course topics. Each section received a different method of delivery (MOD) for their activities: PowerPoint, eLearning, or hands-on. Student performance on related quizzes and exam questions was also considered. Analyses included comparisons of marginalized and non-marginalized students to see if MOD impacted these groups of students differently. Overall, perceived knowledge, confidence, and performance all increased in response to the activities, with no significant differences among the three MODs. The data for marginalized students showed, however, that completing the hands-on MOD resulted in lower performance, perceived knowledge, and confidence. These findings suggest that there may be barriers for marginalized students when completing hands-on activities as compared to virtual activities in the face-to-face classroom.
The purpose of the study was to compare students' feedback on the accuracy, practicability, understanding, and the application of the two systems to classify root canal morphology in the UAE dental schools. This survey-based study involved 4th and 5th year undergraduate students and dental trainees from four dental schools in the UAE. The study was conducted in two phases. In phase one, a PowerPoint presentation describing the two systems (Vertucci and Ahmed et al.) to classify root canal morphology was delivered physically to the students at three separate sessions in each dental school (n = 12). In phase II, a printed questionnaire was distributed to collect their feedback. Fisher's Exact Test was used for statistical analysis and p-value was set at 0.05. Out of 1024 individuals across the four dental schools, 707 (69%) participated in the study. The students and the trainees agreed that the Ahmed et al. system is more accurate (90.1%), more practical (84.6%), and improved the understanding of root canal morphology (91.5%). In addition, they recommended incorporating in the curriculum (91.4%) for teaching preclinical and clinical courses (92.1%). No significant differences (p > 0.05) were found in the feedback between the students and the dental trainees for all the five closed-ended questions. The majority of the undergraduate students across the four dental schools in the UAE had agreed that the Ahmed et al. system is more accurate and practical compared to the Vertucci system, and they recommended its adoption in the dental curriculum.
Serious illness conversations (SICs) are often delayed or avoided in community-based healthcare due to clinician discomfort and lack of training. Given that many patients wish to die at home, yet often do not, there is a need for structured communication training in home care and hospice settings to ensure the care we provide aligns with patient and family preferences. This quality improvement project aimed to assess whether a brief, structured, in-person training session could improve clinician confidence in conducting SICs. A pre-test/post-test design was used. Clinicians participated in a 1.5-hour in-person educational session that included a PowerPoint presentation. Surveys assessing clinician confidence were administered before and after the session. Subjects included 77 clinicians: registered nurses, licensed practical nurses, physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants, and social workers. Clinician confidence was measured using the End-of-Life Professional Caregiver Survey (EPCS), a validated 28-item Likert-style survey tool. Of 77 participants, 45 complete survey pairs were analyzed. Mean EPCS scores improved significantly from 2.4329±0.3959 pre-training to 2.6593±0.2979 post-training (p < .001). A 63% increase in palliative bridge patient identification was also observed. A brief, structured SIC training significantly improved clinician confidence and increased identification of palliative care bridge patients. By embedding SIC training within a community-based organization, this work demonstrated how modest interventions can catalyze a change in practice, reinforcing the idea that SICs are a standard of quality care rather than an optional enhancement.
Educating resident physicians to master the complex. Educating resident physicians to master the complex echocardiographic diagnosis of congenital heart disease (CHD) represents a substantial pedagogical challenge. The central difficulty lies in translating dynamic two-dimensional ultrasound images into a robust three-dimensional spatial understanding. While high-technology teaching aids have emerged, their significant cost and limited accessibility impede widespread adoption. This study was designed to rigorously evaluate the effectiveness of a low-cost, high-cognitive-engagement instructional method-instructor-led, real-time hand-drawn schematic diagrams-in augmenting the CHD ultrasound diagnostic capabilities of resident physicians. A single-center, prospective randomized controlled trial was conducted. Forty residents rotating through the Department of Ultrasound at Zhangzhou Affiliated Hospital of Fujian Medical University from September 2024 to August 2025 were enrolled. Participants were randomly assigned to either an intervention group (n=20) or a control group (n=20). The control group received conventional PowerPoint-based instruction. The intervention group received the same conventional instruction supplemented with instructor-led dynamic hand-drawn schematic diagrams. The primary outcomes were objective assessment scores in ultrasonic theoretical knowledge, practical skill operation, and clinical reasoning abilities. Secondary outcomes encompassed subjective learning satisfaction and self- perceived understanding. All 40 participants successfully completed the study protocol. Theintervention group demonstrated significantly superior performance compared with the control group in theoretical knowledge (88.20 ± 3.96 vs. 82.95 ± 2.37, p < 0.001) and clinical reasoning abilities (90.50 ± 2.76 vs. 82.75 ± 3.60, p < 0.001). However, no statistically significant difference was observed in practical skills scores (89.40 ± 3.24 vs. 87.20 ± 4.99, p = 0.106). Subjective questionnaire surveys revealed that the intervention group provided significantly higher ratings across all assessed dimensions of learning and overall teaching satisfaction (all p < 0.05). In the context of CHD ultrasound education for residents, theintegration of instructor-led hand-drawn schematic diagrams markedly enhances learners', theoretical knowledge and clinical reasoning. The limited direct impact on practical skills highlights the distinct developmental pathways for cognitive versus psychomotor competencies. These findings validate hand-drawn diagrams as an effective, economical, and readily implementable pedagogical tool, particularly well- suited for constructing the complex conceptual and spatial frameworks essential for mastering echocardiography.
The COVID-19 pandemic affected every aspect of life worldwide, including the medical education system, with anatomy teaching being one of the most affected disciplines. To maintain continuity of education, educators rapidly transitioned to virtual teaching methods. The present study aimed to assess the effectiveness of virtual teaching methods during the pandemic by conducting a student-based survey (378 undergraduate and postgraduate medical students) and comparing them with traditional in-person teaching methods. Data were collected using a structured questionnaire designed to evaluate student's preferences and perceptions regarding virtual teaching. The survey showed that PowerPoint presentations were the most preferred method for online theory teaching, with an average of ~89.00% (n=336) selecting this option across all streams. For online practical classes, YouTube dissection videos were chosen by ~50.00% (n=189) of students of all streams as the most suitable method for learning anatomical dissection online. In-person live lectures with live streaming were chosen as the best model of online anatomy teaching by most of the students, with an average of ~80.00% (n=302). Despite the adoption of various digital tools for online teaching, a significant proportion of students reported that their understanding through online teaching was lower compared to classical in-person teaching methods, with an average response of ~94.50%. Overall, the results indicate a general dissatisfaction among students with the fully online model of anatomy teaching; however, the responses also provided valuable suggestions for improvement of virtual teaching methods. The findings of this study highlight the challenges associated with online anatomy education and provide insights into potential strategies for improving virtual teaching methods. The data obtained may help educators to design more effective online teaching approaches, not only in situations such as pandemics but also as part of future blended learning models in medical education.
Breast cancer (BC) is the most common malignant tumor among women in the world, and it is also the most common cancer type that causes female deaths. Accumulating evidence has indicated a close relationship between the gut microbiota (GM) and BC, encompassing aspects such as clinical diagnosis, carcinogenic mechanisms, and treatment. To date, no study has conducted a bibliometric analysis concerning BC and GM. Bibliometrics, as a methodological discipline for quantitative analysis of academic literature, is not only applied in basic medical research but also in clinical medical research. A search for literature was conducted related to BC and GM in the Web of Science Core Collection database from January 1, 2005 to July 31, 2024. Tools such as Microsoft PowerPoint 2019, Microsoft Excel 2019, VOSviewer 1.6.20, and CiteSpace 6.3.R1, were used to visualize not only publishing trends but also hotspots. A total of 842 articles is included, including 456 articles and 386 reviews. Since 2016, the publishing industry has experienced rapid growth. As expected, the United States ranks highest in terms of literature quantity and average citation count. The University of Illinois is the most active institution, whereas the National College of Ireland receives the highest average number of citations. The 3 researchers with the greatest influence are Bai, Peter, Miko, Edit, and Ujlaki, Gyula. The International Journal of Molecular Science has accounted for the largest number of publications, while Science ranked as the most highly cited journal. According to keyword and topic analyses, "quality of life" and "tumor microenvironment" will be the hotspots and frontiers of future research. Overall, this field is receiving increasing attention. We found that the future research hotspots of BC/GM may focus on the mechanisms of tumor occurrence, microbiota combination therapy, and the development of new predictive biomarkers, providing effective suggestions and new insights for scholars.
Visual demonstrations play an important role in supporting older adults' adoption of wearable healthcare technologies, but how they shape acceptance remains underexplored. This study aimed to identify the most suitable demonstration format for further investigation and, using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, examine how its features supported adoption. Using an explanatory sequential mixed-methods design, Phase 1 involved a repeated-measures crossover survey (N = 62) comparing written, PowerPoint, video, and live demonstrations of smartwatch functions to guide the qualitative phase. Phase 2 involved semi-structured interviews (N = 16) to explore how video demonstrations, the highest-scoring format, activated 4 perceptual affordances-visibility, recordability, verifiability, and comparability. Transcripts were coded by UTAUT construct and affordance, followed by thematic analysis. Phase 1 results showed that all enhanced demonstrations scored higher than the written baseline, with video achieving the highest descriptive means across UTAUT constructs. Phase 2 thematic analysis revealed three patterns: "Seeing Is Believing" described how clarity and visual verification fostered trust; "Finding Myself in the Demonstration" emphasized age-appropriate representation and contextual relevance; and "Perceived Family Approval in Technology Adoption" highlighted family validation and support as central to acceptance. Contextual video segments were most effective for performance expectancy and social influence, whereas instructional close-ups often heightened perceived complexity, shaping effort expectancy and facilitating conditions. These findings informed 5 design recommendations: balance close-ups with contextual views, provide clear visual feedback, feature age-appropriate demonstrators, embed daily-life scenarios, and include family interactions to strengthen acceptance.
Assessing Circumstances and Offering Resources for Needs (ACORN) is a US Department of Veterans Affairs (VA) clinical intervention designed to identify and address social needs to improve health and well-being among all veterans. We co-designed the ACORN Dashboard to facilitate access to real-time social needs and intervention data for VA clinical care teams and leadership. This study aimed to (1) describe the iterative development of the ACORN Dashboard, (2) assess end user feedback and Dashboard usage, and (3) discuss the role of social needs dashboards in facilitating continuous quality improvement in health care settings. An interprofessional team of subject-matter experts and end user feedback contributed to the design. Phase 1 included more than 7 months of weekly working meetings. We initially constructed a wireframe in Microsoft PowerPoint, then translated it into a prototype in Power BI, a data visualization software. Using Microsoft Power BI, we built data visualizations to communicate population-level sociodemographic and ACORN screening data. Through feedback sessions, staff from 8 VA medical centers (VAMCs) reviewed the prototype and recommended improvements regarding the Dashboard's purpose, content, and usability. Phase 2 involved 6 weeks of weekly working meetings, where we developed and iteratively refined 5 written drafts of clinically relevant variables for potential inclusion in the Patient-Level Data Page. This list informed a Power BI prototype. We also developed the ACORN Implementation Map page in Power BI to display implementation locations and settings. We again used feedback sessions with 8 VAMCs to review and refine the newly added pages and discuss improvements. To assess usage, we obtained metadata from a VA-specific Power BI report and user experience data from an ACORN VAMC survey. The ACORN Dashboard displays national data that are updated daily, reflecting 83,546 screens administered across 82 VAMCs facilities between July 1, 2021, and April 30, 2025. The Dashboard was viewed 18,192 times by 2251 unique users, and, on average, 263 (SD 91.2) unique users viewed the Dashboard every month between October 1, 2023, and April 30, 2025. Dashboard variables include the number of screens completed, sociodemographic characteristics of veterans screened, prevalence of social needs, and interventions provided to address needs. Phase 1 semistructured feedback sessions included recommendations for a page with patient-level data to supplement the population-level pages, incorporation of additional filters to select specific data, and development of a user guide. In phase 2, key insights included enhancement of end users' ability to search by veteran or staff name, guidance about screening frequency, changing the display order of variables, and the inclusion of variable definitions. Using co-design to develop, maintain, and continually refine data dashboards enhances implementation of social screening and interventions in health care settings. In addition to supporting individual-level patient care, population-level dashboard data inform continuous quality improvement, promote health equity, and identify gaps in services to address identified needs.
Cancer-related cognitive impairment (CRCI) affects a large proportion of cancer survivors and adversely affects quality of life (QoL). While there is no established CRCI treatment, a cognitive-behavioral therapy (CBT), Memory and Attention Adaptation Training (MAAT), has evidence of efficacy in improving self-reported and objective neurocognitive outcomes. However, not all people with CRCI require a full course of MAAT (8 visits). We condensed MAAT into an educational class (4 1-h meetings) as a "stepped care" approach to address CRCI in a busy clinical oncology care setting. Our goal with this quality improvement project was to offer brief, accessible CRCI care and evaluate self-reported cognitive function. "MAAT-Class" utilizes discussion, problem-solving and a PowerPoint presentation emphasizing CRCI education, self-awareness, self-regulation/emotional coping, and compensatory strategies. All participants use a MAAT workbook. Self-report measures assessing cognitive symptoms, emotional function, coping and sleep were administered before and after MAAT-Class. Twenty-two adult participants with diverse cancer diagnoses (breast, leukemia/lymphoma, CNS tumor) provided complete data. Significant improvements were observed in Perceived Cognitive Impairments (p < 0.05; d = 0.79), Impact on QoL (p < 0.05; d = 0.39), Perceived Cognitive Abilities (p < 0.05; d = 0.88), relaxation skills (p < 0.001; d = 0.77) and coping confidence (p < 0.001; d = 0.77). A condensed classroom-based version of MAAT demonstrated improvements in perceived cognitive impairments, QoL and coping. This first-step clinical educational approach could potentially and efficiently help inform patients with CRCI and improve QoL outcomes. Administering MAAT-Class via telehealth could potentially help survivorship care access. However, evaluation with a randomized study is necessary to definitively answer questions of efficacy.
This study aimed to explore the effectiveness of a novel orientation gauge for undergraduate learning in implant dentistry hands-on practice. The individualized simulation models were processed based on cone beam computed tomography (CBCT) and intraoral scanning of a patient with an absence of bilateral mandibular first molars. A novel orientation gauge was invented to instruct students to place implants and assess dental implant buccal-lingual, mesial-distal, or coronal-apical penetration position deviations. Ninety-eight students were randomly enrolled in the implant dentistry program and assigned to the gauge group (n = 47) and the control group (n = 49). Pre-class videos of an implant surgery operation by freehand were given to students 1 week before class. For the gauge group, an extra PowerPoint on the application of the novel orientation gauge was presented before class. Then, students are required to perform implant placement and complete questionnaires before/after class. CBCT and the orientation gauge were used to evaluate the three-dimensional (3D) accuracy of the implant placement. Students' perception related to the clinical practice skills was judged by questionnaire results. The linear deviation of the CBCT examination showed a significant difference concerning angular deviation (p = 0.0193). A significant mesial-distal deviation was observed in the gauge group compared with the control group (mean: 0.5233 vs. 0.9259 mm, p = 0.0077), according to the absolute restoration-level deviation value. A tendency to reduce the buccal-lingual implantation deviation was also noticed in the gauge group (p = 0.0640). Significant differences were elicited in the students' responses before and after training in both groups (p < 0.001). Students' questionnaires showed better results in surgical procedures understanding, prosthetically driven implantology knowledge, the precise 3D spatial position of dental implants, and the usage of surgical cassettes before/after simulation training in the gauge group. The novel orientation gauge can help students reduce implant placement deviations and enhance their understanding of the implant surgery process.