OBJECTIVE: To investigate the current status of clinical genetics specialization development and the diagnostic and therapeutic capabilities for hereditary diseases across medical institutions in Shanghai, and to assess the necessity and feasibility of establishing training bases for clinical genetics specialists. METHODS: By employing a cross-sectional survey design, the Clinical Genetics Committee of Shanghai Medical Association has conducted questionnaire surveys from March to April 2025 across 54 healthcare institutions in Shanghai (including 33 tertiary hospitals and 21 secondary hospitals). The survey involved administrative departments and medical personnel from 15 clinical specialties. The survey has covered current genetic disease diagnosis and treatment practices, relevant and specialised disease types, genetic department establishment, testing capabilities, personnel teams, and training requirements. RESULTS: The results revealed that 78.0% of clinical departments surveyed had treated patients with hereditary disorders. Shanghai possesses diagnostic and therapeutic expertise for over 95% of hereditary diseases listed in its rare disease catalogue, reflecting both the practical clinical demand for such conditions and the city's overall diagnostic and therapeutic strengths in this field. Nevertheless, significant disparities exist in the development of genetics departments across different tiers of healthcare institutions. Resources for genetic testing capabilities (including molecular, cellular, and biochemical testing) are also unevenly distributed across different tiers of hospitals. The survey further revealed that only 26.0% of departments believe that their current physician structure fully meets the diagnostic and treatment demands. Over 90% of departments consider standard training for clinical genetic specialists necessary, with 74.0% expressing willingness to participate in establishing training bases. Based on above findings and thorough deliberation, the Clinical Genetics Committee of the Shanghai Medical Association proposes advancing specialist training and discipline development through establishing a standard training system. The committee has drafted a three-year training protocol featuring a "joint training"-centered model, recommending a pilot-first, dynamically optimized strategy for steadily advancing training base development. CONCLUSION Shanghai faces substantial demand for genetic disease diagnosis and treatment, yet exhibits shortcomings in clinical genetics specialization development, resource allocation, and talent pipeline cultivation. To establish a standard training system holds significant practical importance and is underpinned by a broad demand.
Humans ; China ; Surveys and Questionnaires ; Genetic Diseases, Inborn/genetics* ; Cross-Sectional Studies ; Genetics, Medical/education* ; Genetic Testing

OBJECTIVES

The objective of this study was to synthesize existing literature on nursing informatics (NI) and propose updates to the Philippine Nursing Informatics curriculum that embrace current trends and integrate a globally acknowledged framework.

A literature search was conducted on PubMed and ScienceDirect. This search identified 79 articles, of which only eight met the inclusion criteria. The Technology Informatics Guiding Education Reform (TIGER) initiative provided the framework for analyzing the literature review outcomes and for developing the revised course structure for the Nursing Informatics (NI) curriculum in the Philippines.

The revised course outline incorporated 31 topics across the six domains outlined by the TIGER framework. Upon comparison, it was found that numerous topics identified were absent from the existing NI curriculum in the Philippines. Key subjects identified for inclusion encompass research, examination of standards and terminologies, application in community health, cybersecurity, project management, and advocacy. These areas hold particular relevance for the Philippines, attributed to the limited recognition of NI and the ongoing advancements related to technological applications in healthcare.

The nursing informatics curriculum in the Philippines is not up to date, failing to align with global NI standards. It is recommended that a thorough revision and enhancement be undertaken to ensure alignment with international frameworks and current industry practices.

BACKGROUND

Due to the COVID-19 outbreak, schools had to switch online. The sudden transition to blended teaching and learning (BTL) poses challenges for students and teachers, especially for health science programs that require hands-on practical experience. The validity, reliability, and responsiveness of these self-report questionnaires (SRQs) should be established to ensure the accuracy of the results as intended by the SRQ.

This study critically appraised, compared, and summarized the psychometric properties of SRQ evaluating BTL among health science university students. This review determined the SRQ’s reliability, internal consistency, various forms of validity (content, criterion, construct), and responsiveness.

Following a 10-step procedure based on COSMIN guidelines, we conducted a systematic review of SRQs used by health science university students to evaluate blended teaching and learning. Studies were eligible if they reported psychometric properties of SRQs related to blended learning among university health science students; exclusions included studies focusing on perceptions, attitudes, self-efficacy, and satisfaction, as well as articles such as biographies, editorials, and conference materials. Searches covered multiple electronic databases until April 26, 2023, including PubMed, EMBASE, Web of Science, MEDLINE (OVID), PsycInfo, CINAHL, EBSCOHOST, ERIC, Scopus, Science Direct, Google Scholar, JSTOR, Acta Medica Philippina, Philippine Journal of Health Research and Development, and HERDIN, managed through Zotero. Two independent reviewers performed database searches, title and abstract screening, and full-text evaluations, with a third reviewer resolving any disputes. The COSMIN Risk of Bias Checklist was employed to evaluate included studies on the development and various measurement properties of SRQs. The reviewers assessed SRQ standards, including validity, reliability, internal consistency, measurement error, responsiveness, interpretability, and feasibility. Data extraction and result tabulation were independently completed, with content comparison by two health education experts. This evaluation categorized the SRQs into three quality and validity levels.

The study examined five articles; four were rated as 'doubtful' and one as 'inadequate' in the overall development of SRQ. All four 'doubtful' studies demonstrated questionable content validity when university students were asked about the questionnaire's relevance, comprehensiveness, and comprehensibility. Only half of these studies achieved an 'adequate' rating for content validity based on expert opinions on relevance and comprehensiveness. All but one study scored from 'very good' to 'adequate' in structural validity. Three out of the four studies scored a very good rating for internal consistency, while one was deemed 'inadequate' in internal consistency, cross-cultural validity, and reliability. Three out of four studies scored 'very good' on construct validity, but all overlooked criterion validity and responsiveness. Conducted in various locations, including Australia, Romania, Turkey, and Taiwan, these studies highlighted both common characteristics and limitations in questionnaire development according to the COSMIN guidelines. Four studies were deemed reliable and valid for BTL constructs (Category A); Wu et al. requires further validation (Category B). Study limitations included heterogeneity in populations, settings, and questionnaire versions, potential subjective bias in SRQ content comparison, and the evolving nature of SRQs in blended learning contexts.

The systematic review reports the development and evaluation of SRQs for BTL while identifying gaps in their applicability to health science programs. The Blended Learning Scale (BLS) of Lazar et al. and the Blended Learning Questionnaire (BLQ) of Ballouk et al. showed an ‘adequate' rating for content validity. BLS revealed very good structural validity, internal consistency, and adequate content validation. Although the BLQ lacked Confirmatory Factor Analysis, it yielded valuable constructs for evaluating health sciences students' experiences in BTL. Both tools require improvements on recall period, completion time, interpretability, and feasibility. The review underscores the necessity for cont inuous assessment and enhancement of such instruments in BTL, advocating a rigorous scale development process. Furthermore, it encourages the customization of teaching and learning evaluation tools to suit specific institutional contexts while promoting further validation of these questionnaires across different populations in future research.

BACKGROUND

The clinical learning environment (CLE) significantly influenced the nursing students' learning experience. While clinical learning is the heart of nursing education, certain non-academic factors might be influenced by CLE. Consequently, CLE may be affected during a health crisis like the COVID-19 pandemic.

To determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.

A descriptive cross-sectional study was conducted involving 462 nursing students enrolled during the COVID-19 pandemic. A purposive sampling technique was used to select the participants. Four self-report questionnaires were adopted to gather the data: a 42-item Clinical Learning Environment Inventory (CLEI) scale, short-form Grit (Grit-S) scale, Rosenberg’s Self-Esteem (RSE) scale, and Caring Behavior Inventory (CBI-24) scale. Spearman rho and rank-biserial correlation tools were used to analyze the data.

The results indicated that the clinical learning environment was positively associated with academic grit, selfesteem, and caring behavior. Some profiles of the participants, such as age, sex, year level, type of school, leadership experiences, clinical setting experience, and willingness to be a nurse, were significantly associated with the clinical learning environment, academic grit, self-esteem, and/or caring behavior.

Students’ CLE influences their academic grit, self-esteem, and caring behavior. That is, students who reported a more positive perception of CLE, the higher their academic grit, self-esteem, and caring behaviors. Furthermore, some students’ profile characteristics influence CLE, academic grit, self-esteem, and caring behavior. Enhancing CLE while promoting grit, self-esteem, and caring behaviors of nursing students affiliated with hospitals or any clinical learning settings and promoting alternative means of meeting CLE competencies when face-to-face interactions are restricted during a health crisis are recommended.

BACKGROUND

The clinical learning environment (CLE) significantly influenced the nursing students' learning experience. While clinical learning is the heart of nursing education, certain non-academic factors might be influenced by CLE. Consequently, CLE may be affected during a health crisis like the COVID-19 pandemic.

To determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.

A descriptive cross-sectional study was conducted involving 462 nursing students enrolled during the COVID-19 pandemic. A purposive sampling technique was used to select the participants. Four self-report questionnaires were adopted to gather the data: a 42-item Clinical Learning Environment Inventory (CLEI) scale, short-form Grit (Grit-S) scale, Rosenberg’s Self-Esteem (RSE) scale, and Caring Behavior Inventory (CBI-24) scale. Spearman rho and rank-biserial correlation tools were used to analyze the data.

The results indicated that the clinical learning environment was positively associated with academic grit, selfesteem, and caring behavior. Some profiles of the participants, such as age, sex, year level, type of school, leadership experiences, clinical setting experience, and willingness to be a nurse, were significantly associated with the clinical learning environment, academic grit, self-esteem, and/or caring behavior.

Students’ CLE influences their academic grit, self-esteem, and caring behavior. That is, students who reported a more positive perception of CLE, the higher their academic grit, self-esteem, and caring behaviors. Furthermore, some students’ profile characteristics influence CLE, academic grit, self-esteem, and caring behavior. Enhancing CLE while promoting grit, self-esteem, and caring behaviors of nursing students affiliated with hospitals or any clinical learning settings and promoting alternative means of meeting CLE competencies when face-to-face interactions are restricted during a health crisis are recommended.

INTRODUCTION

The suspension of face-to-face education across all public and private institutions in the Philippines during the COVID-19 pandemic prompted nationwide adoption of blended learning-a hybrid model combining online and modular instruction with limited in-person components, while blended learning became primary instructional approach during this period, the Dr. Jose Fabella Memorial Hospital School of Midwifery‘s specific implementation lacked formal evaluation. This study aimed to analyze students’ and instructors’ experiences, self-efficacy, and satisfaction with blended learning during the pandemic-era “new normal,” addressing a critical gap in assessing pedagogical effectiveness in specialized vocational training contexts.

This study used mixed method approach to assess of DJFMH midwifery students and instructors’ experiences, self-efficacy, and satisfaction by using quantitative questionnaires and qualitative focus groups to explore deeper insights. This pattern enabled the researchers to evaluate the level of experiences, self-efficacy, and satisfaction but also the strengths and weaknesses of the program.

The findings revealed that the demographic profile predominantly consists of young, single, first-time midwifery students with no prior experience in information and communication technologies (ICT) literacy experience and limited professional background. This group was compared to a more experienced cohort of instructors, with both groups using PLDT as their internet service provider. Both students and instructors reported moderate agreement regarding blended learning experiences. In addition, the results indicated a positive correlation between experience and satisfaction. However, there was only a weak correlation between experience and self-efficacy. Instructors generally reported high self-efficacy, while students expressed mixed feelings about their preparedness and skill acquisition, especially in practical midwifery competencies. Overall, both groups demonstrated moderate levels of satisfaction with the blended learning approach. Instructors largely report higher self-efficacy, while students exhibit mixed feelings about their preparedness and skill acquisition, particularly regarding practical midwifery competencies. Both groups display moderate satisfaction with blended learning, especially appreciating its flexibility in time and location, as well as the fresh perspectives it brings to education. However, they also identify several challenges, including the pressure of expectations, limited adjustment to online platforms, technological issues, gaps in applying midwifery skills, disparities in learning resources, and environmental distractions. Despite recognizing the strengths of blended learning, there remains a strong preference among participants for in-person instruction.

The study highlighted the need for multifaceted approach to midwifery education that addresses the disparities in ICT literacy, preferences for in-person instructions, technological competencies, emotional wellbeing, and practice. Policymakers should focus on practical skill development of students and the professional development of instructors to create a more effective and supportive environment. Future studies should conduct longitudinal research to track the progress of students’ skills and confidence.

Education, Medical ; Education ; Research

BACKGROUND

Due to the COVID-19 outbreak, schools had to switch online. The sudden transition to blended teaching and learning (BTL) poses challenges for students and teachers, especially for health science programs that require hands-on practical experience. The validity, reliability, and responsiveness of these self-report questionnaires (SRQs) should be established to ensure the accuracy of the results as intended by the SRQ.

This study critically appraised, compared, and summarized the psychometric properties of SRQ evaluating BTL among health science university students. This review determined the SRQ’s reliability, internal consistency, various forms of validity (content, criterion, construct), and responsiveness.

Following a 10-step procedure based on COSMIN guidelines, we conducted a systematic review of SRQs used by health science university students to evaluate blended teaching and learning. Studies were eligible if they reported psychometric properties of SRQs related to blended learning among university health science students; exclusions included studies focusing on perceptions, attitudes, self-efficacy, and satisfaction, as well as articles such as biographies, editorials, and conference materials. Searches covered multiple electronic databases until April 26, 2023, including PubMed, EMBASE, Web of Science, MEDLINE (OVID), PsycInfo, CINAHL, EBSCOHOST, ERIC, Scopus, Science Direct, Google Scholar, JSTOR, Acta Medica Philippina, Philippine Journal of Health Research and Development, and HERDIN, managed through Zotero. Two independent reviewers performed database searches, title and abstract screening, and full-text evaluations, with a third reviewer resolving any disputes. The COSMIN Risk of Bias Checklist was employed to evaluate included studies on the development and various measurement properties of SRQs. The reviewers assessed SRQ standards, including validity, reliability, internal consistency, measurement error, responsiveness, interpretability, and feasibility. Data extraction and result tabulation were independently completed, with content comparison by two health education experts. This evaluation categorized the SRQs into three quality and validity levels.

The study examined five articles; four were rated as 'doubtful' and one as 'inadequate' in the overall development of SRQ. All four 'doubtful' studies demonstrated questionable content validity when university students were asked about the questionnaire's relevance, comprehensiveness, and comprehensibility. Only half of these studies achieved an 'adequate' rating for content validity based on expert opinions on relevance and comprehensiveness. All but one study scored from 'very good' to 'adequate' in structural validity. Three out of the four studies scored a very good rating for internal consistency, while one was deemed 'inadequate' in internal consistency, cross-cultural validity, and reliability. Three out of four studies scored 'very good' on construct validity, but all overlooked criterion validity and responsiveness. Conducted in various locations, including Australia, Romania, Turkey, and Taiwan, these studies highlighted both common characteristics and limitations in questionnaire development according to the COSMIN guidelines. Four studies were deemed reliable and valid for BTL constructs (Category A); Wu et al. requires further validation (Category B). Study limitations included heterogeneity in populations, settings, and questionnaire versions, potential subjective bias in SRQ content comparison, and the evolving nature of SRQs in blended learning contexts.

The systematic review reports the development and evaluation of SRQs for BTL while identifying gaps in their applicability to health science programs. The Blended Learning Scale (BLS) of Lazar et al. and the Blended Learning Questionnaire (BLQ) of Ballouk et al. showed an ‘adequate' rating for content validity. BLS revealed very good structural validity, internal consistency, and adequate content validation. Although the BLQ lacked Confirmatory Factor Analysis, it yielded valuable constructs for evaluating health sciences students' experiences in BTL. Both tools require improvements on recall period, completion time, interpretability, and feasibility. The review underscores the necessity for cont inuous assessment and enhancement of such instruments in BTL, advocating a rigorous scale development process. Furthermore, it encourages the customization of teaching and learning evaluation tools to suit specific institutional contexts while promoting further validation of these questionnaires across different populations in future research.

OBJECTIVES

The objective of this study was to synthesize existing literature on nursing informatics (NI) and propose updates to the Philippine Nursing Informatics curriculum that embrace current trends and integrate a globally acknowledged framework.

A literature search was conducted on PubMed and ScienceDirect. This search identified 79 articles, of which only eight met the inclusion criteria. The Technology Informatics Guiding Education Reform (TIGER) initiative provided the framework for analyzing the literature review outcomes and for developing the revised course structure for the Nursing Informatics (NI) curriculum in the Philippines.

The revised course outline incorporated 31 topics across the six domains outlined by the TIGER framework. Upon comparison, it was found that numerous topics identified were absent from the existing NI curriculum in the Philippines. Key subjects identified for inclusion encompass research, examination of standards and terminologies, application in community health, cybersecurity, project management, and advocacy. These areas hold particular relevance for the Philippines, attributed to the limited recognition of NI and the ongoing advancements related to technological applications in healthcare.

The nursing informatics curriculum in the Philippines is not up to date, failing to align with global NI standards. It is recommended that a thorough revision and enhancement be undertaken to ensure alignment with international frameworks and current industry practices.

The academic thought of Professor GAO Shuzhong on acupuncture and moxibustion is investigated systematically and summarized as 5 aspects: establishing GAO 's theory and methodological method of "siguan santong" (four gates and three opens); structuring the theory of "yinyang, qi movement, ascending and descending" pivoted at the umbilicus; deepening the laws of "stereo-layered holographic correspondence in the human body"; proposing "the method of bi-location" of acupoint systems based on meridian and collateral theories; developing the characteristic differentiation theory of acupuncture and moxibustion. These summaries reflect the unique perspective and distinctive features of Professor GAO Shuzhong on the theory of acupuncture and moxibustion, and his clinical thinking; and bring the practical significance for the discipline and academic development of acupuncture and moxibustion.
Moxibustion/history* ; Humans ; China ; Acupuncture/education* ; Acupuncture Therapy/history* ; History, 20th Century