1.ACTA at the crossroads.
Acta Medica Philippina 2026;60(1):5-6
Academic publishing is at a critical juncture. The challenges faced by the academics are mired in controversy. Among theseare three hotly debated concerns. First is the issue of whether technological innovations such as artificial intelligence (AI)improves research efficiency or if its use sacrifices research integrity.Another is the controversy between paywall publishingand open access. Lastly, adapting an appropriate business model for sustainability is a contentious issue and the choice betweena commercial or a university-based publishing platform is a difficult one.
Traditional models of scientific investigation relied on tedious intellectual calisthenics in all aspects of research —identifying research gaps, reviewing of published literature, devising valid methodology, collecting data, analysing results, and,finally, drawing conclusions. With the advent of powerful tools employing artificial intelligence, these heavy tasks are efficientlycarried out. The dilemma lies in determining which parts of the work can be attributed to the authors and which are ascribedto the output of large language models (LLMs) and other automated assistance employed.Despite requiring adequate vettingby experts of these AI-aided output, many in the scientific community still question these methods. Can research employingAI be considered honest work? Will full disclosure answer doubts as to the integrity of the scientific work?
Indeed, LLMs just gather information that is already out there, albeit more efficiently. After all, science progresses bystanding on the shoulder of giants. AI makes such work comprehensive and efficient. Standing on those proverbial shoulders,however, require access to prior work, hence our next challenge in academic publishing--open access versus paid access.Paywalls limit the benefits of valuable research to institutions and universities with the capacity to pay. Excluded from these arethose from low resourced countries, with nations from the global south being affected disproportionately. Additionally, whilenumerous authors appreciate the features of open access as it improves their impact and visibility, many feel unduly burdenedsince the cost of publishing in this format is passed on to them.
This brings us to our third issue: who bears the cost of academic publishing? Indeed, it is a lucrative industry, generatingan annual revenue of US$19 billion and an estimated 40 percent profit margin. Many, however, find fault in this businessmodel as concerns about the profit motives of the commercial publishers far overshadow their sustainability goals.
How do we navigate this landscape of controversies? We, at the ACTA, as part of the community of scholars, would needto clarify our mission. Our goals for this publication should be consistent with our values. These values, such as scientific rigor,integrity, and accountability, should be reflected in our policies. We should be cognizant of the role we play in national scientificdiscourse while we endeavor to make an impact in the global scene. We are accountable to our stakeholders — nurturingearly career scholars, supplying evidence to health policymakers, and being accountable to those who provide resources tosustain us. This stewardship is essential so that ACTA will stand shoulder to shoulder with the giants on which science buildsupon to benefit future generations.
Artificial Intelligence ; Commerce ; Costs And Cost Analysis ; Disclosure ; Drawing ; Efficiency ; Family Characteristics ; Forecasting ; Goals ; Gymnastics ; Health ; Health Resources ; Industry ; Intelligence ; Inventions ; Language ; Literature ; Methods ; Play And Playthings ; Policy ; Publications ; Publishing ; Research ; Residence Characteristics ; Role ; Science ; Shoulder ; Social Responsibility ; Universities ; Ursidae ; Volition ; Work ; World Health Organization
2.Determinants of age at adiposity rebound in Filipino pediatric outpatients of a University Hospital.
Emmanuel F. BARAQUEL ; Bernard Emil N. BARRERA ; Danica Louice S. BASILIO ; Aleeza Casey S. BATARA ; Serena Mey M. BAUTISTA ; Sean Kenneth N. BANTING ; Charles Dominic BARRIGA ; Eljon Valen C. BANIQUED ; Marichu J. DE CHAVEZ ; Leilani B. MERCADO-ASIS
Journal of Medicine University of Santo Tomas 2026;10(1):1848-1861
OBJECTIVES
Adiposity rebound (AR), the childhood period at which body mass index (BMI) rises from its lowest point, is linked to increased risk of later obesity. The study aims to determine the average age at AR, describe baseline characteristics and analyze the correlation between these characteristics and timing of AR in a population of Filipino pediatric outpatients.
DESIGNSeven subjects born between 2016 and 2019 from a University Hospital Outpatient Department participated in this cross-sectional analytic study. Childhood anthropometrics were retrospectively collected to determine the age at AR by plot visual inspection. Sex, birth weight and gestational age were obtained from hospital records; breastfeeding duration, maternal BMI, parental obesity, maternal age, maternal smoking, education, parity and family income were gathered through a questionnaire completed by mothers or guardians. Associations were assessed using bootstrap univariate linear regression.
RESULTSThe mean age at AR was 3.2 years (SD = 1.2). Vaginal delivery was significantly associated with later age at AR compared to cesarean section (p = 0.035). Socioeconomic status at ages 2 to 5 showed positive association with delayed AR. Higher monthly family income (≥₱19,000) at ages 2 to 5 years was significantly associated with delayed age at AR. Other baseline childhood and parental factors showed no significant correlation with age at AR.
CONCLUSIONThese results highlight the complex and context-dependent nature of AR, emphasizing the need for further studies to better understand and mitigate early obesity risk in Filipino children.
Human ; Young Adult: 19-24 Yrs Old ; Universities ; Regression (psychology) ; Hospital Records ; Gestational Age ; Body Mass Index ; Obesity, Maternal
3.Perspectives of University of Santo Tomas (UST) administrators toward the use of artificial intelligence (AI) in higher education: A study protocol.
Jose Ma. Rafael RAMOS ; Reinaluz MANALO ; Les CADUYAC ; Enya LUANSING ; Jazztine JORGE ; Fiona PEREZ ; Breanna SANTOS
Philippine Journal of Allied Health Sciences 2026;9(2):34-39
OBJECTIVES
This study aims to create a study protocol that will explore UST administrators’ perceptions of the benefits and risks of AI use in higher education learning environments.
METHODSA qualitative descriptive design will be employed, using semi-structured interviews with at least fifteen administrators selected through purposive sampling. Audio-recorded interviews will be transcribed verbatim and subjected to thematic analysis using NVivo software
RESULTSAdministrators from different college-level fields perceive and engage with AI across various academic contexts. Exploring these perceptions will allow guidance in the development of coherent, contextually grounded institutional policies that promote responsible GenAI use and support digital leadership in Philippine higher education.
Human ; Artificial Intelligence ; Universities ; Software ; Administrative Personnel ; Intelligence ; Risk ; Policy
4.Perceptions of generative artificial intelligence integration in clinical training among occupational therapy interns in Manila, Philippines: A qualitative study protocol.
Nikka Karla Santos ; Maria Ruby FARIÑAS ; Sean James Eire BEHAN ; Ryza Mikyla AGRAVIADOR ; Eladia Denise BUQUING ; Josiah Myron DIOSANTA ; Kristin Chloe EVANGELIO ; Ma. Dulce Regina SANTIAGO
Philippine Journal of Allied Health Sciences 2026;9(2):39-45
BACKGROUND
Generative artificial intelligence (GenAI) is increasingly integrated into healthcare, including occupational therapy (OT), with potential applications in its service delivery and clinical decision-making. While GenAI offers promising educational and clinical support, its generative nature introduces risks related to contextual accuracy, transparency, and ethical use, particularly within supervised clinical training settings where professional judgment is still developing. Empirical research examining GenAI integration in OT clinical training remains limited, especially within the Philippine context.
OBJECTIVEThis is a protocol for a study which aims to explore the perceptions of OT interns in Manila, Philippines, regarding GenAI integration in clinical training, including perceived benefits, challenges, and ethical considerations, guided by Rogers’ Diffusion of Innovations Theory
METHODSThis qualitative study protocol describes an exploratory design that will be used to gather rich and contextualized insights from 24 to 32 OT interns enrolled in universities in Manila with established institutional AI-use policies. Data will be collected through semi-structured online focus group discussions (FGD). Thematic analysis will be used with assistance from atlas.ti.
EXPECTED RESULTSThe study is expected to generate meaningful themes that describe the perceptions of OT interns regarding the integration of GenAI within supervised clinical training contexts. Results are expected to reflect how interns perceive the role of GenAI in supporting clinical decision-making, as well as its perceived challenges and ethical concerns related to institutional policies, data privacy, reliability, and variability in AI-generated outputs.
Human ; Therapeutics ; Universities ; Volition ; Philippines ; Clinical Decision-making ; Artificial Intelligence
5.Quality of care among patients with acute heart failure at the emergency room and adherence of physicians at the University of the Philippines – Philippine General Hospital to the division of cardiovascular medicine – heart failure pathway:A retrospective cohort study.
Mark John D. Sabando ; Felix Eduardo R. Punzalan ; Frances Dominique V. Ho ; Tam Adrian P. Aya-ay ; Kevin Paul Da. Enriquez ; Marie Kirk A. Maramara ; Ronald Allan B. Roderos ; Lauren Kay M. Evangelista
Acta Medica Philippina 2026;60(2):22-32
OBJECTIVES
Clinical pathways (CPs) ensure adherence to heart failure (HF) management guidelines. To optimize quality care in a low resource setting, an evidence-based care pathway for the management of acute HF was implemented at the emergency department (ED) of the Philippine General Hospital (PGH), the designated national tertiary hospital and referral center. This study aimed to describe the characteristics of adults with acute HF admitted at the ED and evaluate the quality of care they received, measured using physician adherence to the hospital’s acute heart failure CP.
METHODSThis was a retrospective, descriptive cohort study. We reviewed the inpatient charts of all adult patients with acute HF admitted to the ED of the PGH and referred to the Division of Cardiovascular Medicine between December 1, 2022 and May 31, 2023. Quality of care was assessed based on adherence to quality indicators adapted from routine and conditional order sets detailed in the pathway. Descriptive statistics was utilized to describe patient characteristics, quality of care, and outcomes.
RESULTSTwo hundred thirty-six (236) patients were included, with a mean age of 51.8 years. Majority were male (53.4%); hypertension (61.4%) and ischemic heart disease (53.8%) were the most common comorbidities, and infection the most common precipitant of decompensation (60.6%). There were optimal adherence rates to routine orders, which included referrals to Internal Medicine and Cardiology, baseline vital signs monitoring, fluid intake and output monitoring, chest radiograph, complete blood count, blood urea nitrogen, sodium, potassium, prothrombin time, partial thromboplastin time, arterial blood gas, urinalysis, and N-terminal pro b-type natriuretic peptide. Conditional orders, such as oxygen support, focused echocardiography, thyroid - stimulating hormone, and the use of vasopressors, diuretics, and venous thromboembolism prophylactic agents, were optimally performed when warranted. However, we noted suboptimal adherence to certain resource-intensive conditional orders, such as hourly monitoring of urine output (61.4%), hooking to cardiac monitor (53.8%), and performance of 12-lead ECG within 10 minutes (56.8%). Further, only 43.9% of patients were referred to the intensive care unit. Troponin I, calcium, magnesium, and albumin were ordered in excess.
CONCLUSIONOverall adherence rate of physicians to the hospital’s Acute Heart Failure Pathway was satisfactory. Work is needed to improve adherence to hourly urine output monitoring, consistent hooking to cardiac monitor, and timely performance of 12-lead ECG – an effort that begins with expanding in-hospital diagnostic equipment and human resource supply. We recommend continuous pathway implementation with periodic evaluation and stakeholder feedback to further improve quality of care.
Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Adult ; Albumins ; Blood ; Blood Urea Nitrogen ; Calcium ; Cardiology ; Chart ; Charts ; Cohort Studies ; Critical Care ; Critical Pathways ; Diagnostic Equipment ; Disease ; Diuretics ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Equipment And Supplies ; Evaluation Studies As Topic ; Feedback ; Heart ; Heart Diseases ; Heart Failure ; Hormones ; Hospitals ; Hospitals, General ; Humans ; Hypertension ; Indicators And Reagents ; Infection ; Infections ; Inpatients ; Intensive Care Units ; Internal Medicine ; Lead ; Magnesium ; Male ; Medicine ; Myocardial Ischemia ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Nitrogen ; Overall ; Oxygen ; Partial Thromboplastin Time ; Patients ; Peptides ; Philippines ; Physicians ; Potassium ; Prothrombin ; Prothrombin Time ; Quality Of Health Care ; Referral And Consultation ; Sodium ; Statistics ; Tertiary Care Centers ; Thorax ; Thromboembolism ; Thromboplastin ; Thyroid Gland ; Time ; Troponin ; Troponin I ; Universities ; Urea ; Urinalysis ; Urine ; Venous Thromboembolism ; Vital Signs ; Work ; Workforce
6.Challenges and opportunities in the implementation of health and safety policies and programs in a state university in the Philippines
Paul Michael R. Hernandez ; Niñ ; a F. Yanilla ; Fevito A. Obidos jr. ; Carlos Primero D. Gundran ; Jo Leah A. Flores ; Homer U. Co ; Lara Fatima L. Lintao ; Arlene A. Samaniego ; Dexter C. Tiro ; Gabriel Jay B. Caeong ; Isabela Louise B. Navoa
Acta Medica Philippina 2025;59(4):14-25
BACKGROUND
State universities in the Philippines should comply with the 2020 Occupational Safety and Health (OSH) standards for government workers and must be guided by the 2017 ASEAN University Network’s Healthy University Framework (HUF) for them to become healthy universities. Both policy documents identify OSH policy and programs as key components.
OBJECTIVEThis study aimed to explore the challenges and opportunities in the implementation of health and safety policies and programs in a state university in the Philippines.
METHODSA case study design was used with a state university as its study site. Investigators conducted 14 key informant interviews and nine focus group discussions which were participated by system officials, campus officials, academic teaching staff, academic non-teaching Staff, support staff, and students. Thematic analysis was used to identify and understand emerging patterns and themes.
RESULTSThe results generated seven themes consisting of Policy and Committee, Dedicated Personnel and Unit,Budget and Technology, Collaboration, Programs and Services, Working and Learning Environment, and Role Models. The identified challenges in the implementation of health and safety programs in the university were: (1) limited budget to implement initiatives, (2) lack of collaboration among its offices, and (3) absence of a dedicated unit and staff. There were also opportunities to improve implementation: (1) strong implementation of certain policies and programs, (2) presence of a good working and learning environment, and (3) existence of role models.
CONCLUSIONThe identified challenges and opportunities correspond to the elements of the system and infrastructure considered as principal determinants of a healthy university. There is a need to recognize the interrelatedness of such elements to ensure effective implementation of health and safety programs in the university. It also underscores the relevance of the HUF in promoting OSH within a university context.
Human ; Health ; Safety ; Universities
8.Lived experiences of well-being of the University Athletic Association of the Philippines Season 84 student-athletes in bubble training during the COVID-19 pandemic: A qualitative phenomenological study.
Ken Erbvin R. SOSA ; Charles Nicolei M. NERMAL ; Karlos Lorenzo A. REA ; Gabrielle Atasha TANHUECO ; Isaac Miguel M. ANDICO ; Janelle Audre C. CHIU ; Timothy D. LAO ; Ma. Julia Isabelle G. PEÑALOZA ; John Mari R. QUILANG ; Zeuch Ryonin B. SILVA
Acta Medica Philippina 2025;59(18):81-98
BACKGROUND AND OBJECTIVE
The COVID-19 pandemic has disrupted the sports industry, resulting in the postponement of events worldwide. This posed a significant burden in the mental and emotional well-being of athletes due to uncertainties and diminished training levels. As an adaptation, bubble camps emerged as a new approach to resuming training and tournaments under stringent regulations of the COVID-19 protocols. In the national context, the University Athletic Association of the Philippines (UAAP) has adapted the bubble set-up by implementing antigen testing, RTPCR, and other health protocols as a prerequisite to bubble training. However, uncertainties in the future of sports continue to present as a psychological toll to the well-being of student-athletes despite the sense of normalcy instilled by bubble training. Existing literature on bubble training is grounded heavily on the quantitative assessments of an athlete's well-being in a bubble set-up and its effectiveness in mitigating COVID-19 transmission, thereby lacking insights that may be obtained from qualitative data. This study explored the experiences of UAAP Season 84 studentathletes in a bubble set-up by examining personal and contextual factors that impacted their well-being.
METHODSThe study employed a qualitative descriptive phenomenological approach based on Seligman's WellBeing Theory. A purposeful sampling technique was used to recruit UAAP student-athletes through online dissemination of Google Forms for recruitment. Only three student-athletes from UAAP fit the eligibility criteria. Data were collected through on-site and online interviews using a semi-structured interview guide to reveal a narrative of the student-athletes' bubble training experiences, common themes, and patterns. The NVivo software program was used for data analysis, utilizing a deductive thematic approach.
RESULTSThe lived experiences of three UAAP studentathletes were classified into six major themes: (1) Availability and Accessibility of Services; (2) Restrictions; (3) Mental Health; (4) Fostering Relationships; (5) Support Systems; and (6) Individual Growth. Accounts of both positive and negative training perceptions and outcomes regarding the bubble set-up were noted from all student-athletes. The set-up provided studentathletes with easy access to training facilities and services, eventual development of mental fortitude and perseverance, improved interpersonal relationships, and opportunities for individual growth. However, the restrictions, isolation, internal and external pressures, and routinary nature of the set-up contributed to the elevated levels of stress and anxiety, eventually leading to fatigue and burnout.
CONCLUSIONThe study elucidates on the multi-faceted experiences of UAAP student-athletes in bubble training, underpinning the essence of the adequacy of training services and facilities, enhanced support systems, and prompt policy development that caters to improving the holistic well-being of student-athletes amidst adverse changes in the trajectory of sports.
Human ; Qualitative Research ; Universities ; College Athletes ; Athletes
9.Psychometric properties of self-report questionnaires in evaluating blended learning in health science university students: A systematic review.
Valentin C. DONES III ; Maria Teresita B. DALUSONG ; Donald G. MANLAPAZ ; Juan Alfonso S. ROJAS ; Ma. Bianca Beatriz P. BALLESTEROS ; Ron Kevin S. FLORES ; Kaela Celine C. HO ; Jose Angelo D. MONREAL ; Audrey Marie A. NARCELLES ; Jose Joaquin R. REYES ; Lianna Andrea B. SANGATANAN
Acta Medica Philippina 2025;59(16):79-92
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.
OBJECTIVESThis 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.
METHODSFollowing 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.
RESULTSThe 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.
CONCLUSIONThe 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.
Human ; Psychometrics ; Checklist ; Self Report ; Universities ; Health Education
10.Psychometric properties of self-report questionnaires in evaluating blended learning in health science university students: A systematic review
Valentin C. Dones III ; Maria Teresita B. Dalusong ; Donald G. Manlapaz ; Juan Alfonso S. Rojas ; Ma. Bianca Beatriz P. Ballesteros ; Ron Kevin S. Flores ; Kaela Celine C. Hor ; Jose Angelo D. Monreal ; Audrey Marie A. Narselles ; Jose Joaquin R. Reyes ; Lianna Andrea B. Sangatanan
Acta Medica Philippina 2025;59(Early Access 2025):1-14
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.
OBJECTIVESThis 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.
METHODSFollowing 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.
RESULTSThe 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.
CONCLUSIONThe 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.
Human ; Psychometrics ; Checklist ; Self Report ; Universities ; Health Education


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