1.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(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
2.Post-pandemic implications of the nursing students' clinical learning environment and its relationship to academic grit, self-esteem, and caring behaviors: A cross-sectional study.
Charlie C. FALGUERA ; Janet Alexis A. DE LOS SANTOS ; Carmen N. FIRMO ; Paulo BATIDOR
Acta Medica Philippina 2025;59(Early Access 2025):1-10
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.
OBJECTIVETo determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.
METHODSA 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.
RESULTSThe 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.
CONCLUSIONSStudents’ 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.
Human ; Clinical Practicum ; Preceptorship ; Mental Health ; Education, Nursing
4.A mental health care setting as a clinical exposure site for interprofessional education: A qualitative study.
Evangeline Bascara DELA FUENTE
Acta Medica Philippina 2025;59(6):110-119
BACKGROUND
Interprofessional collaboration is required as a learning outcome for medical school graduates. Clinical exposure to collaborative practice is one of the recommended strategies in the implementation of interprofessional education. Professionals in mental health units customarily engage in collaborative practice and can provide learning opportunities for medical students. Local data on interprofessional collaboration among practitioners in a mental health care setting in the pandemic is limited and merits study.
OBJECTIVESThe goal of this study was to determine and then describe factors that influence collaborative practice among health professionals in an inpatient mental health care unit in the pandemic. It aimed to generate recommendations from practitioners on strategies to optimize opportunities for medical students to learn interprofessional collaboration.
METHODSThis is a qualitative study which made use of key informant interviews (KIIs) and focused group discussions (FGDs) with members of a multiprofessional mental health team in the mental health unit of a tertiary medical center. Data was analyzed using thematic analysis.
RESULTSThe onset of the COVID-19 pandemic had drastically disrupted health care services and opportunities for interprofessional collaboration. Participants described their roles and identified six factors essential to reenergizing collaborative practice: resources and opportunities for meaningful interaction, quality of relationship and communication among team members, management goals and strategies relevant to the mental health needs and the context of patients and their families, guidelines for collaboration, interprofessional education appropriate to participant levels, and monitoring for quality assurance and improvement. Practical guidelines for promoting the identified factors were outlined. Recommendations to optimize opportunities for interprofessional education were also given.
CONCLUSIONSix factors were identified and described in the study. These can provide practitioners and students with a frame of reference for participating in and learning from collaborative practice in a mental health care unit as they work with other professionals on a shared concern. Addressing practical issues in real life settings will enhance their capacity to meaningfully collaborate with other professionals in managing patients, institutions, projects, and similar situations.
Human ; Interprofessional Education ; Mental Health
5.Utilizing cognitive interview in the item refinement of the Blended Teaching Assessment Tool (BTAT) for health professions education.
Maria Teresita B. DALUSONG ; Glenda Sanggalang OGERIO ; Valentin C. DONES III ; Maria Elizabeth M. GRAGEDA
Philippine Journal of Health Research and Development 2025;29(2):54-59
BACKGROUND
Ahigh-quality measurement tool is essential to accurately assess the innovative teaching strategies in health professions education. The Blended Teaching Assessment Tool (BTAT) aims to evaluate quality blended teaching or instructional delivery in Philippine health science programs. However, there is a lack of studies examining students' cognitive processes to support the validity of questionnaires.
METHODOLOGYCognitive interviewing (CI) was employed to determine whether students interpreted and responded to the items correctly. Content analysis was done using Tourangeau's Cognitive framework. Four CIs were conducted by an expert moderator and note-taker with a total of 8 health science students (2 groups with 3 members, and 2 one-on-one interview) for around 1 to 2 hours via Zoom following a retroactive approach with verbal and spontaneous probing, guided by a semi-structured interview questionnaire.
RESULTSVarious issues related to comprehension, retrieval, judgment, and response were identified, leading to significant revisions of the tool from 82 items across 8 dimensions to 53 items across 5 dimensions. The challenges included unfamiliar terminology, ambiguous phrasing, complex statements, inconsistencies and irrelevance to students' real-life experiences. These findings emphasize the importance of students' feedback in enhancing the validity and reliability of assessment tools.
CONCLUSIONThe Cognitive Interview identified crucial issues in comprehension, retrieval, judgment, and response, making it essential for developing the Blended Teaching Assessment Tool and ensuring valid responses on the quality of blended teaching and learning delivery.
Health Occupations ; Education ; Teaching
7.Video-based education versus traditional health lectures: A randomized comparative study on leprosy understanding, patient perspectives, and quality of life among leprosy patients in a tertiary hospital in the Philippines
Nadra S. Magtulis ; Niñ ; a A. Gabaton
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):44-44
BACKGROUND
Leprosy continues to pose significant health challenges globally, leading to stigma and disability when left untreated. Patient education is crucial in addressing these challenges. While traditional health lectures (THL) are widely used, they face limitations such as inconsistent delivery and low patient engagement. Video-based education (VBE) offers a more modern, scalable alternative, enhancing learning through immersive technology.
OBJECTIVESThis study compared the effectiveness of VBE versus THL in improving leprosy patients’ understanding, perspectives, and quality of life (QoL) in a tertiary hospital in the Philippines
METHODSA randomized controlled trial with 1:1 allocation ratio was conducted among 57 leprosy patients, divided into VBE and THL groups. Baseline and post-intervention questionnaires measured understanding, patient perspectives, and QoL using the Dermatology Life Quality Index, collected immediately after and two weeks post-intervention. Statistical analyses included chi-squared tests, t-tests, and Pearson’s correlations.
RESULTSVBE significantly improved patients’ understanding, perspectives, and QoL compared to THL. Post-intervention, 43% of VBE participants showed a high level of understanding, versus 24% in the THL group (p = 0.048). VBE had greater positive impact on patient perspectives and QoL (p = 0.011 and p = 0.046). Knowledge retention was higher in VBE group after two weeks (p = 0.0373), with improvements in understanding strongly linked to better perspectives and QoL (r = 0.54 and r = 0.65).
CONCLUSIONVBE proved more effective than THL in enhancing understanding and retention, perspectives, and QOL. With its multi-sensory, scalable format, VBE offers a promising and efficient tool for patient education, particularly in resource-limited settings.
Leprosy ; Health Education ; Educational Technology ; Multimedia
8.A Health Education Program for Home Emergency Management of Acute Complications of Diabetes in the Elderly.
Ru-Yue LI ; Yue-Xian SHI ; Qiao-Qin WAN ; Shao-Mei SHANG ; Chao WU
Acta Academiae Medicinae Sinicae 2023;45(5):814-820
Objective To establish a health education program for home emergency management of acute complications of diabetes in the elderly.Methods The program was drafted by literature review and panel discussion.The final draft was formed after two rounds of correspondence from 13 experts.Results The recovery rate of the two rounds of expert correspondence was 100%,and the expert authority coefficient was 0.98.The Kendall's harmony coefficients of the two rounds of correspondence were 0.263 and 0.212 respectively(both P<0.001).The established health education program included indicators of three categories:early stage of acute complications of diabetes at home(understanding the inducing factors),emergency warning(quick and early identification in case of emergency),and emergency treatment at home.Conclusion The contents of the health education program are systematic and reliable and meet the needs of health education for home emergency management of the elderly with diabetes.
Humans
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Aged
;
Delphi Technique
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Health Education
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Diabetes Mellitus/therapy*
;
Diabetes Complications
9.Students and faculty experiences, perceptions and knowledge on distress during the COVID-19 pandemic: A descriptive cross-sectional study
Blesile Suzette S. Mantaring ; Michael P. Sy ; John Robert C. Medina ; Gaea Marelle J. Miranda ; Hannah Maria D. Albert ; Ma. Liza Antoinette M. Gonzales ; Ma. Celina U. Garcia ; Edwin C. Ruamero, Jr. ; Alyssa Jenny E. Tupaz ; Maria Ivy Rochelle S. Tan ; Nymia P. Simbulan
Acta Medica Philippina 2023;57(10):11-25
Background and Objective:
The University of the Philippines Manila (UPM) subcommittee on students in distress was convened during the COVID-19 pandemic to develop “plans, programs and mechanisms” to deal with students experiencing distress and mental health concerns. This study was conducted as one of the activities of the Subcommittee to inform policy to address the following research objective: to describe the experiences, perceptions, and knowledge of both students and faculty members of UP Manila regarding distress.
Methods:
An online survey tool was created using the results from seven online focus group discussions among 20 faculty of UP Manila. The survey was conducted for one month among faculty and students sampled from the seven colleges of UP Manila and the three extension campuses of the Schools of Health Sciences. The different categories which were consistently perceived as important by both faculty and students as well as those with disparity in the perceptions between faculty and students were described and discussed.
Results:
A total of 136 faculty (F) and 290 students (S) participated in the study, representing 39% vs 98% (F vs S) of the target sample, respectively. Results showed that among the effects of stressors for students, avoidance of schoolwork (F79 vs S70.3%) and sleep disturbance (F79.4 vs S72.4%), were perceived by both faculty and students as the most frequently perceived response of students to stress.Among the causes of stress, unclear boundaries between school and home (F73.5 vs S63.1%), family duties (F76.5 vs S50.7%), lack of socialization (F89 vs S57.6%), limited recreational activity (F76.5 vs S64.8%), adapting to new ways of socialization (F67.6 vs S53.8%), and internet signal (F99.3 vs S88.3%) were perceived by both faculty and students as the most frequently perceived causes of stress. Among the coping mechanisms, connecting with friends online (F86.8 vs S69.7%), listening to music (F72.8 vs S78.3%), browsing social media (F82.4 vs S81%), viewing movies (F84.6 vs S74.5%), and sleeping or resting (F67.6 vs S84.1%) were perceived by both faculty and students as the most employed by students to cope with stress.Results also show that there were marked disparities in the perceptions of faculty and students. Among the effects of stressors, the largest disparities were in non-performance in academics (F86 vs S51.7%) and academic failure (F76.5 vs S53.8%). Of the causative factors, the largest disparities were in the areas of death (F94.1 vs S14.5%) or sickness in the family (F66.9 vs S0%), family issues (F82.4 vs S24.5%), financial concerns (F89 vs S36.9%), absence of physical connectedness and interaction, (F94.9 vs S23.8%) lack of socialization (F89 vs S57.6%), owning a gadget (F73.5 vs S22.1%), and lack of funds for the internet (F79.4 vs S22.4%).Among the support systems available in the university (psychosocial, academic and wellness activities of the colleges), 70% of the faculty perceived that the students were aware of the support process offered by the university. In contrast, 28% of students were aware of the support services offered to them.
Conclusion
This study shows that UP Manila faculty and students perceived stress due to the effects of COVID-19 on teaching, learning, and everyday living. Distress among student respondents was commonly perceived to be caused by family concerns, environmental restrictions, connectivity issues, and experiencing a sense of lack. While support services and mental health programs have been in place within the university, only 28% of students perceive that students in distress were aware of the process in receiving support.
Adaptation, Psychological
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Mental Health
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COVID-19
;
Education
10.Dietary advice in diabetes mellitus.
Yu Quan TAN ; Zhi En TAN ; Yan Lin TAN ; Choon How HOW
Singapore medical journal 2023;64(5):326-329


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