Article

Interactive Teaching Enhances Students' Physiological Arousal During Online Learning

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Abstract

The pure transfer of face-to-face teaching to a digital learning environment can be accompanied by a significant reduction in the physiological arousal of students, which in turn can be associated with passivity during the learning process, often linked to insufficient levels of concentration and engagement in the course work. Therefore, the aim of this study was to investigate whether students' psychobiological stress responses can be enhanced in the context of anatomical online learning and how increased physiological parameters correlate with characteristics of learning experiences in a digital learning environment. Healthy first-year medical students (n = 104) experienced a regular practical course in Microscopic Anatomy either in face-to-face learning, in passive online learning or in an interaction-enhanced version of online learning. Compared to passive online learning, students engaged in the interaction-enhanced version of online learning displayed a significantly reduced Heart Rate Variability (P < 0.001, partial η2 = 0.381) along with a strong increase in salivary cortisol (P < 0.001, partial η2 = 0.179) and salivary alpha-amylase activity (P < 0.001, partial η2 = 0.195). These results demonstrated that the physiological arousal of students engaged in online learning can be enhanced via interactive teaching methods and pointed towards clear correlations between higher physiological responses and elementary criteria of learning experience such as engagement and attention.

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... Among these physiological measurements, Heart Rate Variability (HRV) stands out as a particularly valuable tool for examining the autonomic responses associated with stress in educational settings [17][18][19] . The brain's regulation of cardiovascular function, particularly through the vagus nerve and its in uence on heart rate, re ects the body's ability to adapt to stressors. ...
... A systematic review has highlighted the sensitivity and utility of HRV as a marker of neurocardiac stress, illustrating its capacity to capture real-time physiological responses that are often overlooked in purely self-reported measures 19 . Moreover, higher levels of physiological arousal in learning environments have been linked to enhanced engagement with both the learning material and the environment itself 17 . Research suggests that this heightened arousal can correlate with increased enjoyment, better concentration, and greater involvement in academic tasks 11,17 . ...
... Moreover, higher levels of physiological arousal in learning environments have been linked to enhanced engagement with both the learning material and the environment itself 17 . Research suggests that this heightened arousal can correlate with increased enjoyment, better concentration, and greater involvement in academic tasks 11,17 . However, while these elevated arousal levels may boost engagement, they are also associated with higher rates of anxiety 17 . ...
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This mixed-methods study investigated the impact of simulated oral examinations on inducing neurocardiac stress in medical students, integrating physiological measurements, quantitative assessments, and qualitative feedback. Ninety-five students participated, with heart rate variability (HRV) markers such as RMSSD, pNN50, SDNN, and LF/HF ratios used to evaluate stress responses. Both lecturer-led and peer-led simulations significantly reduced HRV markers, indicating heightened sympathetic activation and reduced parasympathetic activity. In lecturer-led simulations, RMSSD showed significant reductions (t = 8.27, p < .001; t = 9.38, p < .001), paralleled in peer-led sessions (t = 4.47, p < .001; t = 4.97, p < .001). The LF/HF ratio significantly increased in lecturer-led exams (z=-2.69, p = 0.007), while peer-led simulations exhibited a more moderate response. Students' perceived competence and confidence significantly improved post-simulation (lecturer-led: t=-8.41, p < .001; student-led: t=-5.82, p < .001), and test anxiety significantly decreased. In the follow-up assessment conducted after the actual exams at the semester's end, 94.85% of students reported that the simulations were helpful in preparing for their final exams, aiding in reducing stress and enhancing performance. These findings highlight the potential of peer-led simulations as a resource-efficient alternative for fostering student resilience and coping under exam stress, though further exploration is needed to fully understand the nuanced autonomic responses in different settings.
... Studying the links between physiological stress, anxiety about OSCE, self-efficacy, and students' exam perceptions salivary cortisol • No significant correlations found between cortisol levels, anxiety and performance Gellisch et al. [70] first-year medical students (n = 104) randomized experimental field study Investigating whether the physiological stress response can be increased during online learning and its correlation with digital learning characteristics HRV; salivary cortisol, salivary alpha amylase ...
... It was also publicized, that SDNN and general joy of life were positively associated [67]. Moreover, demonstrated in another study, that the decrease in HRV, was more prominent in an interaction-enhanced environment compared to a passive online learning session [70]. Hundertmark et al. (2019) found, that in the context of a medical student peer-teaching program, the HRV parameter RMSSD increased over individual course sessions and over measurement days [71]. ...
... In the context of transitioning from face-to-face to online medical education, salivary cortisol was higher in face-to-face session [69]. For digital medical education, salivary cortisol levels were increased in an interaction-enhanced environment in comparison with passive online learning [70]. Subjectively perceived stress correlated positively with salivary cortisol levels, but only in the interactive online teaching condition [70]. ...
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Background: Traditional self-reported measures in health science education often overlook the physiological processes underlying cognitive and emotional responses Purpose: This review aims to analyze the frequency, sensitivity, and utility of physiological markers in understanding cognitive and emotional dynamics in learning environments Methods: A systematic PubMed search identified 156 records, with 13 studies meeting inclusion criteria. Markers analyzed included heart rate (HR), heart rate variability (HRV), cortisol, alpha-amylase, testosterone, s-IgA, blood pressure, oxygen saturation, and respiratory rate Main Findings: HR and HRV were sensitive to educational stressors. Cortisol and alpha-amylase showed mixed results, while testosterone and s-IgA showed limited utility in directly assessing stress responses. No consistent link was found between any marker and immediate learning success Conclusion: Physiological markers in learning environments can offer valuable insights into emotional and cogni-tive dynamics but should not be misconstrued as direct indicators of learning outcomes.
... It has already been shown that activating teaching methods and increased interaction during a learning unit strongly influence students' learning experience [13][14][15]. By developing an appropriate work and learning environment, the lecturer is thus able to modulate the learning experience of students participating in the respective course [16]. ...
... Acutely aversive, emotionally stimulating, or demanding situations can also manifest themselves on a physiological level [27][28][29]. A well-established marker providing fundamental information on the parasympathetic-sympathetic interplay is heart rate variability (HRV) (for an in-depth review see Shaffer and Ginsberg's work [30]), which has already been applied successfully in the evaluation of physiological and emotional parameters in learning environments [15,31,32]. ...
... OL.), so that all constructs were measured equally in the three different learning environments. Based on previous investigations regarding physiological correlates of various teaching environments and methods [15], this in-depth analysis focuses on external factors and examines their influence on the physiological and subjective learning experience. ...
... Some teachers emphasised the need for less pressure and reduced expectations on themselves. Gellisch et al. (2023) argued that active online teaching increased markers of stress in students, associated with higher levels of engagement and attention, and higher achievement anxiety. ...
... Findings consistent with Gellisch et al. (2023) indicate that online teaching can increase stress levels in students. This highlights the importance of implementing interventions that address students' emotional needs and promote effective stress coping strategies. ...
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During the last three years, Peru has been suffering from a social crisis, strikes, protests, etc., triggered by political circumstances, which forced the country to abandon, once again, face-to-face class sessions in order to adopt the virtual teaching model. In this context, the students of technological institutes have been suffering an 80% of interrupted instruction time. The aim of this study was to explore the social phenomenon of online teaching and learning, caused by emergent situations, through the accounts of students and teachers of a technical education institution. For this purpose, the qualitative approach was used, with a phenomenological design, and through the interview technique whose saturation allowed the collaboration of 31 participants. The findings of this phenomenological analysis highlight the complexity of the challenges faced by students and teachers during virtual sessions, addressing technical, social and pedagogical aspects. It infers the need to develop comprehensive strategies to improve connectivity, foster participation and address technological and emotional demands in the online educational environment. Received: 11 September 2024 / Accepted: 21 December 2024 / Published: 05 January 2025
... For the characterization of the mature student group in comparison with the younger group, the A-level grade of their high-school diploma, their competence in natural science subjects necessary for preclinical studies as well as their self-assessment of previous clinical experience was surveyed. Moreover, the online competence of both groups was compared which is especially relevant in times of the recent COVID-19 pandemic and the ongoing transition of solely face-to-face learning to hybrid study concepts with an increasing proportion of online education (Gellisch et al., 2022(Gellisch et al., , 2023. Mature students are characterized by the completion of an apprenticeship prior to entering medical school. ...
... (www.preprints.org) | NOT PEER-REVIEWED | Posted: 3 September 2024 doi:10.20944/preprints202409.0251.v19 ...
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This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psycholog-ical constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < .001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = -6.690, p < .001), competence in natural sciences (t(321.045) = -3.178, p = 0.002), and online competence (t(319.429) = -2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience, academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < .001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < .001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from -0.235 to -0.404, p < .001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying expe-riences. The study highlights the value of a comprehensive approach in medical education, con-sidering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience.
... In synchronous online teaching, creating an environment that fosters knowledge growth is notably more challenging than in conventional settings, with engaging teachers and students with digital tools proving difficult [15,16]. In psychobiological research approaches, an interpretative framework could be developed in which correlations between actual physiological activation and engagement during the respective learning unit could be established: It could be shown that the mere transfer of a course to digital teaching is associated with considerable reductions in students' physiological arousal [17], leading to the recommendation that the development of digital learning environments should be accompanied by the implementation of activating and interactive teaching strategies in order to preserve the feeling of engagement in digital educational scenarios [18]. ...
... Our findings indicate that the three-step digitization approach significantly reduces these negative emotions, aligning with literature that underscores the importance of minimizing such emotional experiences to enhance learning outcomes. While there is some discussion in the literature about the potential constructive roles of negative emotions under certain conditions [18,38], the primary focus of our study -and the broader consensus in educational research -is on the detrimental impact of these emotions on learning processes. By effectively reducing negative emotions, our digitization approach contributes to creating a more positive and conducive learning environment, which is crucial for academic success. ...
Article
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This research work focuses on evaluating the development of our three-step digitization approach, designed to transform traditional lectures into engaging digital learning experiences. Aimed at offering an easy-to-use solution for educators, this approach addresses the pressing challenges of modern educational environments by enhancing accessibility, engagement, and effectiveness of learning through digital means. Quantitative analysis demonstrated a notable increase in knowledge gain for students engaged with the digital format (t(230) = -2.795, p = 0.006) over traditional methods. Additionally, it was observed that the online setting significantly improved concentration levels (t(230) = -5.801, p < .001) and reduced distractions (t(230) = 2.848, p = 0.005). Emotional assessments, based on the Achievement Emotions Questionnaire (AEQ), indicated an elevation in enjoyment (t(230) = -4.717, p < .001) and a reduction in anxiety (t(230) = 9.446, p < .001) within the digital learning environment. A substantial preference for the digital course format was expressed by 61.0% of participants, with 71.4% acknowledging its superior efficiency compared to 14.3% for traditional lectures. Qualitative feedback underscored the digital format's flexibility, comprehensive learning experience, and immediate feedback as key benefits. Nevertheless, nuances such as a preferred understanding in face-to-face interactions and the absence of a social component in digital settings were noted. To conclude, the findings from this study illuminate the significant advantages of the three-step digitization approach in meeting contemporary educational challenges. By facilitating an enhanced knowledge acquisition and fostering a supportive emotional climate, this approach signifies a promising direction for the future of medical education and beyond, fusing the convenience of digital solutions with the depth and engagement of traditional learning methodologies.
... The study of Sukkha et al. (2023) in Thailand posits that interactive group activities require students to collaborate and communicate with one another. Students learn to effectively communicate their ideas, actively listen to others, and work toward common goals through participating in group discussions, problem-solving exercises, or projects (Gellisch et al., 2023). These experiences encourage students to contribute, negotiate, and cooperate with their classmates, which promotes self-management (Gellisch et al., 2023). ...
... Students learn to effectively communicate their ideas, actively listen to others, and work toward common goals through participating in group discussions, problem-solving exercises, or projects (Gellisch et al., 2023). These experiences encourage students to contribute, negotiate, and cooperate with their classmates, which promotes self-management (Gellisch et al., 2023). Students can also take on certain roles and duties within the group through interactive group activities. ...
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The after-effects of the recently concluded COVID-19 pandemic have drastically altered the teaching behaviors of educators which posed a greater challenge in delivering quality education during the unprecedented paradigm shifts in the academe. This study aimed to describe the teaching practices of social studies teachers to facilitate self-directed learning of senior high school students. This study utilized a descriptive qualitative research design. The informants were five (5) senior high school teachers who were identified using a purposive sampling technique. Data were gathered with the use of a duly validated written interview guide distributed online via e-mail and Facebook messenger. Through the use of a thematic approach in analyzing the data, there were three (3) major themes emerged, which include (1) developing students' self-management, (2) establishing students' relationship skills, and (3) nurturing students' decision-making capacity. The findings also included six (6) meaningful categories such as (1) direct instruction, (2) skill-based activities, (3) collaborative discussion, (4) interactive learning activities, (5) research-based activities, and (6) individualized activities. Teaching practices of social studies teachers play a crucial role in ensuring self-directed learning experiences for students. Students were provided with opportunities to apply their knowledge and skills in practical contexts, solve problems, make rational decisions, and engage in tasks that mirror authentic situations.
... For the characterization of the mature student group in comparison with the younger group, the A-level grade of their high-school diploma, competence in natural science subjects necessary for preclinical studies, and their self-assessment of previous clinical experience were surveyed. Moreover, the online competence of both groups was compared, which is especially relevant in times of the recent COVID-19 pandemic and the ongoing transition of solely face-to-face learning to hybrid study concepts with an increasing proportion of online education [21,22]. Mature students are characterized by the completion of an apprenticeship prior to entering medical school. ...
Article
Full-text available
This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psychological constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < 0.001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = −6.690, p < 0.001), competence in natural sciences (t(321.045) = −3.178, p = 0.002), and online competence (t(319.429) = −2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience , academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < 0.001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < 0.001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from −0.235 to −0.404, p < 0.001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying experiences. The study highlights the value of a comprehensive approach in medical education, considering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience. Keywords: socioeconomic status in medical education; psychological constructs and academic performance; impact of prior working experience on medical students; resilience and coping in medical students; apprenticeships and academic confidence; diversity in medical education
... This skew underscores the critical importance of not overlooking the underrepresented cohorts within our study, as they provide essential insights into the broader socio-economic spectrum. Overall, students reported a moderate stress level, which can be well embedded in the literature for the cohort of medical students [66][67][68][69]. Female participants reported higher levels of worry, tension, demands, and less joy than male participants. ...
Article
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Background The escalating prevalence of mental health issues among young adults, set against the backdrop of a global healthcare system under pressure, underscores the necessity for cultivating a resilient medical workforce. This study investigates the influence of socio-economic status (SES) on psychological well-being, with a particular focus on Anxiety Sensitivity (AS) and Intolerance of Uncertainty (IU) among first-year medical students. Understanding the psychological dimensions affecting medical students is crucial for fostering a future medical workforce that is both capable and mentally healthy. Methods This research involved 321 first-year medical students, evaluated using the Perceived Stress Questionnaire (PSQ), Anxiety Sensitivity Index (ASI), the Intolerance of Uncertainty Scale (UI-18), and the Student Self-Efficacy Scale (SSE), alongside socio-economic categorization. Employing descriptive statistics, ANOVA, and correlation analyses, the study aimed at elucidating the SES impact on AS and IU, among other psychological constructs. Results The analysis revealed significant SES-related differences, especially in the realms of Anxiety Sensitivity and Intolerance of Uncertainty. Notably, ASI_C (cognitive concerns) exhibited strong positive correlations with both UI_A (reduced ability to act due to IU) (Pearson’s r = 0.562, p < 0.001) and UI_B (burden due to IU) (Pearson’s r = 0.605, p < 0.001), highlighting the link between cognitive aspects of anxiety and uncertainty intolerance. Furthermore, UI_C (vigilance due to IU) was significantly associated with SES (F(4, 316) = 2.719, p = 0.030, η² = 0.033), pointing to the complex ways in which socio-economic factors modulate responses to uncertainty. Self-efficacy emerged as a significant counterbalance, showing protective associations against the adverse effects of heightened Anxiety Sensitivity and Intolerance of Uncertainty. Conclusion Our findings indicate that lower socio-economic status is associated with higher levels of Anxiety Sensitivity and Intolerance of Uncertainty, which contribute to increased stress among first-year medical students. Additionally, Self-Efficacy emerged as a significant protective factor, mitigating the expressions of AS and IU. Although medical faculties cannot change SES characteristics within their student body, recognizing its impact allows for the development of tailored support systems to address the unique challenges faced by students from diverse socio-economic backgrounds. This study underscores the necessity of considering social diversity, particularly regarding AS and IU characteristics, to foster a supportive and effective medical education environment with an outlook on sustainable mental health in a demanding work context.
... These serious consequences of the COVID-19 pandemic as well as the necessary regulations to limit in-person contact also posed an enormous challenge for educational processes in the relevant institutions [7][8][9][10]. In addition to self-reported declines in mental health and motivational factors, more objective changes such as different cortisol concentrations and altered sympathetic and parasympathetic activation patterns during remote learning compared to face-to-face learning could be demonstrated among German first-year medical students [11,12]. Mental stress among students, diffuse anxiety and difficulties in maintaining concentration during digital courses are widely reported burdens during the ongoing COVID-19 pandemic [13][14][15][16][17]. ...
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Numerous research results have already pointed towards the negative influence of increased mental stress on educational processes and motivational criteria. It has also been shown that the global public health crisis induced by COVID-19 was related to anxiety symptoms and elevated levels of distress. To holistically elucidate the dynamics of the pandemic-related mental stress of first-year medical students, the associated parameters of three different cohorts were measured at the beginning of the pandemic-related restrictions on university life in Germany (20/21), at the peak of the COVID-19-related restrictions (21/22) and during the easing of the restrictions in the winter term 22/23. In a repeated cross-sectional study design, the constructs of worries, tension, demands and joy were collected from first-year medical students (n = 578) using the Perceived Stress Questionnaire. The results demonstrate significantly increased values of the constructs worries (p < 0.001), tension (p < 0.001) and demands (p < 0.001) at the peak of the pandemic related restrictions compared to the previous and following year as well as significantly decreasing values of general joy of life during the observed period of 3 years (all p-values < 0.001). A confirmatory factor analysis was performed to verify the questionnaire's factor structure regarding the addressed target group during the pandemic (CFI: 0.908, RMSEA: 0.071, SRMR: 0.052). These data, collected over a period of three years, provide information regarding dynamically manifesting mental stress during the COVID-19 pandemic, and refer to new areas of responsibility for the faculties to adequately counteract future crisis situations.
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This study provides a comprehensive analysis of user behavior among 684 medical students in Microscopic Anatomy, examining their preferences for digital versus face-to-face guided self-study offers. Participants were given the choice between these two learning modalities, and the results revealed a strong preference for the face-to-face option. Specifically, attendance at in-person sessions increased steadily over the semester, with 78.44% of students reporting that hands-on experiences with the microscope in a physical setting were significantly more practical and engaging. Furthermore, students who chose the face-to-face learning option demonstrated better academic performance, with a failure rate of 13.69% compared to 22.04% among those who did not engage in the in-person sessions. The preference for face-to-face learning was influenced by several factors: 61.38% of students emphasized the importance of direct interactions with tutors, while 74.25% valued the opportunity for peer discussions and exchanges during free microscopy sessions. Moreover, nearly half of the respondents (46.71%) found that studying in the physical presence of the histology lecture hall was more motivating This preprint research paper has not been peer reviewed.
Chapter
Self-efficacy refers to a person's belief in their ability to execute behaviors necessary to produce specific performance outcomes. Bandura explained that there are four main sources of efficacy: performance accomplishments, vicarious experiences, social persuasion, and physiological reactions. Adapting a class structure and creating scaffolding that supports students does not mean that the content is less rigorous; it means how they meet these challenges is supported and developed with faculty guidance and input. Creating online learning environments that nurture students, motivate them, and engage them requires intentional practice and planning, using techniques to build student self-efficacy can assist in this process. This chapter will address how to identify tools and strategies to develop these skills.
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The COVID-19 (coronavirus disease 2019) pandemic in 2020 has had a lasting impact on all areas of personal life. However, the political, economic, legal and healthcare system, as well as the education system have also experienced the effects. Universities had to face new challenges and requirements in teaching and examinations as quickly as possible in order to be able to guarantee high-quality education for their students. This study aims to examine how the German-speaking medical faculties of the Umbrella Consortium of Assessment Network (UCAN) have dealt with the challenges but also the opportunities that the outbreak of the COVID-19 pandemic created in medical education and whether digitalisation has been driven forward as a result. In an initial online-survey we focused our questions on the current teaching situation with regard to digitised teaching content, the support or establishment of adequate framework conditions by the medical faculties and IT facilities and also the execution of examinations during the summer semester 2020. Between August and September 2020, a total of 88 examiners, educators, dean of study and/or technical admins from 32 partner faculties took part in the survey. Students were not included in our survey. Most respondents stated that a switch to a digital semester had worked, the use of e-learning increased compared to previous semesters and that most courses could be converted, with the exception of practical courses, which were largely cancelled. The respondents also indicated that most examinations could still be taken, with the exception of practical examination formats, like Objective Structured Clinical Examinations (OSCEs). However, in the case of face-to-face examinations, strict distance and hygiene conditions had to be obeyed or there had to be a switch to distance-online examinations, which raised many open issues such as equal opportunities of students (technical equipment, internet access, premises) and attempts at deception (third-party help with the exam, mutual exchange between students, web search). In conclusion, we identified several issues regarding the rapid transition to a digital semester due to COVID-19 which were categorised into the following topics: Face-to-face teaching could not take place, (2) know-how of educators, (3) integrity aspects, (4) technical aspects, (5) additional personnel required, (6) additional time and effort required for implementation of digital teaching. Our study shows that a switch to digital teaching and distance online examinations is feasible, but many problems were encountered concerning academic integrity and basic ethical principles still need to be solved. In order to investigate whether above mentioned issued could be solved one year after the transition to a digital semester, we conducted a second survey in which the 32 initially surveyed institutions were questioned again.
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Background In March 2020, due to the SARS-CoV-2 pandemic, the Polish government ordered the closing of all medical faculties, with an obligatory shift to online learning. This lockdown continued, with a short period of blended learning, over the time of summer 2020. Distance learning had previously been rarely used within Polish medical schools, so such a sudden transfer was a major challenge. The aim of the study was to explore undergraduates’ perception of online teaching provided at Polish medical faculties during the pandemic and to analyze how these experiences may inform future curriculum development. Methods The online survey was addressed to undergraduates at Polish medical faculties in November 2020. The questions captured demographics, epidemiological data and students’ perception of various aspects of online teaching. Responses were subjected to thematic analysis and their distribution compared considering demographic parameters . Results Six hundred twenty students from thirteen medical faculties responded to the survey. Major benefits from online teaching perceived by respondents included increased convenience, enhanced quality, a sense of comfort and safety. Major complaints were associated with unsatisfactory content, technical issues, difficulties engaging, poor organization and lack of social life. Students claimed that online teaching required more self-directed learning and discipline and 57.9% considered this impact as negative. 44.5% of respondents took part in educational online activities beyond their scheduled classes. For 49.2% online examinations were reported as more stressful and for 24.8% - less stressful than traditional ones. Differences in the opinions on online teaching were found between men and women, students in early and senior years, Polish and non-Polish ones. Conclusions The sudden move online inevitably was problematic for students. Their perspective afforded us the opportunity to consider shortcomings of pre-pandemic undergraduate curriculum. Online education requires a more self-directed learning, which was challenging for many students, so further enhancement of more autonomous study skills seems necessary. Distress expressed by students indicates the need for urgent support with mental health issues.
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Background With the new pandemic reality that has beset us, teaching and learning activities have been thrust online. While much research has explored student perceptions of online and distance learning, none has had a social laboratory to study the effects of an enforced transition on student perceptions of online learning. Purpose We surveyed students about their perceptions of online learning before and after the transition to online learning. As student perceptions are influenced by a range of contextual and institutional factors beyond the classroom, we expected that students would be overall sanguine to the project given that access, technology integration, and family and government support during the pandemic shutdown would mitigate the negative consequences. Results Students overall reported positive academic outcomes. However, students reported increased stress and anxiety and difficulties concentrating, suggesting that the obstacles to fully online learning were not only technological and instructional challenges but also social and affective challenges of isolation and social distancing suggest that the outcomes for students well-being may overshadow the positive academic outcomes. Conclusion Our analysis shows that the specific context of the pandemic disrupted more than normal teaching and learning activities. Whereas students generally responded positively to the transition, their reluctance to continue learning online and the added stress and workload show the limits of this large scale social experiment. In addition to the technical and pedagogical dimensions, successfully supporting students in online learning environments will require that teachers and educational technologists attend to the social and affective dimensions of online learning as well.
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The use of heart rate variability (HRV) in research has been greatly popularized over the past decades due to the ease and affordability of HRV collection, coupled with its clinical relevance and significant relationships with psychophysiological constructs and psychopathological disorders. Despite the wide use of electrocardiograms (ECG) in research and advancements in sensor technology, the analytical approach and steps applied to obtain HRV measures can be seen as complex. Thus, this poses a challenge to users who may not have the adequate background knowledge to obtain the HRV indices reliably. To maximize the impact of HRV-related research and its reproducibility, parallel advances in users' understanding of the indices and the standardization of analysis pipelines in its utility will be crucial. This paper addresses this gap and aims to provide an overview of the most up-to-date and commonly used HRV indices, as well as common research areas in which these indices have proven to be very useful, particularly in psychology. In addition, we also provide a step-by-step guide on how to perform HRV analysis using an integrative neurophysiological toolkit, NeuroKit2.
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COVID-19 pandemic has disrupted teaching in a vriety of institutions. It has tested the readiness of academic institutions to deal with such abrupt crisis. Online learning has become the main method of instruction during the pandemic in Jordan. After 4 months of online education, two online surveys were distributed to investigate faculty’s and Students’ perception of the learning process that took place over that period of time with no face to face education. In this regard, the study aimed to identify both faculty’s and students’ perceptions of online learning, utilizing two surveys one distributed to 50 faculty members and another 280 students were selected randomly to explore the effectiveness, challenges, and advantages of online education in Jordan. The analysis showed that the common online platforms in Jordan were Zoom, Microsoft Teams offering online interactive classes, and WhatsApp in communication with students outside the class. The study found that both faculty and students agreed that online education is useful during the current pandemic. At the same time, its efficacy is less effective than face-to-face learning and teaching. Faculty and students indicated that online learning challenges lie in adapting to online education, especially for deaf and hard of hearing students, lack of interaction and motivation, technical and Internet issues, data privacy, and security. They also agreed on the advantages of online learning. The benefits were mainly self-learning, low costs, convenience, and flexibility. Even though online learning works as a temporary alternative due to COVID-19, it could not substitute face-to-face learning. The study recommends that blended learning would help in providing a rigorous learning environment.
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Virtual microscopy (VM) is a widely used teaching method in Medical Education in many developed countries. In Brazil, however, this is not the case for most medical schools, considering Brazilian social inequality and uneven access to technology. Recently, the Covid‐19 pandemic has also challenged Universities to seek and make a transition toward more effective methods of full‐time online education. Thus, the main goal of this work was to verify student's perception and academic performance, assessed upon VM implementation in a Brazilian Medical School. Ribeirao Preto Medical School students answered a 26‐question survey with regards to optical microscopy (OM) and VM. Academic performance was compared between participants that were (year of 2019) or were not (year of 2015) exposed to VM. Taken the results together, subjective impressions such as handling, suitability, learning effectiveness, and pleasure using the tools, have shown a higher score for virtual microscopy (median = 29), when compared to optical microscopy (median = 24) with a P‐value < 0.001 by Wilcoxon rank test, upon measurement using an ordinal scale. Regarding academic performance, no statistically significant differences were found between groups (P‐value = 0.38, Cohen's d = 0.19). Therefore, VM proved to be adequate to the Brazilian medical education in light of Brazilian social contexts and Covid‐19 pandemic.
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Objectives: Stress can affect learning and memories in students. Prior stress-related studies on students were conducted mainly through surveys. So, we investigated how heart rate variability (HRV)-measured stress related to academic achievement in medical students during clerkship. Subjects and methods: A cross-sectional study was conducted. HRV measurements were performed in 97 third-year medical students during their family medicine clerkship course. Data on written and skilled exam scores of the end of the school year were also collected. We assessed association between HRV-measured stress and written/skilled exam scores. Results: Written exam scores showed a positive correlation with standard deviation of the N-N intervals (SDNN) (r=0.245, p=0.016), sympathetic nervous system/parasympathetic nervous system (SNS/PNS) balance (r=0.218, p=0.033), and stress index (r=0.381, p=0.004). Students with an unhealthy SDNN, with a dominant SNS, and a high stress index had a higher scorer in written exams than students with a healthy SDNN, a balanced SNS/PNS, and a normal stress index, respectively (p=0.004, 0.018, and 0.012, respectively). Moreover, skilled exam scores were negatively correlated with body mass index (r=-0.249, p=0.014), and were higher in female students (r=0.240, p=0.018). Students with an abnormal autonomic balance diagram (ABD) had a higher score than students with a normal ABD (p=0.03). Conclusion: This study shows that medical students with higher stress measured by HRV have higher academic achievement, especially in written exam. Further studies are needed to reconfirm the results of this study and to assess the long-term effects of HRV measured stress on medical education.
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Background: Practical knowledge and skills of microscopy has classically been delivered for medical students using conventional microscopes (CMs). Using virtual microscopy (VM) in teaching practical histology was established during distance learning for Taif medical students during COVID 19 pandemic period. However, the suitable assessment methods for student performance during distance learning are still debatable. We focused on how to ensure the learner's achievement of course practical outcomes and learning domain. Aims and objectives: This study aimed to ascertain whether using VM to evaluate student learning in practical Histology during distance education programs and if moving to VM affecting students' scores. Materials and methods: For the first time, we used VM during online objective structural practical examination (OSPE) of 3rd year medical students. Different sets of virtual slides were given for students at the time of assessment, then different tasks were described and each student was asked to finalize his/her task during the designed time. A specific rubric was designed for the evaluation of student work. Moreover, student perceptions of VM as teaching and assessment method were assessed using online survey. Post examination psychometric analysis of VM OSPE was done and compared with previous OSPE results of the same batch of students. Results: The average student score was 4.63 ± 0.51 with no significant difference from previous student's scores. The net students' feedback was positive. Their average satisfaction on all items ranged from 3.7 to 4.25 on Likert scale. Students recorded the easy image access at any time and place with VM as the most distinctive feature. Conclusion: Our results indicated that VM is not only an effective method in teaching histology but also it is an assessment method for measuring student performance during online assessment.
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Effective online teaching and learning requires a carefully designed classroom that promotes student engagement with faculty, peers and course content. This research included an investigation of the importance of faculty–student communication and collaboration; student–student communication and collaboration; active learning techniques; prompt feedback; appropriate time for tasks; high performance expectations; and respect for diverse learning styles (preferences) (Chickering and Ehrmann 1996) to faculty in their online teaching and to alumni in their online learning. The participants were 14 college faculty and 111 alumni, from the same graduate program. A 45-item Likert survey and two open-ended questions were presented to the participants to explore the important factors contributing to their online teaching and learning. The results demonstrated that holding students to high standards of performance, academic honesty and professional conduct was the most important factor to both faculty in their online teaching and alumni in their online learning. Additionally, alumni valued engagement with their faculty more than engagement with other students or course content. Students need an online instructor who is organised and communicative in the online classroom, and faculty need a solidly designed online classroom, with engaged students who are timely in their work. An analysis of the findings with specific application to online teaching and learning is presented in this article.
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Objective: To examine whether cumulative cortisol production changes during a period of increased demands when cortisol and stress are assessed concurrently. The study also compared stress perceptions vs. cumulative stressful events on their respective association with cortisol output. Finally, it explored whether certain types of stressful events, those involving school/job performance or social-evaluative threat, were linked to cortisol levels across multiple weeks. Method: The current study assessed cumulative cortisol production via hair sample in 56 undergraduates (88 % female) during both lower stress (summer break) and higher stress (academic term) periods. During the latter, both negative events (checklist) and stress perceptions were assessed weekly, and these reports were aggregated across the 10-weeks to minimize retrospective bias. Results: Cortisol levels in hair samples were significantly higher (d = 0.84) during the academic term (M = 14.24 pg/mg, SD = 11.36) compared to summer break (M = 8.00 pg/mg, SD = 4.14), suggesting greater cumulative exposure to cortisol. Although perceived stress was not associated with cortisol levels (rpartial(53) = .10, p = 0.46), exposure to more stressful events (rpartial(53) = .27, p = 0.047), particularly events involving academic demands (rpartial(53) = .37, p = 0.006), or negative evaluation/social rejection (rpartial(53) = .27, p = 0.045), was positively associated with cumulative cortisol exposure. Conclusions: This study demonstrates that cortisol levels in hair may be linked to cumulative exposure to stressors when measured concurrently (3 months), and that stressful events, rather than perceptions, are reflected in HPA axis activity. Real-world stressors involving performance demands and social-evaluative threat accumulate to enhance cortisol production, consistent with their acute HPA effects in the lab. Hair samples may provide a window into the past by allowing researchers to feasibly assess cortisol production before, during, and after the onset of a chronic stressor.
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In recent years, research in behavioral medicine has become increasingly focused on understanding how chronic and acute exposure to stress impacts health outcomes. During stress, the body’s physiological stress systems are activated. These systems closely interact with the immune system and are, thus, importantly implicated in the onset and maintenance of disease states. While much of the research in behavioral medicine that has investigated the effects of stress on disease has focused on the role of the hypothalamic-pituitary-adrenal axis and its downstream biomarker, cortisol, it is evident that the autonomic nervous system (ANS) also plays a crucial role in both the biological stress process and the manifestation and maintenance of stress-related symptoms. In recent years salivary alpha-amylase (sAA) has emerged as a valid and reliable marker of ANS activity in stress research and is therefore an important biomarker to consider in behavioral medicine. In this commentary, we will highlight research relevant for behavioral medicine that has utilized sAA measurements, both basally, and in response to stress, to examine ANS function in clinical populations. We will additionally summarize findings from studies that have examined the effects of various targeted interventions on changes in sAA levels. Through this, our aim is to present evidence that sAA can serve as a feasible biomarker of ANS (dys)function in health and disease. To this end, we will also highlight important methodological considerations for readers to keep in mind when including sAA assessments in their own studies. The overarching goal of this brief commentary is to highlight how a multidimensional approach toward physiological stress measurement can allow researchers to develop a better understanding of physical health and disease states.
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Virtual microscopy (VM) has been utilized to improve students' learning experience in microscope laboratory sessions, but minimal attention has been given to determining how to use VM more effectively. The study examined the influence of VM on academic performance and teacher and student perceptions and compared laboratory test scores before and after VM incorporation. A total of 662 third‐year students studying histology and 651 fourth‐year students studying pathology were divided into two groups. The light microscopy (LM) group used a light microscope in 2014 and 2015, while the LM + VM group used the VM platform and a light microscope in 2016 and 2017. Four factors positively predict laboratory scores (R square, 0.323; P < 0.001): (i) the pathology course and test‐enhanced learning, (ii) the VM platform and experience, (iii) medical students and lecture scores, and (iv) female students. The LM + VM group exhibited less score variability on laboratory examinations relative to their mean than the LM group. The LM + VM group was also associated with fewer failing grades (F grade; odds ratio, 0.336; P < 0.001) and higher scores (A grade; odds ratio, 2.084; P < 0.001) after controlling for sex, school, course, and lecture grades. The positive effect of the VM platform on laboratory test grades was associated with prior experience using the VM platform and was synergistic with more interim tests. Both teachers and students agreed that the VM platform enhanced laboratory learning. The incorporation of the VM platform in the context of test‐enhanced learning may help more students to master microscopic laboratory content.
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Background: In stress research, economic instruments for introducing acute stress responses are needed. In this study, we investigated whether the socially evaluated cold-pressor group test (SECPT-G) induces salivary alpha-amylase (sAA) and/or cortisol responses in the general population and whether this is associated with anthropometric, experimental, and lifestyle factors. Methods: A sample of 91 participants from the general population was recruited.Salivary cortisol and sAA levels were assessed prior to (t0), immediately after (t1), and10 min after the SECPT-G (t2). Results: A robust cortisol increase was found immediately after the SECPT-G, which further increased betweent1andt2. This was independent of most of the control variables. However, men showed a trend toward higher cortisol increases than women (p= 0.005). No sAA responses were found at all. However, sAA levels were dependent on measurement time point with highest levels between 9 pm and9:30 pm. Participants who immersed their hands into the ice water for the maximally allowed time of 3 min showed higher sAA levels at all time points than participants who removed their hands from the water earlier. Conclusions: We conclude that the SECPT-G is a good means of an acute stress test when cortisol—but not necessarily sAA—responses are intended.
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Mental workload is known to alter cardiovascular function leading to increased cardiovascular risk. Nevertheless, there is no clear autonomic nervous system unbalance to be quantified during mental stress. We aimed to characterize the mental workload impact on the cardiovascular function with a focus on heart rate variability (HRV) non-linear indexes. A 1-h computerized switching task (letter recognition) was performed by 24 subjects while monitoring their performance (accuracy, response time), electrocardiogram and blood pressure waveform (finger volume clamp method). The HRV was evaluated from the beat-to-beat RR intervals (RRI) in time-, frequency-, and informational- domains, before (Control) and during the task. The task induced a significant mental workload (visual analog scale of fatigue from 27 ± 26 to 50 ± 31 mm, p < 0.001, and NASA-TLX score of 56 ± 17). The heart rate, blood pressure and baroreflex function were unchanged, whereas most of the HRV parameters markedly decreased. The maximum decrease occurred during the first 15 min of the task (P1), before starting to return to the baseline values reached at the end of the task (P4). The RRI dimension correlation (D2) decrease was the most significant (P1 vs. Control: 1.42 ± 0.85 vs. 2.21 ± 0.8, p < 0.001) and only D2 lasted until the task ended (P4 vs. Control: 1.96 ± 0.9 vs. 2.21 ± 0.9, p < 0.05). D2 was identified as the most robust cardiovascular variable impacted by the mental workload as determined by posterior predictive simulations (p = 0.9). The Spearman correlation matrix highlighted that D2 could be a marker of the generated frustration (R = -0.61, p < 0.01) induced by a mental task, as well as the myocardial oxygen consumption changes assessed by the double product (R = -0.53, p < 0.05). In conclusion, we showed that mental workload sharply lowered the non-linear RRI dynamics, particularly the RRI correlation dimension.
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Background: The aim of this study is to review the literature on known barriers and solutions that face educators when developing and implementing online learning programs for medical students and postgraduate trainees. Methods: An integrative review was conducted over a three-month period by an inter-institutional research team.The search included ScienceDirect, Scopus, BioMedical, PubMed, Medline (EBSCO & Ovid), ERIC, LISA, EBSCO, Google Scholar, ProQuest A&I, ProQuest UK & Ireland, UL Institutional Repository (IR), UCDIR and the All Aboard Report. Search terms included online learning, medical educators, development, barriers, solutions and digital literacy. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed with inclusion/exclusion criteria. A consensus was drawn on which articles were included. Data appraisal was performed using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and NHMRC Appraisal Evidence Matrix. Data extraction was completed using the Cochrane Data Extraction Form and a modified extraction tool. Results: Of the 3101 abstracts identified from the search, ten full-text papers met the inclusion criteria. Data extraction was completed on seven papers of high methodological quality and on three lower quality papers. Findings suggest that the key barriers which affect the development and implementation of online learning in medical education include time constraints, poor technical skills, inadequate infrastructure, absence of institutional strategies and support and negative attitudes of all involved. Solutions to these include improved educator skills, incentives and reward for the time involved with development and delivery of online content, improved institutional strategies and support and positive attitude amongst all those involved in the development and delivery of online content. Conclusion: This review has identified barriers and solutions amongst medical educators to the implementation of online learning in medical education. Results can be used to inform institutional and educator practice in the development of further online learning.
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The understanding of mechanisms linking psychological stress to disease risk depend on reliable stress biomarkers. Circulating cell-free DNA (cfDNA) has emerged as a potential biomarker of cellular stress, aging, inflammatory processes, and cell death. Recent studies indicated that psychosocial stress and physical exercise might also influence its release. We compared the effects of acute psychosocial and physical exercise stress on cfDNA release by exposing 20 young, healthy men to both an acute psychosocial laboratory stressor and an acute physical exercise stressor. Venous blood and saliva samples were collected before and after stress exposure. Cell-free DNA was extracted from plasma and quantified by qPCR. Furthermore, cfDNA fragment length was analyzed and cfDNA methylation patterns were assayed across time. In addition, release of stress hormones and subjective stress responses were measured. Results showed a twofold increase of cfDNA after TSST and fivefold increase after exhaustive treadmill exercise, with an overabundance of shorter cfDNA fragments after physical exhaustion. Interestingly, cell-free mitochondrial DNA showed similar increase after both stress paradigms. Furthermore, cfDNA methylation signatures-used here as a marker for diverse cellular origin-were significantly different post stress tests. While DNA methylation decreased immediately after psychosocial stress, it increased after physical stress, suggesting different cellular sources of active DNA release. In summary, our results suggest stimulus and cell-specific regulation of cfDNA release. Whereas the functional role of stress-associated cfDNA release remains elusive, it might serve as a valuable biomarker in molecular stress research as a part of the psychophysiological stress response.
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Background Over the past decade, the prevalence of anxiety has increased among college-aged students and college counseling centers have become increasingly concerned about the negative impact of anxiety on students. While college in general can be stressful, college science classrooms have the potential to be especially anxiety-inducing because of the sometimes chilly and competitive environment of the class. Further, college science courses are increasingly being transitioned from traditional lecture to active learning where students take an active role in their learning, often through participating in activities such as clicker questions and group work. There is emerging evidence that suggests active learning activities may cause students to feel anxious, but no studies have thoroughly explored why active learning activities in science courses may increase students’ anxiety. Further, no studies have explored whether active learning activities can reduce students’ anxiety. In this exploratory interview study of 52 students enrolled in large-enrollment active learning college science courses, we investigate how three active learning practices, clicker questions, group work, and cold call/random call, increase and decrease students’ anxiety. Results Students reported that clicker questions and group work had the potential to both increase and decrease their anxiety. The way the active learning activity is implemented and the extent to which students perceive they benefit from the activity seems to influence the effect of the activity on students’ anxiety. Conversely, students reported that cold call and random call only increased their anxiety. From our interviews, we identified the fear of negative evaluation, or the sense of dread associated with being unfavorably evaluated while participating in a social situation, as the primary construct underlying students’ high levels of anxiety associated with speaking out in front of the whole class when they do not volunteer. Conclusion This study illustrates that active learning can both increase and decrease students’ anxiety depending on the way active learning is implemented. We hope that this study encourages instructors to create more inclusive active learning science courses by implementing active learning in ways that minimize students’ anxiety.
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A new quality of learning and teaching in general, is an absolute priority for education. The teachers are not only sources of information, they are also meant to lead managers and teaching so as to develop the interaction among students and training/development of key social personality traits. The students want to understand natural phenomena, to know scientific truths and to acquire knowledge to be applied in practice and for these reasons they are dissatisfied by the traditional education. The teachers and students, in most universities that have used the traditional lecture in courses, have revealed the limited effectiveness in both teaching and learning. The teacher must use methods to encourage discovery learning, heuristic and research methods. Dynamic and communicative teaching methods, also called interactive teaching methods, constitute the basic elements of a recently developed process to motivate learning, so that the students and future engineers develop a critical position about the taught content. Using interactive techniques and strategies, the students become more engaged in learning; retain more information, thus becoming more satisfied.
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Objective: Physical or mental imbalance caused by harmful stimuli can induce stress to maintain homeostasis. During chronic stress, the sympathetic nervous system is hyperactivated, causing physical, psychological, and behavioral abnormalities. At present, there is no accepted standard for stress evaluation. This review aimed to survey studies providing a rationale for selecting heart rate variability (HRV) as a psychological stress indicator. Methods: Term searches in the Web of Science®, National Library of Medicine (PubMed), and Google Scholar databases yielded 37 publications meeting our criteria. The inclusion criteria were involvement of human participants, HRV as an objective psychological stress measure, and measured HRV reactivity. Results: In most studies, HRV variables changed in response to stress induced by various methods. The most frequently reported factor associated with variation in HRV variables was low parasympathetic activity, which is characterized by a decrease in the high-frequency band and an increase in the low-frequency band. Neuroimaging studies suggested that HRV may be linked to cortical regions (e.g., the ventromedial prefrontal cortex) that are involved in stressful situation appraisal. Conclusion: In conclusion, the current neurobiological evidence suggests that HRV is impacted by stress and supports its use for the objective assessment of psychological health and stress.
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Healthy biological systems exhibit complex patterns of variability that can be described by mathematical chaos. Heart rate variability (HRV) consists of changes in the time intervals between consecutive heartbeats called interbeat intervals (IBIs). A healthy heart is not a metronome. The oscillations of a healthy heart are complex and constantly changing, which allow the cardiovascular system to rapidly adjust to sudden physical and psychological challenges to homeostasis. This article briefly reviews current perspectives on the mechanisms that generate 24 h, short-term (~5 min), and ultra-short-term (<5 min) HRV, the importance of HRV, and its implications for health and performance. The authors provide an overview of widely-used HRV time-domain, frequency-domain, and non-linear metrics. Time-domain indices quantify the amount of HRV observed during monitoring periods that may range from ~2 min to 24 h. Frequency-domain values calculate the absolute or relative amount of signal energy within component bands. Non-linear measurements quantify the unpredictability and complexity of a series of IBIs. The authors survey published normative values for clinical, healthy, and optimal performance populations. They stress the importance of measurement context, including recording period length, subject age, and sex, on baseline HRV values. They caution that 24 h, short-term, and ultra-short-term normative values are not interchangeable. They encourage professionals to supplement published norms with findings from their own specialized populations. Finally, the authors provide an overview of HRV assessment strategies for clinical and optimal performance interventions.
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Any intrinsic or extrinsic stimulus that evokes a biological response is known as stress. The compensatory responses to these stresses are known as stress responses. Based on the type, timing and severity of the applied stimulus, stress can exert various actions on the body ranging from alterations in homeostasis to life-threatening effects and death. In many cases, the pathophysiological complications of disease arise from stress and the subjects exposed to stress, e.g. those that work or live in stressful environments, have a higher likelihood of many disorders. Stress can be either a triggering or aggravating factor for many diseases and pathological conditions. In this study, we have reviewed some of the major effects of stress on the primary physiological systems of humans.
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Student engagement is key to successful teaching and learning, irrespective of the content and format of the content delivery mechanism. However, engaging students presents a particular challenge in online learning environments. Unlike face-to-face courses, online courses present a unique challenge as the only social presence between the faculty and the student is via the Internet. In a recent poll conducted by the authors, 100% of the respondents considered student engagement a challenge regardless of the number of years they have been teaching online. This paper explores various strategies that can be incorporated into the design of online learning courses to foster a high level of student engagement based on multiple pedagogies. In addition, the role of collaborative student engagement tools for the design and delivery of online courses is discussed as well as the role these tools play in creating an atmosphere where students actively participate in learning activities and are contributors to lively discussions. Perspectives on various mechanisms of student engagement that are founded in classic active learning pedagogies and enhanced with new technologies are presented in this paper, including perspectives on the design of courses to facilitate student engagement as well as best practices of design and delivery of online courses. Finally, this paper emphasizes the importance of deliberate course design in the pursuit of actively engaging students in online course settings.
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A growing body of research has indicated that acute stress can critically impact memory. However, there are a number of inconsistencies in the literature, and important questions remain regarding the conditions under which stress effects emerge as well as basic questions about how stress impacts different phases of memory. In this meta-analysis, we examined 113 independent studies in humans with 6,216 participants that explored effects of stress on encoding, postencoding, retrieval, or postreactivation phases of episodic memory. The results indicated that when stress occurred prior to or during encoding it impaired memory, unless both the delay between the stressor and encoding was very short and the study materials were directly related to the stressor, in which case stress improved encoding. In contrast, postencoding stress improved memory unless the stressor occurred in a different physical context than the study materials. When stress occurred just prior to or during retrieval, memory was impaired, and these effects were larger for emotionally valenced materials than neutral materials. Although stress consistently increased cortisol, the magnitude of the cortisol response was not related to the effects of stress on memory. Nonetheless, the effects of stress on memory were generally reduced in magnitude for women taking hormonal contraceptives. These analyses indicate that stress disrupts some episodic memory processes while enhancing others, and that the effects of stress are modulated by a number of critical factors. These results provide important constraints on current theories of stress and memory, and point to new questions for future research. (PsycINFO Database Record
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Introduction: Due to scientific and technological development, Medical Education has been readjusting its focus and strategies. Medical curriculum has been adopting a vertical integration model, in which basic and clinical sciences coexist during medical instruction. This context favours the introduction of new complementary technology-based pedagogical approaches. Thus, even traditional core sciences of medical curriculum, like Anatomy, are refocusing their teaching/learning paradigm. Material and methods: We performed a bibliographic review aiming to reflect on Medical Education's current pedagogical trend, by analysing the advantages of the introduction and diversification of pedagogical approaches in Anatomy Education. Results: Anatomy Education's status quo is characterized by: less available teaching time, increasing demands from radiology and endoscopy imaging and other invasive and non-invasive medical techniques, increasing number of medical students and other logistical restrains exposed by the current Medical Education scenario. The traditional learning approach, mainly based on cadaveric dissection, is drifting to complementary newer technologies - such as 3D models or 2D/3D digital imaging - to examine the anatomy of the human body. Also, knowledge transfer is taking different channels, as learning management systems, social networks and computer-assisted learning and assessment are assuming relevant roles. Discussion: The future holds promising approaches for education models. The development of Artificial Intelligence, Virtual Reality and Learning Analytics could provide analytic tools towards a real-time and personalized learning process. Conclusion: A reflection on Anatomy Education, as a comprehensive model, allows us to understand Medical Education's complexity. Therefore, the present Medical Education context favours a blended learning approach, in which multi-modality pedagogical strategies may become the landmark.
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Recently, the application of neuroscience methods and findings to the study of organizational phenomena has gained significant interest and converged in the emerging field of organizational neuroscience. Yet, this body of research has principally focused on the brain, often overlooking fuller analysis of the activities of the human nervous system and associated methods available to assess them. In this article, we aim to narrow this gap by reviewing heart rate variability (HRV) analysis, which is that set of methods assessing beat-to-beat changes in the heart rhythm over time, used to draw inference on the outflow of the autonomic nervous system (ANS). In addition to anatomo-physiological and detailed methodological considerations, we discuss related theoretical, ethical, and practical implications. Overall, we argue that this methodology offers the opportunity not only to inform on a wealth of constructs relevant for management inquiries but also to advance the overarching organizational neuroscience research agenda and its ecological validity.
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