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Physician Assistant Students’ Perception of Online Didactic Education: A Cross-Sectional Study

Physician Assistant Students’ Perception of Online Didactic Education: A Cross-Sectional Study

Purpose: This study describes physician assistant students’ perception toward online didactic education and highlights relationships between student characteristics and their preference for online learning.

Methods: A previously validated survey questionnaire was administered online to physician assistant students enrolled in traditional, in-person training programs across the United States. The survey consisted of five Likert-scale statements measuring perceptions of online learning and was rated on a seven-point Likert scale. Students also reported their age, gender, history of taking an online course, and preferred learning style. Mean scores were reported for agreement with each Likert-scale statement; Pearson correlation coefficients, one-way ANOVA with post hoc Tukey tests, and independent samples t-tests were used to determine relationships between student characteristics and their preference for online learning.

Results: A total of 391 completed surveys met the inclusion criteria for the study and were used in data analysis. The average age of respondents was 25.98 years, 81.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 317) were female, 96.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}, (n = 376) reported taking an online course previously, and preferred learning styles were reported as 36.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 141) visual, 7.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 30) auditory, 15.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 61) reading/writing, and 40.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 159) kinesthetic. Nearly a quarter of respondents indicated they preferred online courses, particularly students with a preferred learning style of reading/writing. No relationships were observed between age, gender, or history of taking an online course and preference for online education.

Conclusion: Most physician assistant students prefer in-person learning. However, a substantial number prefer online learning, and a significant number of these students reported a preferred learning style of reading/writing. More research is necessary to give educational institutions the ability to make data-driven, student-centered program development decisions. However, data in this study indicate a need for continued development of online/hybrid physician assistant programs to better align with current student preferences. 

Introduction

Since the inception of the profession in 1965, physician assistants (PAs) have learned to practice medicine through a combination of in-person didactic instruction followed by the completion of supervised clinical practice experiences at affiliated hospitals and clinics. Although this is an effective curriculum delivery method, pioneers in the field have also recently demonstrated the feasibility of hybrid PA education [1]. In the hybrid model, students complete the didactic year predominantly online, followed by traditional, in-person clinical training. Anderson summarized some of the benefits of online medical education [2]. These include fostering the development of self-directed learners [3], enhancing student engagement in the classroom [4], expanding opportunities for interprofessional education experiences [5,6], promoting digital literacy with medical technology [7], widening the instructor pool [7,8], removing barriers to attending PA school [9], repurposing time spent commuting [4], allowing students to live in and learn about the communities where they may one day practice, and helping to close the gap of clinician shortages in underserved areas [10]. The ability to teach didactic content online may also prove beneficial considering recent changes to the educational landscape following the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2)/coronavirus disease 2019 (COVID-19) pandemic. During this time, remote learning in the didactic year across PA programs increased from 6.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} before the pandemic to 96.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} during the pandemic [11]. During this time, there has also been increasing program director support for online didactic education in PA programs [12]. Now that online didactic PA education is possible, innovative PA educators should seek to determine what method of curriculum delivery students prefer, and analyze these preferences to help guide future program development decisions.

A review of the current literature indicates an overall preference for traditional in-person education over online learning among health professions students, both within and outside of the PA profession; however, research specific to the PA community is limited. In a 2006 seminal study, Day et al. concluded that PA students preferred in-person over online curriculum delivery [13], and in 2009, York et al. observed that 78{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of PA students enrolled in a web-based evidence-based medicine course stated they would have preferred in-person lectures instead of, or in addition to, online learning [14]. A review of the literature outside of the PA profession yields similar findings [15-17]. Although video-recorded lectures were found to be of equal or more educational value when compared to in-person instruction, Harvard Medical School students continued to attend traditional lectures if given the choice [15]. Hamilton et al. reported that third-year pharmacy students favored a blended educational approach as opposed to an exclusively online course [16]. A study by Bramer et al. also found that United Kingdom nursing students preferred a balanced mixture of online and face-to-face learning and did not feel that online learning should replace traditional teaching [17].

Further research is needed to explore the current preferences of didactic PA students regarding in-person versus online education to ensure PA program development decisions are student-centered, evidence-based, and data-driven. This is especially important considering the number of new PA programs in development and the number of existing programs that are adapting their curricula to combat current and evolving barriers to medical education. The current study sought to narrow this information gap by determining the curriculum delivery preferences of currently enrolled didactic PA students. Participants were also asked to report their age, gender, history of taking an online course, and preferred learning styles to determine if an association existed between any of these factors and their preference for online education.

Materials & Methods

Study description 

This was a cross-sectional survey study. Risks were minimal and consisted of time lost by students to complete the survey and the potential loss of confidentiality among participants. To mitigate these risks, the survey was designed to be completed in fewer than five minutes, participation was a one-time endeavor with no follow-up, and no personally identifiable information was collected. The primary benefit of the study was insight into the preferences of didactic PA students regarding their preferred curriculum delivery method. This could help current and future programs plan the instructional design of their curriculum. The study proposal was reviewed and approved by the institutional review board (IRB) of A.T. Still University, Mesa, Arizona, United States (approval number: 2021-174), and secondary approval was given by Franklin Pierce University, Rindge, New Hampshire, United States (protocol number: 08252021) for exempt status prior to data collection. 

Study sample

The Physician Assistant Education Association (PAEA) Program Report 35 reported that the maximum capacity enrollment of didactic students in PA programs across the United States was 11,299 [18]. According to a sample size estimator by Qualtrics (Seattle, Washington, and Provo, Utah, United States), 372 individuals from this population needed to be sampled to adequately represent the target population [19]. Inclusion criteria for participation were as follows: students had to be at least 18 years old, be enrolled in a currently accredited PA Program in the United States, and be in their didactic phase of study. Students at the Yale PA online program were excluded from participation as the principal investigator felt they may reasonably have a favorable bias toward online education. The principal investigator currently works for Franklin Pierce University and has previously been employed by the University of South Alabama; therefore, students from these institutions were also excluded to limit participation bias. 

Survey design and distribution

A previously validated survey instrument from O’Malley et al. [20] regarding perceptions of online education was adapted for use in the study, with the author’s permission. The adapted survey consisted of two questions to identify eligibility criteria, five Likert-scale questions regarding student perception of online education, and four student characteristic/demographic questions: (i) age, (ii) gender, (iii) history of taking an online course previously, and (iv) preferred VARK (visual, auditory, reading/writing, kinesthetic) learning style [21]. An alphabetical list of currently accredited PA programs by state from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) website was used to determine which programs to target for student recruitment [22]. The program director for the first accredited program listed for each state was sent a recruitment email asking whether they would offer participation to their didactic students. Those who agreed were asked to forward a standardized student-specific recruitment email to their currently enrolled didactic students that described the study’s purpose, risks, and benefits, and informed students that participation was voluntary, and completion of the survey was considered their consent to participate. The email also provided a link to the survey should they wish to complete it. If no response was received from a program director after one week, the recruitment email was sent for a second and final time. At the end of every two-week period, the next accredited program listed on the ARC-PA website for each state was contacted. This process continued, every two weeks, until the needed sample size of 372 qualified surveys was completed. 

Data collection, storage, and analysis

Data were collected from September through December 2021. Both ordinal and nominal (categorical) data were collected and stored on the SurveyMonkey platform (Momentive Inc., Waterford, New York). Following data collection, descriptive (frequencies, percentages, means, standard deviations, and confidence intervals) and comparative statistics were conducted using IBM SPSS Statistics for Windows, Version 28.0 (Released 2021, Armonk, New York). To determine if a correlation existed between age and preference for online education, a Pearson correlation coefficient was calculated for each Likert-scale statement; p-values less than .05 were used to determine statistical significance. A one-way ANOVA test was used to compare means among Likert-scale statements according to the four different preferred learning styles of participants; p-values less than .05 were used to determine statistical significance. Post hoc Tukey tests were then conducted to determine pairwise differences between the preferred learning styles for each Likert-scale statement; p-values less than .05 were used to determine statistical significance. Independent samples t-tests were used to determine if there was a significant difference in mean Likert-scale scores between genders or between those who had taken an online course previously versus those who had not; because multiple t-tests were conducted, the criterion for statistical significance was adjusted downward to a p-value less than 0.1 to control for alpha inflation in accordance with the Bonferroni correction.

Results

PA program participation and student characteristics 

The researchers did not directly access the study sample (didactic PA students), which instead had to be recruited to the study by PA program directors of invited programs. Therefore, the total number of student participants who received the survey was unknown and an accurate response rate could not be calculated. Approximately 35{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (50/141) of PA programs invited to the study responded to the email request, and 32{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (45/141) opted to participate. These programs represented didactic PA students across 31 states. At the conclusion of data collection, 472 surveys were received, of which 391 were complete, met inclusion criteria for the study, and were subsequently used for data analysis. The average age of the study sample was 25.98 years (range = 21-51 years). Gender was reported as 18.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 72) male, 81.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 317) female, 0.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 1) gender non-binary, and 0.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 1) preferred not to answer. Most participants (96.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}, n = 376) reported taking an online course previously. The distribution of preferred learning styles of the sample was 36.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 141) visual, 7.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 30) auditory, 15.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 61) reading/writing, and 40.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 159) kinesthetic (hands-on). 

Participant preferences for online education

Table 1 reports the study participants’ agreement and disagreement with statements pertaining to their perception of online education. Most students disagreed to some degree (strongly disagreed, disagreed, or somewhat disagreed) with four out of the five Likert-scale statements studied; 76.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 299) disagreed with the statement “Most people believe that online learning is more effective than traditional methodologies”, 72.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 283) disagreed with the statement “In a course with both traditional and online methodologies, I learn better through the online portion”, 69.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 271) disagreed with the statement “I prefer online courses to traditional courses”, and 59{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 231) disagreed with the statement “I believe that I can learn the same amount in an online course as in a traditional course.” In contrast, most students (56.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}, n = 221) agreed to some degree (strongly agreed, agreed, or somewhat agreed) with the statement “I believe that I can make the same grade in an online course as in a traditional course.”

Likert-scale Statement Strongly Disagree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) Disagree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) Somewhat Disagree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) Neither Agree nor Disagree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) Somewhat Agree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) Agree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) Strongly Agree, n ({e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf})
Most people believe that online learning is more effective than traditional methodologies. 96 (24.6) 125 (32.0) 78 (19.9) 29 (7.4) 39 (10.0) 14 (3.6) 10 (2.6)
In a course with both traditional and online methodologies, I learn better through the online portion. 104 (26.6) 117 (29.9) 62 (15.9) 35 (9.0) 29 (7.4) 27 (6.9) 17 (4.3)
I prefer online courses to traditional courses. 116 (29.7) 96 (24.6) 59 (15.1) 27 (6.9) 41 (10.5) 25 (6.4) 27 (6.9)
I believe that I can learn the same amount in an online course as in a traditional course. 74 (18.9) 83 (21.2) 74 (18.9) 22 (5.6) 55 (14.1) 48 (12.3) 35 (9.0)
I believe that I can make the same grade in an online course as in a traditional course. 41 (10.5) 48 (12.3) 42 (10.7) 39 (10.0) 67 (17.1) 101 (25.8) 53 (13.6)
Table
1: Levels of Agreement with Likert-scale Statements Regarding Perception of Online Education

n, number of participants

Relationships between participant characteristics and their preferences for online education 

Age

One survey respondent was omitted from analysis due to an erroneous input of their age (“2t”) which could not be validated. As reported in Table 2, no significant correlation was observed between age and preference for online education. 

Likert-scale Statement What is your current age?
n Pearson Correlation p-value
Most people believe that online learning is more effective than traditional methodologies. 390 0.02 0.66
In a course with both traditional and online methodologies, I learn better through the online format. 390 0.09 0.07
I prefer online courses to traditional courses. 390 0.06 0.23
I believe that I can learn the same amount in an online course as in a traditional course. 390 0.03 0.56
I believe that I can make the same grade in an online course as in a traditional course. 390 0.01 0.79
Table
2: Correlation of Likert-scale Statements with Age

n, number of participants

Gender

Only male and female genders were used in the analysis as these categories made up 99.49{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the sample. As reported in Table 3, no significant relationship existed between gender and preference for online education. 

Statement Gender n Mean Standard Deviation t df Two-sided p-value Mean Difference 95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} Confidence Interval of the Difference
Lower Bound Upper Bound  
Most people believe that online learning is more effective than traditional methodologies. Male 72 2.64 1.50 -0.16 387 0.87 -0.03 -0.43   0.37    
Female 317 2.67 1.56  
In a course with both traditional and online methodologies, I learn better through the online format. Male 72 2.72 1.68 -0.31 387 0.76 -0.07 0.23 -0.52  
Female 317 2.79 1.75  
I prefer online courses to traditional courses. Male 72 2.89 1.84 -0.09 387 0.93 -0.02 -0.51 0.47  
Female 317 2.91 1.92  
I believe that I can learn the same amount in an online course as in a traditional course. Male 72 3.58 2.07 0.59 387 0.56 0.15 -0.36 0.66  
Female 317 3.43 1.95  
I believe that I can make the same grade in an online course as in a traditional course. Male 72 4.33 2.06 -0.44 387 0.66 -0.11 -0.61 0.39  
Female 317 4.44 1.93  
Table
3: T-test Comparison of Likert-scale Scales by Gender

n, number of participants; t, independent sample t-test; df, degrees of freedom.

History of Taking an Online Course Previously

As reported in Table 4, no significant relationship existed between taking an online course previously and preference for online education. 

Statement Online Course Previously n Mean Standard Deviation t df Two-sided p-value Mean Difference 95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} Confidence Interval of the Difference
Lower Bound Upper Bound  
Most people believe that online learning is more effective than traditional methodologies. Yes 376 2.66 1.53 -0.74 14.58 0.47 -0.41 -1.59   0.77  
No 15 3.07 2.12  
In a course with both traditional and online methodologies, I learn better through the online format. Yes 376 2.77 1.71 -0.79 14.56 0.45 -0.50 -1.85 0.86  
No 15 3.27 2.43  
I prefer online courses to traditional courses. Yes 376 2.90 1.88 -0.61 389 0.54 -0.30 -1.29 0.68  
No 15 3.20 2.31  
I believe that I can learn the same amount in an online course as in a traditional course. Yes 376 3.44 1.96 -1.86 389 0.06 -0.96 -1.98 0.06  
No 15 4.40 2.20  
I believe that I can make the same grade in an online course as in a traditional course. Yes 376 4.38 1.94 -2.74 15.53 0.02 -1.22 -2.17 -0.27  
No 15 5.60 1.68  
Table
4: T-test Comparison of Likert-scale Statements by History of Taking an Online Course Previously

n, number of participants; t, independent sample t-test; df, degrees of freedom.

Preferred Learning Style

As reported in Table 5, the highest mean score (most agreement) for each Likert-scale statement was observed with those who selected reading/writing as their preferred learning style; four out of the five differences in means reached statistical significance. There were also statistically significant findings on the pairwise analysis of the different learning styles (Table 6). 

Likert-scale Statement Visual n Mean Standard Deviation 95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} confidence interval for mean p-value
Lower Bound Upper Bound
Most people believe that online learning is more effective than traditional methodologies. Visual 141 2.75 1.49 2.50 3.00 0.04
Auditory 30 2.70 1.70 2.06 3.34
Reading/Writing 61 3.08 1.80 2.62 3.54
Kinesthetic 159 2.44 1.44 2.21 2.67
In a course with both traditional and online methodologies, I learn better through the online format. Visual 141 2.84 1.71 2.56 3.13 0.02
Auditory 30 2.77 1.87 2.07 3.46
Reading/Writing 61 3.33 2.07 2.80 3.86
Kinesthetic 159 2.53 1.56 2.29 2.78
I prefer online courses to traditional courses. Visual 141 3.01 1.83 2.71 3.32 0.01
Auditory 30 2.73 1.91 2.02 3.45
Reading/Writing 61 3.56 2.25 2.98 4.13
Kinesthetic 159 2.60 1.75 2.32 2.87
I believe that I can learn the same amount in an online course as in a traditional course. Visual 141 3.57 1.99 3.24 3.90 0.55
Auditory 30 3.57 1.96 2.83 4.30
Reading/Writing 61 3.66 2.06 3.13 4.18
Kinesthetic 159 3.30 1.94 3.00 3.61
I believe that I can make the same grade in an online course as in a traditional course. Visual 141 4.43 1.97 4.10 4.75 0.04
Auditory 30 4.47 2.13 3.67 5.26
Reading/Writing 61 5.03 1.75 4.58 5.48
Kinesthetic 159 4.19 1.93 3.89 4.49
Table
5: One-way ANOVA of Likert-scale Statements with Preferred Learning Styles

n, number of participants

Likert-scale Statement Preferred Learning Style (a) Preferred Learning Style (b) Mean difference
(a-b) 		95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} confidence interval for mean p-value
Lower Bound Upper Bound
Most people believe that online learning is more effective than traditional methodologies. Visual Auditory 0.05 -0.75 0.85 1.00
Reading/Writing -0.33 -0.94 0.28 0.50
Kinesthetic 0.31 -0.15 0.77 0.30
Auditory Visual -0.05 -0.85 0.75 1.00
Reading/Writing -0.38 -1.27 0.50 0.68
Kinesthetic 0.26 -0.53 1.05 0.83
Reading/Writing Visual 0.33 -0.28 0.94 0.50
Auditory 0.38 -0.50 1.27 0.68
Kinesthetic 0.64 0.04 1.24 0.03
Kinesthetic Visual -0.31 -0.77 0.15 0.30
Auditory -0.26 -1.05 0.53 0.83
Reading/Writing -0.64 -1.24 -0.04 0.03
In a course with both traditional and online methodologies, I learn better through the online format. Visual Auditory 0.08 -0.82 0.97 1.00
Reading/Writing -0.48 -1.17 0.20 0.26
Kinesthetic 0.31 -0.21 0.82 0.41
Auditory Visual -0.08 -0.97 0.82 1.00
Reading/Writing -0.56 -1.55 0.43 0.46
Kinesthetic 0.23 -0.65 1.12 0.91
Reading/Writing Visual 0.48 -0.20 1.17 0.26
Auditory 0.56 -0.43 1.55 0.46
Kinesthetic 0.79 0.12 1.46 0.01
Kinesthetic Visual -0.31 -0.82 0.21 0.41
Auditory -0.23 -1.12 0.65 0.91
Reading/Writing -0.79 -1.46 -0.12 0.01
I prefer online courses to traditional courses. Visual Auditory 0.28 -0.69 1.25 0.88
Reading/Writing -0.54 -1.28 0.20 0.23
Kinesthetic 0.42 -0.14 0.98 0.22
Auditory Visual -0.28 -1.25 0.69 0.88
Reading/Writing -0.82 -1.90 0.26 0.20
Kinesthetic 0.16 -0.83 1.10 0.98
Reading/Writing Visual 0.54 -0.20 1.28 0.23
Auditory 0.82 -0.26 1.90 0.20
Kinesthetic 0.96 0.23 1.69 0.00
Kinesthetic Visual -0.42 -0.98 0.14 0.22
Auditory -0.14 -1.10 0.83 0.98
Reading/Writing -0.96 -1.69 -0.23 0.00
I believe that I can learn the same amount in an online course as in a traditional course. Visual Auditory 0.00 -1.03 1.03 1.00
Reading/Writing -0.09 -0.87 0.69 0.99
Kinesthetic 0.27 -0.33 0.86 0.65
Auditory Visual -0.00 -1.03 1.03 1.00
Reading/Writing -0.09 -1.23 1.05 1.00
Kinesthetic 0.26 -0.75 1.28 0.91
Reading/Writing Visual 0.09 -0.69 0.87 0.99
Auditory 0.09 -1.05 1.23 1.00
Kinesthetic 0.35 -0.42 1.12 0.64
Kinesthetic Visual -0.27 -0.86 0.33 0.65
Auditory -0.26 -1.28 0.75 0.91
Reading/Writing -0.35 -1.12 0.42 0.64
I believe that I can make the same grade in an online course as in a traditional course. Visual Auditory -0.04 -1.04 0.96 1.00
Reading/Writing -0.61 -1.37 0.16 0.17
Kinesthetic 0.24 -0.34 0.81 0.72
Auditory Visual 0.04 -0.96 1.04 1.00
Reading/Writing -0.57 -1.68 0.55 0.56
Kinesthetic 0.28 -0.72 1.27 0.89
Reading/Writing Visual 0.61 -0.16 1.37 0.17
Auditory 0.57 -0.55 1.68 0.56
Kinesthetic 0.84 0.09 1.60 0.02
 Kinesthetic Visual -0.24 -0.81 0.34 0.72
Auditory -0.28 -1.27 0.72 0.89
Reading/Writing -0.84 -1.60 -0.09 0.02
Table
6: Tukey Post Hoc Pairwise Analysis of Preferred Learning Styles

Discussion

Purpose and major findings

The PA educational community has endured many challenges and evolved significantly over the last few years. Due to the unfortunate COVID-19 global pandemic, almost every PA program across the country quickly discovered its ability to implement didactic curriculum online and continue the education of PA students at a time when clinicians were crucially needed [23]. Academic administrators, faculty, students, and other stakeholders must now decide what role hybrid PA programs have in the future of PA education. Perceptions of PA students toward online learning should be considered in this discussion; determining these perceptions was the purpose of this study. 

Most pre-COVID-19 studies show that health professions students generally prefer in-person over online education [13-17], and the results of the current study align with those findings. However, the current study also reveals a significant number of PA students who do prefer learning in an online environment. Despite the majority of participants (69.31{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}, n = 271) preferring traditional courses, the survey nevertheless identified 23.79{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 93) who preferred online learning. Furthermore, as the sample population did not include students from programs that currently use online programming as a major component of their curriculum [2], the preference for online education of the entire PA student population may be slightly higher than reported here. The current study also provides insight into the type of student who may prefer learning online. Interestingly, data analysis showed no correlation between age and students’ preference for online education. Similarly, there were no significant relationships between gender or having previously taken an online course and preference for online education. However, a statistically significant relationship did exist between self-reported preferred learning styles and preference for online learning. Although only 15.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (n = 61) of the sample reported their preferred learning style as reading/writing, this group had the most agreement with all Likert-scale statements favoring online education; four out of five of these results were statistically significant. 

Relevance of findings 

A substantial interest among PA students in online didactic education is not surprising considering other recent studies of medical students in a post-COVID-19 educational environment. Stoehr et al. collected cross-sectional data from 3,286 medical students across 12 countries [24]. In their study, 91{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of participants agreed that lecture-style education was a suitable teaching concept for online learning, 97{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} indicated they had the devices required for online learning, 80{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} felt comfortable using the software required for online learning, 76{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} felt well prepared for online learning, and 62{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} reported being happy with the quality of online courses [24]. Another post-COVID-19 study of 64 medical students at a United States-based allopathic medical school that moved the entire pre-clinical curriculum to a virtual format during the pandemic demonstrated that 70.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of students reported an unchanged or improved overall medical education in a virtual course module compared to a previous module that was taught in a traditional face-to-face setting [25]. Furthermore, a recent systematic review of 24 studies measuring medical student satisfaction with e-learning during the pandemic indicated that 51.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the 15,473 medical students studied were satisfied [26]. 

Study limitations

A potential limitation to this study is that it was conducted during the COVID-19 pandemic and perceptions of online education may have been influenced by either positive or negative experiences encountered during this turbulent time in medical education. Furthermore, the study was not experimental in nature and, therefore, could not control for other variables that may have influenced student perception of online PA education, such as the quality of instructional design and the types of resources made available to students at different institutions. Another limitation was that students were asked to self-report their VARK [21] learning style instead of completing the VARK questionnaire, and students were limited in their selection to only a single preferred learning style. Other limitations to this study are those inherent to survey-based research, including an inability to clarify study questions if needed and not allowing respondents to further explain their answers beyond predetermined survey selections. 

Conclusions

Most didactic PA students (69.31{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) prefer traditional in-person education over online learning. However, the number of didactic PA students that do prefer online learning (23.79{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) is also substantial. If we generalize these findings to the 11,299 maximum enrollment slots available per the last PAEA Program Report, there are potentially 2,689 students who may benefit from online/hybrid PA education. Despite these findings, only three out of the 282 currently accredited PA programs are designed to offer a significant portion of their curriculum in an online/hybrid format. Although more research is needed regarding hybrid PA education, based on the findings of this study, the researchers recommend more institutions consider exploring and/or piloting this type of program delivery. Future studies may consider determining the characteristics and preferred learning styles of students who decide to apply to online/hybrid PA programs and how a student’s preferred learning style relates to their satisfaction with, and success in, an online PA educational environment.

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Study Finds Teen Suicides Declined With Online Learning

Study Finds Teen Suicides Declined With Online Learning

(TNS) — On-line schooling may perhaps have decreased suicide fees in LGBTQ+ young adults in Dane County through the top of the COVID-19 pandemic, according to a research from UW-Madison’s College of Education and learning, potentially due to the fact the college natural environment for some teenagers was harmful.

But suicide prices for LGBTQ+ teens are even now two to three situations increased than their cisgender and straight friends.

“I you should not want any other guardian to ever, ever, ever truly feel like this,” reported Dia Caulkins, whose child Graciella-Sawyer Caulkins-Feltz died by suicide in November.


Graciella-Sawyer, who was non-binary, was only 14 when they died. They cherished the colours pink and yellow, and unicorns. They had just picked up photography, snapping pics of flowers, sunsets and ice product. They cared about animals and experienced just begun piano classes.

They had been also really form and compassionate, almost to a fault, Caulkins explained.

“They failed to do this to harm us, they did this since they couldn’t see a way out,” she mentioned. “And we have to be executing extra so that they have a place the place they in shape, the place they are acknowledged.”

Globe occasions these kinds of as the war in Ukraine and George Floyd’s death deeply afflicted Graciella-Sawyer. They stopped to communicate with men and women dealing with homelessness, volunteered in the group and checked in on their siblings generally. They were being awesome to anyone, even to those people who had been unkind to them.

“Their capacity for love, apart from for themselves, was wonderful,” Caulkins stated.

“I consider we require to be accomplishing a lot more,” she said.

UW doctoral pupil Erin Gill and assistant professor Mollie McQuillan, who authored the research, stated discovering remedies is specially crucial as anti-LGBTQ+ rhetoric raises, specifically encompassing youth and colleges — from lawsuits above faculty districts’ gender identification insurance policies and discourse in the 2022 gubernatorial race to endeavours to repeal sex schooling curriculum and worries to children’s Satisfaction displays in libraries.

“Our research highlights that we need extra organizational supports and reforms for queer and trans young ones who are obtaining pushed out of faculty and usually are not risk-free in faculty,” McQuillan said.

At the get started of the pandemic , there had been “two stories” about how LGBTQ+ youth ended up fairing, Gill said.

“We were hearing that some kids had been genuinely flourishing not staying in faculty any longer because they had been out of unsafe university environments,” she explained. “But we might also been listening to this other story where youth ended up really struggling at household, regardless of whether they have been in a dangerous property setting or they lacked the supports they had in college.”

THE Research

Those people divergent ordeals are borne out in the UW review, in which McQuillan and Gill as opposed final results from the Dane County Youth Assessment from 2018 and 2021.

The evaluation is a survey given to pupils each and every three decades, inquiring them about distinctive behaviors and risk components, such as drug use and bullying.

Gill and McQuillan’s review found that LGBTQ+ youth described “considerably less” attempts of suicide in 2021 than in 2018, but higher stress and anxiety.

Especially, in 2021, nearly 39 percent of gay or lesbian substantial schoolers documented seriously contemplating or acquiring attempted suicide, when compared with practically 42 percent in 2018.

That rate was approximately 47 {e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} for bisexual college students in 2021, in contrast with approximately 51 percent in 2018.

And for pupils questioning their sexual identification, the price was just more than 35 {e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} in 2021 and just above 38 per cent in 2018.

Corresponding premiums for straight learners, having said that, have been a lot reduced: 14 p.c of them in 2021 and 17 p.c in 2018.

In the meantime, anxiety in substantial schoolers rose from almost 30 percent in 2018 to a lot more than 32 per cent in 2021.

McQuillan stated environmental aspects could assistance reveal why stress enhanced in college students even though suicidal thoughts might have lowered.

Anxiety is thought to be joined to a home natural environment and added pandemic-similar stressors family members had been experiencing, even though other supports in university and the group ended up lower off, McQuillan explained.

But suicide is imagined to be connected far more to peer victimization, or bullying.

“So, victimization does not explain all of this boost in suicidality amongst queer and trans little ones, but it describes some of it. And when young ones were being out of university and enduring likely considerably less victimization, we observed that link of suicidality and not anxiety,” McQuillan stated.

Caulkins miracles if students whose mental wellness improved all through on the web education already had buddies and peer help. “If you will not have any mates, that’s a very lonely spot to be at 12 and 13.”

For Graciella-Sawyer, “the pandemic was horrible,” their mother said.

“It wasn’t like life was straightforward for them right before that, but it was like they had been treading h2o all right,” Caulkins explained. “And as the pandemic went on, they got lonelier and sadder.”

As soon as in-particular person mastering returned, Graciella-Sawyer tried out to make buddies by becoming a member of clubs and keeping associated. But some young children bullied them verbally, and some even took photographs of them and threatened to publish them on line.

“We as grownups, we as the grown-ups, have to instruct kids that their phrases make a difference and they stick with kids who are lonely and sad and isolated,” Caulkins mentioned. “As moms and dads, we have a responsibility to make sure that our youngsters know they are not Okay.”

What she hopes to see: Additional local community constructing in universities, to expose college students to distinctive backgrounds and identities, and better mental overall health services.

The course of action to get counseling for Graciella-Sawyer was sluggish, and now as Caulkins is striving to find counseling for her other little ones as they grieve, the waitlist is months long.

Gill said the research reinforces the value of bolstering and multiplying approaches to assist LGBTQ+ youth. And McQuillan mentioned there ought to be more assistance to “disrupt” bullying that is most likely happening yet again now that young children are again in educational institutions.

“I am seriously encouraged by LGBTQ youth who have been standing up to this political stress,” Gill included. She stated that while college students may perhaps be battling mainly because of the increased rhetoric, there is also an raise in peers and LGBTQ+ youth “championing” one an additional.

McQuillan and Gill hope to broaden their examine next by hunting at statewide info.

As for Graciella-Sawyer, they had been offering to the last: Their organs had been donated.

“And all moms enjoy their young ones, of training course, but definitely, Sawyer definitely preferred to make the planet a improved area, and they need to have been below to do that as an adult,” Caulkins said. “They would have devoted their life to generating it much better.”

©2023 The Wisconsin State Journal (Madison, Wis.). Distributed by Tribune Content Agency, LLC.

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Identifying the challenges of online education from the perspective of University of Medical Sciences Students in the COVID-19 pandemic: a Q-methodology-based study | BMC Medical Education

Identifying the challenges of online education from the perspective of University of Medical Sciences Students in the COVID-19 pandemic: a Q-methodology-based study | BMC Medical Education

This cross-sectional analyze was executed using the Q methodology during the subsequent six techniques utilizing Barry and Proops method [19].

Phase 1 and 2: defining the concourse

At this phase, a concourse space was fashioned with the identification of the matter or idea of the analyze. The offered sights on the situation elevated for the concourse can be formed from a assessment of texts and authorities in this field [19].

In this review, the matter and notion for the concourse were being the problems of on the web education and learning all through the COVID-19 pandemic. The concourse provided a collection of various supplies associated to the investigation subject that was mentioned among the students. The pupils (P-established) who also experienced contributed before to the enhancement of the initial set of statements. Thirty-one particular learners participated in semi-structured interviews, and we tried using to establish their subjectivity about the investigation matter working with the Q approach [20].

In this analyze, the concourse (sample of people) provided college students of the University of Health care Sciences (paramedical learners) who had enough data about online training for the duration of the COVID-19 pandemic.

Stage 3: screening and assortment of statements (Q-sample)

In the course of the semi-structured interviews with 31 learners, 70 statements ended up extracted about the perceived difficulties of online schooling. The Q goods ended up picked quite diligently so that things did not overlap, and at the exact time, no point of view need to be missing. Thus, the variety process usually takes the most time and hard work of all the measures of the Q methodology. For that reason, exploration group taken out related unrelated, and ambiguous statements from the Q set. Eventually, 50 statements had been selected.

Phase 4: picked P-established

Students who participated in the concourse (interviews) had been chosen as a sample of individuals to take part in sorting in the Q examine (P-established). In the present study, learners have been picked by purposive sampling to include college students who experienced an academic, skilled, experimental marriage or prior information about the subject of study. This range of samples designed the contributors with much more varied mentalities enter the examine. It is advised that in Q experiments, the variety of members to form statements should really be less than the number of statements close to the analyze issue [21]. In the present examine, the range of individuals who rated the troubles of on the web education packages was 31 (Table 1).

Desk 1 The Q-established statements and issue arrays in the analyze of worries on the net instruction among pupils

Phase 5: Q-sort

At this stage, the normal distribution table in the type of a Likert scale from − 5 to + 5 was developed offline. Suggestions on distributing the expressions on the typical distribution table have been delivered. In the first phase, the intent of the examine is the quantity of statements picked by means of the interview. In the second phase, position the statements in 3 columns: “I agree”, “I have no viewpoint,” and “I disagree. In the third phase, the statements (necessary) are distributed in the ordinary Likert distribution diagram (− 5 to 5+), detailing the motive for deciding upon the two ends of the Likert scale from their issue of look at and lastly moving into the demographic facts. So, in Q, the sorting process is subjective [19]. In other text, sorting things in the regular distribution make it possible for each and every participant to existing their internal standpoint via sorting.

Stage 6: examination and interpretation of components

Students’ knowledge obtained from Q sorting were being entered into PQ-Method program model 2.35. The system of analysis and interpretation was executed in three levels: (a) identification of factors, (b) conversion of elements into element arrays (c) interpretation of variables applying element arrays.

  1. A)

    Element Identification

The extraction of components in PQ-Method software was performed by the subsequent sequential techniques: (a) principal element examination, (b) identification of latent things, (c) varimax rotation and analysis of loading aspects for unique values earlier mentioned 1.00, d) estimation of the percentage of variance described by the discovered variables and (e) differentiation of interpretable components with at minimum two correlated Q forms [22].

  1. B)

    Transform element to element arrays

The correlation among each Q sort and just one discovered element indicates the degree of interaction in between the Q sorts and the recognized factors [19, 23]. The handbook flagging in PQ-Approach program was used for this examine. The correlation coefficients of at the very least .364 had been thought of as the reduce-off issue (the absolute value of the issue load is increased than ((frac2.58sqrtN)). That factor load was 99{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} significant, respectively, and the value of N was equivalent to the quantity of Q statements (N = 50). Sorted for identified elements [24]. Specs specified on a component are employed to create a aspect array for that element. The variable array represents the sorting of that factor (point of watch) applying z-scores. The component array for each individual issue determined the degree to which each individual expression was in the spectrum, so a extra precise interpretation of just about every component (subjectivity) was attained according to the placement of every single expression. (P-worth< 0.05 vs. 0.01) is also determined from the Z score to distinguish expressions [25].

  1. III)

    Factor interpretation using factor arrays

Distinct Q expressions were identified, and factors were interpreted textually. The defining expressions for a factor were those that had a rating value of “+ 5”, “+ 4”, “4-,” 5- “in factor arrays that had different scores (P < 0.05) in a given factor Compared to their scores on other factors, the post-P-set interview was conducted at the end of Q sorting to confirm the diagnosis and interpretation of item subgroups among the identified factors.

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Study: Homeschoolers Outperform All Other Students on Standardized Test

Study: Homeschoolers Outperform All Other Students on Standardized Test

Several scientific tests have proven that homeschooled learners go on to academically outperform their non-public, constitution, and public college counterparts.

Now, a new analyze about homeschoolers having the Common Understanding Exam, a standardized college entrance examination, reveals they are scoring higher than their peers in other instructional configurations. 

The assessments, according to the CLT web site, emphasize intellectual aptitude and accomplishment and are grounded in the liberal arts tradition.

The exam utilizes looking through passages from basic texts written by people today “whose writings have had a lasting influence on culture and society” alternatively than the informational passages and far more contemporary writings frequently utilised in the SAT and ACT, in accordance to The Daily Wire.

The outlet studies a new examination of the CLT outcomes by Houston Christian College professor Lisa Treleaven located that homeschool college students who took the examination earned signify scores of about 78 details, surpassing non-public school students, who attained mean scores of 75, and charter faculty students, who acquired signify scores of 73. General public university pupils attained necessarily mean scores of 66, marking the least expensive between the cohorts thought of by the review.

Treleaven wrote, “This is dependable with prior exploration results of top-quality tutorial general performance of homeschool pupils as in contrast to other school forms.”

The professor’s 15-webpage research was dependent on the examination effects of 12,000 students who took the CLT from 2016 – 2021. 

Vintage Finding out Test CEO Jeremy Tate who developed the CLT seven years ago, prompt to The Daily Wire that the freestyle framework of homeschooling could give an edge about pupils enrolled in other universities. 

“Homeschooled students simply have more time for leisure reading through,” he informed the outlet. “We overlook that the term college derives from Greek scholē, initially which means leisure. The connection between leisure and learning is profound. Factory model education is antithetical to leisure, but is prevalent for homeschooled college students who are presented the time and area to immerse them selves in wonderful literature.”

In essence, homeschooling lets the kids strengthen as per their mother nature and program. in accordance to Admissionsly.com. 

Treleaven’s investigation demonstrates that homeschooled college students noticeably outdid their peers on the verbal and composing portions of the CLT.  But ended up about equal with personal and charter college students’ examination scores on the quantitative part of the test. 

The professor also termed for more study on homeschool tutorial achievement. 

In accordance to the Countrywide Home Education Investigate Institute, (NHERI) homeschooled kids normally rating 15 to 30 percentile points higher than public-university college students on standardized tutorial achievement assessments. 

Seventy-8 p.c of peer-reviewed scientific tests on academic achievement clearly show homeschool pupils execute statistically significantly superior than these in institutional educational institutions, the NHERI mentioned in analysis info posted on its internet site. 

Between the other points introduced by the institute:

  • Homeschooling is increasing among the minority communities  
  • Homeschool learners rating higher than average on achievement checks regardless of their parent’s stage of formal instruction or their family’s home profits
  • 87{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of peer-reviewed scientific studies on social, psychological, and psychological advancement present homeschool learners conduct statistically drastically much better than those in typical faculties
  • Homeschool learners are significantly currently being actively recruited by colleges

A lot more Mom and dad Are Opting to Homeschool Their Kids

As CBN News documented in June, in the wake of new faculty violence and the “woke” movement, families across the nation are searching at the rewards of homeschooling their kids like hardly ever right before.

Actor and household advocate Kirk Cameron examined the rise in homeschooling’s attractiveness in his documentary produced previous summer season titled The Homeschool Awakening. 

The movie features 17 various people from all forms of backgrounds. Some of the kids are opening enterprises. Many others are traveling the nation with their dad and mom and siblings, and other little ones are executing points like receiving their pilot’s license at age 17.

“Children are studying outside with the full environment as their classroom with each other with their siblings and with their mother and father and with their grandparents,” Cameron mentioned. 

***You should signal up for CBN Newsletters and obtain the CBN Information application to ensure you preserve receiving the most recent news from a distinctly Christian point of view.***

The actor interviewed numerous parents for the movie who once seen homeschooling as odd. “I normally considered homeschooling as rather of a cult,” one dad or mum claimed. Many others explained they once believed of homeschoolers as “bizarre” or “irregular.”

And like individuals dad and mom, Cameron admits he also the moment experienced a “healthy concern” of homeschooling.

“I imagined homeschooling was like, you had to be a Quaker or you experienced to be Amish. I was saying, I mean, does my spouse want to wear a flooring duration, denim jumper, have a head masking and you know, where do we get the uniform?” he joked.

“And then I recognized that I was just out of touch with this amazing strong local community of persons. There are authorities and educational professionals building curriculums that truly incorporate religion and what I am learning is that mother and father are not stuck in a system that they are not happy with,” Cameron said. 

The Lifemark star famous moms and dads are waking up and keeping their general public colleges extra accountable.

“And if you glance at the community education and learning procedure, removing prayer from colleges, eliminating God and the Bible from university and changing those people things with progressive strategies, like the Essential Race Idea, Gender Principle, and teaching kids to decide regardless of whether or not they favor to be a boy or a girl, to choose their individual pronouns, and separating mothers and fathers from their children’s being familiar with of sexuality and when, and how they’re uncovered to express product, these are the kinds of matters that moms and dads are declaring ‘we’re not down for this any more,'” Cameron explained.

He extra potentially the very best component of homeschooling is God gets to keep in the classroom.

“We want our children to realize who they are, who God is, their place in the earth, why they’re below,” Cameron said.

As CBN News noted in December of 2021, a boom transpired in homeschooling in The united states as the number of little ones taught by their parents doubled just after the COVID-19 lockdowns started. 

According to U.S. Census Bureau information, the pandemic sparked new fascination in homeschooling. By the close of 2020, additional than 9 million People reported they experienced attended homeschool at some level in their lives, according to Admissionly.com. 

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MVRHS feasibility study goes to the towns

MVRHS feasibility study goes to the towns

The Martha’s Winery Regional Large College (MVRHS) committee will be asking the Island towns for $2 million for a Massachusetts Faculty Constructing Authority (MSBA) feasibility analyze report on the town conference warrants, which will acquire place in the spring. 

Prior to Martha’s Winery Community Faculties business administrator Mark Friedman shared the quantities throughout the Monday night conference, he clarified that this was a vote to “ask the towns to put a placeholder in their spring city warrants,” and not to truly borrow the revenue. 

“This would not be the formal vote for you folks to basically borrow the dollars. To do that would set off the 60-day thought period beneath which the towns, if they felt it was needed, timetable a unique town assembly,” Friedman stated, adding that the strategy is to have the vote so it can “fold neatly” into a specific town conference or the annual town assembly with out incurring additional expenses. Edgartown and Tisbury have deadlines of Dec. 16 for warrant posting request submissions, and the language suggested by the MSBA will be used. 

Friedman showed two feasibility study price estimations, building on a preceding presentation. The expenditure was observed by calculating the common feasibility value of 4 higher educational institutions — Watertown, Wakefield, Nashoba Regional, and Monument Mountain Regional — and incorporating contingency. The regular was $1.65 million. Friedman showed two choices: Option A, with a 10 per cent contingency ($165,000), and Solution B, with a 20 per cent contingency ($330,000). This provides up to $1.815 million for Option A, the quantity initially proposed, and $1.98 million for Possibility B. 

“We would not endorse heading better than [Option B] for this feasibility analyze, for the reason that it’s our understanding that we would not get any additional value at this phase in the system,” Friedman stated. 

However, committee member Skipper Manter was worried the expense estimate did not consider into thought the “Martha’s Vineyard issue,” describing the problems of accomplishing a large challenge on the Island. This was a level he and committee member Kathryn Shertzer made throughout a past discussion about funding the feasibility examine.

“We can not go back. We have got a person talk to here … I think we should make it $2 million,” Manter said.

“We experienced a fantastic volume of discussion on this matter,” Friedman replied. “The cause why we’re not putting in any extra contingency for the ‘Island factor’ is simply because this is predominantly qualified providers. This is architectural, engineering services, and there is significantly less inflation, or less of an Island issue, associated in that than there is in the logistics to convey elements and construction machines over to this Island.”

When requested by committee chair Robert Lionette, committee member Michael Watts, who is also a Tisbury University committee member where by a college building task is underway, said, “We did not carry that much contingency.” 

“I can convey to you that once you get to an precise development job, it was a 20-in addition {e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} Island aspect. But, we didn’t see that in our OPM (owner’s project supervisor) or architect work,” Watts stated, although the academic consultants and people undertaking geophysical study function experienced to occur from off-Island. Currently, Tisbury University is going by way of a massive renovation and addition undertaking that is costing taxpayers $82 million.

Manter questioned if the feasibility analyze costs will be offset by $500,000 of surplus and deficiencies (E and D) cash, and Friedman mentioned, “We had place that out to our bond counsel, and they have nonetheless to occur back with that actual language” in the warrant write-up. 

“It would consider a little bit of the sticker shock off the $2 million if we could show them that we were using some E and D to decrease that,” Manter claimed. 

Friedman reminded the committee that the last vote for the draft warrant report language with the charge figures would not be until March, and a ask for to appropriate resources will not happen through the approaching funds course of action. Manter mentioned the expenses and offsets ought to be made the decision in advance of then, considering the fact that folks “aren’t going to vote for it except they know how substantially it is.” 

Manter also reported the money for the MVRHS developing committee, a portion of the feasibility analyze approach, should have been “budgeted accordingly” instead than utilizing contingency money from the higher faculty funds, which Friedman said would not be a large total, because it was “a foreseeable expenditure.” Lionette pointed out that the income utilized is reimbursable, but Manter reported that cash would not be readily available right until July. 

“We weren’t in the MSBA when we budgeted past 12 months,” MVRHS Principal Sara Dingledy reported, incorporating that the MVRHS creating committee will require to satisfy in advance of July. “There is operate to be performed in between now and July. I guess it would be excellent to have some assistance on where by we faucet into any type of cash.” 

Right after a little bit far more dialogue, the MVRHS committee voted 7- to ship the draft warrant write-up language to the towns with the quantity of $2 million for the feasibility study. MVRHS committee member Kimberly Kirk did not respond when identified as on. 

In other business, there will be an additional general public listening to for the MVRHS fiscal yr 2024 spending plan on Wednesday, Dec. 21, at 7 pm. Despite the fact that a public hearing was performed on Wednesday, Nov. 30, Lionette explained that the substantial school committee had essentially not designed a quorum throughout that meeting, which is required per recommendations from the Massachusetts Department of Elementary and Secondary Education. In flip, the certification of the price range that was on the Monday, Dec. 5, agenda could not be completed. 

Relating to the funds, the MVRHS committee unanimously authorized asking the cities to put a placeholder line in their city meeting warrants for cash improvement repairs for the large school, and a line of money for the Performing Arts Center’s HVAC technique. The committee options to even more focus on this at a upcoming assembly. 

The MVRHS committee also voted 6-1 to retroactively approve boosts, most at 3 p.c and a number of at 6 per cent, for nonunion salaries. In the checklist of wage boosts Martha’s Winery Superintendent Richie Smith offered, these obtaining a 6 per cent bump contain MVRHS athletic director Mark McCarthy, information and technological innovation specialist Rick Mello, accounting and finance manager Suzanne Cioffi, trainer and nurse assistant Tania Laslovich, and transportation business manager Anastasia Carter. These were being delayed due to the teachers’ wage negotiations. Committee member Louis Paciello abstained, though Manter voted in opposition. Manter expressed worries about the 6 per cent will increase. Immediately after some discussion, the committee voted 6-2 to also give MVRHS facilities manager Mike Taus a 6 {e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} salary increase to acknowledge the tough operate he has accomplished. Lionette and committee member Roxanne Ackerman voted in opposition to, because they imagined Smith’s wage suggestions have been ideal, due to the fact he also sits on the high school’s staff committee.

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Attendance in physical education classes, sedentary behavior, and different forms of physical activity among schoolchildren: a cross-sectional study | BMC Public Health

Attendance in physical education classes, sedentary behavior, and different forms of physical activity among schoolchildren: a cross-sectional study | BMC Public Health

Participants

Schoolchildren (7–12 years-old) from 2nd to 5th-grade in part-time public schools in Feira de Santana (Bahia) participated in this cross-sectional study. Feira de Santana is in the Northeast region of Brazil (inhabitants: 624,107; Human Development Index: 0.712). Data collection covered weekdays (Tuesday to Friday), from March to October of the year 2019 and included a probability sample of students from 2nd to 5th-grade, from public schools in the urban area, with broadband Internet. The sample size was defined based on the following parameters: a population of 15,920 students enrolled in the education system, according to data from the Municipal Department of Education; expected prevalence of outcomes of 50{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}; confidence limit of three percentage points; design effect (deff) of 2.0; and 95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} confidence interval (95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}CI). Based on these parameters, the sample size was calculated at 2,000 students. A further 20{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} was added to make up for presumed losses, resulting in a sample of 2,400 students (Fig. 1).

Fig. 1
figure 1

The cluster sampling process was carried out in three stages: I) all schools in the municipal network were stratified according to the 11 geographic and administrative centers of the Department of Education (clusters); II) one school from each center was randomly drawn; III) all classrooms from 2nd to 5th grade within each school were selected (159 classrooms), and all subjects within the selected classrooms were invited to participate in the study. All methods were carried out in accordance with relevant guidelines and regulations of ethical standards set out in Resolution No. 466/2012 of Brazil’s National Research Ethics Council. Informed consent was obtained from all participants involved in the study and their parents/guardians provided authorization in writing. The study protocol was approved by the Research Ethics Council of the State University of Feira de Santana (Approval No. 02307918.5.0000.0053, Opinion No.: 3.116.495). The Municipal Department of Education provided information regarding the sex, age, and school shift of participants.

Measurement of sedentary behaviors and physical activities

The participants self-reported the SB and physical activity on the Food Intake and Physical Activity of Schoolchildren (Web-CAAFE) questionnaire. The Web-CAAFE is a previously validated self-report questionnaire [27], completed on the internet and based on the previous-day recall. The instrument collects information on weight status, food consumption, physical activity, and SB and includes screens to evaluate physical education classes and to investigate modes of commuting to school.

Participants choose up to 32 items, out of a total of 50 stored in the system, which they had performed the day before across three periods (morning, afternoon, evening). The list contains five SB icons (one for academic tasks, e.g. reading, writing, drawing, painting; four electronic devices, e.g. TV, video game, computer, and cell phone), and 27 physical activity icons classified into: Active play (Play with a ball, Play catch, Soccer, Dance, Marbles, Jump rope, Gymnastics, Elastics, Play in the park, Play in the water/Swim, Ride a bicycle, Rollerblade/Skateboard/Ride a scooter, Fly a kite, Dodgeball, Hide and seek, Play with a dog, Hopscotch), Non-active play (Board games, Playing with dolls/action figures, Playing with toy cars, Spinning top/Bayblade, Listen to music, Play musical instrument), Structured physical activity (Ballet, Fight Sports), and Household chores (Wash the dishes, Sweep). Information on the weekly frequency of participation in physical education classes is assessed through the question “How many times a week do you take part in physical education classes?” (none, 1, 2 3, 4, every day of the week). The closed list of leisure activities, sports, home chores, and sedentary activities was compiled based on results from focal groups, previous instruments for this age range, and the 7-day recall completed by 180 schoolchildren [28].

Participants completed the Web-CAAFE at the school, after receiving verbal explanations about how the software works and how to complete the questionnaire. Students were instructed not to interact during the task and the research team helped when requested, without inducing responses.

Anthropometric measurements

The study included weight and height measurements to calculate the Body Mass Index (BMI), measured by trained researchers, following recommended standardization [29]. Weight was measured using an AVAnutri® digital scale with graduation every 100 g and a maximum capacity of 200 kg. Height was measured using a portable stadiometer, detachable, with a square platform, Seca® brand, with a 205 cm maximum height and graduation every 1 mm. The students were barefoot, wearing school uniform, and with no headwear during measurements. Age-and sex-specific BMI z-scores were calculated according to the International Obesity Task Force (IOTF) [30]. The weight status was categorized into non-overweight (underweight and normal weight), overweight, and obesity according to IOTF reference values [30].

Classification of economic level

Socioeconomic status was investigated based on the analysis of possession of items, education level of the head of the household, and access to public services, according to the Brazilian Economic Classification Criteria [31]. The socioeconomic status was classified into classes, related to the average household income in Reais (R$): A (R$25,554.33), B-C (R$1,748.59 to R$11,279.14), and D-E (R$719.81). Based on the average dollar exchange rate between March and October 2019, income ranges in these classes were: A (US$ 6,485.87), B-C (US$ 443.80 to 2,862.72), and D-E (US$ 182.69).

Data processing and analysis

The weekly attendance in PE was the main exposure analyzed (0/week; 1/week; ≥ 2/week). Daily frequencies of active play, non-active play, and structured physical activity were the main outcomes (count outcomes). These frequencies were obtained by summing all reports in the morning, afternoon, and night. For example, if a participant reported riding a bike in the morning period, playing with a ball in the afternoon, and playing with a dog in the evening, then their sum was 3 counts of active play. SB frequency was obtained by summing the daily reports of academic tasks and screen use. DPA frequency was obtained by summing the daily reports of all physical activities.

Students with intellectual disabilities and ages outside the age group of seven to 12 years participated in the study but were excluded from the statistical analyses. Descriptive statistics are used to present the study variables. Variables without normal distribution after verification of the histograms and the Shapiro–Wilk test are described by median and interquartile range values. Differences in non-normally distributed continuous variables were evaluated using the non-parametric Mann–Whitney test (U). Categorical variables are described as absolute and relative values and compared using Pearson’s chi-square test (Χ2).

The associations between weekly attendance in PE and frequencies of active play, non-active play, and structured physical activity were analyzed using the values of prevalence ratios (PR) and respective 95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}CI estimated via multiple Negative Binomial Regression, with adjustment for age (7–9 years; ≥ 10 years), school shift (morning; afternoon), and BMI z-scores, adopting a robust variance estimation method. Negative Binomial models analyzing the association between weekly attendance in PE and DPA and SB were also adjusted by the daily frequency of household chores. The group of household chores was not included in the present analysis as an outcome because there is no evidence of an association with attendance in PE.

The Negative Binomial distribution is suitable for fitting count data susceptible to overdispersion. In addition, it showed higher linearity in the comparison between observed and predicted values of the outcome. The zero-inflation between the factors was assumed to be constant. Although the negative binomial regression models provide a measure of association such as Incidence-Rate Ratios (IRR), we adopted the prevalence ratio (PR) as the most appropriate way to present our results, considering the cross-sectional design of the study. Statistical significance was assessed using p value < 0.05. Effect modification was tested using interaction terms between weekly attendance in PE and sex, age, school shift, and BMI z-scores. Interactions that showed statistical significance at the critical value of p < 0.05 were described.