BACKGROUND: Point-of-Care Ultrasound (POCUS) consists of a range of increasingly important imaging modalities across a variety of specialties. Despite a variety of accreditation pathways available in the UK, lung POCUS training remains difficult to deliver and accreditation rates remain suboptimal. We describe a multidisciplinary, multi-centre, and multi-pronged approach to lung POCUS education within a region.
METHODS: A survey was conducted in a region. From these results, bottlenecks were identified for improvement. We utilised key stages in an established accreditation pathway, and the Action Learning process. Analysing participant feedback, consensus amongst the team, regional educational needs, and leveraging the expertise within the faculty, we implemented several solutions which were multidisciplinary, multi-centre, and multi-pronged. We also set up a database across several accreditation pathways to facilitate supervision and assessment of rotational trainees.
RESULTS: Utilising the Action Learning process, we implemented several improvements at elements of the lung ultrasound accreditation pathways. An initial regional survey identified key barriers to accreditation: lack of courses (52%), lack of mentors (93%), and difficulty arranging directly supervised scans (73%). A multidisciplinary team of trainers was assembled. Regular courses were organised and altered based on feedback and anecdotal educational needs within the region. Courses were set up to also facilitate continuing professional development and exchange of knowledge and ideas amongst trainers. The barrier of supervision was removed through the organisation of regular supervision sessions, facilitating up to fifty scans per half day per trainer. We collected feedback from courses and optimised them. Remote mentoring platforms were utilised to encourage asynchronous supervision. A database of trainers was collated to facilitate triggered assessments. These approaches promoted a conducive environment and a commitment to learning. Repeat survey results support this.
CONCLUSIONS: Lung ultrasound accreditation remains a complex educational training pathway. Utilising an education framework, recruiting a multidisciplinary team, ensuring a multi-pronged approach, and fostering a commitment to learning can improve accreditation success.

BACKGROUND: Research skills in nursing are crucial for guiding evidence-based practice and enhancing health care. However, undergraduate nursing students often encounter challenges in skill development because of curriculum constraints that prioritize clinical education. Bridging this skill gap is imperative for preparing students for evidence-based practice and nursing scholarship.
OBJECTIVE: This study aimed to investigate the impact of incorporating action learning into undergraduate nursing research classes to improve the quality of nurse education.
METHODS: A mixed-methods approach was employed using pre- and post-online surveys for quantitative analysis and reflective journals for qualitative analysis.
METHODS: The study was conducted at a college of nursing in Seoul, South Korea.
METHODS: A convenience sample of 19 fourth-year nursing students participated in the study.
METHODS: Action learning-based nursing research classes were implemented over ten sessions, integrating lectures and team activities. Pre- and post-assessment data on communication skills, critical thinking tendencies, and problem-solving abilities were analyzed using paired t-tests. The qualitative analysis involved content analysis of individual and team reflective journals.
RESULTS: Participants in action learning-based nursing research classes showed significant improvements in their communication skills (t = 3.46, p = 0.002), critical thinking tendencies (t = 3.80, p = 0.001), and problem-solving abilities (t = 1.82, p = 0.043). From the analysis of reflective journals four main themes were developed: organized team projects, dynamics of learning goal achievement, extended application of learning outcomes, and recommendations for better action learning-based classes.
CONCLUSIONS: This study highlights action learning as an effective educational method that integrates theory and practice in nurse education, helping students prepare for their future roles as nursing professionals. The findings underscore the effectiveness of action learning in improving undergraduate nursing students\' research competency and support the need for continued development of such pedagogical approaches.

Both words and gestures have been shown to influence object categorization, often even overriding perceptual similarities to cue category membership. However, gestures are often meaningful to infants while words are arbitrarily related to an object they refer to, more similar to arbitrary actions that can be performed on objects. In this study, we examine how words and arbitrary actions shape category formation. Across three conditions (word cue, action cue, word-action cue), we presented infants (N = 90) with eight videos of single-category objects which vary in colour and other perceptual features. The objects were either accompanied by a word and/or an action that is being performed on the object. Infants in the word and action condition showed a decrease in looking over the course of the familiarization phase indicating habituation to the category, but infants in the word-action condition did not. At test, infants saw a novel object of the just-learned category and a novel object from another category side-by-side on the screen. There was some evidence for an advantage for words in shaping early object categorization, although we note that this was not robust across analyses.

Wearable devices have been used extensively both inside and outside of the hospital setting. During the COVID-19 pandemic, in some contexts, there was an increased need to remotely monitor pulse and saturated oxygen for patients due to the lack of staff and bedside monitors.
A prototype of a remote monitoring system using wearable pulse oximeter devices was implemented at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, from August to December 2021. The aim of this work was to support the ongoing implementation of the remote monitoring system.
We used an action learning approach with rapid pragmatic methods, including informal discussions and observations as well as a feedback survey form designed based on the technology acceptance model to assess the use and acceptability of the system. Based on these results, we facilitated a meeting using user-centered design principles to explore user needs and ideas about its development in more detail.
In total, 21 users filled in the feedback form. The mean technology acceptance model scores ranged from 3.5 (for perceived ease of use) to 4.4 (for attitude) with behavioral intention (3.8) and perceived usefulness (4.2) scoring in between. Those working as nurses scored higher on perceived usefulness, attitude, and behavioral intention than did physicians. Based on informal discussions, we realized there was a mismatch between how we (ie, the research team) and the ward teams perceived the use and wider purpose of the technology.
Designing and implementing the devices to be more nurse-centric from their introduction could have helped to increase their efficiency and use during the complex pandemic period.

Reversal learning measures the ability to form flexible associations between choice outcomes with stimuli and actions that precede them. This type of learning is thought to rely on several cortical and subcortical areas, including the highly interconnected orbitofrontal cortex (OFC) and basolateral amygdala (BLA), and is often impaired in various neuropsychiatric and substance use disorders. However, the unique contributions of these regions to stimulus- and action-based reversal learning have not been systematically compared using a chemogenetic approach particularly before and after the first reversal that introduces new uncertainty. Here, we examined the roles of ventrolateral OFC (vlOFC) and BLA during reversal learning. Male and female rats were prepared with inhibitory designer receptors exclusively activated by designer drugs targeting projection neurons in these regions and tested on a series of deterministic and probabilistic reversals during which they learned about stimulus identity or side (left or right) associated with different reward probabilities. Using a counterbalanced within-subject design, we inhibited these regions prior to reversal sessions. We assessed initial and pre-/post-reversal changes in performance to measure learning and adjustments to reversals, respectively. We found that inhibition of the ventrolateral orbitofrontal cortex (vlOFC), but not BLA, eliminated adjustments to stimulus-based reversals. Inhibition of BLA, but not vlOFC, selectively impaired action-based probabilistic reversal learning, leaving deterministic reversal learning intact. vlOFC exhibited a sex-dependent role in early adjustment to action-based reversals, but not in overall learning. These results reveal dissociable roles for BLA and vlOFC in flexible learning and highlight a more crucial role for BLA in learning meaningful changes in the reward environment.

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme\'s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.
The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners\' interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.
The authors\' evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another\'s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.
Despite a small sample size, the authors\' results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.
The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.
ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

Educational strategies globally are changing from an authoritative, top-down model to one focused on greater student and stakeholder participation in planning and implementation of research and educational activities. In addition to emphasis on student-centered education, strategies currently evolve to encompass learning organizations and multistakeholder learning networks. These are essential to address the complexity and scope of tomorrow\'s challenges, involving issues that could be called \'wicked problems\' not easily addressed by single disciplines nor resulting in solutions that please all the players. In this study we describe how a transformative innovation - the NEXTFOOD educational approach - may contribute substantially to a transition of agricultural and food education and how it can be developed and diffused within and between teaching institutions. The method was action research informed by several workshops organized at annual consortium conferences during the first three years of the project. The findings show that a successful transformation involves learning both within and across innovation projects repeated at various organisations in a network. The action research model presented in this paper may be useful as an instrument to support the facilitation of transformative innovations. The transition process resulted in substantial changes in mindset, educational practices and organisational structures at the teaching institutions. However, scaling-up promising educational initiatives may encounter several barriers that need to be overcome at individual, group and institutional levels, and we provide insight on how this can be accomplished in a multi-national consortium of universities.

Applied practice experiences are essential components of the Masters of Public Health (MPH) curriculum. The objective of this study was to examine students\' perspectives on the skills and expertise they developed in an MPH course offering applied practice opportunities.
Of 236 students who took the course from 2008 to 2018, email addresses were obtained for 212 and 104 completed the consent form. Following consent, reflection essays were de-identified and analyzed using a rapid qualitative analysis approach. The essays addressed students\' learning experiences and application of the competencies for MPH programs set by the Council for Education in Public Health (CEPH). Deductive and inductive analytical lenses were used to identify the key lessons learned by each cohort of students. Semi-structured guides and matrixes for essay analysis were created using assignment instructions and CEPH competencies.
Although the reflection paper assignment varied across the years, commonalities were observed in the student reflections. Key themes included turning theory into practice, navigating the complex environment of public health practice, skill building, critical self-reflection, challenges encountered, and elements that facilitated project success. Students reported developing practical skills, such as planning for independent research (e.g., preparing for institutional review board (IRB) submission, consulting with faculty and other experts), identifying realistic approaches for data extraction during chart reviews and analyses of electronic medical records, and disseminating findings for diverse stakeholders and audiences. Students also reported strengthening cross-cutting skills such as communication, teamwork, and problem-solving that were useful for navigating power dynamics and balancing competing interests and expectations. Students explored their identity as public health professionals as they navigated the dynamics of public health practice.
The applied practice experience served as a valuable tool for knowledge and skills acquisition. Moreover, it served as an opportunity for students to engage with the unique organizational cultures of their respective community partners and to deepen their understanding the complexities of conducting meaningful community-engaged research.
This study demonstrates the utility of analyzing students\' critical self-reflections as a tool for exploring learning experiences when training future public health professionals. The findings can help educators design future applied practice experiences.

BACKGROUND: The future success of any graduate or professional degree program is dependent upon continuous feedback provided by instructors and students. Various teaching models used by medical educators include didactics, problem/case-based learning, small/large group work, distance/online education, simulation, labs, and service/experiential learning. Action Learning is a process \"that involves a small group working on real problems, taking action, and learning as individuals, as a team, and as an organization.\" Medical school curricula usually begin with a mostly knowledge-based approach to learning the relevant science courses. While it may include some experiential learning, there is limited organized reflection. The idea inherent in Action Learning is \"learn while doing\" and \"reflect on the experience.\" This paper reports the process and outcomes of using the Action Learning Model (ALM) in teaching a master\'s level assessment and measurement medical education class.
OBJECTIVE: The objective of this quality improvement education study was to ascertain students\' knowledge, skills, and attitudes demonstrated in conducting substantive evaluations using the ALM in a graduate medical education assessment and measurement course.
METHODS: This study was a formative evaluation of a 16-week master\'s level medical education assessment and measurement course. The curriculum included teaching the traditional knowledge, skills, and attitudes (KSAs) to conduct formative and summative evaluations in medical education. In addition, students learned applicable quality improvement skills. Specifically, they learned how to identify and work with valid customer (student) requirements, how to map and improve processes, and how to collect and analyze process data. Students were taught the KSAs while conducting a formative evaluation of the class as their major project. They evaluated the class they were taking while reflecting on the experience. In addition to the ALM, the course incorporated both the Bloom Taxonomy (a hierarchical framework for cognition and learning objectives) and the Kirkpatrick Model (a globally recognized method of evaluating the results of training and learning programs). The one-sample significance test was used to evaluate the median of the difference between the pre-and post-test groups. Descriptive statistics were also performed.
RESULTS: Nine students who were medical students, dental students, physicians, and simulation lab technicians participated in the course. Students learned medical education assessment and measurement of knowledge, skills, and attitudes (KSAs) and experienced the process of performing a formative evaluation. The post-test results for all students combined revealed that 277 of the 450 (61.6%) data points were greater than zero. A total of 139 data points showed no improvement and 34 results were worse than the pretest.  Discussion: The ALM for teaching assessment and measurement in medical education can be challenging, but it may provide a more realistic and rewarding educational experience. The students gained a greater appreciation of the positive and negative aspects of using an experiential approach. Finally, the weekly formative surveys provided regular feedback that led to instructional improvements. With regards to medical education, action learning is best suited for students during the clinical phase of their education.

Action learning is a promising approach for building mental health promotion (MHP) capacity. The aim of this study is to explore how action learning processes can strengthen MHP capacity within and across organizations in a community setting. We applied an embedded case study design and a realist evaluation framework to explore key combinations of mechanisms and contextual factors that generated the emergent MHP capacity outcomes of an action learning program, i.e. context-mechanism-outcome-configurations (CMO-configurations). Data consisted of 18 semi-structured face-to-face interviews, 10 telephone interviews, two group interviews, observations, and documents. Interviewees (n = 21) were participants and management employees. Our analytical provision of CMO-configurations provides insights into how contextual factors, such as participant motivation, organizational support, and existing task descriptions, in combination with certain program mechanisms, such as legitimization of specific agendas, learning-by-doing, and collaborations across organizational boundaries, explain the identified outcomes. Outcomes ranged across implementation of MHP initiatives, personal development among participants, and relational and collaborative development. Taken together, our results strengthen the notion that mechanisms of action learning hold the potential to build MHP capacity on an individual, organizational, and community level. This study, also, illustrates that realist evaluation offers a relevant methodology for investigating the underlying workings of capacity building programs.