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Hispanic Immigrants (HI) have lower vaccination rates than their non-Hispanic white counterparts. Culturally appropriate interventions are more influential in evoking change among viewers; therefore, it is important to understand the cultural factors of specific ethnic groups. In this study, we identify cultural barriers to vaccination of Hispanic Immigrants. An electronic survey was administered among HI parents living in the United States. Using structural equation modeling, we found that high religious practice and positive religious beliefs towards vaccination correspond with positive vaccine attitudes (+0.20 and +0.587, respectively). Trust in institutions is strongly correlated with strong positive vaccine attitudes (+0.734). While trusting one's folk practitioner more than a medical doctor leads to negative vaccine attitudes (-0.596), the use of home remedies is associated with positive vaccine attitudes (+0.486). The cultural competence of a medical practitioner, especially regarding folk medicine, is essential to lower cultural barriers HI patients face in vaccination.

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PURPOSE: Altering the curriculum of a program can have negative repercussions for the student experience, including peer mentorships and interclass relationships. This study investigated the effect of curriculum reform on students' emotional and social well-being in a predoctoral dental program. We explored if any of these consequences could be related to stereotype threat. METHODS: We utilized a quasi-experimental design with two different treatments, New Curriculum Treatment (New-CT, n = 44) and Past Curriculum Treatment (Past-CT, n = 43). Quantitative data were collected through surveys to assess students' perceptions of curriculum changes and their impacts on anxiety, confidence, and clinical performance. Qualitative data were gathered via semi-structured interviews to explore personal experiences of stereotype threat and its implications on peer relationships and mentorship dynamics. RESULTS: The findings suggest significant effects of curriculum changes on interpersonal relationships. Past-CT viewed New-CT as overconfident, while New-CT felt heightened performance pressure. Thematic and interview analyses revealed deep-rooted tensions, with New-CT feeling mistrusted and Past-CT resenting New-CT's perceived accelerated competence. Stereotype threat was identified as a key factor worsening these inter-group tensions and affecting clinical performance and relationships. CONCLUSIONS: Curriculum changes in dental education can significantly affect students' well-being, with stereotype threat playing a critical role in these dynamics. When making changes to the structure, sequencing, or content of a program, administrators need to be aware of the potential ramifications these changes could have on students' relationships with their peers.

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Safe and effective vaccines have been developed that protect against high-risk strains of HPV, but uptake is relatively low. We previously identified factors such as sexual attitudes and HPV knowledge that impact the intent of Christian parents to vaccinate their children against HPV. We hypothesized that culturally specific interventions in the form of short videos would be effective at improving HPV vaccine intentions and attitudes. We made three short educational videos, one with a Christian focus, one informational about HPV, and one control. Videos were distributed electronically with accompanying surveys, and responses were measured before and after watching a randomly selected video. The religious-focused and educational interventions significantly (p < 0.0001, p = 0.0015) improved intentions towards HPV vaccination. The religiously-focused video also significantly diminished the belief that the HPV vaccine is unnecessary because of a family's values (p = 0.014). Parents significantly credited both interventions with improving their intent to vaccinate their children against HPV (p < 0.001 for both). These results suggest that culturally focused educational interventions are effective at influencing vaccine intentions and attitudes, even when those are based on religious or cultural feelings. Highly specific interventions are likely to be necessary for optimal improvement in vaccine hesitancy.

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This study investigated how factors and barriers to flu vaccination among college students has changed over the past 16 years. Data were collected from 440 students using a survey and compared to previous data from the same university. Respondents were also asked about their experiences with Covid-19 and its effect on their intent to vaccinate. We found that vaccination rates had increased from 12.4 to 30.5%. Among the unvaccinated, expense, fear of getting influenza from vaccination, fear of side effects, and lack of information have decreased by 28%, 20%, 17%, and 15% respectively. Time, convenience, and perceived risk are still significant barriers to vaccination. Students are getting more encouragement to vaccinate from their health care providers and parents, but it is becoming less effective. The Covid-19 pandemic has changed vaccine attitudes and vaccine fatigue has been a large contributor. Additionally, political affiliation has become a predictor of flu vaccine uptake with conservatives being less likely to vaccinate. There has also been a shift in motivation from concern for personal safety to concern for public safety.

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OBJECTIVE: Advance Care Planning (ACP) via Group Visits (ACP-GV) is an innovative patient-centered intervention used in the United States Department of Veterans Affairs (VA) healthcare system. The goal of ACP-GV is to spread ACP to veterans and caregivers in medically underserved rural areas. Veterans, caregivers and those they trust participate in a group led by clinicians in Veterans Health Administration healthcare and/or community-based settings. To learn how to facilitate ACP-GV, clinicians attend ACP-GV training. The training teaches the ACP-GV group model and the theoretical components of Motivational Interviewing (MI) (Rollnick & Miller, 1995), which are used to empower participants to have conversations about their healthcare values and preferences. Therefore, the aim is to describe the specific MI techniques utilized by group facilitators in the innovative ACP-GV intervention. DISCUSSION: We provide exemplars for how group facilitators apply the MI techniques to the group discussion with participants. Lastly, we provide a scripted case example of a coded MI-concordant session of ACP-GV delivered with veterans in a healthcare setting that can be used in future training and education for clinicians interested in facilitating ACP using a group modality. CONCLUSION: MI is a key aspect of delivering ACP-GV, a high-quality, patient-centered intervention for veterans, caregivers and those they trust.

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One of the primary reasons why students leave STEM majors is due to the poor quality of instruction. Teaching practices can be improved through professional development programs; however, several barriers exist. Creating lasting change by overcoming these barriers is the primary objective of the STEM Faculty Institute (STEMFI). STEMFI was designed according to the framework established by Ajzen's Theory of Planned Behavior. To evaluate its effectiveness, the Classroom Observation Protocol for Undergraduate STEM (COPUS) tool was used before and after an intensive year-long faculty development program and analyzed using copusprofiles.org, a tool that classifies each COPUS report into one of three instructional styles: didactic, interactive lecture, and student-centered. We report the success of our program in changing faculty teaching behaviors and we categorize them into types of reformers. Then, thematically coded post-participation interviews give us clues into the characteristics of each type of reformer. Our results demonstrate that faculty can significantly improve the student-centeredness of their teaching practices in a relatively short time. We also discuss the implications of faculty attitudes for future professional development efforts.

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Traditional teaching practices in undergraduate science, technology, engineering, and mathematics (STEM) courses have failed to support student success, causing many students to leave STEM fields and disproportionately affecting women and students of color. Although much is known about effective STEM teaching practices, many faculty continue to adhere to traditional methods, such as lecture. In this study, we investigated the factors that affect STEM faculty members' instructional decisions about evidence-based instructional practices (EBIPs). We performed a qualitative analysis of semi-structured interviews with faculty members from the Colleges of Physical and Mathematical Sciences, Life Sciences, and Engineering who took part in a professional development program to support the use of EBIPs by STEM faculty at the university. We used an ecological model to guide our investigation and frame the results. Faculty identified a variety of personal, social, and contextual factors that influenced their instructional decision-making. Personal factors included attitudes, beliefs, and self-efficacy. Social factors included the influence of students, colleagues, and administration. Contextual factors included resources, time, and student characteristics. These factors interact with each other in meaningful ways that highlight the hyper-local social contexts that exist within departments and sub-department cultures, the importance of positive feedback from students and colleagues when implementing EBIPs, and the need for support from the administration for faculty who are in the process of changing their teaching.

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INTRODUCTION: Our study investigates early experiential learning as a method of curricular integration by allowing students to begin their clinical experience in the first year of the programme, as well as distributing biomedical classes throughout the predoctoral dental school curriculum. MATERIALS AND METHODS: This study utilises a quasi-experimental design with two different groups, Standard Curriculum Group and Integrated Curriculum Group, n = 87. Data were collected from 2017 to 2021. RESULTS: We found that, on average, it took 608 h less for the participants in an integrated curriculum group to reach clinical competence in comparison to peers who did not experience the same methods of integration in their programme. These data were collected through daily faculty evaluations of students' progression as well as participants' own self-assessment. Our results indicate that participants in the Integrated Curriculum Group also experienced a positive effect on their confidence in their ability to apply the biomedical sciences to patient care. DISCUSSION/CONCLUSION: Our findings demonstrate that predoctoral dental programmes may be able to bring about positive outcomes for students' clinical confidence and competence by providing patient care opportunities early in the programme and sequencing the biomedical sciences throughout the curriculum. As such, it appears that early experiential learning may be a viable option for curricular integration that can have a positive effect on both students' confidence in their clinical abilities and their progression to clinical competence.

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Evolution is one of the most important concepts in biology, but it is rejected by a substantial percentage of religious students due to a perceived conflict with their religious beliefs. The use of religious cultural competence in evolution education (ReCCEE) has been shown to effectively increase evolution acceptance among religious students during in-person instruction, but there is no research that we know of that indicates the effectiveness of these practices during online instruction. In this study, we explored the efficacy of online culturally competent practices for religious students on students' evolution understanding, evolution acceptance, and comfort learning evolution at a religious university. Before and after evolution instruction, we surveyed 178 students in online introductory biology courses and compared these student outcomes to 201 students in the same instructor's in-person introductory biology courses. We found that evolution acceptance and understanding increased in online classes with culturally competent practices, and these gains were similar to those observed in the in-person courses. Despite these similarities, we found that students were more comfortable learning evolution in person than online, but this difference was small. Our findings suggest that the use of culturally competent practices online can be as effective as their use for in-person instruction for improving students' attitudes toward evolution, but in-person instruction may be more effective for cultivating students' comfort while learning evolution.

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Background: Many students enter science classrooms with misconceptions about scientific principles. One of the most perceived controversial scientific principle for students is evolution. Students struggle to learn and accept evolution due to the many misconceptions students have interacted with before they enter a biology class. Evolution misconceptions come from many sources, such as religious beliefs, textbooks, and even unprepared educators. However, with students spending on average over seven hours a day viewing popular media, it is crucial to investigate further the accuracy of the portrayals of evolution in popular media. Results: We gathered data on the sources students saw evolution portrayed in popular media and determined what misconceptions were present in these popular media references. We found that 96% of the popular media references mentioned by students in our study inaccurately depicted evolution. The two most common misconceptions we observed in popular media were that evolution was depicted as a linear process and that individual organisms evolve instead of populations. Conclusion: Popular media does a poor job depicting evolution, which may be why many students are hesitant to learn evolution and overcome misconceptions. We suggest that these incorrect portrayals of evolution may provide an engaging way to teach correct evolutionary principles in the classroom.

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Although most Human papillomavirus (HPV) infections are mild and are cleared by the immune system, some high-risk HPV strains can cause various cancers. Vaccines have been developed that protect against high-risk HPV strains. HPV vaccines have been approved for use by the CDC (Centers for Disease Control and Prevention) and are recommended for everyone aged 11-26. Despite the availability of safe and effective vaccines, uptake is low. HPV vaccine uptake has been extensively studied on a national and international level, but less is known about vaccine acceptance on a state or local level. The state of Utah, in the United States of America, has a relatively low HPV vaccination rate. In this study, we identified factors that impact the intent of Utah parents to vaccinate their children against HPV. A survey was distributed electronically to Utah residents. Survey results were analyzed using confirmatory factor analysis, structural equation modeling, and univariate analysis. Knowledge about HPV and positive vaccine attitudes had the greatest positive effect on intent to vaccinate children against HPV. Cautious sexual attitudes and high religious practice were found to have a negative impact on intent to vaccinate. Effective public health messaging will consider the cultural and religious influences of the target population.

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With the gradual shift to online education models that has taken place in recent decades, research has sought to understand the nuances of student performance in an online model in comparison to more traditional in-person modalities. However, the effects of instructional modality have been difficult to determine given the many variables that exist in course design between these methods. In this study, we attempt to determine the efficacy of asynchronous online instruction by comparing two nearly equivalent courses. The first course was a flipped classroom, a recent and well-studied hybrid model of instruction. The second was an asynchronous fully online course that contained all the same instructional elements as the in-person course but lacked any student or instructor interaction. Student performance was tracked at both a highly-selective private institution and an open-enrollment public institution. Results show that students' performance drops in an asynchronous online course compared to an equivalent in-person experience. Several potential hypotheses are put forth to explain a change in performance that can potentially shape the design of online instruction.

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OBJECTIVE: To characterize the degree to which individual coping strategies may influence speech perception after cochlear implantation. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: Adult, postlingually deaf cochlear implant recipients. INTERVENTIONS: The Coping Orientation to Problems Experience inventory, a validated, multidimensional self-reported coping scale, was administered preoperatively. MAIN OUTCOME MEASURES: Speech perception was measured using consonant-nucleus-consonant (CNC) phoneme and word scores, AzBio sentence accuracy in quiet and noise, and Hearing in Noise Test sentences in quiet preoperatively and at 1, 3, and 6 months postoperatively. Quality of life was measured with the Hearing Implant Sound Quality Index and the Nijmegen Cochlear Implant Questionnaire. RESULTS: Thirty-six patients were included in this study. Mean age at surgery was 70.7 ± 11.4 years. Acceptance was associated with a decreased AzBio in noise score in the 6 months after CI (regression coefficient b = -0.05; 95% confidence interval [CI], -0.07 to -0.03; p < 0.01). Denial was associated with a decreased AzBio in quiet score (b = -0.05; 95% CI, -0.09 to -0.01; p < 0.05), whereas humor was associated with an increased AzBio in quiet score (b = 0.02; 95% CI, 0.01 to 0.04; p < 0.05). Humor was also associated with an increased Hearing in Noise Test score (b = 0.05; 95% CI, 0.02 to 0.07; p < 0.05). Denial was associated with decreased CNC word (b = -0.04; 95% CI, -0.06 to -0.02; p < 0.01) and phoneme (b = -0.04; 95% CI, -0.07 to -0.02; p < 0.01) scores, whereas substance use was associated with increased CNC word (b = 0.03; 95% CI, 0.01 to 0.05, p < 0.01) and phoneme (b = 0.04; 95% CI, 0.02 to 0.06; p < 0.01) scores. Scores on self-reported quality of life measures were not significantly correlated with coping strategies. CONCLUSION: A variety of adaptive and maladaptive coping strategies are used by postlingually deaf adult cochlear implant users. Denial and acceptance may be more predictive of poor speech performance, whereas humor and substance use may be more predictive of improved speech performance.

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Due to public health measures enacted in response to the Covid-19 pandemic, educators and students alike have been suddenly thrust into the realm of online learning. To better understand how active and collaborative learning methods can apply to students studying in isolation, we compared the effects of two teach-and-question assignments: one that utilizes the active learning method of reciprocal peer tutoring and a solo version that requires individual verbalized studying and elaborative interrogation. We used a quasi-experimental design, with student participants enrolled in an online introductory human anatomy course. The first treatment group completed regular teach-and-question study assignments virtually with a peer, and the second treatment group completed the same assignment independently. We found no differences in exam scores between treatments, even for students with high social anxiety; however, student attitudes about the social versus individual assignment did differ for specific types of students. Students who reported experiencing high social anxiety preferred completing the active learning exercise by themselves, and students with low scientific reasoning ability preferred the partnered assignment. This research has potential implications for online classrooms. For instance, our results indicate that students who study independently, or in isolation, may have learning outcomes similar to those of students who study with a peer as long as they study actively. Because we found no negative impact on examination results, it also could be that virtually partnered or independent teach-and-question assignments could be helpful for instructors teaching large online classes to ensure all students are getting individualized feedback and attention.

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Trust in institutions and democracy may be a major contributor to the willingness to be vaccinated. We investigated these factors and others with regard to COVID-19 vaccine uptake in Germany. Even though effective vaccination is a major contributor to slowing down the current pandemic, vaccine hesitancy remains a major challenge. To analyze attitudes toward vaccine hesitancy, a web-based cross-sectional survey was used to understand and describe the influences of attitudes about vaccination against COVID-19 in the German population. A descriptive analysis for the entire dataset was carried out, and multiple proportional odds regression, path model, and structural equation modeling (SEM) were subsequently used to analyze any relationship between latent variables and COVID-19 vaccine acceptance. In total, 1092 responses from across Germany were analyzed. SEM modeling revealed that trust in institutions, trust in non-pharmaceutical interventions, and various demographic factors were associated with intent to vaccinate. Descriptive analysis and multiple proportional odds regression confirmed that a history of influenza vaccination and level of satisfaction with democratic institutions were highly predictive (p < 0.05) for COVID-19 vaccine acceptance. Additionally, social determinants of health such as gender, age, number of children in the family, and the degree of satisfaction with life were also predictors (p < 0.05) for COVID-19 vaccine acceptance. Results also demonstrated a significant relationship between receiving the flu vaccine and acceptance of the COVID-19 vaccination. Governments that provide COVID-19 vaccines and control messaging should strive for trust and transparency to maximize vaccine uptake. Government-based vaccine measures should also involve measures to communicate trust in democratic and scientific institutions.

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Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Most infections are mild and clear without treatment in 1 to 2 years. Some HPV strains result in persistent infection, which can cause various cancers, including cervical, penile, anal, mouth, and throat cancers. Vaccines have been developed that provide protection against the highest risk HPV strains. Despite HPV vaccines having been proven to be safe and effective, uptake has been low. Religiosity has been negatively correlated with HPV vaccine uptake in some studies. It is hypothesized that religiosity and Christian religious affiliation could impact parents' decision to vaccinate their children against HPV via teachings and beliefs about sexual behaviors. A survey was distributed to participants to determine what factors, including religiosity and views about sex, impacted HPV vaccination. The survey results (n = 442) were analyzed using confirmatory factor analysis, structural equation modeling, and univariate factor analysis. The association between religious practice and vaccine attitudes were complex, with religious practice slightly positively correlated with pro-vaccine attitudes and vaccine knowledge, but also with the belief that religious adherence to expectations surrounding sexual behavior will protect children from HPV infection, as well as more negative views towards vaccines, in general.

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BACKGROUND: Evolution acceptance is still low in the United States, especially among religious students. Due to low acceptance, researchers have used a wide variety of methods to increase evolution acceptance. Six culturally competent methods for teaching evolution to religious students have been identified, this manuscript looks specifically at the method of reconciliation between religion and evolution. The reconciliation module has been shown to effectively increase evolution acceptance while allowing students to maintain their religious views. However, we lack an understanding of why this method is effective. We measure evolution acceptance and religiosity at eight religiously affiliated institutions in the United States to again measure the effects of a reconciliation model in biology classrooms. This manuscript also attempts to address classroom influences that allowed students to reconcile evolution with their religious beliefs. RESULTS: Of the eight schools that participated, there were no statistically significant decreases in the religiosity of the students over the semester. Five of the eight institutions had statistically significant increases in their evolution acceptance scores over the semester. We identified three major influences students mentioned as reasons for change towards evolution acceptance: the presence of a role model, discussions on religion and science compatibility, and learning about evolution. CONCLUSIONS: We identified influential practices instructors could integrate into their classrooms to help students better incorporate evolution into their personal views. Having a role model and talking about compatibility between religion and evolution are influential in changing students' views about evolution. Learning the mechanisms of the theory of evolution is also important in changing students' views about evolution and might be more impactful when used in conjunction with a role model or a compatibility discussion. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12052-021-00155-x.

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BACKGROUND: Although progress has been made in evolution education, many educators face significant barriers in their efforts to teach evolution specifically, and science in general. The purpose of this study was to identify faculty-perceived barriers to teaching evolution, specifically in religiously affiliated institutions or institutions with a highly religious student body, as well as resources faculty feel would help promote discourse around faith, evolution and science. To do this, we held a workshop with teams consisting of a science professor, a theologian and a pastor (of the predominant on-campus faith tradition) from 17 different institutions of higher education with highly religious student bodies for the purpose of helping them to create a curriculum to address perceived conflicts between science and faith. During the workshop, participants created posters identifying barriers they face and resources they perceive as helpful. These posters were analyzed for prevalent themes and framed within an ecological model of behavior. RESULTS: These teams identified prevalent barriers at each level of the ecological model. Intrapersonal factors included a fear of rocking the boat and a fear of student conflict. Interpersonal factors included perceived student lack of knowledge, student ideology, and student apathy. Institutional factors included work politics, a lack of relevant discourse surrounding the conflict, and mixed messaging to students. Community factors included social norms associated with various student demographics. And public policy factors included local and state government attempts to limit the teaching of evolution. Additionally, participants identified resources that they felt would facilitate overcoming conflict including colleagues as change agents, various assets, and tools to negate conflict. CONCLUSIONS: We determined that many of the concerns are addressable, and many resources are attainable. We urge the community to work toward these solutions. Additionally, we compare our findings to what the literature has shown and discuss the implications of faculty perceptions as compared to the published literature. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12052-021-00151-1.

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The world is currently dealing with a devastating pandemic. Although growing COVID-19 case numbers, deaths, and hospitalizations are concerning, this spread is particularly alarming in the United States where polarizing opinions, changing policies, and misinformation abound. In particular, American college campuses have been a venue of rampant transmission, with concerning spillover into surrounding, more vulnerable, communities. We surveyed over 600 college students from across the United States and modeled predictors of compliance with non-pharmaceutical interventions. We identified concern with severity, constitutionalism, news exposure, and religiosity as significant positive correlates with compliance, and general trust in science as a significant negative correlate. To determine how applicable nationwide modeling might be to individual local campuses we also administered this same survey to nearly 600 students at two large universities in Utah County. In this population, concern with severity was the only significant positive correlate with compliance; Additionally, feelings of inconvenience were negatively correlated. The effects of feelings of inconvenience, and news exposure were significantly different between populations. These results suggest that we should focus our efforts on increasing knowledge about the pandemic's effects on our society and informing about constitutionality amongst college students. However, we also show that nationwide surveys and modeling are informative, but if campuses are to efficiently curb the spread of COVID-19 this coming semester, they would be best served to utilize data collected from their student populations as these might significantly differ from general consensus data.

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Introduction: New York City is one of the areas most affected by the COVID-19 pandemic in the United States. Healthcare workers are among those at high risk of contracting the virus, and a vital source of information and trust in vaccines to the community. Methods: This study was conducted about attitudes towards COVID-19 vaccination among healthcare workers at a public hospital in New York City during the beginning of COVID-19 vaccination. 428 hospital employees responded. Results: Several factors were significantly associated with vaccine attitudes, including demographics such as gender (p = 0.002), age (p = 0.005), race (p < 0.001) and home location (p < 0.001), role within the hospital (p < 0.001), knowledge about the virus (p < 0.001) and confidence in and expectations about personal protective equipment and behaviors (p < 0.001). Structural equation modeling revealed that the most predictive factors were prior vaccine attitudes and concern with the speed of testing and approval of the vaccines (p < 0.001). Multivariate analysis reinforced these, while also identifying perceived personal risk as significant (p = 0.033). Conclusions: Several modifiable factors that reflect confidence in science, scientific knowledge, personal risk perception, experience and medical authority are correlated with vaccine attitudes, indicating that a holistic educational approach to improve trust in science is likely to be effective in long-term reduction in vaccine hesitancy.